“Acute Fulminant Hepatic Failure in 23-Year-Old Female Taking Homeopathic Remedy” is not a title we see often on a scientific paper. Naturally, it attrackted my interest. In the paper, a US team presented a case of a 23-year-old otherwise healthy woman with body mass index 32.3 and a history of polycystic ovarian syndrome who presented with acute liver failure (ALF) ultimately requiring orthotopic liver transplantation. The patient was originally from India where she reported taking homeopathic medications for various indications for several years without known toxicity. She had no history of alcohol, tobacco, or other drug use. At the time of her presentation, she was living and working in the US and reported she was unable to refill her homeopathic product with the primary ingredient of eggshells from India. She was off of all medications and supplements with the exception of Berberis vulgaris for approximately 1 month before obtaining a similarly named homeopathic product with the primary ingredient of eggshells from Amazon. She reported originally taking 4 pills/d for 10 days, and then increased to 10 pills/d for 10 days as she was unsure of the appropriate dose.
She subsequently developed orange discoloration of her urine and nausea, reportedly without any preceding muscle-related effects or symptoms, and she discontinued all of her medications/supplements. Approximately 2 weeks later, she presented to the emergency department for nausea and malaise, where a blood test revealed abnormal liver enzymes. Mononucleosis screen and hepatitis panel were negative. She had no evidence of hepatic encephalopathy at that time. Ultrasound of the abdomen was notable for hypoechoic liver parenchyma only.
She was discharged home with gastroenterology telehealth follow-up. She was seen 1 week later and reported worsening nausea, vomiting, anorexia, jaundice, and fatigue. She presented to a local emergency department where she received intravenous vitamin K and underwent further laboratory evaluation. She was transferred to another hospital for higher level of care and admitted with acute liver injury. There she received intravenous N-acetylcysteine per institutional protocol, ursodiol, albumin, vitamin K, and fresh frozen plasma transfusions given for coagulopathy. Magnetic resonance cholangiopancreatography was performed and demonstrated no evidence of biliary obstruction or chronic liver disease (no ascites, contour nodularity, mass, or lymphadenopathy), though liver size noted to be small (11.5 cm in span). At 21 to 28 days after the onset of symptoms, her lab results were still highly abnormal and her mental status deteriorated. She was intubated for airway protection given severe encephalopathy, “cooling protocols” were initiated, and she was transferred again to a higher level of care at a center for emergent liver transplant evaluation. She was evaluated and listed as status 1A for acute liver failure. Her clinical status continued to decline and her labs continued to worsen.
An appropriate organ became available 28 hours after listing. At the time of her surgery, her explanted liver was noted to have massive parenchymal loss with hemorrhage, and pathology confirmed near complete collapse of the organ’s framework with only small foci of steatotic hepatocytes remaining. After her initial operation, her hospital course was complicated by coagulopathy, hypotension, leukocytosis, kidney failure requiring temporary dialysis, and multiple operations for completion of biliary anastomoses and delayed complex abdominal wall closure with mesh given large donor size. She was discharged from the hospital 2 weeks after transplant and her outpatient course continues to go well over 1 year after liver transplantation.
The product in this case has not been previously reported to be toxic. Its primary ingredient is calcium from “toasted eggshells,” which is also not generally known to cause liver failure or disease. However, the authors point out that it is not uncommon for supplements such as this one to contain other potentially toxic agents that are not specifically listed on the bottles’ label. For example, toxic metals including lead, mercury, and arsenic have reportedly been discovered in many (almost 20%) naturopathic medicines manufactured in India, particularly those sold by US websites. As such, the authors hypothesize that this patient’s ALF was likely caused by a contaminant (also consumed in higher quantities than intended) in her homeopathic product with the primary ingredient of eggshells.
The authors of this paper repeatedly state that the product was a homeopathic remedy; however, on other occasions they claim that it was a herbal supplement. In their Figure 1, they name the product as ‘OVA TOSTA’; on Amazon USA, I did indeed find a remedy by that name. Sadly, I was unable to obtain any information about its exact ingredients or composition.
Regardless whether the product was herbal or homeopathic, this case report is a poignant reminder that, in so-called alternative medicine (SCAM) many dangerous remedies are offered for sale. Therefore, it is advisible to be cautious and insist on sound information about the quality, safety, and efficacy before trying any such therapy.
20 Responses to Acute Fulminant Hepatic Failure in 23-Year-Old Female Taking Homeopathic Remedy
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Oh really?!!? Your headline says one thing…but your article says something completely different. You actually acknowledge that you don’t actually know if this product is a homeopathic medicine or an herbal medicine…and in fact, you have no friggin’ idea what it is and what is in it.
