Chaparral, Germander and Other Herbs With Liver Toxicity Reports

Safety first. Reports describe liver injury from chaparral and germander products, in some people progressing to cirrhosis or liver failure needing a transplant. [1] NCCIH's turmeric page lists these liver damage symptoms: fatigue, nausea, poor appetite, dark urine or jaundice. [2] If you notice them while using any herbal product, contact a clinician promptly and bring the product. See liver injury warning signs. For a possible poisoning, Poison Help is 1-800-222-1222.

What the plants are

Chaparral is Larrea tridentata (DC.) Coult., a desert shrub in the family Zygophyllaceae, sold as a dietary supplement. [3][1] Germander is Teucrium chamaedrys L. (family Lamiaceae). [4] Skullcap, Scutellaria lateriflora L., is a different plant in the same family. [5] Skullcap supplements have occasionally been adulterated with germander because the genera look alike, and germander contains liver-toxic diterpenes. [6] See skullcap.

Traditional use

Traditional use of chaparral and germander: Proper evidence not found in the sources we read (we searched PubMed and the NCCIH pages we could open). A 1997 paper says chaparral is used for its antioxidant properties, and a 1992 paper calls germander an herbal medicine used to facilitate weight loss. [1][7] These are marketing uses, not evidence of benefit.

What the reports show

The 2013 review says how often herbal liver injury happens is largely unknown, and that it ranges from mild hepatitis to liver failure needing transplantation. [9] In the 2021 review most people recovered completely (82.8%), 6.6% needed a transplant and 10.4% died. [10] Those figures describe reported cases only, and the review says the outlook is good once the product is stopped. [10] A 2017 case table found germander, black cohosh, kava extract and green tea extract had the most publications, and its authors describe germander as no longer sold (the market is not stated). [11]

Other herbs with liver-injury reports

These are covered by NCCIH and have their own pages.

Also see herbs and liver injury for the wider picture, and liver safety and supplements.

Medicines, pregnancy and children

Proper evidence not found in the sources we read for chaparral or germander with medicines, in pregnancy, during breastfeeding or in children. Do not assume safety. People with liver disease, or who take medicines that affect the liver, should ask a pharmacist or clinician first. See how herbs and medicines interact. Tell the surgical team about every herb. [16]

Quality

Mix-ups matter here: skullcap adulterated with germander is one documented route to exposure. [6] Black cohosh products have been found with the wrong herb. [12] Read adulteration, substitution and mislabeling and quality testing. Report reactions through side effects and reporting. We did not read an FDA or EU statement specific to chaparral or germander.