A 13-year-old boy in Texas developed liver failure and hepatitis-associated aplastic anemia after consuming two Herbalife products and an aloe vera beverage over a period of months, according to a report published on February 12, 2024 in the Journal of Pediatric Gastroenterology and Nutrition.

The boy had consumed Herbalife Formula 1 daily for five to six months, and also occasionally consumed an Herbalife Protein drink mix, in addition to regularly consuming (twice per week) an aloe vera beverage (brand not specified), when he developed symptoms including abdominal pain, fatigue, poor appetite, transient nausea and vomiting, and jaundice (Wong, Clin Pediatr 2023). Physicians diagnosed him with hepatitis (liver inflammation) and sub-fulminant liver failure, which they attributed to consumption of the Herbalife products, although it should be noted that, rarely, consumption of aloe vera has been linked with liver injury.

The boy’s condition slowly improved over 22 days in the hospital with discontinuation of the supplements and treatment. However, blood work at his two-month follow-up from hospital discharge revealed hepatitis-associated aplastic anemia, a rare and potentially fatal complication after acute hepatitis characterized by low numbers of red and white blood cells and platelets in the blood. He was treated with immunosuppressive therapy and cyclosporine, and at two-years follow-up, his liver function and blood work were normal.

It’s not clear which, if any, ingredient in the products may have contributed to the reported liver injury. Several other cases of liver injury associated with use of a variety of Herbalife products have been reported in the U.S. and other countries (Schoepfer, J Hepatol 2007; Bessone, Clin Gastroenterol Hepatol 2022), although many such reports have lacked important information, such as complete patient histories or details about use of medications or alcohol, and do not prove cause-and-effect (Zambrone, Braz J Pharm Sci 2015). For example, an analysis of eight such cases involving Herbalife products found that only one case, in which a second exposure to the product elicited the same symptoms, was likely to have been triggered by the product (Teschke, World J Hepatol 2013).

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Herbal and dietary supplement induced liver injury leading to hepatitis-associated severe aplastic anemia: A case report

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