From energy boosts and weight loss to clearer skin and better sleep, dietary supplements promise a lot—and Americans are buying in. Nearly 3 in 4 adults in the U.S. take supplements, often trusting that “natural” equals safe. But behind the labels and wellness buzzwords lies a serious health risk: liver damage.

A growing body of research is raising red flags about how certain herbal and dietary supplements—especially those with multiple ingredients—can lead to drug-induced liver injury, sometimes severe enough to require a transplant.