Do Natural Health Products Cause Toxic Hepatitis?

ABSTRACT

Medicinal herb-induced liver injury reported on the literature ranges from mild elevation of liver enzymes to fulminant liver failure and liver cirrhosis. Medicinal herbs are common ingredients of traditional Chinese herbs. The mechanisms of medicinal herb-induced liver injury are mainly intrinsic hepatotoxicity. In addition to the potential for hepatotoxicity, medicinal herbs frequently induce herb-drug interaction and herb-herb interaction and may affect its own efficacy and safety. Sometimes hepatotoxicity of medicinal herbs originates from the substances of illegal adulterations and contaminations rather than its own indigenous components. Moreover, individual susceptibility to toxic liver injury should be considered in every instance. Two big problems exist in the management of medicinal herbs-induced liver injury. Because the release of prescriptions is not obligatory in Korea, it is impossible to identify ingredients in case of medicinal herbsinduced liver injury. Misconception on the safety of medicinal herbs prevails throughout the country.