Dietary supplement (DS) usage among United States adults has significantly increased. Patients with steatotic liver disease (SLD) may have unique motivations to take DS in light of their liver condition and co-morbidities.

To characterize DS use in SLD patients and explore motivations for their use.

Adults ≥ 18 years old with complete transient elastography and dietary data from the National Health and Nutrition Examination Survey between January 2017 and March 2020 were studied. SLD was defined using consensus criteria, combining clinical indicators with elastography thresholds. The DS Questionnaire (DSQ) was used to record participants’ use of DSQ. Sample weights were applied to estimate national prevalence.

Of 2413 participants with SLD, 1058 reported using DS, for an estimated prevalence of 44.8% [standard error (SE) 2.4] with an average of 2.6 (SE 0.2) DS per person. Among SLD participants taking DSQ, 53.2% (SE 3.3) reported using non-vitamin/non-mineral ones, with an average of 1.8 (SE 0.1) such supplements per person. DS users were more likely to be female, have higher levels of education, and have greater food security (P < 0.02 for all). The most common motivations for using DS were to follow doctor’s advice (36.7%, SE 1.8), to improve overall health (22.1%, SE 2.0), and to maintain health (19.2%, SE 1.9).

Nearly half of individuals with SLD report taking DS. This study underscores the pressing need to deepen our understanding of DS use/motivations to develop tailored patient counseling strategies.

• Dietary supplement
• Disparity
• Steatotic liver disease
• Botanical
• National Health and Nutrition Examination Survey

• CAM
• Chronic liver disease

• Humans
• Female
• Male
• Complementary Therapies/statistics & numerical data
• Germany
• Middle Aged
• Cross-Sectional Studies
• Aged
• Adult
• Liver Diseases/therapy
• Chronic Disease/therapy
• Surveys and Questionnaires
• Patient Satisfaction/statistics & numerical data

• Universitätsklinikum Jena (8979)

• Complementary
• Integrative medicine
• Liver transplantation
• Psychiatry
• Traditional

• Humans
• Liver Transplantation
• Dietary Supplements
• Mental Disorders/drug therapy
• Phytotherapy/methods
• Plant Preparations/therapeutic use

• Access to Care
• Disparities
• Health Policy
• Socioeconomic

• Humans
• Chemical and Drug Induced Liver Injury/epidemiology
• Chemical and Drug Induced Liver Injury/etiology
• Chemical and Drug Induced Liver Injury/therapy
• Liver Diseases/epidemiology
• Liver Diseases/therapy
• Cholestasis/pathology
• Hepatitis, Autoimmune
• Acute Disease

• anxiety
• dietary supplements
• medicine
• perception

• Dietary Supplements/adverse effects
• Humans
• Perception
• Surveys and Questionnaires

• 21KA2002 Ministry of Health, Labour and Welfare Policy Research Grants

• National Ambulatory Medical Care Survey (NAMCS)
• complementary therapies
• herbal products
• integrative health
• national study

• Adult
• Ambulatory Care
• Female
• Health Care Surveys
• Humans
• Office Visits
• Physicians
• Physicians' Offices
• United States/epidemiology

• AIH
• Autoimmune hepatitis
• CAM
• Complementary and alternative medicine
• Supplement

• Antioxidant
• Falcaria vulgaris
• Traditional medicine

• Acetaminophen/toxicity
• Analgesics, Non-Narcotic/toxicity
• Animals
• Antioxidants/pharmacology
• Chenopodiaceae/chemistry
• Drug Interactions
• Male
• Mice
• Mice, Inbred C57BL
• Oxidative Stress/drug effects
• Plant Extracts/pharmacology
• Protective Agents/pharmacology
• Silymarin/pharmacology

Acetaminophen (APAP), used in the composition of thousands of preparations, is the most commonly used analgesic and antipyretic drug. The present study aimed to investigate the potential protective effects of the betulinic acid (BA) treatment through an APAP-induced hepatotoxicity rat model, using inflammatory, biochemical, and histopathological parameters.

The study consisted of four groups: control group, APAP group, BA group, and APAP+BA group. Experimental studies continued for fifteen days. Serum samples were analysed for glucose, total cholesterol (TChol), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), aspartate amino transferase (AST), malondialdehyde (MDA), toll-like receptor-9 (TLR-9), nuclear factor kappa B (NF-κB), and interleukin-18 (IL-18).

