P3139 - From Lean to Mean: A Case Report of Severe Hepatoxicity Linked to Animal Cuts, A Fat Burner Supplement

Ivana Martos, MD¹, Muhammad A.. Mansoor, MD¹, Pablo Santander, MD², Jared Magee, DO, MPH^2
1National Capital Consortium, Bethesda, MD; ²Walter Reed National Military Medical Center, Bethesda, MD

Introduction: A significant portion of the U.S. population uses dietary supplements, including fat burners, with military service members showing higher usage rates compared to civilians. Fat burner supplements lack rigorous scientific studies supporting their efficacy and safety especially in the context of their use amongst military personnel. This case highlights the hepatotoxic effect of a fat burner supplement “Animal Cuts” containing Centella asiatica.

Case Description/Methods: A 28-year-old female active-duty service member with no history of pre-existing liver disease presented due to several weeks of progressive jaundice. Her labs were notable for abnormal liver associated enzymes in a mixed patterns (AST 1173, ALT 1473, ALP 220, total bilirubin 19.20, direct bilirubin 14.9) and coagulopathy (PT 22.1, INR 1.91). Reassuringly, patient did not have any evidence of encephalopathy. Upon interview, patient did not have obvious risk factors but discussed using a fat burner “Animal Cuts” around the time her jaundice started. She underwent comprehensive evaluation for her acute liver injury which was notable for mildly elevated IgG and anti-SMA.



Due to diagnostic uncertainty for Drug-Induced Autoimmune Hepatitis (DIAIH) vs DILI, she underwent a liver biopsy and was started oral prednisone. Liver biopsy confirmed severe hepatocyte necrosis and hemorrhage consistent with severe toxin-induced liver injury. Prednisone was discontinued following liver biopsy results. On surveillance lab evaluation, patient had improvement, but not normalization, of liver enzymes and coagulopathy. She is continuing to be monitored at this time.

Discussion: While specific case reports in military populations are limited, civilian studies have documented severe liver injury associated with dietary supplements. This case emphasizes the challenges in diagnosing and managing acute liver injury related to fat burner supplements containing hepatotoxic ingredients like Centella asiatica. Heightened awareness and stricter regulatory guidelines are essential to mitigate risks associated with these supplements, particularly among military personnel where readiness is critical.


Disclosures:


Ivana Martos, MD¹, Muhammad A.. Mansoor, MD¹, Pablo Santander, MD², Jared Magee, DO, MPH². P3139 - From Lean to Mean: A Case Report of Severe Hepatoxicity Linked to Animal Cuts, A Fat Burner Supplement, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.