• Dragan Jurčić, Maruška Gabrić, Rosana Troskot Perić, Ana Marija Liberati Pršo, Jure Mirat, Aleksandar Včev, Ivan Alerić, and Barbara Ebling.
• 1Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Gastroenterology and Hepatology, Sveti Duh University Hospital, Zagreb, Croatia; 3Faculty of Health Studies, University of Rijeka, Rijeka, Croatia; 4Department of Endocrinology, Diabetes and Metabolic Diseases, Sveti Duh University Hospital, Zagreb, Croatia; 5Jordanovac Hospital for Lung Diseases, Zagreb University Hospital Centre, Zagreb, Croatia.
• Acta Clin Croat. 2019 Dec 1; 58 (4): 771-776.

AbstractLately there has been an increased consumption of herbal preparations, distributed as nutritional supplements, often claimed to be 'natural' and harmless. However, as their use is not subjected to strict pre-marketing testing and regulations, their ingredients are not clearly defined and there is no quality control or proof of their effectiveness and safety. A growing body of references accentuate their harmful effects, in particular hepatotoxicity, which varies from minimal hepatogram changes to fulminant hepatitis requiring liver transplantation. This case report describes liver damage that was highly suspected to originate from Herbalife® products consumption. We excluded alcohol, viral, metabolic, autoimmune and neoplastic causes of liver lesions, as well as vascular liver disease, but we noticed a connection between the use of Herbalife® products and liver damage. The exact mechanism of liver damage in our patient was not determined. After removing the Herbalife® products, liver damage resolved and there was no need to perform liver biopsy. Taking into consideration the growing consumption of herbal products and their potential harmfulness, we consider that more strict regulations of their production process and sale are necessary, including exact identification of active substances with a list of ingredients, toxicologic testing and obligatory side effect report.

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