Liver injury induced by herbal complementary and alternative medicine

Clin Liver Dis. 2013 Nov;17(4):715-35, x. doi: 10.1016/j.cld.2013.07.006. Epub 2013 Sep 4.


Herbal and dietary supplement use is common. Most marketed products consist of complex mixtures. Although they are perceived as safe, instances of hepatotoxicity attributable to these products underscore their potential for injury, but the exact component that is responsible for injury is difficult to discern. The lenient regulatory environment in the United States, which opens the possibility of adulteration and contamination, adds to the challenge of disease attribution. Although many different herbal and dietary supplements have been reported to cause liver injury, in the United States, products used for bodybuilding and weight loss are the most commonly implicated.

Keywords: Causality assessment; Dietary supplements; Hepatotoxicity; Herbal; Regulatory.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Chemical and Drug Induced Liver Injury / etiology*
  • Complementary Therapies / adverse effects*
  • Dietary Supplements / adverse effects*
  • Humans
  • Plant Preparations / adverse effects*
  • United States


  • Plant Preparations