The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

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    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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Profiling and assumed herb-induced liver toxicity

little-guy2Alternative explanations are common in about 47% of suspected drug-induced liver injury.

Researchers in Germany raised the question of whether a similar frequency might prevail in cases of assumed herb-induced liver injury.

First, the details.

  • 23 articles comprised of 573 cases of initially suspected herb-induced liver injury were reviewed.

And, the results.

  • Alternative causes were evident in 278 of 573 cases (49%) of assumed herb-induced liver injury.
    • Hepatitis by various viruses (10%)
    • Autoimmune diseases (10%)
    • Nonalcoholic and alcoholic liver diseases (5%)
    • Liver injury due to treatment with a drug or other herbal (44%)
    • Liver involvement in infectious diseases (5%)
  • Biliary and pancreatic diseases were frequent alternative diagnoses (12%), raising potential treatment problems.
  • Other diagnoses were rare.

The bottom line?

The authors concluded, “Thorough clinical evaluations and appropriate causality assessments [are needed] in future cases of suspected herb-induced liver injury.”

Even when herbal-related toxicity is suspected, a definitive diagnosis is difficult to establish without getting a detailed history of herbal use and proper analysis of the product or plant material.

Never be fooled into making a diagnosis involving herbals by default.

8/7/13 8:53 JR

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