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Another day, another tragic story of organ damage from #herbals:

27/F with #psoriasis of her face, trunk and limbs for 10 yrs. Now this is a tough disease to get, especially for a young woman. Appearance affected, social stigma attached, no easy cure but can be controlled..
Initially consults dermatologist, counselled, started on topical agents, but visible change takes time. Not satisfied and seeking "cure" without "side effects" they approach local practitioner who prescribes herbal formulation to take daily - which she dutifully does for 10 yrs
During a routine evaluation for unrelated back pain, a serum creatinine done is 8.1 mg/dl- shockingly high! Further evaluation and a kidney biopsy reveals interstitial fibrosis in the renal cortex s/o Aristolochic acid nephropathy!
Here is the cheeky little culprit 👇
Meet Aristolochia indica (Indian birthwort/Eeswaramooli). Commonly used in herbal preparations, Chinese traditional medicine and slimming pills. Compounds with these herbs are banned in several countries due its well known toxic effects. It can even cause urinary tract cancers!!
A worldwide problem, its use is banned in several countries, but not in India. In Ayurveda it can be found in several formulations used in asthma, arthritis, skin disease, gastric issues, you name it. These are just a few..
Despite the well known toxicities of AA, there is unfortunately no regulation controlling its use here. Often substituted for similar herbs, no mention of toxic content, no written max dosage, no warning labels. Here is the defense:
Are patients supposed to read these granthas before consuming herbals? At no point was this poor patients warned about renal side effects. No carcinogenic ingredient should ever be allowed in any oral preparation, period. But rules don't seem 2 apply when it comes to #AYUSH
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