12/29/2025
🛑 What the Headlines Didn't Tell You 🛑 Settle in, this is a long one...
If you scrolled through health news last year, you might have seen some truly alarming headlines:
"Botanicals like turmeric and green tea are harming Americans' livers"
"More than 15 million US adults at risk from herbal remedies"
"Study estimates millions risk liver damage from herbs"
If you use turmeric for inflammation, sip green tea daily, or take ashwagandha for stress — you probably felt that little knot in your stomach. Should I stop? Am I hurting myself?
Here's what I want to do today: I'm going to walk you through what that research actually said, what got lost in translation, and why the real story is a lot more nuanced than those fear-mongering headlines suggest.
I'm not here to tell you herbs are perfectly safe for everyone. They're not. Nothing is. But I am here to help you understand the actual numbers — because when you see them clearly, the picture looks very different.
Let's start with what actually happened...
In August 2024, a paper was published in JAMA Network Open estimating how many U.S. adults use six herbs that have been linked to case reports of liver injury:
* Ashwagandha
* Black cohosh
* Garcinia
* Green tea (as a concentrated extract)
* Red yeast rice
* Turmeric/curcumin
The researchers estimated that about 15 million Americans had used at least one of these herbs in the past month.
Then came the headlines. And honestly? They made it sound like 15 million people were walking around with damaged livers.
Using something is not the same as being harmed by it.
🔢 The Numbers Tell a Different Story 🔢
Let's zoom in on ashwagandha as an example.
According to the study's own citations, from 2019 to 2022, there were 23 case reports worldwide of liver injury possibly connected to ashwagandha.
Of those 23 cases:
* 8 were from the United States
* The rest came from around the world, including unbranded products, herbal syrups, and preparations of unclear composition sold at local markets in India
Now, according to the same study, 1.25 million Americans were using ashwagandha in 2020.
So let's do the math:
8 cases out of 1.25 million users
That's 0.0006% — less than one-thousandth of one percent.
To put it another way: if you gathered 125,000 ashwagandha users in a stadium, statistically, you'd expect less than one person to have experienced a liver issue.
And even then, we don't know if the herb was definitely the cause — or if there were other factors involved (like contamination, interactions, or pre-existing conditions).
The study also referenced data from something called the Drug-Induced Liver Injury Network (DILIN), which tracks cases of liver damage from all kinds of medications and supplements.
Here's what the headlines didn't explain:
Over a 10-year period (2004–2013), DILIN recorded 136 total cases of liver injury linked to herbal dietary supplements. Sounds bad, right?
But wait:
* 45 of those cases involved bodybuilding products — many of which were later found to contain illegal anabolic steroids masquerading as herbs
* That leaves roughly 91 cases over 10 years from mainstream herbal supplements
* That's about 9 cases per year in a country where tens of millions of people use herbal products
Again: this doesn't mean harm never happens. It means the actual risk is extremely low.
One reason the headlines sounded so scary is because of a confusing statistic buried in the study. The paper said that 57.6% of U.S. adults use dietary supplements.
But here's the problem: that 57.6% includes everything — vitamins, minerals, fish oil, probiotics, and yes, herbs.
The actual percentage of adults using herbal supplements specifically?
About 7.5%.
That's a huge difference. But the way the study was written made it easy for journalists to conflate the two — making it sound like more than half the country was at risk.
💊 The Missing Context: What About Other Medicines?💊
Here's something else the study didn't do:
It didn't compare the liver injury risk from herbs to the risk from:
* Common painkillers (like acetaminophen, the leading cause of acute liver failure in the U.S.)
* Prescription medications (many of which carry liver warnings)
* Over-the-counter drugs
The researchers noted that 15 million people use these six herbs — which is roughly the same number who use certain prescription cholesterol or anti-inflammatory drugs.
But they didn't tell us how the rates of liver injury compare.
Without that comparison, we're left with a number that sounds scary but lacks meaningful context.
So… Are Herbs Dangerous or Not?
Here's the honest answer:
Herbs are not risk-free.
But neither are pharmaceuticals. Or supplements. Or even food, for that matter.
What we know is this:
* Serious adverse reactions to these six herbs are rare
* Most reported cases involve very high doses, long-term use, contaminated products, or interactions with other medications
* Quality matters — a lot
* Individual sensitivity matters too
The point isn't that herbs are perfectly safe for everyone in every circumstance.
The point is that the actual data doesn't support the kind of fear the headlines created.
If you use turmeric, green tea extract, ashwagandha, or any of these herbs thoughtfully — at reasonable doses, from reputable sources, and ideally with guidance from someone knowledgeable — the risk of liver injury is very, very low.
Should you be reckless? No.
Should you panic? Also no.
�Here's what actually protects you:
✅ Buy from reputable companies that test for purity and potency
✅ Use appropriate doses — more is not always better
✅ Be cautious with concentrated extracts — especially if you're taking them long-term
✅ Talk to your doctor if you have existing liver issues or take medications
✅ Pay attention to your body — if something feels off, listen
When headlines exaggerate risk, people don't become safer — they become confused, fearful, or dismissive of tools that might actually support their health. Given who owns our health care system, confusion and fear are likely the whole point.
We can have honest conversations about rare adverse events without turning plants into villains.
We can ask for better research, better labeling, and better regulation without pretending that herbs are inherently dangerous.
And we can honor both science and thousands of years of traditional use — because they're not mutually exclusive.
15 million people using these herbs doesn't mean 15 million people are in danger.
It means 15 million people are using something that, for the vast majority, appears to be safe when used responsibly.
Could there be more research? Yes. Could quality standards be stronger? Absolutely. Should people be informed about potential risks? Of course. But let's not confuse "inform" with "terrify."
Want to dive deeper into the actual research? The full analysis is available in HerbalGram 142 (Winter 2025), published by the American Botanical Council. It's a great example of how scientific literacy can cut through the noise.
