Severe hepatotoxicity by Indian Ayurvedic herbal products: A structured causality assessment

Rare hepatotoxicity has been ascribed to drugs and dietary supplements (DDS), but a vigorous causality evaluation using a quantitative approach has not always been performed.1-6 Causality assessment is crucial in face of incomplete documentation of cases; the failure of exclusion of other causes for the observed liver disease; and the co-medication with other chemically defined drugs as well as dietary supplements.3-6 We present a well documented case of a female patient with toxic liver disease in temporal and causal relationship with the use of various Indian Ayurvedic herbal products as treatment for vitiligo. " "#