Liver Safety

LiverTox Category A (well-established cause). Severe idiosyncratic hepatitis including liver failure / transplant. Banned or restricted in Germany, UK, France, Switzerland.

LiverTox Category B (for concentrated extracts only, not brewed tea). High-dose EGCG (>800 mg/day) from supplements linked to hepatotoxicity. EFSA 2018 opinion. USP verification recommended.

LiverTox Category B. 2019-2024: rising case reports of idiosyncratic hepatitis. Iceland DHPA 2024 advisory; EU scrutiny ongoing. Heightened risk with existing liver disease or concurrent hepatotoxic drugs.

LiverTox Category B. 50+ reported cases of cholestatic/idiosyncratic hepatitis. EMA HMPC monograph 2011 requires restricted-use label.

LiverTox Category B. FDA 1992 consumer advisory recommending avoidance. Multiple case reports of severe hepatitis; banned/restricted in Canada, Mexico, UK.

LiverTox Category C. 2020-2024 rise in acute liver injury cases linked specifically to high-dose concentrated turmeric/curcumin extracts with enhanced-bioavailability formulations (piperine, phospholipid complex). Not associated with culinary use.

LiverTox Category C (paradoxically — despite its traditional use for liver protection). Rare case reports of hepatitis. Potency and purity vary; standardized silymarin ≥70% recommended.

LiverTox Category C. 40+ published case reports of acute liver injury. EMA HMPC 2010 monograph requires warning label in EU. FDA advisory encourages caution.

LiverTox Category C. Case reports of acute liver injury, though some attributed to adulteration with germander (a Category A hepatotoxin). Buy from brands with third-party identity testing.

LiverTox Category C. Pulegone metabolite causes centrilobular necrosis. Multiple human fatalities on record from pennyroyal oil ingestion.

LiverTox Category D (hepatotoxicity — separate concern from IARC Group 2B carcinogenicity classification). A handful of hepatitis reports.

LiverTox Category D. Rare cases of acute hepatitis reported; causality uncertain. Some reports confounded by concurrent pharmaceuticals.

LiverTox Category D. A small number of published case reports of acute hepatitis associated with valerian supplements. Causality uncertain; concomitant hepatotoxic agents common.

LiverTox Category D. Multiple case reports of acute liver injury associated with weight-loss supplements containing Garcinia cambogia + hydroxycitric acid. Often co-formulated with other hepatotoxic ingredients.

LiverTox Category D. Few case reports of hepatitis; causality uncertain. Major drug-interaction concern (CYP3A4 induction) — can reduce levels of warfarin, oral contraceptives, immunosuppressants, HIV antivirals.

LiverTox Category D. Rare case reports; causality for most remains uncertain. Generally considered safe short-term use.

LiverTox Category D. Rare cases of acute hepatitis reported with Panax ginseng supplements; most cases confounded by complex herbal formulations.