ArticleInternational journal of environmental research and public health2023
Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury.
Article in International journal of environmental research and public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 34 citations in OpenAlex.
- Heavy metals and pesticides in medicinal plants: environmental sources, plant responses, and human health risk assessment.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2026Review
- Spontaneous Reports of Suspected Adverse Reactions to Ashwagandha: Analysis of Data From the Italian Nutrivigilance System.Phytotherapy research : PTR · 2026Article
- Potential Adverse Effects of Ashwagandha: A Critical Review of Preclinical and Clinical Evidence.Phytotherapy research : PTR · 2026Review
- Evaluating the Safety of Ashwagandha as a Food Additive: A Focus on Reproductive, Thyroid, and Immune System Effects.Phytotherapy research : PTR · 2026Review
- Ashwagandha: Is It Safe? Part 2: A Preclinical Evidence Review.Phytotherapy research : PTR · 2026Review
- Nutraceutical Applications ofFoods (Basel, Switzerland) · 2026Review
- Review
- The Clinical Implications of Ashwagandha (Nutrients · 2026Review
- Vanished Without a Trace: A Middle-Aged Man With Vanishing Bile Duct Syndrome-A Case Report.Case reports in gastrointestinal medicine · 2026Article
- Ashwagandha-Induced Herb-Induced Liver Injury Assessed With the Updated 2016 RUCAM.Case reports in hepatology · 2026Article
- A multi-detector analytical approach for characterizing complex botanical extracts: a case study on ashwagandha.Analytical and bioanalytical chemistry · 2025Article
- Etiopathogenic and Therapeutic Considerations in a Multiple Sclerosis Case with Acute Toxic Hepatitis.Reports (MDPI) · 2025Article
- Developing an approach for evaluating the cardiotoxic potential of botanicals.Frontiers in toxicology · 2025Review
- Ashwagandha (Journal of dietary supplements · 2025Article
- Extraction of Bioactive Compounds FromInternational journal of food science · 2025Review
- Article
- Screening tools to evaluate the neurotoxic potential of botanicals: building a strategy to assess safety.Expert opinion on drug metabolism & toxicology · 2024Review
- Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM: An Emerging Cause.Pharmaceuticals (Basel, Switzerland) · 2023Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In recent years, cases of liver damage caused by ashwagandha herbal supplements have been reported from different parts of the world (Japan, Iceland, India, and the USA). Here, we describe the clinical phenotype of suspected ashwagandha-induced liver injury and the potential causative mechanism. The patient was admitted to the hospital because of jaundice. In the interview, it was reported that he had been taking ashwagandha for a year. Laboratory results showed an increase in total bilirubin, alanine transaminase (ALT), aspartate transaminase (AST), (gamma-glutamyl transpherase (GGT), alkaline phosphatase (ALP), total cholesterol, triglycerides, and ferritin. Based on clinical symptoms and additional tests, the patient was diagnosed with acute hepatitis and referred to a facility with a higher reference rate to exclude drug-induced liver injury. An R-value was assessed, indicative of hepatocellular injury. The result of the 24 h urine collection exceeded the upper limit of normal for copper excretion in urine twice. The clinical condition improved after intensive pharmacological treatment and four plasmapheresis treatments. This case is another showing the hepatotoxic potential of ashwagandha to cause cholestatic liver damage mixed with severe jaundice. In view of several documented cases of liver damage caused by ashwagandha and the unknown metabolic molecular mechanisms of substances contained in it, attention should be paid to patients reporting the use of these products in the past and presenting symptoms of liver damage.
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