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Herbal products have become increasingly popular in the U.S., with an estimated 60% of Americans using them. Although many consumers believe that they benefit from these products, hepatoxicity occasionally has been reported with chaparral, germander, kava kava, and ephedra. Because the FDA does not regulate or control natural supplements, the efficacy and potential risks of these products have not been rigorously studied. Two companion reports now describe 22 patients who sustained liver injury from Herbalife nutritional supplements.
The first report described 10 Swiss patients (median age, 51) who developed Herbalife-associated hepatotoxicity between 1998 and 2004. The second report described 12 Israeli patients (median age, 49.5) who suffe…