The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.
Liver injury from herbal and dietary supplements
Open accessAbstract
Herbal and dietary supplements (HDS) are used increasingly both in the United States and worldwide, and HDS-induced liver injury in the United States has increased proportionally. Current challenges in the diagnosis and management of HDS-induced liver injury were the focus of a 2-day research symposium sponsored by the American Association for the Study of Liver Disease and the National Institutes of Health. HDS-induced liver injury now accounts for 20% of cases of hepatotoxicity in the United States based on research data. The major implicated agents include anabolic steroids, green tea extract, and multi-ingredient nutritional supplements. Anabolic steroids marketed as bodybuilding supplements typically induce a prolonged cholestatic but ultimately self-limiting liver injury that has a distinctive serum biochemical as well as histological phenotype. Green tea extract and many other products, in contrast, tend to cause an acute hepatitis-like injury. Currently, however, the majority of cases of HDS-associated liver injury are due to multi-ingredient nutritional supplements, and the component responsible for the toxicity is usually unknown or can only be suspected. HDS-induced liver injury presents many clinical and research challenges in diagnosis, identification of the responsible constituents, treatment, and prevention. Also important are improvements in regulatory oversight of nonprescription products to guarantee their constituents and ensure purity and safety. The confident identification of injurious ingredients within HDS will require strategic alignments among clinicians, chemists, and toxicologists. The ultimate goal should be to prohibit or more closely regulate potentially injurious ingredients and thus promote public safety. (Hepatology 2017;65:363-373).
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Björnsson, E. S., Bergmann, O. M., Björnsson, H. K., Kvaran, R. B., & Olafsson, S. (2013) · Gastroenterology · doi:10.1053/j.gastro.2013.02.006 · Cited by 865
Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network
Navarro, V. J., Barnhart, H., Bonkovsky, H. L., Davern, T., Fontana, R. J., Grant, L., Reddy, R. K., Seeff, L. B., Serrano, J., Sherker, A. H., et al. (2014) · Hepatology · doi:10.1002/hep.27317 · Cited by 418 · cited 3×
“(8) The majority of agents implicated were complex mixtures sold under commercial names.”
InfluentialSelf-citation
Cited by
EASL Clinical Practice Guidelines: Drug-induced liver injury
Andrade, R. J., Aithal, G. P., Björnsson, E. S., Kaplowitz, N., Kullak-Ublick, G. A., Larrey, D., & Karlsen, T. H. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2019.02.014 · Cited by 1,276
Andrade, R. J., Chalasani, N., Björnsson, E. S., Suzuki, A., Kullak-Ublick, G. A., Watkins, P. B., Devarbhavi, H., Merz, M., Lucena, M. I., Kaplowitz, N., et al. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0105-0 · Cited by 924
Drug-induced liver injury—types and phenotypes
Hoofnagle, J. H., & Björnsson, E. S. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1816149 · Cited by 652
Self-citationDysregulated Microbial Fermentation of Soluble Fiber Induces Cholestatic Liver Cancer
Singh, V., Yeoh, B. S., Chassaing, B., Xiao, X., Saha, P., Aguilera Olvera, R., Lapek, J. D., Zhang, L., Wang, W.-B., Hao, S., et al. (2018) · Cell · doi:10.1016/j.cell.2018.09.004 · Cited by 532
ACG Clinical Guideline: Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury
Chalasani, N. P., Maddur, H., Russo, M. W., Wong, R. J., Reddy, K. R., & on behalf of the Practice Parameters Committee of the American College of Gastroenterology (2021) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001259 · Cited by 430
Drug-induced liver injury: Pathogenesis, epidemiology, clinical features, and practical management
Björnsson, H., & Björnsson, E. (2022) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2021.10.035 · Cited by 212
Self-citationDrug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines
Devarbhavi, H., Aithal, G., Treeprasertsuk, S., Takikawa, H., Mao, Y., Shasthry, S. M., Hamid, S., Tan, S. S., Philips, C. A., George, J., et al. (2021) · Hepatology International · doi:10.1007/s12072-021-10144-3 · Cited by 181
Teschke, R., & Eickhoff, A. (2015) · Frontiers in Pharmacology · doi:10.3389/fphar.2015.00072 · Cited by 132
Halegoua-DeMarzio, D., Navarro, V., Ahmad, J., Avula, B., Barnhart, H., Barritt, A. S., Bonkovsky, H. L., Fontana, R. J., Ghabril, M. S., Hoofnagle, J. H., et al. (2023) · The American Journal of Medicine · doi:10.1016/j.amjmed.2022.09.026 · Cited by 119
Self-citationBjörnsson, H. K., Björnsson, E. S., Avula, B., Khan, I. A., Jonasson, J. G., Ghabril, M., Hayashi, P. H., & Navarro, V. (2020) · Liver International · doi:10.1111/liv.14393 · Cited by 125
“5 mg/dL, [2] moderate, with bilirubin ≥2.”
