#1

Hi there.
First time on this forum :wink:
I’ve been trying antiaging supplement for almost 6 months.
Generally I was inspired by Bryan Johnson & David sinclair’s protocols and I was trying a smaller doses, including

  • Rapamycin 3mg/wk,
  • Acarbose 50mg/d,
  • Magnesium 100mg/d,
  • Vitamin D3 4000IU/d with K2,
  • Creatine and taurine
  • EPA/DHA 1000mg/d

Above all I also take about 1.5 grams of plant extract, mostly alkaloid and polyphenols, such as Berberine, Curcumin, EGCG, Pterostillbene, Ashwagandha…

I think most of my supplement are relatively safe(both quality and pharmacology), will not hurt liver or kidney, but things got worse after I took my regular medical check-up yesterday.

My liver enzymes get super high, ALT was 705, AST was 256, which are both more than 10x higher from the upper limit, indicating severe liver damage. Now I stop all my supplement and taking prescription drugs from hospital until my liver recovered.

Since I have no NAFLD or any other liver disease, I don’t take any alcohol, so the top 1 possibility is drug induced liver injury.

I don’t know which supplement caused this…I bought my drug and supplement from drugstore so I think my liver damage is from supplement itself.
Acarbose may cause liver damage to some people but generally slight, and I only take 50mg before dinner.
High dose polyphenols may cause too much oxidative stress to liver and I don’t take NAC to reduce it.

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#2

Ashwagandha has been known to cause acute liver injury. A few case studies have reported acute liver injury after starting ashwagandha supplements, typically within a few weeks of use. The injuries were often reversible after stopping the supplement, and symptoms such as jaundice or elevated liver enzymes resolved over time.

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#3

I take all of those same supplements and my ALT and AST scores have gone up a few points but not 10X. I would say that either the testing was botched or you are taking a fake yet toxic supplement. Or your dosing is off.

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#4

It would be sensible to drop the lot and see if your liver improves. My guess as with others is Ashwaghanda.

The question, of course, is what your liver enzymes were before. However, I would not push it with the liver.

Second priority would perhaps equally be Berberine, Curcumin, EGCG, Pterostilbene.

Ashwaghanda is, however, quite well known to cause liver damage from time to time.

As far as I am personally concerned, however, it would drop things right back to find out what is causing the issue. It could, of course, be something in food.

Personally I would put the short term priority of avoiding liver damage in front of any longevity issues.

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#5

My first concern is the quality of the supplements, but I only buy products from popular brands like LE and Swanson. Rapamycin, acarbose are prescribed drug I get from hospital.

My doctor can’t tell what cause it :smiling_face_with_tear:

I’ll try even smaller dose and fewer supplement a few month later.

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#6

Incidentally I probably take more supplements etc than anyone else on this forum. However, I do weekly blood tests and my last results were ALT 20.1 AST 27.6 and ALP 61.

I take all that you take apart from Ashwaghanda which I have taken previously, but has caused issues and I avoid it for now. I don’t take acarbose either.

I don’t take ECGC or creatine every day. My dosing on others is complex.

Hence your situation is either
a) Ashwaghanda,
b) The polyphenols and a sensitive liver for some reason - they are much less of an issue
c) Something else (could be a quality issue).

However, you want your liver to be fully functional.

The primary reason I started weekly blood tests was to know quickly if something was going wrong. I have continued doing so because I find it enables me to have a better understanding of trends.

Interestingly I have concluded I need to supplement a little iron to handle the blood loss from the testing.

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#7

oh fuck, SOME melatonin supplements contain 10:1 ashwanganda (just as some contain selenium), that means I should only take the ones that don’t add loads of it

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#8

Avoiding herbal supplements is a reasonable conclusion due to the challenge of sourcing the raw materials. I continue to eat herbs and spices but I am avoiding herbal (read: concentrated doses) supplements.

I figure if supplements probably don’t do much, why take a risk on contamination….

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#9

I don’t take melatonin pills with any active ingredient other than melatonin, but I do take about 50 physical pills a night.

When it comes to herbal pills their effect is often dose dependent.

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#10

From your list, I would suspect the plant extracts. Ashwaghanda, EGCG, Curcumin have each shown to be capable of causing liver damage, usually with higher doses and prolonged use.

