Ahmed Eltelbany, MD, MPH1, Osama Hamid, MD, MRCPI1, Rama Nanah, MD1, Swathi Paleti, MD2 1Cleveland Clinic, Cleveland, OH; 2University of New Mexio, Albuquerque, NM
Introduction: Liver detoxification supplements are prominently featured on popular online retailers with numerous dedicated pages and claims that they “naturally” cleanse the liver. We aim to evaluate the highest rated and frequently reviewed liver detoxification supplements on a popular online retailer to facilitate patient counseling regarding marketing myths, supplement formulations, and evidence for efficacy and safety.
Methods: The Amazon marketplace was queried using the keywords “liver” + “cleanse” with default search settings and ranking items based on sales. The top 10 liver supplements identified on June 3rd, 2023 were reviewed based on price, ratings, reviews, manufacturer details, and ingredients. The total number of product sales and generated revenue was analyzed using AMZScout, a proprietary Amazon analytics platform and reviews were analyzed using Fakespot.com, a proprietary Amazon customer review analysis software.
Results: The top 10 liver cleansing supplements had an average of 11,526 reviews per product and a mean rating of 4.42 ± 0.12 stars. Review reliability analysis revealed that only 65.04% of product reviews were genuine. Furthermore, sales analysis of the top 10 products revealed total monthly sales of 115,256 units with a total monthly revenue of $2,442,963 at an average price of $26.45 for a one-month supply. 65 unique ingredients were identified across these liver cleansing supplements of which none are recommended by either the American Association for the Study of Liver Diseases or the European Association for the Study of Liver.
Discussion: Liver cleansing supplements are easily available online. Despite the lack of support by any scientific liver association, the supplements generated sales of over $2.4 million each month on a single online US retailer. Our investigation revealed that limited human studies have evaluated liver cleansing and detoxification supplements, resulting in no definitive findings of efficacy. In the absence of additional human studies, patients should be cautioned before considering liver cleansing supplements, given the limited availability of effective Food and Drug Administration approved therapies.
Figure: Figure 1: Daily Sales Trend of the Best Selling “Liver Cleanse” Supplement from 2017-2023
Table: Table 1: Summary of the Top Selling “Liver Cleanse” Supplements on Amazon.com
Disclosures:
Ahmed Eltelbany indicated no relevant financial relationships.
Osama Hamid indicated no relevant financial relationships.
Rama Nanah indicated no relevant financial relationships.
Swathi Paleti indicated no relevant financial relationships.
Ahmed Eltelbany, MD, MPH1, Osama Hamid, MD, MRCPI1, Rama Nanah, MD1, Swathi Paleti, MD2, 18, Liver Cleansing Imposters: An Analysis of Popular Online Liver Supplements, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
