Hepatic Damage by Natural Remedies

Andrade, Raúl J.; Medina‐Cáliz, Inmaculada; González-Jiménez, Andrés; García‐Cortés, Miren

doi:10.1055/s-0038-1623518

Cited by 36 publications

(10 citation statements)

References 143 publications

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“…Apart from the problem of variability in silymarin complex composition, health issues related to contaminating bioactive compounds become important. Together with explosive trends in the use of herbal-based dietary supplements in the general population, the increased incidence of herbal-based dietary supplements-induced liver injury is being recognized as a clinical problem 41,42 . Although most of these toxic liver effects seem to be idiosyncratic 42 , the possible harmful effects of contaminating biological factors are not being considered seriously.…”

Section: Discussionmentioning

confidence: 99%

Poor chemical and microbiological quality of the commercial milk thistle-based dietary supplements may account for their reported unsatisfactory and non-reproducible clinical outcomes

Fenclová

Nováková

Viktorová

et al. 2019

Sci Rep

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Herbal-based dietary supplements have become increasingly popular. The extract from milk thistle ( Silybum marianum) , is often used for the treatment of liver diseases. However, serious concerns exist regarding the efficacy, composition, as well as the safety of these over-the-counter preparations. Therefore, the aim of the present study was to investigate the composition as well as chemical and biological safety of 26 milk thistle-based dietary supplements purchased from both the U.S. and Czech markets between 2016 and 2017. The study was focused on a determination of the composition of active ingredients, as well as analyses of possible contaminants including: mycotoxins, plant alkaloids, and pesticide residues, as well as the microbial purity. High-throughput analyses were performed using advanced U-HPLC-HRMS techniques. Large differences in the silymarin content were observed among individual milk thistle preparations, often in contrast with the information provided by the manufacturers. In addition, substantial inter-batch differences in silymarin content were also demonstrated. In all milk thistle preparations tested, large numbers and high concentrations of mycotoxins and several pesticides, as well as the substantial presence of microbiological contamination were detected, pointing to serious safety issues. In conclusion, our results strongly indicate the need for strict controls of the composition, chemical contaminants, as well as the microbiological purity of commercial milk thistle extracts used for the treatment of liver diseases. Poor definition of these preparations together with contamination by biologically active substances may not only account for the inconsistency of clinical observations, but also be responsible for possible herbal-based dietary supplements-induced liver injury.

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Section: Discussionmentioning

confidence: 99%

Poor chemical and microbiological quality of the commercial milk thistle-based dietary supplements may account for their reported unsatisfactory and non-reproducible clinical outcomes

Fenclová

Nováková

Viktorová

et al. 2019

Sci Rep

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“…77 The RUCAM scale calculates scores which features in 7 different domains such as chronology (latency and de-challenge), risk factors, concomitant drug use, exclusion of other causes, previous information on drug's hepatotoxicity potential and response to re-challenge with a higher score indicates increased likelihood of hepatic injury due to consumption of a specific substance. 78 However, several pitfalls have questioned the reliability of this method in multi-ingredient products as RUCAM can be calculated only for a single drug each time. Of note, several adverse events induced by multi-ingredient products with a high score of RUCAM scale (highly probable) were reported.…”

