Severe hepatotoxicity by Indian Ayurvedic herbal products: a structured causality assessment.

The case of a 64 year old female patient is presented who has treated herself for 9 months with various Indian Ayurvedic herbal products for her vitiligo and experienced a causally related severe hepatotoxicity (ALT, 601 U/L; AST, 663 U/L; Bilirubin, 5.0 mg/dL). After discontinuation, a rapid improvement was observed.

Suspected black cohosh hepatotoxicity--challenges and pitfalls of causality assessment.

Objectives: Black cohosh (BC) is a herbal drug or herbal dietary supplement used for treatment of menopausal symptoms. Recently, however, reports have appeared about the occurrence of rare toxic liver disease in an assumed relationship with the use of BC.

Methods: We have analyzed and reviewed the data of all 69 reported cases with suspected BC hepatotoxicity.

Black cohosh hepatotoxicity: quantitative causality evaluation in nine suspected cases.

Objective: Black cohosh (BC), synonym for Actaea racemosa and Cimicifuga racemosa, is a herbal remedy for the treatment of menopausal symptoms. Recently, worldwide discussions have emerged as to whether its use maybe associated with the risk of rare hepatotoxicity in a few susceptible women.

Methods: We have evaluated the causal relationship in nine cases with suspected hepatotoxicity by the use of BC.