A Pennsylvania woman has warned about the potential harm of ‘natural’ supplements after suffering fatal liver damage within two months of taking an herbal capsule for menopausal symptoms.
Dental insurer Amber Heimbach, 39, described her eyes and skin as ‘yellow like Marge Simpson’ – a recognized symptom of jaundice, which occurs when the liver does not function properly.
Doctors treating the mother of four concluded that the life-threatening problem appeared to be the result of the black cohosh she was taking to combat hormone-related mood swings.
The herb, which is found in North American forests, has previously been the subject of health warnings from international government agencies – due to its ‘toxicity’ to the liver.
The 39-year-old mother of four developed yellowing skin and eyes two months after she started taking a herbal supplement to combat menopausal symptoms.
British government authorities have issued warnings about the supplement Ms Amber Heimbach is taking, due to its ‘toxic’ effect on the liver.
However, it is marketed as a “natural remedy” for menopausal symptoms, and costs about $8-13 dollars for about 100 capsules.
Ms Heimbach’s ordeal began in October last year, when she visited her GP for help with premenopausal symptoms, including mood swings and heavy bleeding.
She was offered prescription medication, but chose to go the natural route and purchase it black cohosh from her local drugstore.
The tablets successfully relieved her symptoms for almost two months before she started feeling unwell.
Amber, from Harrisburg, Pennsylvania, said: ‘I know I’m approaching the age of pre-menopause and I noticed a lot of different symptoms.
‘I had heavy bleeding and emotional ups and downs. I noticed that my hormones were out of balance.
Before taking the supplement, Amber Heimbach was a “healthy” woman who rarely visited her doctor.
Yellowing of the skin and eyes are hallmarks of jaundice, which happens when the liver stops functioning properly.
‘I went to my doctor and they suggested putting me on medication and contraception. I’m a pretty healthy person so I didn’t feel ready to do that or take medication.
“I wanted to go the healthier route and see if there were any vitamins or supplements I could take to ease some of my side effects.”
Ms. Heimbach said she “did a little research” and came across black cohosh, which “helps with stress and provides an energy boost,” according to the ads she came across.
“It was natural and freely available, so I assumed it would be fine.”
Initially, Ms. Heimbach noticed some improvement in her symptoms.
She said: ‘I had fewer mood swings, I slept better and I had more energy. It worked well.’
However, in mid-November she started experiencing stomach pain, which seemed to be getting worse.
Her skin and eyes began to “look a little yellow,” prompting her to visit the emergency room.
A poorly functioning liver cannot get rid of bilirubin – a substance that, when released, causes a yellow discoloration of the eyes and skin, called jaundice.
Doctors ran tests and discovered telltale signs of an enlarged gallbladder, as well as rising levels of enzymes released when the liver is damaged.
She was rushed to the emergency room and a few days later underwent another barrage of tests to check for any underlying diseases that might have caused her liver to stop functioning.
Ms Heimbach said specialists explained there was a chance she would need a liver transplant.
Black cohosh, found in North American forests, is sold under the guise of a ‘natural’ product to support menopause
‘They were trying to find out what was wrong with me. There have been many conversations about getting a liver transplant and keeping an eye on my gallbladder.
‘They were more concerned about my liver seeping into my gallbladder.
A 2016 report from the UK Medicines and Healthcare products Regulatory Agency (MHRA) states that there is growing concern worldwide about the risk of adverse effects on the liver associated with the use of black cohosh.
The government agency recommended adding warnings regarding rare side effects to black cohosh products.
“I kept thinking, ‘What’s happening to me?’” Ms. Heimbach said. ‘I am a very healthy person, I never go to the hospital, I go to the doctor once every five years.
‘It scared me. I was afraid of being away from my family and having to have a liver transplant and whether my body would accept that.’
She informed her doctors about the natural supplement she had been taking for the past 50 days that she thought might be causing her unusual symptoms.
“They were pretty sure the black cohosh was causing all these problems. All the other tests they did came back negative.”
A 2020 study published in the United States National Library of Medicine (NLM) stated that products labeled black cohosh have been implicated in many cases of liver damage.
Fortunately, Ms. Heimbach received intensive treatment and was subsequently discharged from the hospital, as her enzyme levels gradually returned to normal.
But her eyes and skin still don’t completely lose their yellow tint, much to her family’s amusement.
‘The big joke was that I looked like the highlighter of the family. Some family members said, “Why don’t you get a blue wig, you could be Marge Simpson,” she said.
‘They were very loving and tried to help me through it. If you pull my eyelid down you can still see a little yellowness, but if you don’t you can’t see it now.
“I feel so blessed that I didn’t need a transplant. Any woman considering taking supplements, do your research and consult your doctor.
“I’ll never touch it again in my life.”