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Chaparral-associated hepatotoxicity

N M Sheikh¹, R M Philen, L A Love

¹Center for Food Safety and Applied Nutrition, Food and Drug Administration, Washington, DC, USA.

Archives of Internal Medicine

|April 28, 1997

Summary

This summary is machine-generated.

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Chaparral, a botanical dietary supplement, may cause severe liver damage, including irreversible injury and liver failure. Healthcare providers should monitor for adverse effects and report them.

Area of Science:

Hepatology
Toxicology
Integrative Medicine

Background:

Dietary supplements, including botanicals like chaparral (Larrea tridentata), are widely used for health purposes.
Chaparral is recognized for its antioxidant properties but has been linked to liver injury since 1990.
The full clinical spectrum of chaparral-associated hepatitis remains incompletely understood.

Purpose of the Study:

To investigate the clinical presentation and outcomes of adverse events linked to chaparral ingestion.
To assess the potential for chaparral to cause significant liver damage.

Main Methods:

A review of 18 case reports submitted to the Food and Drug Administration (FDA) between 1992 and 1994.
Data sources included reports from healthcare professionals, state health departments, and consumers.

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Main Results:

Hepatotoxicity was evident in 13 of the 18 reported cases.
Liver injury manifested as jaundice and elevated liver enzymes 3–52 weeks post-ingestion, resolving after cessation.
The pattern was predominantly toxic or drug-induced cholestatic hepatitis, with 4 cases progressing to cirrhosis and 2 to acute liver failure requiring transplantation.

Conclusions:

Chaparral use is associated with potential for acute to chronic, irreversible liver damage, including fulminant hepatic failure.
This highlights the risk of toxic effects from certain dietary supplement ingredients.
Healthcare professionals should routinely inquire about supplement use, monitor for adverse effects, and report serious events via FDA's MEDWatch Program.