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.
A supplement marketed as a “liver detox” should therefore not automatically be assumed to protect the liver.
Ironically, some herbal products promoted for liver health have themselves been associated with liver injury.
## 9. Creatine in People With Kidney Problems
Creatine is one of the most widely used sports supplements.
For healthy adults taking standard doses, existing research generally does not show that creatine causes kidney damage.
However, the situation is different for people who already have impaired kidney function or who are taking medications that can affect the kidneys.
Creatine supplementation can also raise blood creatinine levels because creatinine is a breakdown product of creatine. That may complicate interpretation of certain kidney blood tests.
Therefore, people with known kidney disease should discuss creatine supplementation with a healthcare professional rather than assuming that a bodybuilding supplement is automatically appropriate for them.
## Why Dose Matters So Much
Many nutrients follow a simple principle:
