Table 3.
Reported Hepatotoxicity of Herbal Supplements.
| Herbal Supplement | Preparation/Compound | Toxicity |
|---|---|---|
| Black cohosh (Actaea racemosa) | Extract | Liver necrosis, autoimmune hepatitis, protein adducts [69,70]. |
| Ginseng (Panax ginseng and P. quinquefolius) | Extract | Possible liver injury in a patient after interaction with imatinib [134]. |
| Greater celandine (Chelidonium majus) | Extract | Reports of hepatocellular injury in humans [148,149,150,151]. |
| Single report of cholestasis in human [148]. | ||
| Black Pepper (Piper nigrum) | Piperine | Increased liver enzymes with CCl4 and hepatic lipid peroxidation in mice [10]. |
| St. John’s Wort (Hypericum perforatum) | Extract | Liver injury associated with copaiba use [125]. |
| Extract | Increased toxicity associated with tert-butyl hydroperoxide [152]. | |
| Green tea (Camellia sinensis) | Epigallocatechin-3-gallate | Hepatotoxic in mice [64]. |
| Extract | Hepatotoxic in rats [65]. | |
| Germander (Lamiaceae family, Teucrim Genus) | Hepatotoxic in humans [61,153,154,155]. | |
| Teucrin A, teuchamaedryn A | Hepatotoxic to isolated rat hepatocytes, CYP3A4 dependent [156]. | |
| Teucrin A | Hepatocellular toxicity in mice [157]. | |
| Gingko biloba | Extract | May be hepatotoxic in mice [130]. |
| Extract | Hepatotoxic in humans [61]. | |
| Camphor (Cinnamomum camphora) | Topical cream | Single report of hepatotoxicity in a human [158]. |
| Kava kava (Piper methysticum) | Extract | Hepatotoxic in humans [61]. |
| Pennyroyal oil (Mentha pulegium and Hedeoma pulegioides) | Oil | Hepatotoxic in mice [159]. |
| Oil | Hepatotoxic in humans [160,161,162]. | |
| (R)-(+)-pulegone | CYP2E1/1A2-dependent hepatotoxicity in mice [163]. | |
| Pulegone, menthol | Hepatotoxic in mice [164]. | |
| Menthone | Hepatotoxic in rats [165,166]. | |
| Pulegone, menthol | Hepatotoxic in rats [164,167]. | |
| Gardenia (Fructus gardenia) | Extract (30% geniposide) | Hepatotoxic in rats [91]. |
| Geniposide | Hepatotoxic in rats [92]. | |
| Extract | Hepatotoxic in rats [92]. | |
| Garlic (Allium sativum) | Homogenate | Hepatotoxic in rats [144,145]. |
| Found in multiple species of plants | Monocrotaline | CYP3A4-dependent hepatotoxicity in mice [168]. |
| Dehydromonocrotaline, dehydrorectronecine | Toxic to human hepatoma cell lines [168,169]. | |
| Garcinia cambogia | Extract | Hepatotoxic to humans [170]. |
| Mistletoe (Viscum coloratum) | Extract | Hepatotoxic to humans [171]. |