Self-citationHerbal and Dietary Supplement-Induced Liver Injuries in the Spanish DILI Registry
Medina-Caliz, I., Garcia-Cortes, M., Gonzalez-Jimenez, A., Cabello, M. R., Robles-Diaz, M., Sanabria-Cabrera, J., Sanjuan-Jimenez, R., Ortega-Alonso, A., García-Muñoz, B., Moreno, I., et al. (2018) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2017.12.051 · Cited by 111
Drug-induced liver injury: Highlights of the recent literature
Real, M., Barnhill, M. S., Higley, C., Rosenberg, J., & Lewis, J. H. (2019) · Drug Safety · doi:10.1007/s40264-018-0743-2 · Cited by 103
HLA‐B*35:01 and Green Tea–Induced Liver Injury
Hoofnagle, J. H., Bonkovsky, H. L., Phillips, E. J., Li, Y., Ahmad, J., Barnhart, H., Durazo, F., Fontana, R. J., Gu, J., Khan, I., et al. (2021) · Hepatology · doi:10.1002/hep.31538 · Cited by 98
Self-citationBelardo, D., Michos, E. D., Blankstein, R., Blumenthal, R. S., Ferdinand, K. C., Hall, K., Klatt, K., Natajaran, P., Ostfeld, R. J., Reddy, K., et al. (2022) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2022.100323 · Cited by 90
Rani, J., Dhull, S. B., Rose, P. K., & Kidwai, M. K. (2024) · Phytomedicine · doi:10.1016/j.phymed.2023.155142 · Cited by 91
Siddiqui, S., Ahmed, N., Goswami, M., Chakrabarty, A., & Chowdhury, G. (2021) · Current Research in Toxicology · doi:10.1016/j.crtox.2021.02.002 · Cited by 63
Bessone, F., García-Cortés, M., Medina-Caliz, I., Hernandez, N., Parana, R., Mendizabal, M., Schinoni, M. I., Ridruejo, E., Nunes, V., Peralta, M., et al. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.01.011 · Cited by 60
Hepatic Damage by Natural Remedies
Medina-Caliz, I., Gonzalez-Jimenez, A., Garcia-Cortes, M., Lucena, M. I., & Andrade, R. (2018) · Seminars in Liver Disease · doi:10.1055/s-0038-1623518 · Cited by 40
Xiao, X., Tang, J., Mao, Y., Li, X., Wang, J., Liu, C., Sun, K., Ye, Y., Zou, Z., Peng, C., et al. (2019) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2018.12.003 · Cited by 30
Shahbaz, O., Mahajan, S., & Lewis, J. H. (2017) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2017.1362391 · Cited by 30
Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults
Likhitsup, A., Chen, V. L., & Fontana, R. J. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.25822 · Cited by 30
The development of a database for herbal and dietary supplement induced liver toxicity
Zhu, J., Seo, J.-E., Wang, S., Ashby, K., Ballard, R., Yu, D., Ning, B., Agarwal, R., Borlak, J., Tong, W., et al. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19102955 · Cited by 29
Nash, E., Sabih, A., Chetwood, J., Wood, G., Pandya, K., Yip, T., Majumdar, A., McCaughan, G. W., Strasser, S. I., & Liu, K. (2021) · Medical Journal of Australia · doi:10.5694/mja2.51173 · Cited by 28
Ashwagandha‐induced acute liver injury: A case report
Tóth, M., Benedek, A. E., Longerich, T., & Seitz, H. (2023) · Clinical Case Reports · doi:10.1002/ccr3.7078 · Cited by 24
Zhu, J., Chen, M., Borlak, J., & Tong, W. (2020) · Archives of Toxicology · doi:10.1007/s00204-019-02621-4 · Cited by 18
Huang, Y.-S., Chang, T.-T., Peng, C.-Y., Lo, G.-H., Hsu, C.-W., Hu, C.-T., & Huang, Y.-H. (2021) · Hepatology International · doi:10.1007/s12072-021-10241-3 · Cited by 17
Methods for causality assessment of idiosyncratic drug‐induced liver injury
García‐Cortés, M., Matilla‐Cabello, G., & Lucena, M. I. (2025) · Liver International · doi:10.1111/liv.16083 · Cited by 15
Teschke, R., Eickhoff, A., Wolff, A., & Xuan, T. D. (2018) · Current Pharmacology Reports · doi:10.1007/s40495-018-0124-7 · Cited by 14
Dissemond, J., Havers, T., Held, S., Geisler, S., Kostov, T., Diel, P., Türschmann, S., Parr, M. K., & Isenmann, E. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2540408 · Cited by 2
Metadata
- Authors
- Navarro, V. J., Khan, I., Björnsson, E., Seeff, L. B., Serrano, J., & Hoofnagle, J. H.
- Venue
- Hepatology
- Published
- 2017-01
- Volume
- 65
- Issue
- 1
- Pages
- 363-373
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2525477789
- Cited by
- 462
- References
- 2
- FWCI
- 40.73
- Type
- journal article
- Language
- en
- Open access
- green
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
