Ayurvedic drug backed by AYUSH Ministry causes liver damage, says study

The BJP-led central government’s blanket promotion of everything herbal doesn’t appear to be a good idea as groups of doctors have reported severe liver damage in some people triggered by an Ayurvedic herb called Giloy, whose consumption was encouraged as an immunity booster to prevent and treat Covid-19.

In a multi-centre study, doctors from 12 cities reported Giloy (Guduchi in Sanskrit) induced liver toxicity in at least 43 patients. This is the second study with a similar conclusion in the last nine months after another group of doctors from Mumbai reported Giloy-induced liver injury in six patients.

The Union Ministry of Ayurveda, Unani, Siddha and Homeopathy (AYUSH) that batted for the herb and issued three press statements in the last nine months claiming Giloy is safe, admitted that overdose of Giloy might be dangerous, without explaining how much of the herb would be considered safe.

Also Read | Giloy safe; misleading to relate it to liver damage: Centre

“At present, we know that Giloy causes autoimmune-like liver injury and the liver injury is not dose-dependent. It is idiosyncratic liver injury, which is a type of liver injury that can occur with any dose and any duration of use and not just overdose,” said Cyriac Abby Phillips, a liver specialist at Rajagiri Hospital at Aluva, who led the multi-centre study.

“This is very dangerous as persons with silent autoimmune disorders or those with confirmed autoimmune diseases (such as hypothyroidism, diabetes, lupus and rheumatoid arthritis) must be cautioned from taking Giloy as it can potentially activate and modulate the immune system for the worse and can cause flares of immune-mediated organ damage, especially in the liver,” he told DH.

DH reached out to AYUSH secretary Vaidya Rajesh Kotecha seeking his comments on what could be the appropriate dose for Giloy, but is yet to receive a response even after two weeks.

However, in a press statement issued on February 16, 2022, the ministry said, “Giloy is a popularly known herb for its immense therapeutic applications in traditional systems of medicine and has been used in the management of Covid-19. Considering the overall health benefits, the herb cannot be claimed to be toxic.”

“Giloy or Guduchi has been used in Ayurveda since long. Its efficacy in managing various disorders is well established. Relating Giloy to liver damage would be misleading and disastrous to India’s traditional medicine system,” the AYUSH ministry said in another press release on July 7, 2021.

The two releases were issued after the publication of the two studies describing the adverse effects of the herb and advising people to act cautiously while using herbal medicines.

“All medications, 'traditional' or otherwise, must be subjected to the same levels of formal testing for safety (and for actually having useful effects!). The various 'passes' given by regulatory systems to many 'non-mainstream' medications in these respects are incorrect,” commented immunologist Satyajit Rath, who is not involved with either of the two studies.

“Since Guduchi is represented as (and sold as) something that 'improves immunity', I should point out that the idea of a general immune stimulatory 'medicine' is extremely problematic, so much so that it is almost a relief that most, if not all, such 'immunity boosters' sold in the market do not actually 'do' anything much to the immune system,” said Rath, who retired from National Institute of Immunology, Delhi.

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