# Drug‐Induced Liver Injury Associated With Turmeric and Black Pepper Based Dietary Supplements Consumption: A Case Report

## TL;DR

A man developed liver injury from taking turmeric and black pepper supplements, highlighting the risks of dietary supplements and the need for doctors to ask about their use.

## Contribution

This case report highlights the under-recognized risk of liver injury from turmeric-based supplements combined with black pepper.

## Key findings

- A 61-year-old man developed drug-induced liver injury from long-term use of turmeric and black pepper supplements.
- Liver function normalized after discontinuing the supplements, confirming the supplements as the cause.
- The case emphasizes the importance of healthcare providers inquiring about dietary supplement use.

## Abstract

For centuries, turmeric has been utilized for its therapeutic properties; however, it is now being more frequently associated with the development of drug‐induced liver injury (DILI). The popularity of dietary supplements (DS) is rising, yet patients frequently omit disclosing their use to healthcare providers, as they do not perceive them as drugs. This dynamic will expose doctors to more patients suffering from the adverse effects of DS consumption. We present the case of a 61‐year‐old white European male, presenting with right upper quadrant abdominal pain, initially managed with antibiotic therapy based on radiological evidence of acute cholecystitis. The clinical course was complicated by progressive jaundice and severe hepatitis, necessitating hospital admission for comprehensive diagnostic evaluation. Despite an exhaustive assessment, a definitive etiology was elusive until the patient revealed self‐administration of a DS comprising turmeric and black pepper over the preceding year as adjunctive treatment for depressive symptoms. This disclosure led to the diagnosis of DILI, and complete normalization of hepatic function was observed within 2 months following discontinuation of the DS. This case underscores the potential for turmeric‐containing DS, particularly those combined with bioavailability enhancers such as black pepper, to trigger DILI in patients at risk. Healthcare professionals should proactively inquire about their patients' DS consumption and remain vigilant for their potential adverse effects.