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Herbal and dietary supplement hepatotoxicity.

Abstract

Herbal and dietary supplements (HDS) are commonly used in the United States and throughout the world. The Dietary Supplement Health and Education Act and public standards set through the U.S. Pharmacopeia provide regulatory framework for these products. These regulations help to ensure the safety of grandfathered and new HDS coming onto the market, and the opportunity to identify and take action against unsafe products that have been distributed. The clinical patterns of presentation and severity of HDS-associated hepatotoxicity can be highly variable, even for the same product. In addition, accurate causality assessment in cases of suspected HDS hepatotoxicity is confounded by infrequent ascertainment of product intake by healthcare providers, under-reporting of HDS use by patients, the ubiquity of HDS and the complexity of their components, and the possibility for product adulteration. Additional measures to prevent HDS-induced hepatotoxicity include greater consumer and provider awareness, increased spontaneous reporting, and reassessment of regulations regarding the manufacturing, distribution, and marketing of these products.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. victor.navarro@jefferson.edu

    Source

    Seminars in liver disease 29:4 2009 Nov pg 373-82

    MeSH

    Adverse Drug Reaction Reporting Systems
    Chemical and Drug Induced Liver Injury
    Consumer Product Safety
    Dietary Supplements
    Drug Approval
    Government Regulation
    Humans
    Pharmacopoeias as Topic
    Plant Preparations
    Risk Assessment
    Risk Factors
    Severity of Illness Index
    United States

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19826971

    Citation

    Navarro, Victor J.. "Herbal and Dietary Supplement Hepatotoxicity." Seminars in Liver Disease, vol. 29, no. 4, 2009, pp. 373-82.
    Navarro VJ. Herbal and dietary supplement hepatotoxicity. Semin Liver Dis. 2009;29(4):373-82.
    Navarro, V. J. (2009). Herbal and dietary supplement hepatotoxicity. Seminars in Liver Disease, 29(4), pp. 373-82. doi:10.1055/s-0029-1240006.
    Navarro VJ. Herbal and Dietary Supplement Hepatotoxicity. Semin Liver Dis. 2009;29(4):373-82. PubMed PMID: 19826971.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Herbal and dietary supplement hepatotoxicity. A1 - Navarro,Victor J, Y1 - 2009/10/13/ PY - 2009/10/15/entrez PY - 2009/10/15/pubmed PY - 2009/12/18/medline SP - 373 EP - 82 JF - Seminars in liver disease JO - Semin. Liver Dis. VL - 29 IS - 4 N2 - Herbal and dietary supplements (HDS) are commonly used in the United States and throughout the world. The Dietary Supplement Health and Education Act and public standards set through the U.S. Pharmacopeia provide regulatory framework for these products. These regulations help to ensure the safety of grandfathered and new HDS coming onto the market, and the opportunity to identify and take action against unsafe products that have been distributed. The clinical patterns of presentation and severity of HDS-associated hepatotoxicity can be highly variable, even for the same product. In addition, accurate causality assessment in cases of suspected HDS hepatotoxicity is confounded by infrequent ascertainment of product intake by healthcare providers, under-reporting of HDS use by patients, the ubiquity of HDS and the complexity of their components, and the possibility for product adulteration. Additional measures to prevent HDS-induced hepatotoxicity include greater consumer and provider awareness, increased spontaneous reporting, and reassessment of regulations regarding the manufacturing, distribution, and marketing of these products. SN - 1098-8971 UR - https://www.unboundmedicine.com/medline/citation/19826971/Herbal_and_dietary_supplement_hepatotoxicity_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1240006 DB - PRIME DP - Unbound Medicine ER -