Complimentary Medicine (Tinospora cordifolia/Gulvel/Guduchi) Induced Liver Injury

Abstract

Tinospora cordifolia is a wild herb found in the hills of Western Maharashtra, has been utilized in Ayurvedic medicine to treat hepatitis as a hepatoprotective agent. Furthermore, during the current COVID 19 pandemic, it has recently been ingested by the general public as an immune booster. The purpose of this study was to describe the hepatotoxic effects of Tinospora cordifolia and the clinical outcomes. The study was conducted in Western India's multispecialty tertiary care center. Twenty individuals with impaired liver function test (LFTs), a history of Tinospora cordifolia ingestion, and no additional etiologies were included. These patients were followed until their LFT levels stabilized or they died. We observed 20 patients who had taken Tinospora cordifolia and had clinical hepatitis as well as abnormal LFT. The Roussel Uclaf Causality Assessment Method (RUCAM) score for all of these individuals was larger than 6(6.7±0.3), indicating causation. The severity of the presentation and course ranged from mild to severe, with 95% (n=19/20) of patients recovering with supportive care, while one death is due to acute on chronic liver failure. The average time to recovery was 72.6 ±9.6 days. With large doses, Tinospora cordifolia may induce hepatotoxicity most likely in genetically vulnerable elderly. It is important to raise awareness among community about the risks of the unchecked and indiscriminate use of herbal products and their toxicities.