Until September of last year, I had rarely been a patient. However, I’d spent over two decades inside the healthcare system as an attorney, a consultant and a CEO. My work has taken me through hospital boardrooms, regulatory strategy sessions and digital health startups. I thought I understood how health decisions were made and was fortunate to have collaborated with top clinicians, policymakers and executives in the field. Then a supplement triggered a health crisis I never saw coming.
Late last year, a popular over-the-counter herbal product left me severely jaundiced, emaciated (losing 40+ pounds), unable to sleep for days at a time, and bedridden for months. Bloodwork showed my bilirubin—a key liver function marker—had skyrocketed to 38 times the normal level. At one point, I was being evaluated for a liver transplant. My kidneys were showing signs of strain.
The culprit? Ashwagandha, a supplement I had recently started taking—sold everywhere from upscale wellness boutiques to grocery store shelves and generally considered safe. Marketed as a natural remedy for stress and sleep, it had been recommended to me by trusted friends and colleagues, including physicians.
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With the help of a specialist who had seen similar cases, I fully recovered. But the experience exposed serious shortcomings in both our healthcare and regulatory systems.
Safe until proven dangerous
Unlike pharmaceutical drugs, supplements aren’t required to go through clinical trials or prove safety before hitting the market. As outlined by the FDA under the Dietary Supplement Health and Education Act (DSHEA), the agency can only intervene after consumers have been harmed. That’s not prevention. That’s damage control.
While the severity of my reaction may have been statistically rare, there are other similar cases. Recent clinical studies and news have noted a significant rise in supplement-induced liver injuries, nearly doubling over the past decade according to data from the Drug-Induced Liver Injury Network (DILIN) and the National Institutes of Health. As I learned firsthand, even standard doses of these common supplements can affect individuals in very different ways.
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Half of supplements are mislabeled
In my case, I saw multiple physicians across disciplines. Few asked about supplements. Even fewer considered that an over-the-counter capsule could be the root cause of acute liver failure. The specialist who helped me confirmed that this diagnostic blind spot is common.
My hepatologist and one of the country’s leading experts on liver injury says as many as 50% of supplements are mislabeled. That means what’s printed on the bottle might not reflect what’s inside, and what’s inside might not be safe. Toxins, heavy metals, unlisted fillers and potency variations are all too common. Without independent, third-party testing to verify what’s actually in a supplement, consumers are left relying on blind trust.
Outpacing regulators
With more than $60 billion spent annually on dietary supplements in the U.S., the pace of growth has far exceeded the development of oversight mechanisms. The FDA remains entirely reactive as it must demonstrate that a supplement poses a “significant or unreasonable risk” before it can act. Meanwhile, countless products remain on shelves.
I’m not sharing this to provoke fear — but to advocate for a smarter, safer conversation around health products. We need stricter oversight, independent third-party testing, more rigorous research, and a cultural shift in how we think about “natural” remedies, especially as terms like biohacking and longevity become more mainstream than meaningful.
The surge in plant-based self-medication — fueled by wellness marketing and online misinformation — continues to outpace clinical guidance, leaving many patients at risk and providers underprepared.
I was fortunate to have access to leading specialists who ultimately helped me recover. Most people don’t.
And that’s exactly why this conversation matters.
Photo: Syolacan, Getty Images
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