From the Guidelines
Valerian root is not significantly associated with hepatotoxicity, and its use is considered safe regarding liver function when taken as directed. The evidence from recent studies, such as the one published in Mayo Clinic Proceedings in 2021 1, suggests that valerian can be considered for continuation in patients, indicating its safety profile. While there might be concerns about potential interactions with other medications or effects in patients with pre-existing liver conditions, the overall data support the safety of valerian root regarding hepatotoxicity.
Key points to consider include:
- The typical recommended dosage of valerian root for sleep or anxiety is 300-600 mg of extract taken 30-60 minutes before bedtime, or 2-3 grams of dried root prepared as tea.
- Valerian works primarily by interacting with GABA receptors in the brain, similar to benzodiazepines but through different mechanisms.
- Patients with existing liver disease should exercise caution and consult healthcare providers before use, as with any herbal supplement.
- Quality and purity of products can vary, so purchasing from reputable manufacturers is advisable.
- If any unusual symptoms develop while taking valerian, such as jaundice, abdominal pain, or unusual fatigue, discontinue use and seek medical attention.
It's also important to note that the 2021 study from Mayo Clinic Proceedings 1 provides guidance on the preoperative management of surgical patients using dietary supplements, including valerian, and suggests considering its continuation, which further supports its safety. However, the decision to use valerian root should always be made under the guidance of a healthcare provider, especially in patients with complex medical histories or those taking other medications.
From the Research
Valerian Root and Hepatotoxicity
- The association between valerian root and hepatotoxicity is a topic of interest, with some studies investigating the potential risks of herbal medicinal products, including valerian, on liver health 2, 3, 4, 5.
- A study published in 2021 found that valerian root extract did not induce oxidative stress in human liver hepatocellular carcinoma (HepG2) and human colorectal adenocarcinoma (Caco2) cell lines, suggesting that it may be safe at recommended tolerated concentrations 2.
- However, another study published in 2003 noted that single medicinal herbs and combination preparations, including valerian, are associated with hepatotoxic events, ranging from transient elevations of liver enzyme levels to fulminant liver failure and death 3.
- A review of herbal hepatotoxicity published in 2007 listed valerian as one of the herbal products that have been reported to be associated with liver injury, although the relationship is uncertain in some cases 4.
- A systematic review and meta-analysis published in 2020 found no severe adverse events associated with valerian intake in subjects aged between 7 and 80 years, suggesting that valerian may be a safe and effective herb for promoting sleep and preventing associated disorders 6.
- Another study published in 2015 discussed the importance of stringent causality assessment in cases of suspected herb-induced liver injury (HILI) and highlighted the need for regulatory surveillance and evidence-based clinical trials to ensure the safe use of herbal medicinal products, including valerian 5.