Is Cascara Sagrada Safe?

Introduction

Cascara sagrada, derived from the bark of the Rhamnus purshiana tree, is commonly used as a herbal laxative. Despite its popularity, concerns have been raised regarding its safety, particularly in relation to liver toxicity and contamination with harmful substances.

Key Insights

Liver Toxicity and Hepatitis
- Cascara sagrada has been associated with liver injury, including cholestatic hepatitis and portal hypertension, potentially due to its anthraquinone derivatives .
- Cases of severe toxic hepatitis and liver failure have been reported following prolonged use of cascara sagrada.
- Liver injury from cascara sagrada is typically reversible upon discontinuation of the herb .
Contamination with Aflatoxins
- Cascara sagrada bark is susceptible to contamination by aflatoxins, which are toxic compounds produced by certain molds. Quality control measures are necessary to ensure the safety of cascara sagrada products.
Regulatory Status
- The FDA has classified cascara sagrada as not generally recognized as safe and effective for over-the-counter use due to safety concerns.
Occupational Hazards
- Exposure to cascara sagrada in occupational settings can cause respiratory allergic diseases, including asthma and rhinitis, due to sensitization to the plant extracts.

Conclusion

Cascara sagrada poses several safety concerns, including potential liver toxicity, contamination with aflatoxins, and occupational respiratory allergies. Regulatory bodies like the FDA do not recognize it as safe for over-the-counter use. Therefore, caution is advised when using cascara sagrada, and it is essential to adhere to recommended dosages and ensure product quality to mitigate risks.

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Summary

Consensus Meter

Introduction

Key Insights

Conclusion

Sources and full results

Cascara sagrada-induced intrahepatic cholestasis causing portal hypertension: case report and review of herbal hepatotoxicity

Mycotoxicological control on raw material and tablets of cascara sagrada (Rhamnus purshiana)

Assessment of Healthy and Harmful Maillard Reaction Products in a Novel Coffee Cascara Beverage: Melanoidins and Acrylamide

2259 Severely Jaundiced Body Builder: A Case of Acute Cholestatic Syndrome With Anabolic Androgenic Steroid Use

A Serendipitous Find: A Case of Cholangiocarcinoma Identified Incidentally After Acute Liver Injury Due to Cascara sagrada Ingestion.

[Toxic hepatitis following consumption of the herbal medicinal product Cascara Sagrada].

Safety of dried coffee husk (cascara) from Coffea arabica L. as a Novel food pursuant to Regulation (EU) 2015/2283

Status of certain additional over-the-counter drug category II and III active ingredients. Final rule.

Occupational respiratory allergic disease induced by Passiflora alata and Rhamnus purshiana.

A paper chromatographic study of aloe, aloin and of cascara sagrada.

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