Monday, September 3, 2007

Aloe vera may harm the liver

aloe vera
Is aloe vera a wonder herb? If a herb could cure the same disease as it causes, you certainly could call it a wonder. But let me tell the story from the start.

It was last week when I found a report on a 73-year-old woman who was admitted to the hospital for acute hepatitis in Iowa. Extensive lab testing did not reveal the cause of her disease. She was asked time and again whether she was taking any home medications, which she denied. It was only later that she admitted to using oral aloe vera capsules for constipation. After having stopped taking aloe vera, her liver values returned to normal levels. A similar case has been reported earlier in Germany.

Amazing results of a Google search

In search of more such cases I launched Google with the keywords aloe vera and hepatitis and got two completely different kinds of results.

The first two hits lead to the Mayo clinic and to a nutrition expert, both reporting the German case and warning from hepatitis. The third hit was irrelevant.

And now the fourth hit - from Internet Health Library, a self-declared "Alternative Medicine, Complementary Therapy and Natural Health Care Resource":

"Aloe Vera has long been acknowledged for it's beneficial effects for wounds and burns (when applied externally) and there is growing evidence that, when taken internally, it has powerful healing properties. In one study in China, 38 patients suffering from chronic hepatitis were given extract of aloe vera (injections of 10-15ml/kg,ir x4) and it was found that the level of inflammation was reduced by 87% and the researchers stated that they believe the aloe could thereby alleviate symptoms by protecting patient's liver cells."
I must say, I am surprised.

Trying to solve the puzzle

In the Iowa and German cases, the patients have taken aloe vera capsules for a long time. In the Chinese study, patients have been injected aloe vera for a short time. Patients? The abstract of the Chinese study is very short, and it mixes injection trials with rats, mice, dogs and human patients:
"The injection(10-15 ml/kg/d, ip x 4), total glycoside (125-225 mg/kg/d, ip x (3-4); 600 mg/kg/d, ig x 3) and crystal III (120 mg/kg/d, ip x 4) of Aloe vera var. chinensis were found to be effective in lowering the elevated sGPT induced by CCl4, thioacetamide and D-aminogalactose in mice or rats. It was also observed that these agents could protect hepatic cells from the CCl4-induced injury. When dogs were given in with Aloe injection of 0.1 ml/kg/d x 180, no toxicity was noted. The total effective sGPT-lowering rate of Aloe injection on 38 patients of chronic hepatitis with positive HBsAg was 86.8%."
This study seems to be of dubious quality, and in addition it is wrongly cited by the Internet Health Library.

Claims of online herbal shops

To sum up our findings: We have two case reports of liver harm caused by aloe vera capsules and a dubious Chinese study about a positive effect on some liver values after aloe vera injections.

The first herbal shop shows up at position 7 of the Google search. It is selling aloe vera capsules for a great number of indications, stating:
"The benefits of aloe vera are manifold. (...) Other situations in which it appears to work when taken internally include congestion, intestinal worms, indigestion, stomach ulcers, colitis, hemorrhoids, liver problems such as cirrhosis and hepatitis, kidney infections, urinary tract infections, prostate problems, and as a general detoxifier."
And here we are at the end of our miraculous journey that led us from hepatitis as a possible harm of aloe vera to hepatitis as a possible benefit of aloe vera. To achieve such a miracle, it seems that you must cherry-pick a dubious Chinese study, cite it the wrong way and apply it to the wrong aloe vera product.

Take home message
Natural herbs are not harmless, and not all claims of online herbal shops can be trusted.

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