A Pennsylvania woman has warned of the potential harms of ‘natural’ supplements after she developed deadly liver damage within two months of taking a herbal capsule for menopause symptoms.
Dental insurance worker Amber Heimbach, 39, described her eyes and skin as ‘looking yellow like Marge Simpson’ – a recognized symptom of jaundice, which develops when the liver malfunctions.
Doctors treating the mom of four concluded that the life-threatening problem appeared to be the result of the black cohosh she’d been taking to combat hormone-related mood swings.
The herb, which is found in North American woodlands, has previously been the subject of health warnings from international government agencies – due to its ‘toxcity’ 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 agencies have issued warnings about the supplement taken by Ms Amber Heimbach, due to its ‘toxic’ effect on the liver.
However, it is marketed as a ‘natural health remedy’ for menopausal symptoms, costing around $8-13 dollars for roughly 100 capsules.
Ms Heimbach’s ordeal began in October last year, when she visited her primary care physician for help with pre-menopausal symptoms including mood swings and heavy bleeding.
She was offered prescription medication, but instead opted to go down the natural route, purchasing black cohosh from her local drug store.
The tablets successfully alleviated her symptoms for nearly two months before she began to feel unwell.
Amber, from Harrisburg, Pennsylvania, said: ‘I know I’m approaching the age of pre-menopause and I was noticing a lot of different symptoms.
‘I was having heavy bleeding and emotional ups and downs. I could tell my hormones were out of balance.
Prior to taking the supplement, Amber Heimbach was a ‘healthy’ woman who rarely visited her doctor.
Yellowing 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 birth control. I’m a pretty healthy person so didn’t feel ready to do that or go on any medication.
‘I wanted to go down 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 bit of research’ and stumbled on black cohosh which ‘helps with stress and gives you an energy boost’, according to the advertisements she came across.
‘It was natural and over-the-counter so I presumed it would be fine.’
Initially, Ms Heimbach noticed some improvement in her symptoms.
She said: ‘I had less mood swings, I was sleeping better and I had more energy. It was working well.’
However by mid-November she began experiencing stomach pains, which seemed to be getting worse and worse.
Her skin and eyes began ‘looking a bit yellow’, prompting her to visit the emergency room.
A liver that is working poorly cannot get rid of bilirubin – a substance which, when release, triggers yellowing of the eyes and skin called jaundice.
Doctors performed tests and discovered tell-tale signs of an enlarged gallbladder, as well as rocketing levels of enzymes released when the liver is damaged.
She was rushed to urgent care and, a few days later, underwent a further barrage of tests to check for any underlying disease that may have caused her liver to fail.
Ms Heimbach said specialists explained there was a chance she may need a liver transplant.
Black cohosh, which is found in North American woodlands, is sold under the guise of a ‘natural’ menopause support product
‘They were trying to figure out what was happening to me. There were a lot of conversations about getting a liver transplant and also keeping an eye on my gallbladder.
‘They were more concerned that my liver was seeping over into my gallbladder.
A 2016 report from the UK Medicines and Healthcare products Regulatory Agency (MHRA) said there has been a growing concern worldwide about the risk of adverse effects on the liver associated with use of black cohosh.
The government agency recommended that warnings regarding rare adverse reactions should be added to black cohosh products.
‘I just kept thinking ‘what is happening to me?,’ said Ms Heimbach. ‘I’m a very healthy person, I never go to hospital, I go to the doctor once every five years.
‘It was scaring me. I was scared about being away from my family and having to go through a liver transplant and whether my body would accept it.’
She informed her doctors about the natural supplement she had been taking for the last 50 days which she believed may have been causing her unusual symptoms.
‘They were pretty confident that the black cohosh was causing all these issues. All the other tests they were doing came back negative.’
A 2020 study published The United States National Library of Medicine (NLM) stated that products labeled as black cohosh has been implicated in many instances of liver injury.
Luckily, Ms Heimbach was given intensive treatment and subsequently discharged from hospital, as her enzyme levels gradually returned to normal.
But her eyes and skin are still yet to completely lose their yellow tinge, much to the amusement of her family.
‘The big joke was that I looked like the highlighter in 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 trying to help me get through it. If you pull my eyelid down you can still see a bit of yellowness but without doing that, you can’t see it anymore now.
‘I just feel so blessed I didn’t need a transplant. Any woman considering taking supplements, do your research and consult with your doctor.
‘I’ll never touch it again in my life.’