Liver Injury from Turmeric: Is it becoming a bigger problem?

Liver Injury from Turmeric

As a hair doctor, I test the health of my patients’ livers quite often. AST and ALT are the typical blood tests that I order. Most often, I’m testing it before we start certain types of oral medications that could affect the liver. Methotrexate, JAK inhibitors, hydroxychlorqouine, mycophenolate are good examples of drugs that have the potential to affect the liver and therefore need baseline blood tests before starting.

Sometimes, liver enzyme levels come back elevated before we start a new drug and the question arises - what’s causing this?

A variety of possibilities exist including metabolic syndrome, alcohol use, medications the patient uses, autoimmune liver disease, fatty liver disease, hepatitis, obesity, cancer and more. This list is potentially quite long.

Turmeric Needs to Be Considered in Liver Injury

It has been estimated that there are about 80,000 herbal and dietary supplements on the market. It is increasingly appreciated that some are associated with a chance of liver injury.

A new study reminds us that liver injury from turmeric could be increasing in the United States. authors identified 10 cases of turmeric-associated liver injury in a database of liver injury patients between 2011 and 2017. 8 patients were women and 8 were white. Median age was 56 years. Liver disease started 1-4 months after starting the drug. 5 were hospitalized and 1 died. HLA typing demonstrated that 7 patients carried HLA-B*35:01 indicating that there could be a genetic prediposition to liver injury.

REFERENCE

Halegoua-DeMarzio D et al. Liver Injury Associated with Turmeric-A Growing Problem: Ten Cases from the Drug-Induced Liver Injury Network [DILIN] Am J Med. 2023 Feb;136(2):200-206

Navarro VJ et al. Liver injury from herbal and dietary supplements. Hepatology. 2017;65(1):363. Epub 2016 Nov 17.