Hepatotoxicity associated with herbal products

A significant number of herbal products have been associated with hepatotoxicity. Attribution of liver injury to a specific herbal product may be difficult. There are few clinical or laboratory manifestations that specifically suggest that liver injury is the result of a specific herbal. Compounding this difficulty is that the patient may have liver disease from another cause, may be consuming other potentially hepatotoxic products, or may be using a contaminated herbal product. The most important clue often is the temporal relationship between initiation of the herbal product and the appearance of liver injury; of equal importance is the resolution of the injury following withdrawal of the herbal product.