Section: Discussionmentioning

confidence: 99%

Complementary and Alternative Therapies for Weight Loss: A Narrative Review

Lua

Ahmad

Mansor

et al. 2021

J Evid Based Complementary Altern Med

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Despite various strategies, overweight and obesity problems are still increasingly prevalent worldwide with serious health outcomes. Consequently, the continuous demand for more effective, safe and acceptable therapies for reducing body weight is also escalating—including complementary and alternative therapies (CATs). The aim of this review is to provide a summary of the most commonly- and recently-used CATs, with evaluation of their safety and efficacy for weight loss. Electronic scientific databases such as Scopus, PubMed and EBSCO Host were explored for articles that reported CATs for overweight and obesity treatment from 2015 to December 2019. Only systematic reviews, meta-analysis and randomized controlled trials (RCTs) published in English were included. Studies whereby CATs were not utilized for reducing body weight were excluded. Eight systematic reviews and meta-analyses and 11 additional RCTs with 765 participants (50.2% overweight and 49.8% obese) related to hypnotherapy, acupuncture and dietary supplements met the inclusion criteria. Their results suggested that spirulina, chitosan, probiotic, EPA + DHA, vitamin D, fiber, and herbal extract supplementation may all provide small reductions in body weight (ranging from 1-10 kg). Interestingly, hypnotherapy and acupuncture reported significantly greater reduction in body weight compared with placebo (p < 0.001 and p < 0.0001, respectively). Nonetheless, the evidence is still relatively limited and not encouraging to provide a definitive conclusion due to the methodological shortcomings and the presence of adverse events in chitosan and fiber supplementation. Hence, studies of this nature need to be further replicated and improved to corroborate the efficacy and safety of the CATs to combat weight issues.

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“…Data derived from different DILI registries shows that the contribution of HDS to the total number of cases of hepatotoxicity varies across countries, ranging from 1.3% to 62% (Andrade et al, 2018). Asian countries, due to the use of Chinese traditional medicine and related compounds, exhibited higher figures (Shen et al, 2019;Suk et al, 2012;Wai et al, 2007;Zhu et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…The CIOMS/RUCAM scale was the tool more frequently used for causality assessment despite its known limitation, particularly in the setting of multi-ingredient products, that makes the identification of a single causative agent very difficult (Andrade et al, 2018). Additional limitations when applying the CIOMS/RUCAM scale are the lack of previous information about adverse events induced by herbal products or incomplete timing criteria (García-Cortés et al, 2011).…”

Section: Prospective Retrospectivementioning

confidence: 99%

“…There are currently considerable differences in the kind of policies and regulations on production and post-marketing monitoring of HDS among different Latin American countries, representing the most heterogeneous and less regulated market in the world (Andrade et al, 2018). The WHO Traditional Medicine Strategy 2014-2023 is expected to help strengthen regulatory frameworks and safety monitoring in LA (World Health Organization, 2019.…”

mentioning

confidence: 99%

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Profile of herbal and dietary supplements induced liver injury in Latin America: A systematic review of published reports

Santos

Gasca

Paraná

et al. 2020

Phytotherapy Research

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Hepatotoxicity related to HDS is a growing global health issue. We have undertaken a systematic review of published case reports and case series from LA from 1976 to 2020 to describe the clinical features of HDS related hepatotoxicity in this region. We search in PubMed, Web of Science, Scopus and specific LA databases according to PRISMA guidelines. Only HILI cases published in LA that met criteria for DILI definition were included. Duplicate records or reports that lacked relevant data that precluded establishing causality were excluded. Finally, 17 records (23 cases) were included in this review. Centella asiatica, Carthamus tinctorius, and Herbalife® were the most reported HDS culprit products, the main reason for HDS consumption was weight loss. The clinical characteristics of HDS hepatotoxicity in our study were compared to those of other studies in the USA, Europe and China showing a similar signature with predominance of young females, hepatocellular damage, a high rate of ALF and mortality, more frequent inadvertent re‐challenge and chronic damage. This study underscores the challenge in causality assessment when multi‐ingredients HDS are taken and the need for consistent publication practice when reporting hepatotoxicity cases due to HDS, to foster HDS liver safety particularly in LA.

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Hepatic Damage by Natural Remedies

Cited by 36 publications

References 143 publications

Poor chemical and microbiological quality of the commercial milk thistle-based dietary supplements may account for their reported unsatisfactory and non-reproducible clinical outcomes

Poor chemical and microbiological quality of the commercial milk thistle-based dietary supplements may account for their reported unsatisfactory and non-reproducible clinical outcomes

Complementary and Alternative Therapies for Weight Loss: A Narrative Review

Profile of herbal and dietary supplements induced liver injury in Latin America: A systematic review of published reports

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