ArticleAlimentary pharmacology & therapeutics2019
Severe and protracted cholestasis in 44 young men taking bodybuilding supplements: assessment of genetic, clinical and chemical risk factors.
Article in Alimentary pharmacology & therapeutics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 69 citations in OpenAlex.
- Oxymetholone-Associated Cholestatic Drug-Induced Liver Injury With Profound Hyperbilirubinaemia: A Longitudinal Case Report.Case reports in hepatology · 2026Article
- Article
- Challenges in herbal-induced liver injury identification and prevention.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Knowledge, Prevalence, and Consequences of Dietary Supplements Intake among Iranian Bodybuilders.Current developments in nutrition · 2024Article
- Recent advances in the diagnosis of drug-induced liver injury.World journal of hepatology · 2024Review
- Cholestasis Linked to Bodybuilding Supplements: Exploring the Risks of Contamination.Case reports in hepatology · 2024Article
- Rare variant contribution to cholestatic liver disease in a South Asian population in the United Kingdom.Scientific reports · 2023Article
- Premature Death in Bodybuilders: What Do We Know?Sports medicine (Auckland, N.Z.) · 2023Article
- Mifepristone induced liver injury in a patient with Cushing syndrome: a case report and review of the literature.Journal of medical case reports · 2023Review
- Review
- The Use of Dietary Supplements in Fitness Practitioners: A Cross-Sectional Observation Study.International journal of environmental research and public health · 2021Observational
- Impact of Herbal and Dietary Supplements Causing Drug-Induced Liver Injury in Latin America.Clinical liver disease · 2020Review
- Body Building and Aminotransferase Elevations: A Review.Journal of clinical and translational hepatology · 2020Review
- Signatures in drug-induced liver injury.Current opinion in gastroenterology · 2020Review
- Liver Histology: Diagnostic and Prognostic Features.Clinics in liver disease · 2020Review
- Outcomes and Toxicology of Herbal Drugs in Alcoholic Hepatitis - A Single Center Experience from India.Journal of clinical and translational hepatology · 2019Article
- Diagnostic challenges in drug-induced liver injury.Clinical liver diseaseArticle
- Versatility of Anabolic Androgenic Steroid-Induced Hepatotoxicity.Journal of clinical and experimental hepatologyArticle
- Anabolic steroid-associated liver injury.Clinical liver diseaseReview
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17 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundBodybuilding supplements can cause a profound cholestatic syndrome.
aimTo describe the drug-Induced liver injury network's experience with liver injury due to bodybuilding supplements.
methodsLiver injury pattern, severity and outcomes, potential genetic associations, and exposure to anabolic steroids by product analysis were analysed in prospectively enrolled subjects with bodybuilding supplement-induced liver injury with causality scores of probable or higher.
resultsForty-four males (mean age 33 years) developed liver injury with a median latency of 73 days. Forty-one per cent presented with hepatocellular pattern of liver injury as defined by the R > 5 ([Fold elevation of ALT] ÷ [Fold elevation of Alk Phos] (mean, range = 6.4, 0.5-31.4, n = 42) despite all presenting with clinical features of cholestatic liver injury (100% with jaundice and 84% with pruritus). Liver biopsy (59% of subjects) demonstrated a mild hepatitis and profound cholestasis in most without bile duct injury, loss or fibrosis. Seventy-one per cent were hospitalised, and none died or required liver transplantation. In some, chemical analysis revealed anabolic steroid controlled substances not listed on the label. No enrichment of genetic variants associated with cholestatic syndromes was found, although mutations in ABCB11 (present in up to 20%) were significantly different than in ethnically matched controls.
conclusionsPatients with bodybuilding supplements liver injury uniformly presented with cholestatic injury, which slowly resolved. The ingested products often contained anabolic steroids not identified on the label, and no enrichment in genetic variants was found, indicating a need for additional studies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.