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Related Experiment Videos

Hepatotoxicity and complementary and alternative medicines.

Thomas D Schiano1

  • 1Division of Liver Diseases, Box 1633, One Gustave L. Levy Place, The Mount Sinai Medical Center, New York, NY 10029, USA. thomas.schiano@msnyuhealth.org

Clinics in Liver Disease
|July 26, 2003
PubMed
Summary

Many herbal medicines show promise for liver injury in lab studies but lack human trial evidence. Increased use of these alternative medicines, especially for chronic liver disease, carries risks of liver damage and requires better regulation and awareness.

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Area of Science:

  • Integrative Medicine
  • Hepatology
  • Pharmacology

Background:

  • Herbal medicines demonstrate in vitro antioxidant, antifibrotic, immunomodulatory, and antiviral activities potentially beneficial for liver injury.
  • Despite in vitro promise, herbal medicines have shown limited efficacy in human clinical trials for liver conditions.
  • Challenges in clinical trial design include poorly understood mechanisms of action, lack of manufacturing standardization, and complex ingredient profiles.

Purpose of the Study:

  • To review the current status of herbal medicines in treating liver injury.
  • To highlight the challenges in establishing efficacy and safety through clinical trials.
  • To emphasize the growing use and potential risks associated with complementary and alternative medicines in liver disease.

Main Methods:

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  • Review of existing literature on herbal medicines and liver injury.
  • Analysis of challenges in randomized controlled trial (RCT) design for herbal products.
  • Discussion of regulatory and manufacturing hurdles for complementary and alternative medicines.

Main Results:

  • Herbal medicines have not demonstrated consistent efficacy in human trials for liver disease.
  • The increasing popularity of these agents, particularly in chronic liver disease, is noted.
  • Significant hepatotoxicity, morbidity, and mortality have been associated with some herbal treatments.

Conclusions:

  • Standardized regulatory oversight and improved manufacturing processes are needed for herbal medicines.
  • Physicians and patients must be educated on the potential harms and drug interactions of commonly used natural products.
  • Increased public awareness regarding herb-drug interactions is crucial for patient safety.