The former director of the Division of Dietary Supplement Programs at the FDA, and current CEO of the Natural Products Association (NPA), Dr. Daniel Fabricant, has expressed skepticism regarding a new study that purportedly shows a rise in liver injury cases caused by dietary supplement use. The study, published in the journal Hepatology, tracked 839 individuals from 2004 to 2013 with liver injuries from supplements, herbs, or medications. The study’s authors concluded that cases of supplement-caused liver damage increased from 7.0% to 20% during that time. However, Dr. Fabricant notes there is good reason to view these results with caution. For example, there are many factors that can cause or contribute to an injury besides the supplement itself; these might include the presence of pharmaceuticals, microbial contamination, heavy metals, unidentified drug interactions, and a poor medical history. Even the researchers behind the study cautioned that their findings do not mean there is a rise in supplement-induced liver damage, as they only studied a very specific group of people. Moreover, data shows that supplements are still far safer than conventional medications; medications caused 709 of the reported injuries in the study, versus the 130 attributed to supplements.