Herbal remedies are widely used for various health purposes, yet their potential to cause adverse effects is often overlooked. Asowosi, also known as bitter melon, is one such plant incorporated into traditional medicine practices for blood sugar management. This case study presents the comprehensive findings regarding a 38-year-old male who initially presented with transaminitis and weakness. The cause of the patient's elevated liver enzymes was unclear, as he reported occasional alcohol consumption. However, upon further questioning, he disclosed two to three weeks of herbal remedy use, including Asowosi. The supplement had been selected for its accessibility and familiarity. While the exact mechanism of injury in this case remains unclear, herbal products can have physiologic effects that warrant consideration during diagnostic evaluation. Determining the etiology of this patient's acute liver injury was challenging due to the limited clinical information available on Asowosi. After supportive care and discontinuation of the herbal remedies, the patient's condition improved, and liver histology supported a diagnosis of herb-induced liver injury (HILI). This case underscores the importance of including herbal and nonprescription products in the differential diagnosis of unexplained liver injury and encourages prompt recognition and reporting of similar cases.
Guerra Daniela, Shams Elham, Igorra Pedro, Nickle Sarah, Aziz Muhammad
Jan 2026
Cureus
asowosi, bitter melon, dietary supplements, herbal hepatotoxicity, naturopathy, transaminitis
Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.