Adaptogens and MASH: To me, ‘probably fine’ is not a medical plan
I do not like guessing games when my liver is one of the players
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It was the happy little mushroom peeking out from a trash can and winking at a neighbor across the street that grabbed my attention.
No, I’m not talking about psychedelic mushrooms. It was a commercial for mushroom coffee. The cartoon mushroom looked high on life and perhaps a few of his own ingredients, and somehow, I was captivated. The idea of mushrooms in my coffee sounded weird, but if it could help me do half the things the woman in the commercial started doing after she drank it, maybe I should give it a try, too.
After several viewings, my algorithms did what algorithms do. They crept into the bushes, took notes and started serving me more spectacular introductory ads. One offer came with a travel mug, wooden storage container, and tiny wooden spoons. It looked as if a miniature woodland army would be making my coffee each morning and helping me battle through my day.
After confirming my order, I figured I should learn what I would soon be drinking. Then one ingredient stopped me cold.
It was probably fine for many people. I am not many people. I have a sick liver.
These mushroom coffee products usually are not made with magic mushrooms. They are often blends of coffee, cacao, herbs, powdered mushrooms, and plant-based substances marketed as adaptogens. Adaptogens can include herbs, roots, and mushrooms promoted for stress, focus, energy, or immune support.
That does not automatically make them dangerous. It also does not automatically make them safe.
I’ll stick with my black coffee
Chances are, if you are reading this column, you are not the average wellness customer any more than I am. If you have metabolic dysfunction-associated steatohepatitis (MASH), cirrhosis, or another chronic liver condition, you should treat trendy powders, drinks, and supplements with caution. To borrow loosely from “Ghost”: You might be in danger, girl. Or guy. Or anyone with a liver already working overtime.
Some ingredients raise fewer alarms than others. Lion’s mane, for example, has not been strongly linked to liver injury in available reports, though human safety data are still limited. That is not the same as a free pass. When your liver is already compromised, “probably fine” is not a medical plan.
The ingredient that made me pause was ashwagandha, a popular adaptogen often marketed for stress, sleep, and anxiety. It has been associated with rare cases of clinically apparent liver injury, including jaundice, itching, and cholestatic or mixed liver injury. Some severe cases have occurred in people with preexisting liver disease. That is the part that matters to me.
One problem with many of these products is that the exact amount of each ingredient may not be clear. If a label lists a “proprietary blend,” you may see the total amount of the blend and the names of the ingredients, but not the amount of each individual ingredient. That leaves people with liver disease guessing about dose, exposure, and risk. I do not like guessing games when my liver is one of the players.
So how do you know whether a sneaky ingredient is hiding in your food or drink? Read the label. Then read it again, preferably before you buy it. I recently noticed that a free “healthy” soda included with my grocery order also contained ashwagandha. I had assumed it was just a probiotic-style drink, another bubbly little passenger on the wellness train that is still a soda. After one delicious sip, I poured the rest down the drain.
“What doesn’t kill you” still might send you to MyChart with follow-up questions.
There is one beverage I can recommend with far more confidence: plain coffee.
Coffee is not a cure, and it is not a substitute for medical care. But regular coffee consumption has been associated in studies with improved liver markers, less fibrosis, and reduced liver-related outcomes in people with liver disease including MASH. The key word is “plain.” A coffee drink loaded with sugar, syrups, and whipped cream is more dessert architecture than liver support.
As much as I love mushrooms, I will stick to eating them the old-fashioned way, preferably in a creamy sauce over pasta. For my morning cup, I’ll keep my regular Sumatra or Kona and enjoy one of the best legal drugs known to humankind.
No sugar, though. My liver does not need it. Besides, I’m sweet enough.
Note: Liver Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Liver Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to liver disease.
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