Table 3

Table 3 Herbal products with known hepatotoxicity
Herbal product10 11Intended useBiopsy findings
Chaparral leaf (creosote bush, Larrea tridentata),12 teas and capsulesAntimicrobial, anti-aging, skin conditionsAcute hepatitis, cholestasis, hepatocellular necrosis
Germander (Teucrium genus),13 14 teas and tabletsAntiseptic, antipyretic, abdominal ailments, obesityAcute hepatitis, centrizonal necrosis, rarely chronic liver disease with cirrhosis
Pennyroyal (Mentha pulegium, Hedeoma pulegioides),15 “squaw mint” oilEmmenagogue, abortifacient, anti-flea agent for petsCentrizonal necrosis
Glue thistle (Atractylis gummifera),16 found in Mediterranean region and North AfricaEmetic, diuretic, antipyreticCentrizonal necrosis, panacinar necrosis
Jin bu huan (Lycopodium serratum),17 marketed as anodyne tablets in 1990sSleeping aid, analgesicAcute hepatitis, chronic hepatitis, microvesicular steatosis
Kava (Piper methysticum)2 18Stress relief, anti-anxiety, sleeping aid, premenstrual syndromeAcute hepatitis, fulminant hepatitis
Mistletoe (Phoradendron and Viscum geni)19Digestive aid, heart tonic, sedativeAcute hepatitis