Ephedra

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

Ephedra, also known as ma huang, is a natural herbal supplement that has been used for centuries in traditional Chinese medicine for its stimulant effects. However, ephedra has been associated with drug-induced liver injury (DILI) in some cases.

Mechanism of DILI

Ephedra contains ephedrine and pseudoephedrine, which are sympathomimetic agents that can cause liver injury through various mechanisms. These include direct hepatotoxicity, immune-mediated reactions, and metabolic idiosyncrasy.

Clinical Presentation

Patients with ephedra-induced DILI may present with symptoms such as jaundice, fatigue, nausea, vomiting, and abdominal pain. Laboratory tests may show elevated liver enzymes and bilirubin levels.

Management

The most important step in managing ephedra-induced DILI is to discontinue the use of ephedra-containing products. Supportive care may be provided to manage symptoms and monitor liver function. In severe cases, liver transplantation may be necessary.

Prevention

Healthcare providers should be aware of the potential hepatotoxic effects of ephedra and advise patients against its use, especially in individuals with pre-existing liver conditions or those taking other medications that can interact with ephedra.

Overall, while ephedra may have some beneficial effects, its potential for causing liver injury should not be overlooked, and caution should be exercised when using this herbal supplement.

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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