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In the setting of concurrent supplement use, distinguishing what caused liver damage is challenging. A 57\u2010year\u2010old woman who had nonalcoholic fatty liver disease developed sudden jaundice after finishing her short nitrofurantoin treatment while consuming a commercial weight\u2010loss supplement. The laboratory results demonstrated a significant liver cell damage pattern with autoimmune test results positive while liver biopsy showed nonspecific inflammation that supported drug\u2010induced liver injury over drug\u2010induced autoimmune such as hepatitis. The patient received intravenous N\u2010acetylcysteine emergently after removing all suspected hepatotoxic substances from her treatment plan. N\u2010acetylcysteine was administered empirically due to concern for progression, although its role in nonacetaminophen DILI remains uncertain. The case demonstrates that clinicians should evaluate for polysubstance\u2010induced liver damage when patients present with multiple possible liver\u2010damaging substances.<\/jats:p>","DOI":"10.1155\/crgm\/1187155","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T05:26:31Z","timestamp":1781933191000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Delayed\u2010Onset Hepatocellular Liver Injury Associated With Nitrofurantoin and Herbal Supplement Use: A Case Report With Multiple Potential 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