Dharmesh P .Chavan,
Sunila A. Patil,
Sunil. P. Pawar,
- Student, B. Pharm, Department of Pharmaceutics, P. S. G. V. P. Mandal’s College of Pharmacy, Shahada, Maharashtra, India
- Associate Professor, Department of Pharmaceutics, P. S. G. V. P. Mandal’s College of Pharmacy, Shahada, Maharashtra, India
- Principal, Department of Pharmaceutics, P. S. G. V. P. Mandal’s College of Pharmacy, Shahada, Maharashtra, India
Abstract
This article explores the expanding role of dietary supplements and nutraceuticals in toxicology. Although they are widely consumed, there is little proof that using supplements or nutraceuticals can improve health in people who are eating a healthy diet. However, some of these products can be extremely toxic. Moreover, very few people tell their doctors they take supplements. Therefore, there is a high chance of negative drug-supplement interactions. An outline of the main nutraceutical and supplement products is given in this article. as well as information on known adverse effects and potential drug interactions. The review focuses on the balance between increasing health benefits and limiting hazards. Due to the detrimental effects of modern lifestyles on public health, herbal dietary supplements have gained popularity due to their medicinal and nutritional advantages. However, things like adulteration, contaminants, numerous substances, and inadequate processing or storage can all jeopardize their safety and effectiveness. Adverse clinical outcomes are still a major worry because regulation is laxer than for pharmaceutical medications. Common herbal supplements like aloe, green tea, ginseng, ginkgo, tongkat ali, flaxseed, St. John’s wort, and with ania are reviewed in this article along with their toxicological consequences. Uncontrolled supplement use can be harmful to one’s health. This article aims to the mechanism action behind these toxicities and regulatory challenges that come with assessing risk moreover. In which highlight some current trends and methods that can help enhance safety assessment to make medical professional and government agencies well informed decisions. Understanding the complex relationships between toxicology, dietary supplements, and nutraceuticals is essential for promoting public health and well-being.
Keywords: Nutraceutical, dietary supplement, toxicology herb drug interaction, safety assessment, pharmacovigilance
[This article belongs to Research and Reviews: A Journal of Pharmaceutical Science ]
Dharmesh P .Chavan, Sunila A. Patil, Sunil. P. Pawar. Review of Nutraceuticals and Dietary Supplements in Toxicology. Research and Reviews: A Journal of Pharmaceutical Science. 2025; 17(01):08-17.
Dharmesh P .Chavan, Sunila A. Patil, Sunil. P. Pawar. Review of Nutraceuticals and Dietary Supplements in Toxicology. Research and Reviews: A Journal of Pharmaceutical Science. 2025; 17(01):08-17. Available from: https://journals.stmjournals.com/rrjops/article=2025/view=233157
References
(1) Xie.x, Analysis on the Serious Adverse Effects Caused by Dietary Supplements, Advances in Social Science, Education and Humanities Research 2021 . 638;1143-1147;
(2) J. J .R. Martin, P. B. Kim, and Watt.J. Adverse Effects of Nutraceuticals and Dietary Supplements. Annu Rev Pharmacol Toxicol 2018 Jan 6:58;1-22; DOI: 10.1146/annurev-pharmtox-010617-05284
(3) A . A Mudhi , A , Maream . A. N.Mariam ..A, A, O. Asma, B. Laila , M Aidin , A. Aisha, S. L Kok and H. E. L- Swee. Nutraceuticals: Transformation of Conventional Foods into Health Promoters/Disease Preventers and Safety Considerations 2021, 26; 2540;1-28.