In general, plant extracts are very. very dirty drugs. I personally am super careful with adding any plant extracts to my stack. The potential for interaction is huge, and it’s very difficult to pin down what is responsible. Two extracts can be OK separately, but taken together suddenly cause unexpected problems. Now you mix five or more - boy, in my mind that’s russian roulette. I’ve taken curcumin, but dropped it since going on rapamycin. Otherwise, I’ve only taken grape seed extract and garlic powder, briefly. That’s it, sum total. The risks are just not worth it.

Meanwhile the benefits are often poorly researched. And what you buy can differ in batches, unlike strictly regulated and standardized pharmaceuticals. They come from plants grown under a variety of conditions with many variables dependent on soil, season, pesticides, pollution. And this is true regardless of the brand (though obscure brands are of course a whole other source of danger). Regardless of brand (do they test each and every one of their batches?) I’m always worried about things like lead and heavy metals, including in spices, let alone these extracts, especially from places with poor consumer protection standards like India or China. Concentrated extracts, compounds you’d never consume in such quantities naturally from fruits and vegetables. No thanks.

And take a close look at those studies of plant extracts. The quality is usually poor. Frequently heavily biased in countries where the extracts have historical presence like various Chinese or Indian “traditional medicine”. I don’t trust them at all.

Bottom line, people think that somehow anything from plants is “natural” and therefore safe. The opposite is true - these are incredibly dirty drugs with hundreds of poorly studied compounds. Taking them is always risky. Give me well characterized pharmaceuticals any day - at least I can be reasonably confident about what it is that I’m getting.

Drop everything and reintroduce one by one. But first take a long hard look at whether you have good grounds for taking something. And consider the risks, especially of plant extracts - you might find the benefits poorly substantiated while the risks sky high.

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#11

I would agree with the idea of dropping everything and then tracking liver status. However, when testing multiple interventions against a single outcome it is worth dividing them into sets and for instance trying half the interventions.

This form of sorting through the interventions will find out which intervention it is (if it is only one and not a combination) more quickly than testing each one.

However, Ashwaghanda is clearly the prime suspect.

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#12

Thank you for your advice!
I test liver enzymes 3 or 4 times a year, only ALT is a littile bit higer than upper limit (around 60) due to poor sleep.
I never notice Ashwaghanda can lead to liver injury :smiling_face_with_tear: . Peter Attia takes it for stress， Bryan Johnson takes it for testosterone, so I want to try the same.
I thought it may caused by acarbose since I felt slightly discomfort in the liver area every time I took acarbose.

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#13

Although the consumption of green tea is generally considered to be harmless to health, several hundred case reports have been published in the past 30 years in which signs of liver damage and even liver failure requiring transplantation have been described in connection with green tea. Only a few of these cases involved green tea consumption as it is traditionally prepared. Most of them were concentrated GTE preparations taken in powder or tablet form for weight reduction.

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#14

I don’t know what country you live in and how easy it is to get a blood test. However, I would not delay on resolving this. There really is no sense waiting to find out if your liver is going to give up on you.

You don’t have to test weekly as I do, but delay is not your friend.

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#15

Yes I went to hospital today and doctor prescribed me some liver-protecting drug and tomorrow I’ll do IV therapy. Doctor asked me to do blood test every week until all enzymes lower to normal range

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#16

Thank you for your advice
I’ll quit all my supplement for a few month, and maybe never take plant extract especially ashwagandha again.
David sinclair and Bryan Johnson are taking mutiple plant extract, many company are selling mega dose plant extract, so I thought they are generally safe. :woozy_face:
Maybe I can not do kitchen sink protocol like Dave Pascoe
My liver can’t hold these plants with mixed ingredients.

Herb-induced liver injury: Systematic review and meta-analysis

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#17

I believe Nutrafol and Athletic Greens have both had case reports of liver injury.

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#18

I cannot comment on the drug and I personally would take citrate, but that’s my thaang. However, weekly tests is definitely a good thing. I have been doing weekly tests since May 2022. I find them really helpful.

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#19

Could be Curcumin. My doc told me to be careful. I take it only occasionally and always half dose.

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#20

This is rare; but everyone is different. I guess this simply points out the importance of monitoring.

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