Promises of sexual enhancement may lure many patients into using over-the-counter (OTC) supplements that could lead to serious side effects, including liver injuries. Recent findings have raised concerns about the safety of some unregulated male enhancement products.
Erectile dysfunction (ED) affects millions of men worldwide. According to a 2019 report by the National Institutes of Health, around 30 million American men, or 30% of men over 18, experience ED. This demand for solutions led retailers like CVS, Walgreens, and Amazon to stock OTC enhancement supplements. These products often claim to improve sexual performance, but their potential risks are not always well-known or disclosed to consumers.
The University of South Florida Study on Liver Injuries
Researchers at the University of South Florida Morsani College of Medicine uncovered a disturbing connection between male enhancement supplements and drug-induced autoimmune hepatitis (DIAIH), a serious condition that affects the liver. Autoimmune hepatitis (AIH) happens when the immune system attacks the liver. Diagnosing this condition can be tricky since its symptoms overlap with other liver disorders like drug-induced liver injury (DILI).
Typically, AIH is more common in women and is identified by high levels of certain liver enzymes like alanine aminotransferase and aspartate aminotransferase, increased levels of immunoglobulin G (IgG), and specific types of immune cells. However, in this case, researchers noticed these markers in a male patient who admitted to using ExtenZe, a popular OTC male enhancement supplement.
The researchers believe that the liver converted ingredients in ExtenZe into substances called neoantigens. Once the immune system detected these neoantigens, it mistakenly attacked the liver, causing harm. Though the exact mechanism is still unclear, the researchers concluded that the male enhancement supplement played a role in triggering the autoimmune response.
Similar Case in Virginia
A similar case was reported by medical officers in Virginia, where a male patient developed jaundice and sought emergency care. Initially, healthcare providers believed the liver injury was caused by acetaminophen toxicity, and they treated the patient accordingly. However, his condition improved only temporarily, and he returned to the hospital two weeks later.
Upon further investigation, it was discovered that the patient had been using Nugenix, a testosterone booster supplement, alongside acetaminophen. This combination caused significant liver damage. The Nugenix supplement led to oxidative stress in the liver, generating reactive oxygen species (ROS) that damaged liver cells. When the patient took acetaminophen, it further worsened the condition.
This case differed from the autoimmune response seen in the ExtenZe case. Instead of an immune attack, the Nugenix-induced liver injury resulted from oxidative stress. Despite the different mechanisms, both cases highlight the potential risks of OTC male enhancement supplements, especially when used alongside other medications.
Diagnosis and Treatment Challenges
Accurately diagnosing liver injuries caused by supplements like ExtenZe and Nugenix can be difficult. Both drug-induced liver injury (DILI) and drug-induced autoimmune hepatitis (DIAIH) present with similar symptoms, making it challenging for healthcare providers to distinguish between the two. Certain medications, such as minocycline, nitrofurantoin, and alpha-methyldopa, are known to cause DIAIH, while acetaminophen toxicity is linked to DILI.
Successful treatment for both conditions often requires quick identification and removal of the offending substance. Patients are typically given steroid treatments and supportive care to aid recovery. However, failure to correctly diagnose the condition early on can lead to prolonged liver damage.
Common Ingredients in Male Enhancement Supplements
Both ExtenZe and Nugenix contain similar ingredients, some of which are known to interact with medications and contribute to liver injuries.
- ExtenZe includes ingredients such as DHEA, pregnanolone, ginseng, and horny goat weed.
- Nugenix contains ashwagandha, eurycoma longifolia, and ginseng.
Ginseng, an ingredient found in both supplements, has been associated with liver injuries in some cases. This suggests that ginseng, particularly when taken in large doses or combined with other medications, may play a role in the liver damage reported in these cases.
The Importance of Identifying Supplement Use in Patients
Both groups of researchers emphasize the need for healthcare providers to ask patients about any supplements they may be using, especially in cases of liver injury. Many people view OTC supplements as safe since they are available without a prescription. However, these products often contain active ingredients that can interact with other medications and cause harm.
It’s also important for patients to understand that “natural” does not always mean “safe.” Many supplements, including those marketed as male enhancement products, can have powerful effects on the body. Before starting any new supplement, it’s essential to consult with a doctor or pharmacist to assess potential risks.
Further Research Needed
Although researchers have identified a link between some OTC male enhancement supplements and liver injuries, more studies are needed to fully understand the relationship between these products and conditions like DIAIH and DILI. Until then, healthcare professionals and consumers should be aware of the potential risks associated with these supplements.
Conclusion
While male enhancement supplements like ExtenZe and Nugenix promise improved sexual performance, they may come with hidden dangers, particularly for the liver. The recent cases of liver injury associated with these products highlight the importance of caution when using OTC supplements. Healthcare providers should prioritize asking patients about supplement use during evaluations, and patients should always consult with a healthcare professional before starting any new product.
Source: Pharmacy Times
