A 2018 study by researchers from the Department of Experimental Pharmacology & Toxicology at the University of Port-Harcourt
reviewed the clinical case reports of herbal hepatotoxicity in developing countries. "Studies in Nigeria have highlighted a possible correlation between the use of herbs and liver disease. In Uganda, an association between the use of traditional herbal medicine with liver fibrosis was demonstrated. Reports from China have revealed incidences of acute liver failure due to herbal medicine use."
Relying on data from a 2015 study by Konstantinos Tziomalos
and Evangelos Stournaras
, herbal medicine-related hepatotoxicity represents the second most common cause of drug-induced liver injury (DILI) in Western countries.
“In the United States, the drug-induced liver injury network, which studies liver toxicity related to conventional medications or herbal supplements, constitutes the largest database of herbal medicines-related hepatotoxicity. Herbal products also represent the most common cause of DILI in the East. In a prospective Korean nationwide study on DILI, these products were the causative agents of 232 of 371 reported cases of DILI (62.5%).”