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To the Editor: Traditional Chinese herbs have widespread use outside of China by both emigrants and an increasing number of Western patients. Typically, 3 to 15 different drugs are combined in a prescription based on the patient's individual symptoms. While Chinese herbal remedies appear to be relatively safe, they are not free of risks, and a number of severe adverse events, including death, have been reported.¹ Although hepatotoxic effects associated with Chinese drugs have been described,^2-3 it is unclear how often such adverse effects occur.

Methods

We investigated the frequency of clinically relevant elevations of liver enzymes in 1507 consecutive patients treated with traditional Chinese herbs at the Hospital for Traditional Chinese Medicine in southeast Germany. Seventy-two percent of patients were female, the mean (SD) age was 52 (14) years, two thirds experienced chronic pain, and the mean (SD) hospital stay was 27 [5] days. Blood samples were obtained at admission . . . [Full Text of this Article]