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, as well as febrile illnesses, asthma, coughs, depression, and congestive heart failure. It was also said to improve digestion and increase appetite. What traditional herbalists appear to have missed is that germander is toxic to the liver.
In the 1980s, germander became a popular treatment for weight control in France. A small epidemic of hepatitis was the result.1-12 Subsequent research demonstrated conclusively that the herb is toxic to the liver but has not precisely identified the constituents at fault.13-18 Problems have also occurred when products labeled as containing skullcap have turned out to contain germander instead.19
Germander was subsequently banned in France and many other countries. Unfortunately, numerous websites continue to promote the use of this herb. We recommend avoiding germander entirely.
Polymeros D, Kamberoglou D, Tzias V. Acute cholestatic hepatitis caused by Teucrium polium (golden germander) with transient appearance of antimitochondrial antibody. J Clin Gastroenterol. 2002;34:100–1.
Perez Alvarez J, Saez-Royuela F, Gento Pena E, Lopez Morante A, Velasco Oses A, Martin Lorente J. Acute hepatitis due to ingestion of Teucrium chamaedrys infusions [in Spanish]. Gastroenterol Hepatol. 2001;24:240–3.
Stickel F, Seitz HK, Hahn EG, Schuppan D. Liver toxicity of drugs of plant origin [in German]. Z Gastroenterol. 2001;39:225–32, 234–7.
Stickel F, Egerer G, Seitz HK. Hepatotoxicity of botanicals. Public Health Nutr. 2000;3:113–24.
Laliberte L, Villeneuve JP. Hepatitis after the use of germander, a herbal remedy. CMAJ. 1996;154:1689–92.
Larrey D. Liver involvement in the course of phytotherapy [in German]. Presse Med. 1994;23:691–3.
Dao T, Peytier A, Galateau F, Valla A. Chronic cirrhogenic hepatitis induced by germander [in French]. Gastroenterol ClinBiol. 1993;17:609–10.
Ben Yahia M, Mavier P, Metreau JM, et al. Chronic active hepatitis and cirrhosis induced by wild germander. 3 cases [in French]. Gastroenterol Clin Biol. 1993;17:959–62.
Larrey D, Vial T, Pauwels A, Castot A, Biour M, David M, Michel H. Hepatitis after germander ( Teucriumchamaedrys) administration: another instance of herbal medicine hepatotoxicity. Ann Intern Med. 1992;117:129–32.
Pauwels A, Thierman-Duffaud D, Azanowsky JM, Loiseau D, Biour M, Levy VG. Acute hepatitis caused by wild germander. Hepatotoxicity of herbal remedies. Two cases [in French]. Gastroenterol Clin Biol. 1992;16:92–5.
Castot A, Larrey D. Hepatitis observed during a treatment with a drug or tea containing wild germander. Evaluation of 26 cases reported to the Regional Centers of Pharmacovigilance [in French]. Gastroenterol Clin Biol. 1992;16:916–22.
Mattei A, Bizollon T, Charles JD, et al. Liver damage induced by the ingestion of a product of phytotherapy containing wild germander. Four cases [in French]. GastroenterolClin Biol. 1992;16:798–800.
Loeper J, De Berardinis V, Moulis C, Beaune P, Pessayre D, Pompon D. Human epoxide hydrolase is the target of germander autoantibodies on the surface of human hepatocytes: enzymatic implications. Adv Exp Med Biol. 2001;500:121–4.
De Berardinis V, Moulis C, Maurice M, et al. Human microsomal epoxide hydrolase is the target of germander-induced autoantibodies on the surface of human hepatocytes. Mol Pharmacol. 2000;58:542–51.
Fau D, Lekehal M, Farrell G, et al. Diterpenoids from germander, an herbal medicine, induce apoptosis in isolated rat hepatocytes. Gastroenterology. 1997;113:1334–46.
Lekehal M, Pessayre D, Lereau JM, Moulis C, Fouraste I, Fau D. Hepatotoxicity of the herbal medicine germander: metabolic activation of its furano diterpenoids by cytochrome P450 3A depletes cytoskeleton-associated protein thiols and forms plasma membrane blebs in rat hepatocytes. Hepatology. 1996;24:212–8.
Kouzi SA, McMurtry RJ, Nelson SD. Hepatotoxicity of germander ( Teucrium chamaedrys L.) and one of its constituent neoclerodane diterpenes teucrin A in the mouse. Chem Res Toxicol. 1994;7:850–6.
Loeper J, Descatoire V, Letteron P, et al. Hepatotoxicity of germander in mice. Gastroenterology. 1994;106:464–72.
Bergner P. Scutellaria, skullcap: uses. Available at: http://www.ibiblio.org/herbmed/archives/Best/1994...utellaria-1.html. Accessed September 13, 2003.
Last reviewed September 2014 by EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
