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Weight Control. Resources Reference Desk Find an Expert. It is absolutely impossible for the monks of the Earth Profound Realm to have such a pause.
Among them was a male monk who came to participate in the assessment, and said carefully. I will meet the principal later, this senior is more suitable than you for the first game. Start Here. Diagnosis and Tests. Treatments and Therapies. Living With. Related Issues. Health Check Tools. National Heart, Lung, and Blood Institute. Statistics and Research. Clinical Trials. The fulminant hepatitis that this patient experienced is not rare; however, without a complete history inclusive of patient's nutritional supplements, the diagnosis may have continued to be elusive.
Following are the components of the Hydroxycut product, which is still available online. From all of these components chromium, Garcinia Cambogia Extract and Camellia Sinensis of tea extracts are found to have an association with the hepatotoxicity related to Hydroxycut. There have been several cases reported in the past linking these components to cause hepatotoxicity. In all of those cases, when the product containing the component is withdrawn, improvement in liver enzymes was seen.
Garcinia Cambogia has HCA as the main component, which is an inhibitor of the ATP-Adenosine Triphosphate citrate lyase so it blocks de novo synthesis of fatty acids and helps in weight reduction. However, two recent reports show its association with hepatotoxicity. One report shows the synergistic effect of HCA with montelukast in causing liver damage.
However, there have been some cases reporting its dangerous side-effects such as acute hepatitis, thrombocytopenia, and renal failure. There have been several cases that show an association of Camellia Sinensis with liver toxicity ranging from acute hepatitis to liver failure. Although, it is difficult to prove a causal relationship between Hydroxycut and hepatotoxicity, in our case liver damage was seen after starting Hydroxycut use and improvement in liver enzymes was seen after stopping it.
In addition, absence of any other etiologies proven by extensive lab test suggests that Hydroxycut was most probable cause of the hepatotoxicity. Our patient did not have any existing liver disease or any comorbid disease. While causation is difficult to prove in any drug induced injury, the temporal relationship after Hydroxycut exposure and gradual improvement after withdrawing the involved medication plus absence of any other etiologies despite comprehensive testing would point to Hydroxycut being the most likely possible cause for hepatotoxicity.
Earlier reports from Dara et al. In May, , FDA-Food and Drug Administration issued a warning regarding Hydroxycut related hepatotoxicity because of 23 case reports suggesting evidence of such consequences and so the product was removed from the market by the manufacturer.
Our case report emphasizes on the importance of post-marketing surveillance of nutritional supplements and over the counter medications.
Though Hydroxycut is off the market, there are several other supplements in the market, and we do not know, which health consequences they carry. Physicians should always be alert about non-prescription drug usage by patients and should always try to inquire about that and report any unusual side-effects to designated authorities. More stringent policy and regulations are required for stopping such harmful products from coming to the market.
Source of Support: Nil. Conflict of Interest: None declared. National Center for Biotechnology Information , U. Ann Med Health Sci Res. Author information Copyright and License information Disclaimer.
Address for correspondence: Dr. E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.
This article has been cited by other articles in PMC. Abstract In the recent era, use of various nutritional supplements is highly encouraged amongst the people of United States.
Keywords: Hydroxycut, Liver toxicity, Nutritional supplements. Introduction In US, nutritional supplements are largely unregulated; frequently, health advisories are issued regarding these products, but these may not be heeded by general public that may not be aware of the consequences of taking an unregulated substance promoted for its health benefits.
Case Report A year-old man with no significant past medical history presented as a referral from a community hospital for evaluation of hepatitis, initially diagnosed as choledocholithiasis.
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