Is Pre-workout Bad for Your Liver? Answered by a Doctor

As a doctor, I advise caution when considering the use of any pre-workout supplements to prevent potential harm to the liver.

Generally, pre-workouts do not adversely affect liver health, particularly if you are in good physical condition, adhere to the recommended dosages, and avoid engaging in risky trends. Most individuals will likely experience no issues when following these guidelines.

I've seen a few gym buddies get overzealous with their pre-workout doses, chasing that extra 'edge.' Unfortunately, one of them ended up with elevated liver enzymes, a sobering reminder that more isn't always better. It's a lesson I share with everyone now: respect the dosage guidelines to avoid drug-induced liver injuries.

Here’s when you can suffer from a drug-induced liver injury:

• Proprietary blends — Many dietary supplements are proprietary blends, which means the manufacturer doesn’t disclose exactly what the supplement contains and in which quantities.
• Not FDA regulated — Dietary supplements aren’t FDA regulated, so you can’t know if they are safe or not.

This being said, you can choose a pre-workout supplement that’s been third-party tested to ensure a degree of quality.

"The FDA does not regulate herbal supplements as they do with medications. They will pull a supplement off the market but only after there have been complaints of side effects."

- Carol Denysschen, Chair of Health and Nutrition Dietetics at Buffalo State

Here’s which ingredients in bodybuilding supplements are and aren’t safe for your liver:

• Protein — This is the most widely used pre-workout as it helps build muscle. You'll be fine if you take it correctly and in small doses. But if you ingest too much protein, you’ll interfere with the liver and kidney function. A good rule is to stick to 50g of whey protein or 30g daily for six months.
• Dimethylamylamine Or (DMAA) — DMAA is seen as dangerous because it raises heart stress and blood pressure. Moreover, it can cause liver failure. Many supplements containing DMAA have been pulled from the shelves in the US, and manufacturers mostly use amino acids to mimic the DMAA effect.
• Niacin — Niacin helps during intense workouts and doesn’t have many side effects. However, if you take a high dose of Niacin, you’ll have elevated liver enzymes.
• Creatine — Is produced naturally in the body, but it’s also one of the most common ingredients of bodybuilding supplements. It gives a boost of energy and helps you work out for longer. The good news is that it won’t cause liver damage. However, it can cause kidney stress and dehydration if taken for too long. That’s why it’s best to use creatine in cycles.

Here is a list of pre-workouts with creatine that we tested and got approval for.

• Nitric oxide — Nitric oxide is a compound that improves blood flow by relaxing blood vessels. Pre-workouts have compounds that the body uses to create nitric oxides, such as L-arginine and L-citrulline. It can improve athletic performance, and the current research doesn’t indicate it causes liver damage, so this is a safe ingredient.
• BCAAs — Taking Branched-chain amino acids or BCAAs after a workout also increases muscle mass and eases muscle soreness. It’s found in dietary protein sources, so you don’t even need a workout supplement to get an adequate amount of BCAAs.
• Green tea extract — Green tea helps with metabolism increasing and aids in weight loss, but some research has found it can cause liver damage and liver injury.

Are Pre-workouts Safe?

Overall, men's pre-workout supplements are safe.

In my experience, pre-workouts can be a safe boost for your routine, as I've used them myself with no issues. But I've learned it's all about moderation and being mindful of how long you're using them. Stick to third-party tested brands and always follow the prescribed dose.

Additionally, it's imperative to steer clear of anabolic steroids, which are a primary culprit behind liver damage and various other health complications. As a physician, I must caution against the potential risks of drug-induced liver injury that may arise from the use of certain pre-workout supplements.

You should take supplements under medical supervision if you have existing medical issues. The doctor mentioned that elevated levels of muscle enzymes may indicate liver damage from pre-workout use.

If you’re on the lookout for safe and effective supplements, check out our round-up of the best organic pre-workouts formulated without artificial ingredients that might jeopardize your liver health.