Citation

Tagle M. Gastroenterol Hepatol (NY) 2022; 18(7): 422-424.

Copyright

(Copyright © 2022, Gastro-Hep Communications, Publisher Clinical Advances - Millennium Medical Publishing)

DOI

unavailable

PMID

36397769

PMCID

PMC9666813

Abstract

Several registries around the world record cases of drug-induced liver injury. The US Drug-Induced Liver Injury Network (often referred to as DILIN) has recorded more than 839 cases of liver injury, approximately 10% of which are caused by herbs. Recently, Dr Fernando Bessone, Dr Nelia Hernandez, and other hepatologists in Latin America established the Latin American DrugInduced Liver Injury Network (known as LATINDILIN) in collaboration with a Spanish registry. These and other doctors, including myself, have prospectively collected more than 350 cases of drug-induced liver injury, of which 29 (>8%) were caused by herbs. Thus, herbal drug- induced liver injury is quite common.

Our research in Latin America found the most common causes to be Camellia sinensis, which is the active compound of green tea, and Herbalife products, which contain a mixture of herbs (although it is not known which herb[s] can cause liver injury). These herbal products are perceived to be innocuous and healthy, and are often thought to be beneficial for weight loss, but that is not the case. They can induce autoimmunity and frequently cause injury of the liver. Another herb that can cause liver injury is Garcinia cambogia, which is especially popular in Argentina and is sold by health food stores as well as on websites such as Amazon. Other herbal causes of liver injury include Ginkgo biloba and kombucha tea, which is very popular, particularly in Peru.

Interestingly, these liver injuries are not caused by ingesting a set amount of these herbal products. These injuries are known as idiosyncratic reactions, which are not related to the quantity of an herbal product. They are unexpected reactions to usual portions of the product. Any person with any amount may be susceptible to developing such an injury...

Language: en