Herbal Hepatotoxicity

  • Chit Shing Jackson Woo
  • Hani El-NezamiEmail author


The liver is probably the most important organ responsible for protecting humans from exposure to foreign compounds. With its strategic location between the intestinal tract and the circulation system, and its unique metabolic capacity, the liver acts as the first defense barrier metabolizing and detoxifying foreign compounds. In contrast, these features have rendered it highly susceptible to adverse and toxic effects. The current herbalism all over the globe has led to the increasing consumption of herbal products with an associated incidence of herbal hepatotoxicity. Herbal hepatotoxicity has been a well-recognized issue for years, but so far systematic studies are lacking. This chapter presents the current situation of liver damage induced by herbal products, the classification of herb-induced liver injuries (HILI), and their potential risk factors. The hepatotoxicity of selected well-known herbal products as reported in the literature is reviewed, and causality assessment for HILI is discussed.


Herbal hepatotoxicity Herb-induced liver injury Herbal medicine Herbs Herbal remedy 



Adenosine diphosphate


Adverse drug reaction


Atractylis gummifera


Adenosine triphosphate




Complementary and alternative medicine


Causality assessment tool


Council for the International Organization of Medical Sciences




Cytochrome P


Drug-induced liver injury


Drug-Induced Liver Injury Network


Epstein-Barr virus




Food and Drug Administration


Hepatitis A virus


Hepatitis B virus


Hepatitis C virus


Herbal and dietary supplements


Herb-induced liver injury


Herpes simplex virus

MV Scale

Maria and Victorino Scale


Nordihydroguaiaretic acid


Pyrrolizidine alkaloids




Roussel Uclaf Causality Assessment Method


Tumor necrosis factor


Vesicular stomatitis virus


World Health Organization


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© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Consumer and RetailSGS Hong Kong LimitedFanlingHong Kong
  2. 2.School of Biological Sciences, Faculty of ScienceThe University of Hong KongPokfulamHong Kong

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