A new study is providing more evidence that using Hydroxycut dietary supplements can cause liver damage. The new Hydroxycut study was recently published in the American Journal of Gastroenterology.

Hydroxycut was recalled last spring, after the FDA warned consumers to stop using the products. At the time, the FDA said it had received 23 reports of serious liver problems ranging from jaundice and elevated liver enzymes, an indicator of potential liver injury, to liver damage requiring liver transplant, linked to use of Hydroxycut products. In one case, a 20-year-old died as a result of Hydroxycut-associated liver damage.

For this latest Hydroxycut study, researchers from the University of Southern California, Los Angeles analyzed 17 cases of liver damage among Hydroxycut users that had not yet appeared in the medical literature. Nine of the cases had been reported to the FDA, while eight were seen by the authors of the study. The researchers investigated the patients’ medical histories and ruled out other causes of liver damage, like viral hepatitis or liver inflammation caused by an abnormal immune system reaction.

In eight of the liver-damage cases, the researchers conclude there was a greater than 95 percent likelihood that the weight-loss aid was to blame. In five cases, the researchers concluded that Hydroxycut was “highly likely” the cause (a 75 to 95 percent chance), while it was probably to blame in two cases (a 50 to 74 percent chance). The last two cases were considered to be possibly linked to Hydroxycut use.

Three of the patients involved in the study ended up needing a liver transplant and one died. The study authors said the results of their analysis strengthen the evidence that Hydroxycut itself has caused liver damage in some users. The study also showed that liver damage induced by Hydroxycut can be severe.