Finally, research published in the British Journal of Clinical Pharmacology in 2020, suggested that ginseng may inhibit various cytochromes, which are involved in the metabolism of drugs.

The problem with these remedies appears to be that they form toxic metabolites that damage live cells when ingested.

As a result, the liver can become so badly damaged that it ceases to function, which causes liver failure in some cases.

The authors concluded their report with the statement: "A diagnosis of herbal supplement-induced liver injury requires an effective inquiry into any herbs or supplements a patient may be taking, patients may be hesitant to provide this information.

"It is imperative for clinicians to familiarise themselves with herbal supplements to better inquire about their use with patients and educate them on potential side effects."

The patient was using a herbal tea with known hepatotoxic ingredients and had definitive improvement after cessation of use. 

 

"This [...] shows the value of further inquiry into supplement use once common causes of acute liver injury are ruled out," added the authors.

As a rule of thumb, WebMD suggests practising caution when using supplements that contain the following ingredients:

  • Aloe vera
  • Black cohosh
  • Cascara
  • Chaparral
  • Comfrey
  • Ephedra
  • Kava.

Patients using other medications should always speak to a healthcare provider before starting a new dietary regimen that includes vitamins and supplements.