Liver doctors say a recent uptick in the use of herbal and dietary supplements has skyrocketed rates of idiosyncratic drug-induced liver injury (DILI), a rare adverse drug reaction that mimics symptoms of the hepatitis virus. In response, the American College of Gastroenterology (ACG) has updated its clinical guidelines for treating the condition; the update includes a list of the top-offending vitamins and supplements on the market today, according to an ACG media release.

DILI is a relatively rare spectrum of liver diseases caused by drugs or toxins that can lead to jaundice, liver failure, chronic infection and even death if left untreated. Over the past decade, experts say, rates of the condition have gone up in large part because of trendy “natural” supplements flooding the market. In the United States, such products are often not well-regulated and have very little clinical oversight before hitting pharmacy shelves.

In recent tests, scientists have discovered traces of heavy metals and even prescription drugs in these so-called health-promoting supplements, as well as hyper-concentrated formulas of herbal extracts, such as green-tea extract, that can be potentially dangerous to the human body.

The new guidelines, which are intended for health care providers, offer an overview of risk factors, diagnosis evaluation methods and tips on how to manage liver toxicity. The report focuses on both patients who have pre-existing chronic liver diseases as well as those who have recently taken herbal or dietary supplements.

To read the ACG release, click here.