Herb-induced liver injury, Covid-19, and You: Beware.

Herb-induced liver injury, Covid-19, and You: Beware.

Herb-induced liver injury is an underreported phenomenon in daily medical practice in resource-limited settings. Patients hardly discern information related to which herbs they might have used before their presenting complaints. Herbs, herbal medicines, and dietary supplements consumption have sky-rocketed during the ever-worsening Covid-19 pandemic in Uganda – and Africa at large. Mind you, three-quarters of the sub-Saharan population are reportedly using herb medications for the ‘cure’ of their diseases. There’s, therefore, a growing concern that clinicians may see a plethora of patients – those with and without Covid-19, presenting with signs and symptoms of liver damage due to the surge of herbs and herbal medication use. Today’s article highlights the basics you must know concerning herb-induced liver injury. Beware of what you use to take or even steam yourself. You may be on the list of those awaiting a liver transplant due to acute liver failure from the herbs you consumed.

The human liver is crucial to the body’s survival: it is the epicentre of metabolism – the breakdown and build-up of simple and complex molecules that the body continually requires. It is also where detoxification of toxins from food and drugs takes place. It’s, therefore, highly susceptible to injury from various sources.

Most liver diseases are subtly progressive. Many patients often inadvertently present late with chronic liver disease. Herbs and herbal medicine use cause herb-induced liver injury in a few susceptible individuals. However, those individuals may be you!

Herb-induced liver injury manifests in similitude with drug-induced liver injury – a widely acclaimed condition because clinicians almost always pinpoint the drug culprit. It isn’t the same with liver injury due to a herbal concoction. The patients hardly disclose such information. They may lie about it. Clinicians, unless inherently aware of the community practices, scarcely inquire about such. They, therefore, report herb-induced liver injury less often.


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Though self-limiting in many instances, herb-induced liver injury can culminate in fulminant hepatitis, chronic liver disease, acute liver failure, death, and liver transplantation.

Herbs and the herbal medication manufacturing process have vivid loopholes. It is never scientifically supervised. Often, manufacturers rely on a hunch – from their mentors who got the knowledge from their great grand relatives.

Herbs and herbal medications are arduous to recommend. None of them contains one active ingredient. They are, often, a concoction of plant species- shoots, leaves, roots, and flowers. Such constituents may turn out toxic during the production process. In many instances, their manufacture is so unhygienic that you feel sorry for the final unsuspecting consumer. No regulations exist. Those that do rarely undergo implementation.

Herbs and herbal medications may cause liver injury because many of them have unknown toxicity. Also, due to close similarity, it becomes easy to substitute a non-poisonous herb with a toxic one. Anecdotal reports show that herbalists may deliberately or unknowingly contaminate the herbal mixture with hepatotoxic non-herbal drugs like ibuprofen, pesticides, heavy metals, and chemicals to increase their potency. Furthermore, the toxic effect of a standard drug may potentiate due to unforeseen interaction with other drugs in the mixture. A wide array of herbs and herbal medications bear misidentification and mislabelling. It becomes easy to take a wrong concoction, and your liver pays the ultimate price.

In a nutshell, it’s prudent that you not only stop self-medicating but also shy away from the use of unauthorised herbs and herbal medications. None of them has ever undergone any clinical trial to ascertain the nature of the active ingredient and the specific disease it cures. It is especially imperative that you don’t follow the growing wave of panic among Ugandans perpetuated by the ever-worsening Covid-19 pandemic and complicated by the ignorant social media “clinicians.” Beware of what the herbs can do to your liver. It’s utterly expensive to treat acute or chronic liver disease.

For further information about the herb-induced liver injury, read Cecilia N A and Orish E O’s paper.

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