Herbal, dietary supplements, oligo and trace elements consumption among chronic liver disease patients and caregivers: a cross-sectional study.

Use of herbal and dietary supplements (HDS) is widespread among patients with chronic liver disease (CLD). Despite the potential for adverse effects (AEs) and drug interactions (ADRs), these products are often perceived as "natural," safe, and not requiring medical prescription. This study aimed to assess HDS, oligo and trace element consumption among patients with CLD, to examine sociodemographic correlates, to determine the extent to which use is overseen by general practitioners or specialists versus self-medication, and to document reasons for use and perceived benefits. Over a 6-month period, patients with CLD attending the outpatient clinic of the Internal Medicine and Hepatology Unit of the University Hospital of Palermo, along with their caregivers, were surveyed regarding their use of supplements. A self-administered questionnaire collected information on demographics, lifestyle habits, supplement use, motivations, perceived benefits, and prescription awareness. A total of 323 participants were enrolled: 220 (68.1%) were CLD patients and 103 (31.9%) were caregivers. Overall, 110 (34%) subjects, 39 patients and 71 caregivers, reported using at least one supplement. Consumption was slightly more frequent among caregivers than patients (37.9% vs 32.3% p = ns). Among users, HDS were the predominant products (87/110; 79.1%), followed by oligo and trace elements (36/110; 33.0%); 21/110 (19.1%) reported combined use. The most common reasons for supplement use were anxiety and sleep disorders (each 15/110; 13.6%), osteoporosis/osteoarthrosis (15/110; 13,6%), dyslipidemia (12/110; 10.9%), and dyspepsia (11/110; 10.0%). Compared with caregivers, patients more frequently used supplements for anemia (7.3%), anxiety (13.6%), and steatotic liver disease (7.3%). Perceived benefit was reported by 70.9% of users, whereas AEs and ADRs were uncommon (3.6%). Supplement consumption for liver steatosis was more common among males than females (14.3% vs 2.9%; p = 0.034). Osteoporosis-related supplement use showed a significant positive correlation with age (p = 0.019). Consumption of HDS, oligo and trace elements is common among CLD patients, and it increases with age. Their use appears driven by perceived health knowledge and a desire for well-being. Further studies are needed to enhance health education and prevent inappropriate or excessive use of these products.