Table 1

Toxicity associated with herbal medicines

Herbal productMechanism of toxicityToxicity
Tibetan Herbal VitaminContamination with leadSeizures, developmental delay, anaemia
Jin Bu JuanIncorrect plant used (genus stephania not polygala)Respiratory depression, bradycardia, CNS depression
Neem tree oilIncorrect route (given orally instead of topically)Encephalopathy
Various traditionalDirect toxicity of herbal product (contain pyrrolozidine alkaloids)Hepatic veno-occlusive disease
Wau wa creamAdulteration of productCorticosteroid toxicity
St John’s wortInduction of drug metabolism leading to drug interactionDepends on drug (often loss of therapeutic effect)