Usnic Acid - interesting read

[freak]

Author(s):Hsu LM; Huang YS; Chang FY; Lee SDSource:Journal Of Gastroenterology And Hepatology [J Gastroenterol Hepatol] 2005 Jul; Vol. 20 (7), pp. 1138-9.

‘FAT BURNER’ HERB, USNIC ACID,
INDUCED ACUTE HEPATITIS IN A
FAMILY
To the Editor,
Usnic acid, a compound derived from lichens, has been
claimed to possess anti-inflammatory, antibiotic and
antineoplastic effects. Recently, it has become popular
as a slimmer food supplement worldwide. However, a
few cases with usnic acid associated hepatic injury have
been reported.1–3 We found three sisters with severe
usnic acid-induced hepatitis in our hospital recently.
The potential of hepatotoxicity of this herb will be
emphasized in the present paper.
Case 1, a 36-year-old previously healthy Taiwanese
woman, was admitted because of epigastric pain and
abnormal liver biochemical tests, including serum alanine
aminotransferase (ALT) of 442 U/L (upper limit
of normal [ULN] < 40), aspartate aminotransferase
(AST) of 226 U/L (ULN < 45) and alkaline phosphatase
(ALK-P) of 217 U/L (ULN < 100) on 2
December 2003. She had taken one capsule of a weight
loss herb containing usnic acid and soybean three times
per day for approximately 2 weeks prior to admission.
The patient was anicteric and her serum viral hepatitis
markers and associated autoantibodies were all negative.
She was discharged on the next day without warning
of the possible adverse reaction of the weight loss
preparation. On 18 December, her liver enzyme tests
were ALT 122 U/L and AST 58 U/L. Five days later,
the patient readministered the weight loss herb but discontinued
it after 3 days due to recurrent epigastric discomfort.
On 31 December, the serum levels of ALT and
AST resurged to 1135 U/L and 808 U/L, respectively.
After withdrawal of the drug, her liver enzyme tests
returned to the normal limit in February 2004.
Case 2, the sister of patient 1, was a 32-year-old overweight
woman admitted to another hospital on 22
December 2003 with the chief problems of poor appetite,
malaise and progressive jaundice for 10 days. She
was transferred to our hospital on 31 December 2003.
Drug history revealed she had administrated one to two
capsules of the same weight loss herb three times per
day for 1 month before her illness began. Her serum
total bilirubin was 28.98 mg/dL (ULN < 1.6), ALT
778 U/L, AST 563 U/L, ALK-P 118 U/L, and international
normalized ratio was 2.63. Her serum viral hepatitis
markers and autoantibodies were negative. The
initial ultrasound showed normal liver parenchyma
Letters to the Editor 1139
without evidence of biliary tract obstruction. The
patient’s serum bilirubin and aminotransferase levels
declined slowly. Grade one encephalopathy developed
4 weeks later. Computerized tomography disclosed
shrunken liver with massive ascites thereafter. The
patient was prepared to have a liver transplantation.
Fortunately, her symptoms gradually improved without
liver transplantation, and her liver enzyme tests were
normalized in April 2004.
In fact, their elder sister had also taken the same
drug, but discontinued it after 3 days because of flu-like
symptoms and dark urine. She did not seek medical
attention and the symptoms resolved after withdrawal of
the drug.
The weight loss drug taken by these three sisters was
manufactured and given in capsules by their relatives
who lived in North America. This herb contained only
ingredients of usnic acid derived from lichen and soybean.
Based on the temporal relationship and the positive
accidental rechallenge in case 1, we speculate that
the acute hepatitis in these two sisters was related to the
weight loss herb. Perhaps their elder sister was the third
victim.
This ‘fat burner’ herb also contained soybean, which
is generally thought to be innocuous. Obviously, usnic
acid is the main culprit responsible for inducing hepatotoxicity
in our cases, as in the previous reports.1–3
Since its first isolation in the early 18th century, usnic
acid has become the most comprehensively studied
lichen metabolite and one of the few that is commercially
available. Because of its potential antibiotic properties,
it was traditionally used as a topical application
to wounds and skin inflammations in China. Internal
use of usnic acid in the treatment of bronchitis was also
noted on occasions. Recently, health food supplements
containing usnic acid have been promoted for use in
weight reduction. However, the fact that a few cases
with severe hepatic injury due to usnic acid found
recently challenges the safety and justification of using
this herb.
Recent studies showed that usnic acid can act as a
mitochondria uncoupler that abolishes oxidative phosphorylation.
4,5 It may induce necrosis of murine hepatocyts
with features of a disruption of mitochondrial
bioenergetics and the involvement of oxidative stressinduced
free radicals in mediating cell death.4,5 The
usnic acid-induced hepatotoxicity that occurred in
these three sisters implies the possibility of a idiosyncratic
drug reaction due to genetic polymorphism of a
drug-metabolizing enzyme. However, case 2 took more
herbs than case 1, and had more severe hepatic injury.
This may also support dose-related intrinsic toxicity as
the mechanism of usnic acid-related hepatotoxicity.
Herbal substances are generally thought to be natural
and innocent without side-effects. However, in patients
with fulminant hepatic failure, the prevalence of herbal
supplement use is high.3 The present case report further
emphasizes that herbal remedy is not always innocuous.
Weight loss preparations containing usnic acid are still
widely available worldwide. From all of these painful
experiences, usnic acid warrants strict vigilance. The
attempt to use usnic acid as a ‘fat burner’ should be
discouraged.
Li-Ming Hsu, Yi-Shin Huang, Full-Young Chang,
Shou-Dong Lee
Department of Gastroenterology, Taipei Veterans General
Hospital and National Yang-Ming University School of
Medicine, Taipei, Taiwan
REFERENCES
1 Favreau JT, Ryu ML, Braunstein G et al. Severe hepatotoxicity
associated with the dietary supplement LipoKinetix.
Ann. Intern. Med. 2002; 136: 590–5.
2 Durazo FA, Lassman C, Han SHB et al. Fulminant liver
failure due to usnic acid for weight loss. Am. J. Gastroenterol.
2004; 99: 950–2.
3 Estes JD, Stolpman D, Olyaei A et al. High prevalence of
potentially hepatotoxic herbal supplement use in patients
with fulminant hepatic failure. Arch. Surg. 2003; 138: 852–
5.
4 Han D, Matsumaru K, Rettori D, Kaplowitz N. Usnic acidinduced
necrosis of cultured mouse hepatocytes: inhibition
of mitochondrial function and oxidative stress. Biochem.
Pharmacol. 2004; 67: 439–51.
5 Pramyothin P, Janthasoot W, Pongnimitprasert N, Phrukudom
S, Ruangrungsi N. Hepatotoxic effect of (+) usnic acid
from Usnea siamensis Wainio in rats, isolated rat hepatocytes
and isolated rat liver mitochondria. J. Ethnopharmacol.
2004; 90: 381–7.

