From the Guidelines
If Damiana use is associated with elevated liver function tests (LFTs), you should discontinue the herb immediately and consult a healthcare provider. This recommendation is based on the principle of prioritizing liver health and minimizing potential harm, as seen in the management of drug-induced liver injury in various clinical contexts 1. When managing elevated LFTs, it's crucial to monitor liver enzymes closely and rule out other causes of liver dysfunction. The healthcare provider may recommend follow-up blood tests and additional diagnostic tests to assess the liver's condition. While the exact mechanism of Damiana-induced hepatotoxicity is not well understood, it is essential to avoid substances that can stress the liver, such as alcohol and certain medications like acetaminophen. Symptoms like jaundice, abdominal pain, dark urine, or fatigue accompanying elevated LFTs warrant immediate medical attention, as they could indicate more severe liver issues. Once LFTs normalize, discussing the reintroduction of Damiana at a lower dose or switching to an alternative herb with a better liver safety profile should be done under the guidance of a healthcare provider, considering the potential risks and benefits, as outlined in recent recommendations for managing suspected drug-induced liver injury 1. Key considerations include the severity of the initial liver injury, the presence of underlying liver disease, and the potential for rechallenge with the offending agent, which should be approached with caution and based on a structured assessment of the risks and benefits 1.
From the Research
Damiana and Elevated Liver Function Tests (LFTs)
- Damiana, also known as Turnera diffusa, is a plant that has been traditionally used to treat various ailments, including liver diseases 2.
- However, there is limited research on the effects of damiana on liver function tests (LFTs).
- A study on the hepatoprotective effects of a compound called hepatodamianol, which is found in damiana, showed that it had a greater hepatoprotective effect than silibinin, a widely used hepatoprotective agent, in an in vitro model using HepG2 cells 2.
Elevated LFTs: Causes and Investigations
- Elevated LFTs can be caused by various factors, including liver diseases, alcoholism, and certain medications such as statins 3, 4, 5.
- A study on the predictive value of LFTs for detecting liver-related disease in primary care found that alanine aminotransferase (ALT) was associated with hepatocellular disease, while alkaline phosphatase (ALP) was associated with biliary disease and tumors of the hepatobiliary system 3.
- Another study found that statins can cause dose-dependent borderline elevations of LFTs, but these elevations are clinically and statistically insignificant 5.
Management of Elevated LFTs
- If damiana is suspected to be the cause of elevated LFTs, it is recommended to discontinue its use and monitor LFTs regularly 2.
- A study on the investigation of abnormal LFTs in primary care found that a restricted panel of ALT and ALP was an efficient choice of analytes for excluding liver disease, but repeating a complete panel in response to an abnormal reading is not the optimal strategy 3.
- It is essential to investigate the cause of elevated LFTs and to manage the underlying condition accordingly, rather than just monitoring LFTs 6, 3, 4, 5.