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Reported problems have included:
* hepatitis
* severe liver damage
* liver failure
* rare cases requiring liver transplantation
The FDA has previously issued warnings about the potential for severe liver injury with kava-containing supplements.
People with existing liver disease or those taking medications that affect the liver should be particularly cautious.
## 8. Multi-Ingredient Herbal and “Detox” Supplements
One of the biggest challenges with herbal supplements is that a product may contain many ingredients at once.
Examples include products marketed for:
* weight loss
* bodybuilding
* “liver cleansing”
* detoxification
* energy
* metabolism
* sexual performance
When a supplement contains ten or twenty ingredients, identifying which ingredient caused a reaction can become difficult.
Herbal and dietary supplements account for a recognized proportion of drug-induced liver injuries, and multiple herbal ingredients—including green tea extract, kava, Garcinia cambogia and others—have been implicated in published cases.
