Elevated Liver Enzymes and Artemisinin

News reports say high doses of an herbal supplement may cause elevated liver enzymes and possibly even hepatitis. The supplement, which has long been used in Chinese herbal medicine, is made from leaves of the sweet wormwood shrub.

The herbal supplement, which contained artemisinin, was taken by a man in Seattle on the suggestion of a naturopathic provider who was trying to help the man for a parasitic infection.

The August. 14 issue of Morbidity and Mortality Weekly Report says the patient, who previously had a normal liver, suffered elevated liver enzymes and abdominal pain after taking a supplement which contained 600 mg of artemisinin for 10 days. The man's liver enzymes were high enough to be considered consistent with hepatitis. He was treated in a hospital for three days for monitoring. Normal liver function returned about two weeks later.

Artemisinin has been approved by the WHO as a treatment for malaria. The problem in the case of the Seattle man, however, may have been the fact that the dose was substantially higher than recommended for malaria. 

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