STM Journals Peer-reviewed research from Consortium e-Learning Network

Research and Reviews: A Journal of Pharmaceutical Science Review Article

Review of Nutraceuticals and Dietary Supplements in Toxicology

  1. Dharmesh P .Chavan Department of Pharmaceutics, P. S. G. V. P. Mandal’s College of Pharmacy, Shahada
  2. Sunila A. Patil Department of Pharmaceutics, P. S. G. V. P. Mandal’s College of Pharmacy, Shahada
  3. Sunil. P. Pawar Department of Pharmaceutics, P. S. G. V. P. Mandal’s College of Pharmacy, Shahada

Abstract

This article explores the expanding role of dietary supplements and nutraceuticals in toxicology. Although they are widely consumed, there is little proof that using supplements or nutraceuticals can improve health in people who are eating a healthy diet. However, some of these products can be extremely toxic. Moreover, very few people tell their doctors they take supplements. Therefore, there is a high chance of negative drug-supplement interactions. An outline of the main nutraceutical and supplement products is given in this article. as well as information on known adverse effects and potential drug interactions. The review focuses on the balance between increasing health benefits and limiting hazards. Due to the detrimental effects of modern lifestyles on public health, herbal dietary supplements have gained popularity due to their medicinal and nutritional advantages. However, things like adulteration, contaminants, numerous substances, and inadequate processing or storage can all jeopardize their safety and effectiveness. Adverse clinical outcomes are still a major worry because regulation is laxer than for pharmaceutical medications. Common herbal supplements like aloe, green tea, ginseng, ginkgo, tongkat ali, flaxseed, St. John’s wort, and with ania are reviewed in this article along with their toxicological consequences. Uncontrolled supplement use can be harmful to one’s health. This article aims to the mechanism action behind these toxicities and regulatory challenges that come with assessing risk moreover. In which highlight some current trends and methods that can help enhance safety assessment to make medical professional and government agencies well informed decisions. Understanding the complex relationships between toxicology, dietary supplements, and nutraceuticals is essential for promoting public health and well-being.

Keywords

References (38)

