Germander

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

Germander (Teucrium chamaedrys) is a plant that has been associated with drug-induced liver injury (DILI). The use of germander as a medicinal herb or dietary supplement has been linked to cases of hepatotoxicity, which can manifest as liver inflammation, injury, or failure.

Mechanism of DILI

Germander contains various bioactive compounds, such as diterpenoids, that are believed to be responsible for its hepatotoxic effects. These compounds can induce oxidative stress, mitochondrial dysfunction, and inflammation in liver cells, leading to liver damage.

Clinical Presentation

Patients who develop DILI from germander may experience symptoms such as jaundice, fatigue, abdominal pain, nausea, and vomiting. In severe cases, acute liver failure can occur, necessitating urgent medical intervention.

Diagnosis and Management

Diagnosing germander-induced DILI involves a thorough medical history, physical examination, and laboratory tests to assess liver function. Imaging studies and liver biopsy may also be performed to evaluate the extent of liver damage. Treatment typically involves discontinuing the use of germander and providing supportive care to help the liver recover.

Prevention

To prevent DILI from germander, it is important to be cautious when using herbal remedies and dietary supplements. Consultation with a healthcare provider or a qualified herbalist is recommended before starting any new herbal treatment. Monitoring liver function tests regularly while using herbal products can also help detect liver injury early.

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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