[th_vai]

Interesting man, I don't like most of commercial fat burners cause i think most of them are bullshit, never tried one with usnic acid, but after reading couple of times its toxic to the liver I would prefer to stay away from them

[freak]

yeah some of these fat burners come with like 50000 ingredients that you have no idea what they are or even how to say the name. like ooooooooo wild bitter gourd plant extract, that'll deffinately help trim some lard of my ass. what the fuck does the shit do? how has it been linked to fat loss?? i bet they just go to a wholesaler, buy the cheapest and coolest named things and throw them all together and put it out as a fat burner.

[ANADROLicfreak]

freak i gotta give it to ya.you are one researching fiend.lol

[kknec1]

How many mg were in those caps?

[freak]

freak i gotta give it to ya.you are one researching fiend.lol

i try

[apex23]

Good read....It would be interesting to see how many mgs of Usnic acid was in those capsules.

[Minnphat]

Yea I had the same question a while back on Usnic Acid, I am still wondering if it is safe or if I should stop taking it. Right now I am only taking around 30 mg a day and i feel fine, but if people think it it that dangerouse I will def stop. Has anyone asked dave in his q and a

[freak]

Yea I had the same question a while back on Usnic Acid, I am still wondering if it is safe or if I should stop taking it. Right now I am only taking around 30 mg a day and i feel fine, but if people think it it that dangerouse I will def stop. Has anyone asked dave in his q and a

have you had blood work done?? if i was taking the stuff, which i wouldnt, but IF i was, i would deffinately be keeping tabs on my blood. it can happen pretty fast, one blood check your fine, 6 months later you show symptoms of organ damage/failure. your organs are deffinately something you want to take care of, consider losing your liver. my dad had to take a bodybuilder ,that was getting ready for a contest, in for emergency liver transplant, the doctors believe it was the herbal diuretics that caused the liver failure...

[freak]

has anyone used this stuff before?? how were the results?

[ivan drago]

I believe Mitrotropin has Usnic Acid in their blend, although I always shy away from companies that hide behind 'proprietary blends.' I always increase my anti-oxidant ingestion while taking Usnic Acid... the effects are alright, but nothing to run and look in the mirror about (but this could be due to under dosing)

[SallyAnne]

How many mg were in those caps?

From what I have read, you need really high doses of usnic acid to create any problems. In other words, they would have had to be taking at least 15x the recommended daily amount or something like that.

[ivan drago]

From what I have read, you need really high doses of usnic acid to create any problems. In other words, they would have had to be taking at least 15x the recommended daily amount or something like that.

One thing that always gets to me... is that for some reason we are often forced to be at the mercy of supplement companies and manufacturers to obtain our ingredients, rather than having the buying power to purchase our own raws and create our own 'proprietary' blends as we see fit. I know that money talks, and these large overseas chemical manf's are not going to sell the consumer 100g of anything direct, but I am always concerned about the true sourcing practices, purity, quality, and overall concern the CEO's show (who are often never involved in their day-to-day encapsulation of their products) when making their capsules. I am hard pressed to believe these companies, at least a plurality of them, do real COA's or compound testing and verification following GMP batch practices....

[SallyAnne]

One thing that always gets to me... is that for some reason we are often forced to be at the mercy of supplement companies and manufacturers to obtain our ingredients, rather than having the buying power to purchase our own raws and create our own 'proprietary' blends as we see fit. I know that money talks, and these large overseas chemical manf's are not going to sell the consumer 100g of anything direct, but I am always concerned about the true sourcing practices, purity, quality, and overall concern the CEO's show (who are often never involved in their day-to-day encapsulation of their products) when making their capsules. I am hard pressed to believe these companies, at least a plurality of them, do real COA's or compound testing and verification following GMP batch practices....

I don't think all the fault lies with the supplement companies. We're a "more is better" society when it comes to drugs and short cuts in weight loss. You can't control how much someone takes of your product, but are still held responsible if they "overdose" on something that would have been safe in the prescribed amounts.

I'm not totally convinced that usnic acid (taken properly) is dangerous. Yes, there are studies showing that it is linked to liver damage, but these studies are on mice that were given some extremely high dosages that aren't practical in human application.

[-BLP-]

somalyze work wonder