Germander in therapeutics
Germander, a herb native to the Mediterranean region, has a longstanding history of being used in traditional medicine to address various health issues, including gout, asthma, and digestive problems. Despite its historical use, germander is recognized for its significant liver toxicity, which has led to serious health complications. The plant gained attention in the 1980s in France as a weight loss aid, contributing to an outbreak of hepatitis linked to its consumption. Research has identified specific compounds within germander, notably furan-containing neoclerodane diterpenoids like teucrin A and teuchmaedryn A, as the primary agents responsible for its harmful effects on the liver. While germander is banned in France and several other countries, it remains legal in the United States, albeit with FDA-mandated warnings regarding its potential liver toxicity. Despite the risks, some online sources still promote germander for various health benefits, including gallbladder support and fever reduction. This situation highlights the complexities surrounding the use of traditional remedies, especially those that may pose significant health risks.
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Germander in therapeutics
DEFINITION: Toxic plant product claimed to treat specific health conditions.
Overview
The herb germander is a dramatic counterexample to the widely held belief that if a treatment has been used for thousands of years, it must be safe. Germander grows wild in the Mediterranean region, especially in Greece and Syria. It has a long tradition of use for gout, febrile illnesses, asthma, coughs, depression, and congestive heart failure. It was also said to improve digestion and increase appetite. Traditional herbalists appear to have missed the fact that germander is toxic to the liver.
In the 1980s, germander gained popularity as a weight control treatment in France, leading to a small epidemic of hepatitis. Subsequent research unequivocally established its liver-toxic nature. However, for a long time, the exact constituents responsible for this toxicity remained unidentified, adding a layer of complexity to the issue. In the mid-2020s, it is understood that furan-containing neoclerodane diterpenoids, specifically teucrin A and teuchmaedryn A, are the compounds in germander that damage liver cells. Complications have also arisen when products labeled as containing skullcap were found to contain germander instead. Despite being banned in France and many other countries, numerous Internet sites continue to advocate for its use, with some users claiming benefits for the gallbladder, fever reduction, and stomach issues. Germander is not banned in the United States. However, the US Food and Drug Administration requires all supplements containing germander to carry a warning about liver toxicity.
Bibliography
De Berardinis, V., et al. "Human Microsomal Epoxide Hydrolase Is the Target of Germander-Induced Autoantibodies on the Surface of Human Hepatocytes." Molecular Pharmacology, vol. 58, 2000, pp. 542-551.
"Germander - LiverTox." NCBI, 12 Mar. 2018, www.ncbi.nlm.nih.gov/books/NBK548282. Accessed 9 Sept. 2024.
Kouzi, S A, et al. "Hepatotoxicity of Germander (Teucrium Chamaedrys L.) and One of Its Constituent Neoclerodane Diterpenes Teucrin A in the Mouse." Chemical Research in Toxicology, vol. 7, no. 6, 1994, pp. 850–856. American Chemical Society Publications, doi:10.1021/tx00042a020. Accessed 9 Sept. 2024.
Loeper, J., et al. "Human Epoxide Hydrolase Is the Target of Germander Autoantibodies on the Surface of Human Hepatocytes: Enzymatic Implications." Advances in Experimental Medicine and Biology, vol. 500, 2001, pp. 121-124.
Polymeros, D., et al. "Acute Cholestatic Hepatitis Caused by Teucrium polium (Golden Germander) with Transient Appearance of Antimitochondrial Antibody." Journal of Clinical Gastroenterology, vol. 34, 2002, pp. 100-101.
Stickel, F., et al. "Hepatotoxicity of Botanicals." Public Health Nutrition, vol. 3, 2000, pp. 113-124.