You've probably heard that taking large amounts of dietary supplements causes liver damage, specifically toxic hepatitis. Doctors often speculate on this topic, especially amusingly on the social network Threads (for some reason, it's a cross-section of society with weak intellects :)). So, to be fair, I'll say they're partly right, and I'll describe the problem in detail.
Detoxification phases
Our bodies were designed by clever engineers (that's right, evolution has nothing to do with it) who developed a detoxification system—protection against all kinds of xenobiotics (substances foreign to the body). This system is roughly divided into three phases (transformation, neutralization, and utilization) and consists of various proteins and enzymes that attempt to carry out various chemical reactions with everything that enters our body, whether through the mouth or elsewhere.
For example, the very first chemical reaction in the detoxification phases is oxidation. It's carried out by proteins of the cytochrome P450 (CYP) family. After this reaction, substances entering our body become more reactive (capable of interacting with others). For example, if you drank some weed, it breaks down inside your body into various molecules—alkaloids and so on. The body primarily attacks all these molecules with these enzymes to oxidize, reduce, or break them down through hydrolysis (but usually, the main thing is oxidation).
Why is this necessary?
To prepare the substance for utilization by other enzymes. These other enzymes constitute the second phase of detoxification, where other protein enzymes attach water-soluble fragments (glucuronic acid, sulfate, glutathione, etc.) to the oxidized substance , after which the substance is more easily excreted in urine, bile, sweat, and sebum . This marks the third phase of detoxification—utilization.
What does dietary supplement have to do with it?
So, why do people ruin their livers with dietary supplements if everything is so well-designed? The fact is that these detoxification phases work differently in different people. This is due to genetics and epigenetics. For example, some people have slow metabolism during the first phase of detoxification (mutations in cytochrome P450, for example, in CYP2D6). Such people are called poor metabolizers . Everything they eat and drink is slowly eliminated from the body , and if they start chugging dietary supplements, they are almost guaranteed to suffer liver, kidney, and other organ damage in the future.
This is especially true for herbal supplements. These people need to be very careful when choosing supplements without a gene test. Another problem with these supplements is that some herbal substances further slow down detoxification enzymes. A prime example is curcumin (all the case reports of liver damage from it are due to what I described) – it inhibits cytochrome P450 enzymes. Another example of this inhibition is grapefruit juice. Avoid supplements or medications containing it.
Furthermore, if we consider problems in the second phase of detoxification, such as Gilbert's syndrome and other conditions, the liver can also be easily damaged by taking various supplements. However, in this case, you should be wary of fat-soluble substances, as these are more likely medications than supplements – for example, steroids, retinol, and other medications.
Also remember that acne, rosacea, and dermatitis can also be related to detoxification problems . If you started drinking something and got acne, stop drinking it.