  1. Xie.x, Analysis on the Serious Adverse Effects Caused by Dietary Supplements, Advances in Social Science, Education and Humanities Research 2021 . 638;1143-1147;
  2. J. J .R. Martin, P. B. Kim, and Watt.J. Adverse Effects of Nutraceuticals and Dietary Supplements. Annu Rev Pharmacol Toxicol 2018 Jan 6:58;1-22; doi:10.1146/annurev-pharmtox-010617-05284
  3. A . A Mudhi , A , Maream . A. N.Mariam ..A, A, O. Asma, B. Laila , M Aidin , A. Aisha, S. L Kok and H. E. L- Swee. Nutraceuticals: Transformation of Conventional Foods into Health Promoters/Disease Preventers and Safety Considerations 2021, 26; 2540;1-28.
  4. Takeshita, M., Ishida, Y. I., Akamatsu, E., Ohmori, Y., Sudoh, M., Uto, H., Tsabouchi,
  5. H. and Kataoka, H. 2009. Proanthocyanidins in blueberry leaves sup-presses expression of subgenomic Hepatitis C virus RNA. J. Biol. Chem. 284: 21165-21176
  6. Department of Pharmacy, NIMS Institute of Pharmacy, NIMS University, Jaipur, Rajasthan India, Rehmani A. NUTRACEUTICALS: REVOLUTIONIZING HEALTHCARE IN 21ST CENTURY. Indian Journal of Health Care Medical & Pharmacy Practice. 2024;5(1):123-133. doi:10.59551/ijhmp/25832069/2024.5.1.160
  7. A.A Abubakar, k. Sing, .I. A Muhammad,T.S Adamu, A Review on Dietary Supplements: Health Benefits, Market Trends, and Challenges November 2020, 5(11);26-35
  8. H. Amy, L Elizabeth , j. Ahmad . Almalki, L.R,Amy . I. Angela, Calderón, A Review of the Toxicity of Compounds Found in Herbal Dietary Supplements. Hudson A et al. A Review of.Planta Med 2018; 84; 613-626
  9. Chuah LO, Yeap SK, Ho WY, Beh BK, Alitheen NB. In VitroandIn VivoToxicity ofGarciniaor Hydroxycitric Acid: A Review. Evidence-Based Complementary and Alternative Medicine. 2012;2012:1-12. doi:10.1155/2012/197920
  10. Isomura T, Suzuki S, Origasa H, Hosono A, Suzuki M, Sawada T, et al. Liver-related safety assessment of green tea extracts in humans: a systematic review of randomized controlled trials. European Journal of Clinical Nutrition. 2016;70(11):1221-1229. doi:10.1038/ejcn.2016.78
  11. Teschke R, et al. "Kava hepatotoxicity: a clinical survey and critical analysis of 26 suspected cases." Liver Int. 2011;31(5):742–752.
  12. J. Joseph., ScD .Knapik; W .Daniel., PhD. Trone; A. Ryan., MPH. Steelman; K. F . Emily, PhD, RD; R. Harris. Lieberman, Ph. Adverse Effects Associated with Multiple Categories of Dietary Supplements: The Military Dietary Supplement Use Study. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS October 2022;122;(10) Pages 1851-1863
  13. Shahverdian A, Jafari M. Dietary Supplement Safety in Older Adults: A Review of Published Case Reports. The Senior Care Pharmacist. 2025;40(1):32-49. doi:10.4140/tcp.n.2025.32
  14. A Desai, S Anandand L.A James. An Overview of the Nutraceuticals Industry: Demand, Challenges, Regulations and Clinical Evidence.journal of food science Research, 6(2).pp1-24
  15. J.N Victor, I.Khan, E Bj€ornsson, B. Leonard, Seeff, ,s. Jose , H. Jay Hoofnagle. Liver Injury From Herbal and Dietary Supplements. HEPATOLOGY 2017,65;(1)Pp 363-373
  16. M. Gabriela , D. S . Antonella. V. Annabella, Hepatotoxicity of green tea: an update. Article in Archives of Toxicology · May 2015, 89(8)
  17. E. A Etienne, Y. Feng , L. Ji. Aristolochic Acid-Induced Nephrotoxicity: Molecular Mechanisms and Potential Protective Approaches.International journal of molecular science . 2020, 21;1157;pp1-20
  18. A. CHRISTINE. M.D. HALLER, L. NEAL. M.D. BENOWITZ, ADVERSE CARDIOVASCULAR AND CENTRAL NERVOUS SYSTEM EVENTS ASSOCIATED WITH DIETARY SUPPLEMENTS CONTAINING EPHEDRA ALKALOIDS. December 21, 2000;343;25; pp 1833-1838
  19. W. A.saeed, M. A Dhamen, R. Ahmad, N.Ahmad, A. A Naqvi. Clinical uses and Toxicity of Ephedra sinica: An Evidence-Based Comprehensive Retrospective Review (2004–2017) Pharmacognosy Journal 2, Mar-Apr, 2019; 11(2): 439-444
  20. Rowin J, Lewis SL. Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology. 1996;46(6):1775-1776. doi:10.1212/wnl.46.6.1775
  21. WHO, 2007 – Guidelines for Assessing Quality of Herbal Medicines with Reference to Contaminants and Residues.
  22. Garcia-Cortés et al., 2021, Food Chem Toxicol, 149:111998.
  23. N. GARY., MD, MPH ASHER; H. AMANDA CORBETT, PharmD; and L .ROY. H, PharmD, PhD. Common Herbal Dietary Supplement– Drug Interactions, American Family Physician July 15, 2017;96;2;101-107
  24. A Gupta , K. Kumari , F. Hasan , V. Kumar , P .Kumar , Herb-Drug Interactions: A Critical Exploration in Modern Healthcare Practices. Journal of Medicinal Natural Products June 2025; 2(2);pp 1-9
  25. Gardiner P. Factors Associated With Dietary Supplement Use Among Prescription Medication Users. Archives of Internal Medicine. 2006;166(18):1968. doi:10.1001/archinte.166.18.1968
  26. Izzo AA, Ernst E. Interactions Between Herbal Medicines and Prescribed Drugs. Drugs. 2009;69(13):1777-1798. doi:10.2165/11317010-000000000-00000
  27. Cohen PA. (2014). Hazards of dietary supplements adulterated with pharmaceutical drugs. NEJM, 370(14):1277–80.
  28. Saper RB. Lead, Mercury, and Arsenic in US- and Indian-Manufactured Ayurvedic Medicines Sold via the Internet. JAMA. 2008;300(8):915. doi:10.1001/jama.300.8.915
  29. Hoofnagle JH, Björnsson ES. Drug-Induced Liver Injury — Types and Phenotypes. New England Journal of Medicine. 2019;381(3):264-273. doi:10.1056/nejmra1816149
  30. WHO Uppsala Monitoring Centre. VigiBase: Global database of individual case safety reports (Accessed 2023).
  31. Bent S, Tiedt TN, Glidden D, et al. (2003). The relative safety of Ephedra compared with other herbal products. Ann Intern Med, 138(6):468–71.
  32. FSSAI. (2016). Food Safety and Standards (Health Supplements, Nutraceuticals, Food for Special Dietary Use, Food for Special Medical Purpose, Functional Food and Novel Food) Regulations.
  33. FoodandDrugAdministration, Recalls, Market Withdrawals, & Safety Alerts. Available online: https://www.fda.gov/safety/ recalls-market-withdrawals-safety-alerts (accessed on 16 August 2022).
  34. . Mazzanti, G.; Menniti-Ippolito, F.; Moro, P.A.; Cassetti, F.; Raschetti, R.; Santuccio, C.; Mastrangelo, S. Hepatotoxicity from green tea: A review of the literature and two unpublished cases. Eur. J. Clin. Pharm. 2009, 65, 331–341.
  35. ( 34). Woodbury, A.; Sniecinski, R. Garlic-Induced Surgical Bleeding: How Much Is Too Much? A & A Case Rep. 2016, 7, 266–269.
  36. McEwen,J. St John’s Wort: Important Interactions between St John’s Wort (Hypericum perforatum) Preparations and Prescription Medicines. In The Therapeutic Goods Administration. Available online: https://www.tga.gov.au/node/597 (accessed on 15 March 2001).
  37. Ronis, M.J.; Gomez-Acevedo, H.; Blackburn, M.L.; Cleves, M.A.; Singhal, R.; Badger, T.M. Uterine responses to feeding soy protein isolate and treatment with 17-estradiol differ in ovariectomized female rats. Toxicol Appl Pharm. 2016, 297, 68–80.
  38. McCarver, G.; Bhatia, J.; Chambers, C.; Clarke, R.; Etzel, R.; Foster, W.; Hoyer, P.; Leeder, J.S.; Peters, J.M.; Rissman, E.; et al. NTP-CERHRexpert panel report on the developmental toxicity of soy infant formula. Birth Defects Res. B Dev. Reprod. Toxicol. 2011, 92, 421–468
Support