Unpredictable Adverse Reactions to Herbal Products

Colalto, Cristiano

doi:10.4172/2157-7609.1000e105

Cited by 4 publications

(6 citation statements)

References 24 publications

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“…In this context, some ethical issues might emerge. Although these products could essentially be considered a placebo (which is unethical), it is essential to protect patients from unnecessary exposure to substances unable to achieve the desired effect, but which instead bringing risk of sensitisation or adverse reaction (Colalto, ; Niggemann & Grüber, ). EBPG could prove the ideal tool for improving safety in prescription of herbal medicinal products by giving a description of the standardisation of the extract, posology, and other similar things.…”

Section: The Importance Of Considering Different‐users Experiencementioning

confidence: 99%

What phytotherapy needs: Evidence‐based guidelines for better clinical practice

Colalto¹

2017

Phytotherapy Research

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In recent decades, the pharmacological properties of numerous medicinal plants and opportunities in phytotherapy have been explored through research projects, reviews, and monographs. These studies confirm that medicinal plants offer new approaches to tackling diseases. However, improvement of phytotherapy in clinical practice relies on a number of critical factors. In particular, the studies are very heterogeneous, and results and their interpretation by healthcare workers vary greatly, so preventing consistency in clinical practice. There is therefore a lost opportunity to improve phytotherapy practice, because the work being done and the related systematic reviews cannot act as a body of data on which to base clear clinical recommendations. Approaches such as the Grading of Recommendations Assessment, Development and Evaluation or the Scottish Intercollegiate Guidelines Network methodology could easily help standardise the use of phytotherapy in clinical practice. In this context, evidence-based phytotherapy guidelines could offer new healthcare approaches to the treatment of diseases.

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Section: The Importance Of Considering Different‐users Experiencementioning

confidence: 99%

What phytotherapy needs: Evidence‐based guidelines for better clinical practice

Colalto¹

2017

Phytotherapy Research

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“…The general topic of liver injury due to herbal medicines is an important but neglected subject. For most herbs, HILI is a rare disease, occurring in a few susceptible individuals, and has characteristics similar to those of drug induced liver injury (DILI) [3,[28][29][30][31][32] as well as many other liver diseases unrelated to herbs and drugs [33][34][35]. In addition, diseases of other organs such as the gall bladder, bile ducts and pancreas may mimic symptoms of HILI and DILI [35].…”

Section: General Aspects and Quality Specifications Of Hilimentioning

confidence: 99%

“…Herbs are used either in their original forms as teas and food additives, or are manufactured into herbal products like herbal drugs and herbal supplements. Though, erroneously, herbs and herbal products were considered safe for a long time, there is now growing evidence that herbs may cause adverse reactions of variable severity involving numerous organs including the liver .…”

Section: Introductionmentioning

confidence: 99%

Herbal hepatotoxicity: a critical review

Teschke

Frenzel

Glass

et al. 2013

Brit J Clinical Pharma

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This review deals with herbal hepatotoxicity, identical to herb induced liver injury (HILI), and critically summarizes the pitfalls associated with the evaluation of assumed HILI cases. Analysis of the relevant publications reveals that several dozens of different herbs and herbal products have been implicated to cause toxic liver disease, but major quality issues limit the validity of causality attribution. In most of these reports, discussions around quality specifications regarding herbal products, case data presentations and causality assessment methods prevail. Though the production of herbal drugs is under regulatory surveillance and quality aspects are normally not a matter of concern, low quality of the less regulated herbal supplements may be a critical issue considering product batch variability, impurities, adulterants and herb misidentifications. Regarding case data presentation, essential diagnostic information is often lacking, as is the use of valid and liver specific causality assessment methods that also consider alternative diseases. At present, causality is best assessed by using the Council for International Organizations of Medical Sciences scale ( CIOMS) in its original or updated form, which should primarily be applied prospectively by the treating physician when evaluating a patient rather than retrospectively by regulatory agencies. To cope with these problems, a common quality approach by manufacturers, physicians and regulatory agencies should strive for the best quality. We propose steps for improvements with impact on future cases of liver injury by herbs, herbal drugs and herbal supplements.

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“…The augmented liver injury was accompanied by fibrotic change, possibly through activation of ␣-SMA-positive matrixproducing cells. Herbs are generally thought safe in the past, but now there is growing evidence that they might cause adverse effects on health [31][32][33][34]. Because of their hundreds of chemical components, they have unpredictable levels of active ingredients and potentially harmful effects [35].…”

Section: Discussionmentioning

confidence: 99%