(4) Takeshita, M., Ishida, Y. I., Akamatsu, E., Ohmori, Y., Sudoh, M., Uto, H., Tsabouchi,
H. and Kataoka, H. 2009. Proanthocyanidins in blueberry leaves sup-presses expression of subgenomic Hepatitis C virus RNA. J. Biol. Chem. 284: 21165-21176
(5) C.S Dharmendra , R . Aliya, S. Mithilesh , S .K Rajesh, NUTRACEUTICALS: REVOLUTIONIZING HEALTHCARE IN 21ST CENTURY, Indian Journal of Health Care, Medical & Pharmacy Practice Jan-Jun 2024,5(1);123-133 DOI: https://doi.org/10.59551/IJHMP/25832069/2024.5.1.160
(6) A.A Abubakar, k. Sing, .I. A Muhammad,T.S Adamu, A Review on Dietary Supplements: Health Benefits, Market Trends, and Challenges November 2020, 5(11);26-35
(7) H. Amy, L Elizabeth , j. Ahmad . Almalki, L.R,Amy . I. Angela, Calderón, A Review of the Toxicity of Compounds Found in Herbal Dietary Supplements. Hudson A et al. A Review of.Planta Med 2018; 84; 613-626
(8) L .O. Chuah S. K. Yeap, W. Y Ho B k Beh, N. B. Alitheen, in vitro and in vivo toxicity of garcinia or hydroxycitric Acid: a review. Evid Based Complement AlternatMed 2012:2012:19792 doi: 10.1155/2012/197920
(9) Isomura. T , Suzuki S, Origasa H, Hosono A , Suzuki m, Sawada t,, Terao S, Muto. Y Koga.T,Liver-related safety assessment of green tea extracts in humans: a systematic review of randomized controlled trials. European Journal of Clinical Nutrition in 2016 Nov;70(11):1221-1229 .doi: 10.1038/ejcn.2016.78.
(10) Teschke R, et al. “Kava hepatotoxicity: a clinical survey and critical analysis of 26 suspected cases.” Liver Int. 2011;31(5):742–752.
(11) J. Joseph., ScD .Knapik; W .Daniel., PhD. Trone; A. Ryan., MPH. Steelman; K. F . Emily, PhD, RD; R. Harris. Lieberman, Ph. Adverse Effects Associated with Multiple Categories of Dietary Supplements: The Military Dietary Supplement Use Study. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS October 2022;122;(10) Pages 1851-1863
(12) S. Alex,j. Mahtab Dietary Supplement Safety in Older Adults: A Review of Published Case Reports r Care Pharm 2025 Jan 1;40(1):32-49 DOI: 10.4140/TCP.n.2025.32
(13) A Desai, S Anandand L.A James. An Overview of the Nutraceuticals Industry: Demand, Challenges, Regulations and Clinical Evidence.journal of food science Research, 6(2).pp1-24
(14) J.N Victor, I.Khan, E Bj€ornsson, B. Leonard, Seeff, ,s. Jose , H. Jay Hoofnagle. Liver Injury From Herbal and Dietary Supplements. HEPATOLOGY 2017,65;(1)Pp 363-373
(15) M. Gabriela , D. S . Antonella. V. Annabella, Hepatotoxicity of green tea: an update. Article in Archives of Toxicology · May 2015, 89(8)
(16) E. A Etienne, Y. Feng , L. Ji. Aristolochic Acid-Induced Nephrotoxicity: Molecular Mechanisms and Potential Protective Approaches.International journal of molecular science . 2020, 21;1157;pp1-20
(17) A. CHRISTINE. M.D. HALLER, L. NEAL. M.D. BENOWITZ, ADVERSE CARDIOVASCULAR AND CENTRAL NERVOUS SYSTEM EVENTS ASSOCIATED WITH DIETARY SUPPLEMENTS CONTAINING EPHEDRA ALKALOIDS. December 21, 2000;343;25; pp 1833-1838
(18) W. A.saeed, M. A Dhamen, R. Ahmad, N.Ahmad, A. A Naqvi. Clinical uses and Toxicity of Ephedra sinica: An Evidence-Based Comprehensive Retrospective Review (2004–2017) Pharmacognosy Journal 2, Mar-Apr, 2019; 11(2): 439-444
(19) Rowin, J., & Lewis, S. L. (1996). Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology, 46(6), 1775–1776. https://doi.org/10.1212/WNL.46.6.1775
(20) WHO, 2007 – Guidelines for Assessing Quality of Herbal Medicines with Reference to Contaminants and Residues.
