Germander
Germander as it relates to DILI in Health report: Genetics of Antibiotics-Induced Liver Injury
Germander and DILI
Germander has been linked to several cases of liver injury, with symptoms ranging from mild liver enzyme elevations to severe hepatitis and even acute liver failure. The mechanism by which germander causes liver injury is not fully understood, but it is believed to be related to the presence of furano diterpenoids in the plant.
Regulatory Actions
Due to the potential for liver injury, regulatory agencies in several countries have taken action to restrict the use of germander in dietary supplements and herbal products. In the United States, the Food and Drug Administration (FDA) issued a warning in 1994 advising consumers to avoid products containing germander.
Conclusion
While germander has been used for its medicinal properties for centuries, its association with liver injury highlights the importance of caution when using herbal remedies. Individuals should be aware of the potential risks associated with germander and consult with a healthcare provider before using products containing this herb.
Supplements for DILI
Here are some dietary supplements related to the content in this report. Click the shopping cart to purchase the supplement from our partners.
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Green tea extract
Contains catechins which may increase oxidative stress and liver cell damage when combined with hepatotoxic antibiotics.
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Greater celandine
Alkaloids like chelidonine may further impair liver function when the organ is under stress from antibiotics.
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Chaparral
Nordamnacanthal is a quinone that could synergistically increase antibiotic liver toxicity through mitochondrial dysfunction.
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Germander
Diterpenoids may amplify antibiotic liver injury by disrupting bile salt export and causing cholestasis.
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Mistletoe
Contains toxic lectins which could worsen immunological reactions or alter detox pathways of antibiotic metabolites.
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Skullcap
Flavonoids may inhibit pathways involved in hepatic metabolism and clearance of antibiotics from the liver.
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Valerian
Isovaltrate and other constituents thought to directly damage cell membranes, potentially worsening antibiotic hepatocellular toxicity.
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Kava kava
Kavalactones like desmethoxyyangonin may inhibit CYP450 liver enzymes important for antibiotic clearance.
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St. John's wort
Hyperforin alters PXR nuclear receptors and could decrease bile acid transport, contributing to antibiotic cholestasis.
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Ginseng
Ginsenosides may inhibit P-glycoprotein transporters important for antibiotic efflux from hepatocytes, allowing accumulation of toxic levels.
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Aloe vera
Anthraquinone glycosides possibly damage cell membranes and worsen antibiotic-mediated liver cell necrosis.
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Ashwagandha
Withanolides thought to cause oxidative stress which synergizes with redox-cycling antibiotic metabolites.
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Andrographis
Diterpene lactones may reduce bile acid secretion and flow, contributing to cholestatic injury.
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Noni juice
Anthraquinones could impair mitochondrial function and increase antibiotic hepatotoxicity.
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Peppermint oil
Menthol interferes with CYP450s and UGTs involved in antibiotic metabolism and clearance.
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Kratom
Mitragynine and 7-hydroxymitragynine are metabolized in liver and could enhance antibiotic toxicity.
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Ephedra
Ephedrine alkaloids may deplete glutathione and reduce the liver's defense against antibiotic oxidative damage.
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