Herbalife products tied to acute liver failure in India
Consumption of Herbalife products to acute liver failure, according to a case study report published by medical staff in India.
The report also details heavy metal, toxic compounds, psychotropic substance and bacterial contamination.
The case report was published in the March-April 2019 edition of the Journal of Clinical and Experimental Hepatology.
Titled “Slimming to the Death: Herbalife -Associated Fatal Acute Liver Failure—Heavy Metals, Toxic Compounds, Bacterial Contaminants and Psychotropic Agents in Products Sold in India”, the report is co-authored by staff from
- The Liver Unit, The Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala;
- Medgenome Labs, Narayana Health City, Bommasandra, Bengaluru, Karnataka; and
- Envirodesigns Ecolabs, Eco Tower, Palarivattom, Kochi, Kerala
According to the report, ‘India is fast becoming the largest growing market for Herbalife products‘.
Although it hasn’t yet, sales revenue in India ‘is expected to surpass United States in sales revenue in the coming years‘.
Citing the many Herbalife nutrition clubs that have popped up, the report states the clubs are promising ‘fake health benefits (which) portend a serious public health concern‘.
The documented Herbalife acute liver case was the result of ‘a young woman who consumed three products over a period of 2 months‘.
Herbalife products consumed daily by the woman include
Formula 1 Shake Mix, two scoops twice daily with skimmed milk; Personalized Protein Powder, two tablespoons into the Shake Mix twice daily and Afresh Energy Drink, 10 g twice daily.
The products were purchased from a local Herbalife nutrition club.
After 2 months, she developed progressive loss of appetite for a week, followed by jaundice and transient pruritus.
Blood work was taken at this point and analyzed.
Twelve days later, jaundice worsened and she was brought to our emergency in grade 3 hepatic encephalopathy.
A transjugular liver biopsy showed extensive periportal and perivenular bridging necrosis with moderate-to-severe mixed inflammatory infiltration, inter- face hepatitis, cholangitis, severe ballooning, steatosis and intracanalicular cholestasis.
With fulfilment of King’s College criteria, the patient was urgently referred to a transplant centre, but she passed away on wait list soon after.
Similar Herbalife liver failure cases reported in Israel, Spain, Switzerland, Iceland, Argentina and the US are referenced.
The estimated incidence of liver toxicity is 25-30 cases per 100,000 consumers of Herbalife products.
No further cases have been observed after the latest series in 2015 until now.
Medical staff were unable to retrieve product samples from the victim’s family, but were able to source the same product from the nutritional club.
This nutritional club was functioning without a licence, selling Herbalife products in the name of health and wellness and was eventually shutdown by the Department of Health Services, Government of Kerala.
In order to broaden their samples, the staff sourced eight Herbalife product samples from the internet.
Collected samples were
subjected to heavy metal analysis, toxicology and bacterial contamination studies.
The results of those studies revealed
high levels of heavy metals in all the sourced Herbalife products and undisclosed toxic compounds including traces of psychotropic recreational agent in 75% of samples.
“Multiple bacterial communities of “highly pathogenic species” were also found.
We also believe that it is not only the heavy metals but also possible unknown but toxic phytochemical constituents and adulterants that would have aggravated the liver injury in our patient.
Bear in mind the samples were unopened product sourced directly from Indian Herbalife distributors.
As to the lack of reported cases, the staff state;report states
Our report, the first from Asia–Pacific probably, clears that confusion as potential Herbalife toxicity is evident from an increased use of Herbalife products in a region that is sufficiently powered to identify and report it.
Other high consumption regions such as Vietnam and Cambodia maybe under reporting the adverse events associated with a
‘safe food supplement’.
Herbal nutritional supplements have uncharacterised, unlabelled, inconsistent and mostly undisclosed components without clear health (probably most often harmful) benefits.
The report concludes by calling on Herbalife dietary supplements (HDS) to be classified as drugs.
As with any drug, it is important to put HDSs through preclinical and clinical scientific studies and postmarketing vigilance so that unknown and potentially harmful causes for severe adverse effects, such as liver failure due to the use of such agents, may be more identifiable and controlled.
With increase in growth of herbal and dietary nutritional supplement use and expansion of associated nutrition clubs in India and with adequate evidence of liver toxicity and presence of unfavourable substances in such products, there is without doubt a growing public health concern in our hands.
Our thanks to Reddit user ceeceesmartypants and the AntiMLM subreddit for bringing the Journal of Clinical and Experimental Hepatology report to our attention.