But heck, that’s how you roll: make sensational headlines but back it up with no real evidence.
And what is particularly interesting is that NO ONE here acknowledges the obvious elephant in the room (or the obvious non-elephant).
It is so much fun to watch this site. Is this “The Onion”?
oh, dear, Dana!
are you outdoing yourself in stupidity?
it’s not my headline but the one from the original paper.
and what is more, I make this fairly clear in the first sentence of MY post.
Ok…so, when you CAN smear homeopathy, you choose to do it whether it is accurate or not…and then, you choose to blame someone else (“How convenient!”).
Just sayin’.
or perhaps:
when I can be authentic to the original paper, I try to be so?
sorry that you don’t like the fact that the remedy turns out to be homeopathic after all – see comments by others
Edzard on Wednesday 15 November 2023 at 08:37
“sorry that you don’t like the fact that the remedy turns out to be homeopathic after all..”
You are now, implying here, that homeopathic remedies have “effect” (-ve or positive), a very different position to that held earlier, with numerous trials evaluating outcomes confirming homeopathic remedies are placebos, serially diluted until any effect was impossible.
If this is an issue about contamination, then the message is misleading.
Contamination is a very common issue in the pharmaceutical industry.
https://www.pharmaceuticalprocessingworld.com/drug-recalls-2022-2023-contamination-sterility-concerns/
https://www.cancercenter.com/community/blog/2019/10/what-you-should-know-drug-recalls
https://www.reuters.com/business/healthcare-pharmaceuticals/bayer-recalls-one-lot-cancer-drug-vitrakvi-2023-11-17/
https://www.pharmtech.com/view/pharma-industry-contends-with-contamination-based-recalls
do you have a point other than displaying your love of logical fallacies?
Dana
Why are you so happy to repeatedly demonstrate your stupidity?
Every point in your supposed gotcha covered and discussed. You just couldn’t be bothered to read that far, could you?
A very honest question: Where did you learn to read and write? Where did you acquire reading comprehension? At the tree nursery? Because there is no other way I can explain your constant failures in this blog.
It says that the woman was ‘otherwise healthy.’ Well if she was ‘otherwise healthy’ then why would she have chosen or been prescribed Calc Ova Tosta? There is only one line for this remedy in the Materia Medicas I have found and it clearly states
‘Feeling as if back were broken in two’ in one reference and’ a feeling as if spine was broken’ in another reference and not much else.
So why would anyone believing in homeopathy take this remedy unless they thought that something was seriously wrong with their back? Wouldn’t most people consult a Dr or Chiropractor(only joking Edzard) in such pain?
Back pain can of course be a symptom of liver disease.
yes, but
1) lots of people take all sorts remedies without being ill
2) most people with back ache are actually healthy
“…otherwise healthy woman with body mass index 32.3 and a history of polycystic ovarian syndrome”
Ova Tosta is a rare homeopathic remedy with only one very specific indication which is for back pain. She wasn’t taking a common remedy like Calc carb that could be for many symptoms.
The researchers should have looked into whether she had back pain and if so as to whether any pain was liver related.
Please show us the ‘provings’ of Calcarea Ova Tosta to back your claim — because I have not yet seen a homeopathic pathogenetic trial (aka ‘proving’) that demonstrates a “homeopathic remedy with only one very specific indication”. For example:
“The proving of Nux Vomica consists of 1301 symptoms.”
— Vera Resnick, Institute for Homoeopathic Medicine
I am not claiming that Calc ova tosta as a homeopathic remedy helps severe back pain or that there is any justified proving. I am not claiming that homeopathy works or that there is any lab on this planet that can distinguish between Calc ova tost and any other homeopathic remedy. Is that clear now?
All I am stating is that the common reference books state ‘severe back pain’ and not a lot else unlike most common remedies where there are many symptoms listed. If we assume for this issue that these references to back pain are just made up it doesnt make any difference to my point. This lady could have had severe back pain and taken this remedy if she believed in homeopathy as unlike other common remedies it has a very specific indication. The issue of any back pain should have been investigated.
“I am not claiming that Calc ova tosta as a homeopathic remedy helps severe back pain or that there is any justified proving. I am not claiming that homeopathy works or that there is any lab on this planet that can distinguish between Calc ova tost and any other homeopathic remedy. Is that clear now?”
Nobody said you were making such claims.
