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This article reviews the demographics and motivations of dietary supplement (DS) consumers and the regulatory framework for DS in the US and other developed countries. It examines in detail three groups of multi\u2010ingredient HDS associated with hepatotoxicity: OxyElite Pro (two formulations), green tea extract\u2010based DS, and \u201cdesigner anabolic steroids.\u201d These examples illustrate the difficulties in identifying and adjudicating causality of suspect compound(s) of multi\u2010ingredient HDS\u2010associated liver injury in the clinical setting. 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