Abstract
To highlight the current trends of weight loss supplement (WLS) use in the United States, detail their potential for drug-induced liver injury (DILI), identify specific compounds associated with hepatoxicity that are commonly found in WLS, and address ongoing diagnostic as well as treatment challenges. The regulatory nature of WLS exposes patients to a variety of potential healthcare pitfalls associated with WLS use. These include marketing claims with little supportive evidence, compound adulteration, and herb-drug interactions. While well-known historical cases have resulted in specific compound banning, supplements associated with DILI remain on the market. Trends in the clinical presentation of DILI due to WLS are present but are by no means dogmatic. Furthermore, DILI predictability is clinically challenging due to a variety of complexities. Cessation of the offending agent continues to be the treatment mainstay outside of liver transplantation in the most severe of cases. Increased accessibility and consumer demand will continue to drive WLS usage. With this, clinicians must actively screen all patients for their use and be aware of specific herbals implicated in DILI. Educating patients on the risks of WLS use is imperative given limited treatment options.
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