“This lady could have had severe back pain and taken this remedy if she believed in homeopathy as unlike other common remedies it has a very specific indication.”
You keep claiming that. You keep failing to provide evidence.
What is it that you failed to understand in my comment on Tuesday 14 November 2023 at 20:04? As you appear to be exceptionally dim, I shall explain it again using UNEQUIVOCAL EVIDENCE…
According to you, Calcarea Ova Tosta “unlike other common remedies it has a very specific indication”.
Well, genius, according to the supplier I linked to previously:
QUOTE
BJain Calcarea Ova Tosta
[pictured: 3X TRITURATION TABLETS]
Relieves White Discharges (Vaginal) White Thick Egg Like Discharge
• Treats abnormal vaginal discharges
• Effective in treating leucorrhoea
• Relieves back pain
• Treats warts on hands
• Aids in treating white discharges in females as well as conditions associated with leucorrhoea
• Effective in relieving form backache complaints in women associated with leucorrhoea
• Eases discomfort caused by multiple warts on the hands by reducing them
• Promotes improved sleep and is useful in relieving from restlessness and anxiety
• Useful for the treatment of backache
• Helps treat ovarian cysts
• Helps treat pain in and around the hip area
END OF QUOTE
I was only referring to the common materia medicas eg Vermeulen, Boericke and Clark that are the usual homeopathic references.
I had no idea that Calc ova tosta had other symptoms claimed by this manufacturer although backache does feature rather a lot doesnt it? This seems to have rather passed you by in your haste to post.
However, for your research and dedication to platforming Calc ova tosta to the world I award you a certificate of homeopath silver medalist class. If you can show me evidence of a lab that can detect homeopathic potencies then I will award you a gold medalist certificate. This is my first time of asking.
If I ever get severe back ache bending down to pick up my wallet made big and fat through homeopathy then I now know to maybe try Calc ova tosta so long as I also have leucorrhoea and warts on hands . Although I would see a Dr first ( Not a Chiro- thanks to Edzard) as I always would advise for anyone with such symptoms.
Thanks Pete
“If you can show me evidence of a lab that can detect homeopathic potencies then I will award you a gold medalist certificate.”
A muppet in a laboratory might fail to detect a homeopathic 3X potency trituration. Remind us, dear genius, of the concentration resulting from a homeopathic 3X potency trituration, assuming that the process was performed correctly.
You’ve done a marvellous job of:
● straw manning not just the article on which you are commenting, but even your own comments 🤣;
● emulating belligerent stupidity;
● demonstrating that you have not read and understood the paper on which the article is based.
I’ve thoroughly enjoyed the spectacle. Perhaps you’ll be kind enough to entertain us a little further by using your genius to justify all of your existing comments in the context of Figure 1. Timeline of patient case trajectory and its accompanying text; including the thrice-mentioned term in the paper “contaminant(s)”.
Ova Tosta is a rare remedy seldom used and unlike any common remedy has only one specific indication which is for serious back pain.
Any researcher should have identified this glaring fact and investigated whether there was serious back pain prior to taking the remedy.
Non critical thinkers like you Pete will often make assumptions in their haste. If you go on Amazon you will see a full range of potencies available for Calc ova tosta in various dosage forms. You assumed the 3x potency was taken probably because it was the first picture on your search. Non critical thinkers when confronted often quickly resort to ‘you are dim’ kind of comments.
So on reflection I withdraw your silver medalist certificate as you really must try harder. Don’t worry though I can help you.
I advise you read ‘Thinking Fast and Slow’ by Kahneman- Maybe you need to work on the slow thinking part. Now because you obviously have a tendancy to scan read that is Kahneman not Hahnemann. Hahnemann wrote some other books that you could always read but just slow…… down …. a ….bit and take it easy.
All the best.
JK stated on Tuesday 14 November 2023 at 19:56:
“Ova Tosta is a rare homeopathic remedy with only one very specific indication which is for back pain.”
JK stated on Wednesday 15 November 2023 at 08:36:
“Ova Tosta is a rare remedy seldom used and unlike any common remedy has only one specific indication which is for serious back pain.”
I provided just one example of multiple indications being claimed for Calcarea Ova Tosta, especially the indication “• Helps treat ovarian cysts”, which is relevant to this case of an “otherwise healthy woman with body mass index 32.3 and a history of polycystic ovarian syndrome”. The potency in that one example happened to be 3X; nowhere did I claim that 3X was the potency used by the woman.
Thank you for entertaining us with yet another straw man fallacy in lieu of addressing the article, the paper on which it is based, and the simple questions put to you.