Herbal Hepatotoxicity

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Abstract
So-called alternative, nontraditional, or unconventional medicine is widely used in the United States, and unconventional remedies are consumed by a large proportion of the population.1Nutritional supplements and herbal compounds are heavily promoted and often readily available in pharmacies, supermarkets, health food stores, and offices of ethnic herbalists. Advertising in lay nutrition, health, and bodybuilding magazines, as well as word of mouth, also promotes consumption of these products. Since many of these preparations are derived from botanical species, they are considered safe. However, these herbal products, in the form of teas, powders, tablets, and capsules, are not regulated by federal or state agencies, and neither safety nor efficacy studies have been performed. The report by Gordon et al2in this issue ofTHE JOURNALis a striking reminder that some of these unregulated products are potent hepatotoxins. Fulminant hepatic failure resulting from the ingestion of chaparral highlights the

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