Hepatotoxicity and Nephrotoxicity of Widely Used Medicinal Herbs: A Critical Appraisal of Safety Evidence Against the Assumption That “Natural” Means Safe
DOI:
https://doi.org/10.61280/89qdmp44Keywords:
Herbal hepatotoxicity, Herb-induced liver injury, Nephrotoxicity, Aristolochic acid, Medicinal Plants, Pharmacovigilance, Herb–drug interaction, Quality controlAbstract
Herbal medicines are used by a large share of the world’s population. Many people believe these medicines are safe because they come from plants.. The published literature has not kept up with this belief. There are studies on the effectiveness of medicinal plants.. Data on safety especially for the liver and kidneys are not easy to find. They are spread out across case reports, pharmacovigilance systems and a few registry studies. These data are rarely gathered in a way.This narrative review looks at the evidence on liver and kidney damage linked to used herbal medicines. It tests the idea that "natural" means safe. The review includes literature from databases. The evidence was graded based on study type, causality assessment and biological plausibility.The review covers the patterns of liver injury caused by herbs. It discusses the ways herbs can harm the liver and kidneys. These include forming chemicals causing oxidative stress, damaging mitochondria, triggering immune reactions harming kidney tubules and damaging DNA. It also identifies herbs that have strong signals for harm. These include Aristolochia species, green tea extract, kava, turmeric, ashwagandha, Tinospora cordifolia, plants containing pyrrolizidine alkaloids and Garcinia cambogia.The review also looks at how problems like contamination, heavy metals and interactions with medicines make it harder to confirm cause and effect. Four key gaps stand out. First harms are often not reported in studies that look at effectiveness. Second many studies do not assess causality well. Third herbal products are not standardized. Fourth there is monitoring of kidney function.The review ends with advice for researchers, doctors and regulators. It stresses the need, for safety data better study methods and stronger oversight. The message is clear: just because something is natural does not mean it is safe.
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