Hydroxycut hepatotoxicity: A case series and review of liver toxicity from herbal weight loss supplements

Table 1 Hydroxycut ingredients supplement facts (serving size 2 caplets)

Amount per serving	% daily value
Calcium (as hydroxycitrate) 156 mg	161
Chromium (as polynicotinate) 133 mg	1111
Potassium (as hydroxycitrate) 218 mg	61
Garcinia Cambogia (66% hydroxycitric acid)	2
Gymnema Sylvestre (25% gymnemic acid)	2
Soy Phospholipids	2
Rhodiola rosea extract (5% rosavins)	2
Green Tea as Camelia Sinensis (91 mg of EGCG)	2
White Tea as Camelia Sinensis ( 15% EGCG)	2
Oolong Tea as Camelia Sinensis (15% EGCG)	2
Caffeine anhydrous	2

¹Percent daily values based on 2000 calory diet;

²Daily values not established.

Table 2 Components of popular weight loss supplements

Brand name	Potentially hepatotoxic components
Hydroxycut	Garcinia Cambogia, Chromium, Camelia Sinensis
Ephedrasile Hardcore	C. Sinensis, Valerian, St John’s wort
Zalestrim	C. Sinensis. Black Cohosh, Dong Quai
Slim-Citi	Hoodia
Ephedra	Mau Hang
Leptoril	C. Sinenis, Aspirin
Adipokinetix	C. Sinensis
Xenadrine	C. Sinensis, Ma Huang
Lipovox	C. Sinensis
Lean fire	C. Sinensis
Miracle Burn	Hoodia
7 DFB	Noni extract
Curvatrim	C. Sinensis, Dong Quai
Ambi-Slim	C. Sinensis, Garcinia Cambogia, Chromium, Valerian
TrimSpaX32	C. Sinensis, Hoodia Gordoni
Eroved	Hoodia, Garcinia Cambogia, Chromium
Zylorin	Hoodia, C. Sinensis, Chromium
Jet Fuel	C. Sinensis, Hoodia,
VPX redline	C. Sinensis
Metabolene	C. Sinensis, Chromium, Hoodia

Table 3 Patterns of injury in herbal hepatotoxicity

	Cholestatic	Hepatocellular	Autoimmune	Fulminant failure
Atractylis Gummifera[50]				X
Black Cohosh [51,52]			X	X
Callilepsis Laureola[53]				X
Camelia Sinensis[24-28]		X		X
Chapparral[54]	X			X
Chromium picolinate[18,19]		X
Cascara Sagrada[55]	X
Dai-Saiko-To[5]			X
Garcinia Cambogia[7]	X	X
Germander[56,57]		X		X
Greater Celadine[58,59]	X		X
Jin Bu Huan[60]	X
Kava[61-63]		X
Noni[64]		X
Paeonia[65]		X
Paulina Cupana		X
Penny Royal[66,67]				X
Senna[68]		X
Shou wu pian[5]		X
Syo-Saiko-To[69]	X	X
Teucrium Polium[5]				X
Usnic Acid[70,71]		X		X
Valerian[72]		X