Abstract
Background
There is a growing trend towards seeking natural supplements to “boost” the body even in the absence of illnesses. One such trend is the use of “liver cleanses” which claim to detoxify the liver. These products are available over the counter and majority of them have not been tested, approved or regulated by authorities. There is no proof of their effectiveness and in fact, they may be harmful to the body.
Aims
We present a case of fulminant hepatitis induced by Himalaya Herbal Healthcare LiverCare, a proprietary formula of unknown herbs, promoted as “a herbal supplement that promotes detox and normal liver enzyme levels, with antioxidant properties that support liver cell integrity” .
Methods
A previously healthy 54 year old woman presented to her family doctor with progressive jaundice, generalized itching and dark urine along with dyspepsia. She was found to have transaminitis and synthetic liver dysfunction. There was no travel history or infectious symptoms. The only medication she was taking was a “liver cleanse” (Himalaya Herbal Healthcare LiverCare Himalaya LiverCare and Himalaya Triphala) prescribed by her naturopath one yearfew weeks prio agor for unclear indications. A liver biopsy showed submassive necrosis and fulminant hepatitis in keeping with drug induced liver injury (DILI) most likely due to the liver cleanse. The liver cleanse was stopped and her clinical symptoms and liver function tests improved .but A year later she developed drug induced auto-immune hepatitis and one year later cirrhosis. She was put on transplant list. While waiting for her transplant, she continued to take the patient continued to take other unidentified herbal medications recommended by her naturopath, including some for “adrenal fatigue” for the liver and was found to. develop auto-immune hepatitis Sand liver cirrhosis of which she ultimately passed awaydied two years after initial biopsy.
Results
N/A
Conclusions
This case highlights the importance of considering herbal supplements in the differential for fulminant hepatitis, and drug-induced autoimmune hepatitis and cirrhosis while actively seeking a history of use from patients. It raises concerns about certain liver cleanses causing hepatotoxicity rather than detoxifying the liver as they claim and calls for better public education and controlled trials to evaluate and regulate such natural products.
Funding Agencies
None