Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury
Lubarska M, Hałasiński P, Hryhorowicz S, Mahadea DS, Łykowska-Szuber L, Eder P, Dobrowolska A, Krela-Kaźmierczak I
International journal of environmental research and public health · 27 citations
How it was studied
- Design
- Case report (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
Based on full-text disclosure statement.
Publication
- Published
- 2023-02-22 · Int J Environ Res Public Health · vol. 20 · issue 5 · p. 3921
- Publisher
- Multidisciplinary Digital Publishing Institute
- Cited
- 45 citations · more than 99% of similar papers · 14.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 42 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Phytochemicals and Medicinal Plants · Complementary and Alternative Medicine Studies · Drug-Induced Hepatotoxicity and Protection
- Keywords
- Medicine, Liver injury, Jaundice, Aspartate transaminase, Alanine transaminase, Bilirubin, Cholestasis, Liver function tests, Alkaline phosphatase, Internal medicine, Gastroenterology, Toxic hepatitis, Transaminase, Urine, Cirrhosis, Urinalysis, Physiology, Hepatitis, Biology, Biochemistry, Enzyme
- MeSH
- liver, humans, liver diseases, jaundice, alanine transaminase, aspartate aminotransferases, plant extracts, male, chemical and drug induced liver injury, chemical and drug induced liver injury, chronic
8 authors
From PL
- Marta LubarskaPoznan University of Medical Sciences
- Przemysław HałasińskiPoznan University of Medical Sciences
- Szymon Hryhorowicz · correspondingInstitute of Human Genetics; Polish Academy of Sciences
- Dagmara MahadeaPoznan University of Medical Sciences
- Liliana Łykowska‐SzuberPoznan University of Medical Sciences
- Piotr EderPoznan University of Medical Sciences
Abstract
In recent years, cases of liver damage caused by ashwagandha herbal supplements have been reported from different parts of the world (Japan, Iceland, India, and the USA). Here, we describe the clinical phenotype of suspected ashwagandha-induced liver injury and the potential causative mechanism. The patient was admitted to the hospital because of jaundice. In the interview, it was reported that he had been taking ashwagandha for a year. Laboratory results showed an increase in total bilirubin, alanine transaminase (ALT), aspartate transaminase (AST), (gamma-glutamyl transpherase (GGT), alkaline phosphatase (ALP), total cholesterol, triglycerides, and ferritin. Based on clinical symptoms and additional tests, the patient was diagnosed with acute hepatitis and referred to a facility with a higher reference rate to exclude drug-induced liver injury. An R-value was assessed, indicative of hepatocellular injury. The result of the 24 h urine collection exceeded the upper limit of normal for copper excretion in urine twice. The clinical condition improved after intensive pharmacological treatment and four plasmapheresis treatments. This case is another showing the hepatotoxic potential of ashwagandha to cause cholestatic liver damage mixed with severe jaundice. In view of several documented cases of liver damage caused by ashwagandha and the unknown metabolic molecular mechanisms of substances contained in it, attention should be paid to patients reporting the use of these products in the past and presenting symptoms of liver damage.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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