Current Pharmacology Reports

, Volume 4, Issue 2, pp 120–131 | Cite as

Liver Injury from Herbs and “Dietary Supplements”: Highlights of a Literature Review from 2015 to 2017

  • Rolf Teschke
  • Axel Eickhoff
  • Albrecht Wolff
  • Tran Dang Xuan
Drug-induced Liver Injury (X Ma, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Drug-induced Liver Injury


Purpose of the Review

To present highlights of recent liver injury from herbs and “dietary supplements,” based on a literature review from 2015 to 2017.

Recent findings

Challenging are quality issues of herb and dietary supplements (HDS) products, influenced by the circadian clock system in plants that controls many important metabolic pathways including photosynthesis and molecular processes of gene expression. Important also is plant stress, caused by pathogen attacks, heavy UV radiation, draft, soil contamination by salts or heavy metals, involving oxidative stress through generation of free radicals including reactive oxygen species (ROS), damaging the plant’s integrity. Finally, expectations are high if physicians publish case reports of HDS liver injury using the Roussel Uclaf Causality Assessment Method (RUCAM), but intentional overscoring of causality gradings must be resisted. In critical situations, reevaluation of original case data was a good approach clarifying divergencies.


Plant stress impairs the quality of herbs, requiring better understanding of plant physiology, and clinical liver injury cases need better causality assessment using RUCAM.


Herb-induced liver injury Herbal and dietary supplement liver injury Herbal product quality Causality assessment RUCAM Roussel Uclaf Causality Assessment Method Plant physiology plant chronobiology 


Compliance with Ethical Standards

Conflict of Interest

The authors received no financial support for writing this commissioned manuscript. No conflicts of interest have been declared in relation to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Rolf Teschke
    • 1
  • Axel Eickhoff
    • 1
  • Albrecht Wolff
    • 2
  • Tran Dang Xuan
    • 3
  1. 1.Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Teaching Hospital of the Medical FacultyGoethe University Frankfurt/MainHanauGermany
  2. 2.Department of MedicineGeorg August University GöttingenGöttingenGermany
  3. 3.Division of Development Technology, Graduate School for International Development and Cooperation (IDEC)Hiroshima UniversityHigashi HiroshimaJapan

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