Internal and Emergency Medicine

, Volume 13, Issue 6, pp 857–872 | Cite as

Acute liver injury following Garcinia cambogia weight-loss supplementation: case series and literature review

  • Giada CrescioliEmail author
  • Niccolò Lombardi
  • Alessandra Bettiol
  • Ettore Marconi
  • Filippo Risaliti
  • Michele Bertoni
  • Francesca Menniti Ippolito
  • Valentina Maggini
  • Eugenia Gallo
  • Fabio Firenzuoli
  • Alfredo Vannacci


Herbal weight-loss supplements are sold as self-medication products, and are often used under the misconception that their natural origin guarantees their safety. Food supplements are not required to provide any benefit/risk profile evaluation before marketing; however, possible risks associated with use of herbal extracts in food supplements are becoming more and more documented in the literature. Some herbs are listed as the leading cause of herb-induced liver injury, with a severe or potentially lethal clinical course, and unpredictable herb–drug interactions. Garcinia cambogia (GC) extract and GC-containing products are some of the most popular dietary supplements currently marketed for weight loss. Here, we present four cases of acute liver failure in women taking GC extract for weight loss, and a literature review of clinical evidences about hepatic toxicity in patients taking dietary supplements containing GC extract.


Adverse events Dietary supplements Garcinia cambogia Herb-induced liver injury Hydroxycitric acid Liver transplantation Weight-loss supplements 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent


Supplementary material

11739_2018_1880_MOESM1_ESM.pdf (121 kb)
Supplementary material 1 (PDF 120 kb)


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Copyright information

© SIMI 2018

Authors and Affiliations

  • Giada Crescioli
    • 1
    Email author
  • Niccolò Lombardi
    • 1
  • Alessandra Bettiol
    • 1
  • Ettore Marconi
    • 1
  • Filippo Risaliti
    • 2
  • Michele Bertoni
    • 2
  • Francesca Menniti Ippolito
    • 3
  • Valentina Maggini
    • 4
    • 5
  • Eugenia Gallo
    • 4
    • 5
  • Fabio Firenzuoli
    • 5
  • Alfredo Vannacci
    • 1
  1. 1.Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and ToxicologyUniversity of FlorenceFlorenceItaly
  2. 2.Division of General Medicine 2New Hospital “Santo Stefano”PratoItaly
  3. 3.National Centre for Drug Research and EvaluationNational Institute of HealthRomeItaly
  4. 4.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  5. 5.Referring Center for Phytotherapy, Tuscany Region CareggiUniversity HospitalFlorenceItaly

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