Herbal medicines linked to liver inflammation

Some types of herbal medicines have been linked to liver inflammation in patients, suggesting the need for these products to be regulated to reduce further risks to consumers, UK researchers report.

"The preparation and prescribing of these medications urgently needs tighter control, as evidence of their potential toxicity has been recognized for some years and is a growing problem," according to Dr. Margaret F. Bassendine of the Center for Liver Research in Newcastle Upon Tyne and her colleagues.

In the latest issue of the European Journal of Gastroenterology and Hepatology, the researchers present the stories of two patients who experienced extensive liver inflammation after taking a mixture of Chinese herbal roots, one of whom died following a liver transplant.

Bassendine and her co-authors also conducted a review of medical literature written in English and identified 29 more patients with liver inflammation linked to herbal treatments.

Why certain herbal medicines can cause inflammation of the liver is, at present, unknown, the authors note. "It is difficult to provide conclusive evidence of what caused (liver inflammation) since traditional Chinese herbal medicines are sold in Europe as food supplements and therefore evade the controls that apply to conventional medicines," Bassendine's team writes. Some products are mixtures that contain adulterants.

However, certain herbal products are mentioned more frequently than others by people who experienced liver complications, the authors add. One product that was taken by 11 patients, called Jin bu huan, is an extract of a plant that behaves like an opiate. Six patients also reported taking Dictamnus dasycarpus, which is sometimes used to treat eczema.

In the first case the authors present, a 31-year-old woman who was given an infusion of Chinese herbal roots to help alleviate joint pain. The woman soon became jaundiced and developed dark urine. She stopped taking the medications 5 weeks after she began. She was not on any other medications, and tests found no signs of hepatitis virus in her blood, which can cause liver damage.

Nevertheless, her condition worsened. After doctors gave her an infusion of an antibody that improved the functioning of her liver, she fully recovered.

In the second case, a 32-year-old man began taking Chinese herb roots to treat benign tumors in his fatty tissue, and finished the entire nine doses of the treatment even after he began to feel unwell. After the treatment ended, he became jaundiced and also developed dark urine, and his condition began to deteriorate rapidly. He received a liver transplant, but died from an infection 13 days after the operation.

"Physicians and the general public should remain alert to the possibility of adverse effects from all herbal remedies, which are being used widely without definite evidence in common conditions such as asthma," Bassendine and her team conclude.