TLR9, IL-18, NF-κB, and MDA levels increased significantly in liver injury groups. These increases considerably decreased by the BA treatment. All groups showed immunopositivity for 8-hydroxy-2’–deoxyguanosine (8-OHdG) and interleukin (IL-1β) in the hepatocytes, inflammatory cells, and epithelial cells of bile ducts.

BA can be used as an effective agent in the prevention and treatment of acute liver diseases due to its inhibitory properties in multiple pathways and its potent antioxidant effects.

• Acetaminophen
• betulinic acid
• interleukin-18
• nuclear factor kappa B
• toll-like receptor-9

Complementary Alternative Medicine (CAM) has been widely used in the world, but limited data are available on the use of CAM in depression. This study aimed to evaluate the use of CAM and its associated factors in depression. This cross-sectional study was conducted on 300 depressed patients referred to the Yasuj Neurology and Psychiatric Clinic, southern Iran, between 2019 and 2020. A valid semistructured international questionnaire was used; amongst the participants, 230 (77%) were female. The mean age of the patients was 41.47 ± 12.2 years and the mean duration of the disease was 4.49 ± 4.88 years. The prevalence of CAM use was 37.6% among the patients. The results showed a significant difference between the CAM users and nonusers regarding the disease duration (p=0.045) and body mass index (p=0.007). Moreover, the results of logistic regression analysis revealed a significant relationship between CAM use and female gender, disease duration, overweight, obesity, and self-employment (p=0.039, p=0.028, p=0.029, p=0.048, and p=0.044, resp.). The most frequently used type of CAM was herbal medicine (97.35%) followed by pray therapy (23.89%). Additionally, the most widely used herbs were borage (77%), chamomile (46.9%), and lavender (21.2%). Furthermore, 62.8% of the patients reported that their main reason for using CAM was its effectiveness. The majority of the patients (77%) had not consulted their physicians prior to utilization of CAM therapies. Herbal medicine was the most common form of CAM in depression, with a high satisfaction level. Thus, it is necessary to increase physicians' awareness in different fields of CAM.

• AIH
• CBD
• Fatigue
• Pain

• Alcohol
• Ayurveda
• CAM
• DILI
• Hepatitis

• Attitude
• Chronic viral hepatitis
• Complemantary and Alternative Medicine
• Prevalence
• Turkey

Patients infrequently disclose use of dietary supplements to providers. Little is known about factors that motivate patients to disclose supplement use. The study aimed to identify reported factors motivating patients’ disclosure and nondisclosure of dietary supplement use and explore differences based on type of supplement and provider practice.

Mixed methods study combining qualitative content analysis of semi-structured interviews with statistical analyses to assess differences in identified factors by provider practice type and supplement type. Seventy-eight English-speaking patients who reported taking 466 dietary supplements in the previous 30 days were recruited from primary care and Complementary and Alternative Medicine (CAM), and Integrative Medicine (IM) offices in Southern California.

We identified nine themes related to disclosure and nine related to nondisclosure of dietary supplement use. Major themes were features of the office visit, circumstances in patient health and medical care, and provider/patient characteristics. The most commonly raised theme promoting disclosure of supplement use was provider inquiry. Patients associate disclosure with having concerns about a supplement but also with annual physical exams and some routine topics of discussion, including self-care, lab results, and new medication prescriptions. Themes related to nondisclosure included lack of provider inquiry, features of the office visit, such as supplements being unrelated to the visit purpose, and patients’ convictions that supplements are safe or not important to discuss. Themes did not vary by supplement type. Primary care patients were more likely than CAM/IM patients to attribute nondisclosure to convictions that supplements were beneficial, not worth mentioning, or equivalent to food (p ≤ 0.001).

When providers fail to ask directly about dietary supplement use, disclosure is often an impromptu decision that is driven by the content of provider-patient interactions. Ensuring disclosure of dietary supplement use to prevent potential drug-supplement interactions or adverse health outcomes likely requires consistent, proactive provider queries about supplement use.

