Table 1.
Herbs and Associated Liver Injury
| HDS | Nature of Liver Injury |
|---|---|
| Atractylis gummifera | Diffuse hepatic necrosis |
| Black cohosh | Elevated liver tests, liver failure |
| Camphor | Elevated liver tests, Reye syndrome |
| Cascara | Bridging fibrosis, bile duct proliferation |
| Chaparral | Cholestasis, zone 3 necrosis |
| Chaso (and onshido) | Elevated liver tests, liver failure |
| Greater celandine | Cholestasis |
| Germander | Zone 3 necrosis, cirrhosis |
| Green tea extracts | Acute hepatitis, hepatocellular injury |
| Impila | Hepatic necrosis |
| Ju bu huan | periportal fibrosis, steatosis |
| Kava | Elevated liver tests, liver failure |
| Ma huang | Elevated liver tests, liver necrosis |
| Mistletoe (skullcap, valerian) | Elevated liver tests, acute hepatitis |
| OxyElite Pro (aegeline) | Acute hepatitis, liver failure |
| Noni juice | Acute hepatitis, liver failure |
| Pennyroyal | Acute hepatitis, liver failure |
| Pyrrolizidine (comfrey, mate, bush tea) | Veno‐occlusive disease |
| Sho‐saiko‐to (dai‐saiko‐to, TJ‐9) | Bridging fibrosis, steatosis |
This table has been adapted and modified from Zakim and Boyer.1