A new survey study from the University of Michigan estimates that up to 18.6 million people in the United States use at least one herbal remedy that may harm the liver. When used moderately, herbal treatments, such as green tea and other plant-based supplements, can provide health benefits; however, in concentrated forms, such as capsules, it is easy to overdose. The use of dietary supplements and herbal treatments has significantly increased worldwide due to their tangible health benefits, and they can be purchased over the counter. According to reports, hospitalizations due to liver problems caused by herbal remedies are rising in the United States and globally. Hepatologist Alyssa Leichty and her colleagues warned in their research paper that "the safety and efficacy of herbal and dietary supplements are not well-established due to the lack of regulatory requirements by the FDA for human or clinical trials before marketing." Using data from 9,685 individuals registered in the National Health and Nutrition Examination Survey (NHANES) in the United States, researchers found that the six most commonly consumed herbal products, often used to treat conditions such as high cholesterol, depression, and pain, are frequently involved in liver injury. The rates of liver injury caused by these dietary supplements have nearly tripled in the past 20 years, rising from 7% in 2004 to 20% by 2014.