• Communication
• Dietary supplements
• Patient disclosure
• Physician-patient relations
• Qualitative research

• complementary therapies
• depression
• safety
• systematic review
• treatment outcome

• Acupuncture Therapy
• Antidepressive Agents/therapeutic use
• Cognitive Behavioral Therapy
• Complementary Therapies
• Crocus
• Curcumin
• Dance Therapy
• Depressive Disorder/therapy
• Depressive Disorder, Major/therapy
• Dietary Supplements
• Drugs, Chinese Herbal/therapeutic use
• Fatty Acids, Omega-3/therapeutic use
• Humans
• Hypericum
• Meta-Analysis as Topic
• Mindfulness
• Music Therapy
• Phototherapy
• Plant Preparations/therapeutic use
• Qigong
• S-Adenosylmethionine/therapeutic use
• Systematic Reviews as Topic
• Tai Ji
• Trace Elements/therapeutic use
• Vitamins/therapeutic use
• Yoga
• Zinc/therapeutic use

Little is known about patterns and correlates of Complementary Health Approaches (CHAs) in chronic pain populations, particularly in rural, underserved communities. This article details the development and implementation of a new survey instrument designed to address this gap, the Complementary Health Approaches for Pain Survey (CHAPS).

Following pilot-testing using pre-specified criteria to assess quality and comprehension in our target population, and after feedback regarding face-validity from content experts and stakeholders, the final cross-sectional self-report survey required 10–12 minutes to complete. It contained 69 demographic, lifestyle and health-related factors, and utilized a Transtheoretical Model (TTM) underpinning to assess short- and long-term use of 12 CHAs for pain management. Twenty additional items on pain severity, feelings, clinical outcomes, and activities were assessed using the Short-Form Global Pain Scale (SF-GPS); Internal reliability was assessed using Cronbach’s alpha.

Investigators conducted consecutive sampling in four West Virginia pain management and rheumatology practices.

301 Appalachian adult patients seeking conventional care for pain management.

Response rates were high (88% ± 4.1%). High quality and comprehension deemed the CHAPS an appropriate measurement tool in a rural population with pain. Missing data were unrelated to patient characteristics. Participants predominantly experienced chronic pain (93%), had five or more health conditions (56%, Mean = 5.4±3.1), were white (92%), female (57%), and middle-aged (Mean = 55.6 (SD = 13.6) years). Over 40% were disabled (43%) and/or obese (44%, Mean BMI = 33.4±31.5). Additionally, 44% used opioids, 31% used other prescription medications, and 66% used at least one CHA for pain, with 48% using CHAs for greater than 6 months. There was high internal reliability of the SF-GPS (alpha = .93) and satisfactory internal reliability for each of the five TTM stages across (all) twelve CHAs: precontemplation (0.89), contemplation (0.72), preparation (0.75), action (0.70), and maintenance (0.70).

The CHAPS is the first comprehensive measurement tool to assess CHA use specifically for pain management. Ease of administration in a population with pain support further use in population- and clinic-based studies in similar populations.

• Adolescent
• Adult
• Aged
• Analgesics, Opioid/therapeutic use
• Chronic Pain/drug therapy
• Complementary Therapies/methods
• Cross-Sectional Studies
• Female
• Health Surveys/methods
• Humans
• Male
• Middle Aged
• Pain Management/methods
• Pain Measurement/methods
• Psychometrics
• Rural Population
• Self Report
• Young Adult

• T32 GM081741 NIGMS NIH HHS
• U54 GM104942 NIGMS NIH HHS
• T32 GM081741 NIH HHS
• National Institute of General Medical Sciences

A 24-year-old man was admitted due to acute hepatitis with unknown etiology. After his condition and laboratory data gradually improved with conservative therapy, he was discharged 1 month later. Two months after his discharge, however, liver dysfunction reappeared. After his mother accidentally revealed that he took complementary and alternative medicine, discontinuation of the therapy caused his condition to improve. Finally, he was diagnosed with a recurrent drug-induced liver injury associated with Japanese complementary and alternative medicine. It is important to take the medical history in detail and consider complementary and alternative medicine as a cause of liver disease.

• Alternative medicine
• Complementary medicine
• Drug-induced liver injury