לא רק כמותרפיה: גם תוספים עלולים להרוג

Jpn J Clin Oncol. 2006 Nov 14 An Alternative Medicine, Agaricus blazei, may have Induced Severe Hepatic Dysfunction in Cancer Patients. Mukai H, Watanabe T, Ando M, Katsumata N. 1 Division of Oncology/Hematology, National Cancer Center Hospital East, Kashiwa, Chiba. We report three cases of patients with advanced cancer who showed severe hepatic damage, AND two of whom died of fulminant hepatitis. All the patients were taking Agaricus blazei (Himematsutake) extract, one of the most popular complementary AND alternative medicines among Japanese cancer patients. In one patient, liver functions recovered gradually after she stopped taking the Agaricus blazei, but she restarted taking it, which resulted in deterioration of the liver function again. The other patients who were admitted for severe liver damage had started taking the Agaricus blazei several days before admission. Although several other factors cannot be completely ruled out as the causes of liver damage, a strong causal relationship between the Agaricus blazei extract AND liver damage was suggested and, at least, taking the Agaricus blazei extract made the clinical decision-making process much more complicated. Doctors who are aware of their patients taking the extract may accept it probably because they believe there is no harm in a complementary AND alternative medicine. When unexpected liver damage is documented, however, doctors should consider the use of the Agaricus blazei extract as one of its causal factors. It is necessary to evaluate many modes of complementary AND alternative medicines, including the Agaricus blazei extract, in rigorous, scientifically designed AND peer-reviewed clinical trials.

Z Gastroenterol. 2001 Mar;39(3):225-32, 234-7. [Liver toxicity of drugs of plant origin] Herbal drugs are widely used AND often contain highly active pharmacological compounds. Recently, reports have mounted about hepatotoxicity of herbal remedies which ranges from mild liver enzyme alterations to chronic liver disease AND liver failure. Hepatotoxicity of Chinese herbs has been recognized, e.g. during treatment of patients with atopic eczema. However, the toxic compounds remain to be determined. Hepatic veno-occlusive disease may result from pyrrolizidine alkaloids which are contained in numerous plants worldwide. Teucrium chamaedrys, commonly referred to as germander, may cause hepatitis AND even liver cirrhosis. Significant hepatotoxicity has also been observed after the ingestion of chaparral. Recently, greater celandine, which is widely used for biliary disorders AND dyspepsia, was identified as a cause of cholestatic hepatitis. Hepatotoxic reactions have also been observed after the ingestion of Atractylis gummifera, Callilepsis laureola, Senna, Kavapyrone AND Pulegium. The aim of this review is to summarize potentially hepatotoxic herbal remedies, to further elucidate their mechanisms of toxicity AND thereby underline the likelihood of plants to be the cause of liver damage. ********************************** Public Health Nutr. 2000 Jun;3(2):113-24. Hepatotoxicity of botanicals. OBJECTIVE: Hepatic impairment resulting from the use of conventional drugs is widely acknowledged, but there is less awareness of the potential hepatotoxicity of herbal preparations AND other botanicals, many of which are believed to be harmless AND are commonly used for self-medication without supervision. The aim of this paper is to examine the evidence for hepatotoxicity of botanicals AND draw conclusions regarding their pathology, safety AND applications. DESIGN: Current literature on the hepatotoxicity of herbal drugs AND other botanicals is reviewed. The aetiology, clinical picture AND treatment of mushroom (Amanita) poisoning are described. RESULTS: Hepatotoxic effects have been reported for some Chinese herbal medicines (such as Jin Bu Huan, Ma-Huang AND Sho-saiko-to), pyrrolizidine alkaloid-containing plants, germander (Teucrium chamaedrys), chaparral (Larrea tridentata), Atractylis gummifera, Callilepsis laureola, AND others. The frequency with which botanicals cause hepatic damage is unclear. There is a lack of controlled treatment trials AND the few studies published to date do not clarify the incidence of adverse effects. Many plant products do not seem to lead to toxic effects in everyone taking them, AND they commonly lack a strict dose-dependency. For some products, such as Sho-saiko-to, the picture is confused further by demonstrations of hepatoprotective properties for some components. Mushroom poisoning is mostly due to the accidental consumption of Amanita species. Treatment with silymarin, thioctic acid, penicillin AND liver transplantation have been shown to be effective but require early diagnosis. CONCLUSIONS: Severe liver injury, including acute AND chronic abnormalities AND even cirrhotic transformation AND liver failure, has been described after the ingestion of a wide range of herbal products AND other botanical ingredients, such as mushrooms. It is concluded that in certain situations herbal products may be just as harmful as conventional drugs.