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J Clin Exp Hepatol. 2019 Mar-Apr;9(2):268-272. doi: 10.1016/j.jceh.2018.08.002. Epub 2018 Aug 28.

Slimming to the Death: Herbalife®-Associated Fatal Acute Liver Failure-Heavy Metals, Toxic Compounds, Bacterial Contaminants and Psychotropic Agents in Products Sold in India.

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The Liver Unit, The Cochin Gastroenterology Group, Ernakulam Medical Centre, Kochi, Kerala 682028 India.
Medgenome Labs, Narayana Health City, Bommasandra, Bengaluru, Karnataka 560099 India.
Envirodesigns Ecolabs, Eco Tower, Palarivattom, Kochi, Kerala 682025 India.


Herbalife® is a global nutrition and weight management company selling and marketing nutritional and weight loss supplements. The United States Federal Trade Commission described Herbalife® in 2016 as a scam disguised as healthy living. Herbalife®-associated liver injury was reported from multiple countries in the West. India is fast becoming the largest growing market for Herbalife® products, expected to surpass the United States in sales revenue. We report the first case of a fatal acute liver failure from the Asia-Pacific region, in a young woman who consumed Herbalife® products over 2 months. We also present unsettling data that showcase heavy metal contamination, toxic compounds, psychotropic substances, and pathogenic bacterial contamination in similar Herbalife® products in India. The growth of Herbalife® in India and expansion of its nutrition clubs in major cities that promise fake health benefits portend a serious public health concern.


AIH, Autoimmune Hepatitis; BL, Butyrolactones; HDSs, Herbal and Dietary Supplements; HILI; Herbal supplements; ULN, Upper Limit of Normal; liver disease; obesity; weight loss

[Available on 2020-03-01]

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