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Abstract
Medicinal herb-induced liver injury reported on the literature ranges from mild elevation of liver enzymes to fulminant liver failure and liver cirrhosis. Medicinal herbs are common ingredients of traditional Chinese herbs. The mechanisms of medicinal herb-induced liver injury are mainly intrinsic hepatotoxicity. In addition to the potential for hepatotoxicity, medicinal herbs frequently induce herb-drug interaction and herb-herb interaction and may affect its own efficacy and safety. Sometimes hepatotoxicity of medicinal herbs originates from the substances of illegal adulterations and contaminations rather than its own indigenous components. Moreover, individual susceptibility to toxic liver injury should be considered in every instance. Two fundamental problems exist in the management of medicinal herbs-induced liver injury. One is a problem on the verification of herbal medicinal prescriptions, because the details of the herbal prescriptions are not usually disclosed to the public in Korea. Another one is a nation-wide prevailed misconception asserting natural products such as medicinal herbs are not harmful.
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