| ISSN |
1948-5182 (online) |
| Open Access |
This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
| Copyright |
© The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. |
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| Permissions |
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| Publisher |
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA |
| Website |
http://www.wjgnet.com |
| Category |
Gastroenterology & Hepatology |
| Manuscript Type |
Minireviews |
| Article Title |
Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs
|
| Manuscript Source |
Invited Manuscript |
| All Author List |
Cyriac Abby Philips, Rizwan Ahamed, Sasidharan Rajesh, Tom George, Meera Mohanan and Philip Augustine |
| Funding Agency and Grant Number |
|
| Corresponding Author |
Cyriac Abby Philips, MD, Research Scientist, the Liver Unit and Monarch, Cochin Gastroenterology Group, Ernakulam Medical Center, 10th Floor, E.M.C Hospital, NH-Bypass, Palarivattom, Kochi 682028, Kerala, India. abbyphilips@gmail.com |
| Key Words |
Ayurveda; Complementary and alternative medicines; Drug induced liver injury; Herb induced liver injury; Chronic liver disease; AYUSH system |
| Core Tip |
Ayurvedic herbal medications (AHM) can cause liver injury ranging from asymptomatic elevation of liver enzymes to cirrhosis and portal hypertension. Patients who develop AHM related liver injury have history of consumption of complex polyherbal formulations. In most cases, the identification of the offending hepatotoxic agent is difficult due to the number and complexity of herbs involved. However, multiple observational studies, quality case series, and well-performed case studies have demonstrated the hepatotoxic potential associated with certain herbs used in Ayurvedic practice. The commonly utilized and over the counter available Indian herbs or their extracts, such as Ashwagandha, Aloe vera, Guggul, Puncture vine, Turmeric, Gotu-kola, Bakuchi, Senna, Noni, Malabar tamarind, and Gurmar have been associated with various types of liver injury ranging from acute self-limiting hepatitis, chronic hepatitis, prolonged cholestasis, hepatic sinusoidal obstruction syndrome, cirrhosis, and portal hypertension and can present clinically as acute severe liver injury, acute liver failure, acute decompensation of cirrhosis or acute on chronic liver failure. Physician knowledge regarding regional and local complementary and alternative practices among the general and patient population is essential in identifying those who develop complications of liver disease secondary to herbal hepatotoxicity, to make optimal treatment decisions, and for early prognostication. |
| Publish Date |
2020-09-21 16:02 |
| Citation |
Philips CA, Ahamed R, Rajesh S, George T, Mohanan M, Augustine P. Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs. World J Hepatol 2020; 12(9): 574-595 |
| URL |
https://www.wjgnet.com/1948-5182/full/v12/i9/574.htm |
| DOI |
https://dx.doi.org/ 10.4254/wjh.v12.i9.574 |
