Chiraito and Kidney Damage

Mention of Chiraito (चिराइतो) terrifies me these days. Chiraito (Swertia chirayita) is a plant that seems to be widely used in alternative medicine. Nepal apparently is the major exporter of Chiraito, to such an extent that IUCN has listed it as a "vulnerable plant" because of "over-harvestation." My introduction to this herb was through a cousin's husband who told me a tale of his kidney damage in his venture to quash diabetes through the bitter solution of this plant. Luckily, after stopping it and spending a fortune in investigating the reason for kidney damage, including a pilgrimage to Indian healthcare system, his kidney has slowly started normalizing. It has now been several years since his initial tryst with the bitter devil. Although he still has a happy go lucky attitude to difficult struggles in life, I am sure it has left an aftertaste. 

I had not made much of Chiraito but recently another patient with diabetes came to me. This  man had taken Chiraito and his kidney functions went from completely normal to those requiring dialysis within a span of a month. I referred him to a kidney specialist. Who knows which direction his kidney functions will go, but its for sure that he will have to endure a suffering attributable to apparently benign Chiraito. Herbs don't have side-effects compared to allopathic medications, we have been told. But not to these two people and perhaps many more that I do not know.

This time, I decided to look up if there was any information about Chiraito. There was a recent lab study conducted in India that showed that it has a bitter chemical called amarogentin that inhibits an enzyme called COX-2 (cycloxygenase-2). Inhibition of COX-2 is a process used in several pain medications. And we do know that several of these pain medications can cause kidney damage if used for long time and at high doses. What must have happened with two of these Chiraito patients is that they had too much and too long of this substance.

That is an uncertain territory we enter with alternative medicine. We have no systematic  information about the substance that we are given. It is based almost entirely upon a blind trust: of a kabiraj or a relative who swears to its usefulness. It might work or it might be a poison. But it would be a mistake to claim that all herbs are innocuous and without side-effects.