Internal usage of comfrey should be avoided because it contains hepatotoxic pyrrolizidine alkaloids (PAs). (Note, there are also non-hepatotoxic pyrrolizidine alkaloids.) Use of comfrey can, because of these PAs, lead to veno-occlusive disease (VOD). VOD can in turn lead to liver failure, and comfrey, taken in extreme amounts, has been implicated in at least one death. [7]
In 2001, the United States Food and Drug Administration issued a warning against internal usage of herbal products containing comfrey. [8] There are ways to remove the pyrrolizidine alkaloids from comfrey, and some herbal product manufacturers have begun doing so (although the products will still be labelled “for external use only”).
Excessive doses of Symphytine, one of the PAs in comfrey, may cause cancer in rats. [9] This was shown by injection of the pure alkaloid. The whole plant has also been shown to induce precancerous changes in transgenic rats. [10]
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Alis volat propriis
State Motto of Oregon