Drug-Induced Liver Injury Associated With an Over-The-Counter Supplement

Use of herbal and dietary supplements has increased worldwide, with a parallel rise in herbal and dietary supplement-associated liver injury in the United States. Limited regulation and inconsistent labeling complicate diagnosis. We report a 65-year-old woman who developed severe hepatocellular drug-induced liver injury after chronic ingestion of Artri King, an unregulated product previously flagged for undisclosed pharmaceutical ingredients, including diclofenac and corticosteroids. Evaluation excluded viral, autoimmune, and metabolic etiologies. Liver biopsy demonstrated a hepatocellular injury pattern, and liver tests improved after discontinuation. This case underscores the need for routine supplement screening and stronger regulatory oversight.