* nutrient accumulation
* medication interactions
* electrolyte abnormalities
* worsening kidney function
* liver injury
People with chronic kidney disease are also sometimes advised to limit or avoid certain minerals depending on their blood results and stage of disease.
Supplement choices in this situation should be individualized rather than based on internet recommendations.
## Watch for Possible Signs of Liver Injury
Seek medical advice promptly if you develop symptoms such as:
* yellowing of the skin or eyes
* unusually dark urine
* persistent nausea or vomiting
* unusual fatigue
* significant itching
* loss of appetite
* pain in the upper right abdomen
* pale stools
These symptoms do not automatically mean that a supplement caused liver damage, but they deserve medical evaluation.
## Watch for Possible Signs of Kidney Problems
Symptoms that may require medical attention include:
* significantly reduced urine output
* swelling in the legs or ankles
* blood in the urine
* persistent nausea
* severe weakness
* unexplained shortness of breath
* confusion
* severe flank or back pain
Kidney disease may also cause no obvious symptoms in its early stages, which is why blood and urine testing can be important.
## “Natural” Does Not Mean Harmless
This is one of the most important lessons when using supplements.
Plants contain biologically active chemicals. Concentrating those chemicals into extracts, powders, or capsules can create effects that are very different from consuming small amounts of the plant as food.
The NIH Office of Dietary Supplements specifically cautions that natural products can still cause harm and recommends discussing supplement use with healthcare professionals.
## How to Use Supplements More Safely
A few precautions can reduce unnecessary risk:
