Turmeric Shots and Risk of Liver Damage
Yes, turmeric shots like the Dose brand can potentially induce liver damage similar to other supplements on the market, with multiple case reports documenting turmeric-associated drug-induced liver injury. 1, 2, 3, 4
Evidence of Turmeric-Associated Liver Injury
Case Reports and Clinical Evidence
- Multiple recent case reports document turmeric supplement-associated hepatitis and liver injury 1, 2, 3, 4
- A clinicopathological series identified 11 cases of turmeric supplement-associated hepatitis, with 10 females (91%) affected 3
- Presentation patterns include:
- Asymptomatic liver function test abnormalities (55% of cases)
- Symptomatic presentation with malaise and/or jaundice (45% of cases)
- Predominantly elevated transaminases (91% of cases)
- Histological findings of acute hepatitis (73% of cases) 3
Causality Assessment
- Using the Roussel Uclaf causality assessment method (RUCAM), the likelihood of turmeric supplement-associated liver injury was rated as "probable" in 8 cases and "possible" in 3 cases 3
- Liver function tests normalized in all patients after discontinuation of turmeric supplements 3
Risk Factors and Mechanisms
Potential Mechanisms of Liver Injury
- The exact mechanism of turmeric-induced liver injury remains unclear
- Some cases have presented with features resembling autoimmune hepatitis 4
- The injury pattern is predominantly hepatocellular with pan-lobular or zone 3 predominant inflammation 3
Manufacturing and Quality Concerns
- Similar to other dietary supplements, turmeric products may contain:
- Variable amounts of active ingredients
- Potential contaminants
- Undisclosed additives that could contribute to liver toxicity 2
Safety Considerations
Contradictory Evidence
- While case reports document liver injury, some controlled studies suggest safety in healthy individuals
- A small prospective clinical study (n=12) of standardized turmeric extract containing 95% curcuminoids at 500mg twice daily for 90 days showed no significant alterations in liver function parameters 5
- This contradiction highlights the importance of individual susceptibility factors and possible manufacturing quality issues
Monitoring Recommendations
- Based on guidance for other potentially hepatotoxic supplements, patients taking turmeric supplements should be monitored for:
High-Risk Populations
Individuals with the following factors may be at higher risk for supplement-induced liver injury:
- Pre-existing liver disease
- Alcohol consumption
- Obesity
- Diabetes
- Advanced age
- Concomitant use of multiple hepatotoxic drugs 6
Clinical Approach to Suspected Turmeric-Induced Liver Injury
If liver injury is suspected:
- For elevations <2× upper limit of normal (ULN): continue monitoring with repeat testing in 2-4 weeks
- For elevations ≥2× but <3× ULN: consider discontinuation and repeat testing in 2-4 weeks
- For elevations ≥3× ULN: discontinue supplement and increase monitoring frequency
- For elevations >5× ULN: discontinue supplement and consider hepatology consultation 6
Conclusion
While turmeric has been traditionally used for centuries and is generally well-tolerated, emerging evidence suggests that concentrated turmeric supplements, including shots like the Dose brand, can cause drug-induced liver injury in susceptible individuals. Consumers should be aware of this potential risk, particularly those with pre-existing liver conditions or taking other medications. Healthcare providers should inquire about turmeric supplement use when evaluating patients with unexplained liver function abnormalities.