Germander

Germander as it relates to DILI in Health report: Genetics of Antibiotics-Induced Liver Injury

Germander (Teucrium chamaedrys) is a perennial herb that has been traditionally used for its medicinal properties. However, it has been associated with cases of drug-induced liver injury (DILI).

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.

  1. Green tea extract

    Contains catechins which may increase oxidative stress and liver cell damage when combined with hepatotoxic antibiotics.

  2. Greater celandine

    Alkaloids like chelidonine may further impair liver function when the organ is under stress from antibiotics.

  3. Chaparral

    Nordamnacanthal is a quinone that could synergistically increase antibiotic liver toxicity through mitochondrial dysfunction.

  4. Germander

    Diterpenoids may amplify antibiotic liver injury by disrupting bile salt export and causing cholestasis.

  5. Mistletoe

    Contains toxic lectins which could worsen immunological reactions or alter detox pathways of antibiotic metabolites.

  6. Skullcap

    Flavonoids may inhibit pathways involved in hepatic metabolism and clearance of antibiotics from the liver.

  7. Valerian

    Isovaltrate and other constituents thought to directly damage cell membranes, potentially worsening antibiotic hepatocellular toxicity.

  8. Kava kava

    Kavalactones like desmethoxyyangonin may inhibit CYP450 liver enzymes important for antibiotic clearance.

  9. St. John's wort

    Hyperforin alters PXR nuclear receptors and could decrease bile acid transport, contributing to antibiotic cholestasis.

  10. Ginseng

    Ginsenosides may inhibit P-glycoprotein transporters important for antibiotic efflux from hepatocytes, allowing accumulation of toxic levels.

  11. Aloe vera

    Anthraquinone glycosides possibly damage cell membranes and worsen antibiotic-mediated liver cell necrosis.

  12. Ashwagandha

    Withanolides thought to cause oxidative stress which synergizes with redox-cycling antibiotic metabolites.

  13. Andrographis

    Diterpene lactones may reduce bile acid secretion and flow, contributing to cholestatic injury.

  14. Noni juice

    Anthraquinones could impair mitochondrial function and increase antibiotic hepatotoxicity.

  15. Peppermint oil

    Menthol interferes with CYP450s and UGTs involved in antibiotic metabolism and clearance.

  16. Kratom

    Mitragynine and 7-hydroxymitragynine are metabolized in liver and could enhance antibiotic toxicity.

  17. Ephedra

    Ephedrine alkaloids may deplete glutathione and reduce the liver's defense against antibiotic oxidative damage.

It is essential to consult your healthcare provider before starting any of these supplements. They can have side effects, and some may interact with medications or other supplements you're already taking.
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