(21) Garcia-Cortés et al., 2021, Food Chem Toxicol, 149:111998.
(22) N. GARY., MD, MPH ASHER; H. AMANDA CORBETT, PharmD; and L .ROY. H, PharmD, PhD. Common Herbal Dietary Supplement– Drug Interactions, American Family Physician July 15, 2017;96;2;101-107
(23) A Gupta , K. Kumari , F. Hasan , V. Kumar , P .Kumar , Herb-Drug Interactions: A Critical Exploration in Modern Healthcare Practices. Journal of Medicinal Natural Products June 2025; 2(2);pp 1-9
(24) Gardiner P, Graham RE, Legedza AT, et al. (2006). Factors associated with dietary supplement use among prescription medication users. Arch Intern Med, 166(18):1968–74. DOI: 10.1001/archinte.166.18.1968
(25) Izzo AA, Ernst E. (2009). Interactions between herbal medicines and prescribed drugs: An updated systematic review. Drugs, 69(13):1777–98. DOI: 10.2165/11317010-000000000-00000
(26) Cohen PA. (2014). Hazards of dietary supplements adulterated with pharmaceutical drugs. NEJM, 370(14):1277–80.
(27) Saper RB, Phillips RS, Sehgal A, et al. (2008). Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the internet. JAMA, 300(8):915–23. DOI: 10.1001/jama.300.8.915
(28) Hoofnagle JH, Serrano J, Knoben JE, Navarro VJ. (2013). LiverTox: Clinical and research information on drug-induced liver injury. Hepatology, 57(3):873–874. DOI: 10.1056/NEJMra1816149
(29) WHO Uppsala Monitoring Centre. VigiBase: Global database of individual case safety reports (Accessed 2023).
(30) Bent S, Tiedt TN, Glidden D, et al. (2003). The relative safety of Ephedra compared with other herbal products. Ann Intern Med, 138(6):468–71.
(31) FSSAI. (2016). Food Safety and Standards (Health Supplements, Nutraceuticals, Food for Special Dietary Use, Food for Special Medical Purpose, Functional Food and Novel Food) Regulations.
(32) FoodandDrugAdministration, Recalls, Market Withdrawals, & Safety Alerts. Available online: https://www.fda.gov/safety/ recalls-market-withdrawals-safety-alerts (accessed on 16 August 2022).
(33). Mazzanti, G.; Menniti-Ippolito, F.; Moro, P.A.; Cassetti, F.; Raschetti, R.; Santuccio, C.; Mastrangelo, S. Hepatotoxicity from green tea: A review of the literature and two unpublished cases. Eur. J. Clin. Pharm. 2009, 65, 331–341.
( 34). Woodbury, A.; Sniecinski, R. Garlic-Induced Surgical Bleeding: How Much Is Too Much? A & A Case Rep. 2016, 7, 266–269.
(35)McEwen,J. St John’s Wort: Important Interactions between St John’s Wort (Hypericum perforatum) Preparations and Prescription Medicines. In The Therapeutic Goods Administration. Available online: https://www.tga.gov.au/node/597 (accessed on 15 March 2001).
(36)Ronis, M.J.; Gomez-Acevedo, H.; Blackburn, M.L.; Cleves, M.A.; Singhal, R.; Badger, T.M. Uterine responses to feeding soy protein isolate and treatment with 17-estradiol differ in ovariectomized female rats. Toxicol Appl Pharm. 2016, 297, 68–80.
(37)McCarver, G.; Bhatia, J.; Chambers, C.; Clarke, R.; Etzel, R.; Foster, W.; Hoyer, P.; Leeder, J.S.; Peters, J.M.; Rissman, E.; et al. NTP-CERHRexpert panel report on the developmental toxicity of soy infant formula. Birth Defects Res. B Dev. Reprod. Toxicol. 2011, 92, 421–468

Research and Reviews: A Journal of Pharmaceutical Science
| Volume | 17 |
| Issue | 01 |
| Received | 14/10/2025 |
| Accepted | 23/11/2025 |
| Published | 26/11/2025 |
| Publication Time | 43 Days |
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