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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Hepatol. Apr 27, 2026; 18(4): 116710
Published online Apr 27, 2026. doi: 10.4254/wjh.v18.i4.116710
Acute liver failure linked to OxyShred pre-workout supplement: A case report and review of literature
Sarah Householder, Noah Brazer, Ysabel C Ilagan-Ying
Sarah Householder, Department of Internal Medicine, Yale-New Haven Hospital, New Haven, CT 06511, United States
Noah Brazer, Yale School of Medicine, New Haven, CT 06511, United States
Ysabel C Ilagan-Ying, Department of Digestive Diseases, Yale-New Haven Hospital, New Haven, CT 06511, United States
Author contributions: Householder S wrote the first draft of the manuscript with assistance from Brazer N and Ilagan-Ying YC; Ilagan-Ying YC guided the project and provided expert analysis; all authors revised the manuscript for intellectual content and approved the final version of this manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Sarah Householder, MD, Department of Internal Medicine, Yale-New Haven Hospital, 20 York Steet, New Haven, CT 06511, United States. sarah.householder@yale.edu
Received: November 18, 2025
Revised: December 14, 2025
Accepted: January 27, 2026
Published online: April 27, 2026
Processing time: 154 Days and 9.2 Hours
Core Tip

Core Tip: Pre-workout supplement (PWS) use has grown rapidly with the expanding fitness market, yet many products contain poorly regulated herbal ingredients linked to liver injury. Multi-ingredient supplements cause most herb-related hepatotoxicity, and consumers often assume they are regulated despite minimal oversight. OxyShred thermogenic fat burner (OxyShred), a popular PWS, includes several agents associated with liver damage. A healthy 31-year-old woman developed acute liver failure requiring transplantation after eight weeks of consistent OxyShred use. This case highlights the risks of unregulated supplements, the need for physician inquiry about PWS use, and the importance of stronger federal requirements for safety evidence and ingredient transparency.