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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]" /><meta name="citation_title" content="Chaste Tree" /><meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="citation_date" content="2023/01/20" /><meta name="citation_pmid" content="36745730" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK588847/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Chaste Tree" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="DC.Date" content="2023/01/20" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK588847/" /><meta name="description" content="Chaste tree is an extract of the small flowering tree Vitex agnus-castus which has been used in traditional medicine for women’s health conditions including menstrual pain, premenstrual tension and infertility. Oral forms of chaste tree have not been implicated in serum aminotransferase elevations or in instances of clinically apparent liver injury." /><meta name="og:title" content="Chaste Tree" /><meta name="og:type" content="book" /><meta name="og:description" content="Chaste tree is an extract of the small flowering tree Vitex agnus-castus which has been used in traditional medicine for women’s health conditions including menstrual pain, premenstrual tension and infertility. Oral forms of chaste tree have not been implicated in serum aminotransferase elevations or in instances of clinically apparent liver injury." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK588847/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/livertox/ChasteTree/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK588847/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="All Drug Records" href="/books/n/livertox/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" alt="Cover of LiverTox" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK588847_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK588847_dtls__"><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>; 2012-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/livertox/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Chaparral/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/ChelatingAgents/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK588847_"><span class="title" itemprop="name">Chaste Tree</span></h1><p class="small">Last Update: <span itemprop="dateModified">January 20, 2023</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="ChasteTree.OVERVIEW"><h2 id="_ChasteTree_OVERVIEW_">OVERVIEW</h2><div id="ChasteTree.Introduction"><h3>Introduction</h3><p>Chaste tree is an extract of the small flowering tree <i>Vitex agnus-castus</i> which has been used in traditional medicine for women’s health conditions including menstrual pain, premenstrual tension and infertility. Oral forms of chaste tree have not been implicated in serum aminotransferase elevations or in instances of clinically apparent liver injury.</p></div><div id="ChasteTree.Background"><h3>Background</h3><p>Chaste tree is derived from fresh or dried, green, sterile shoots of the plant <i>Vitex agnus-castus</i>, a small flowering tree native to Asia and the Mediterranean regions but which is now widely cultivated. In the past it was believed to decrease sexual desire, for which reason it was named “chaste tree”, which is also the meaning of “agnus” (in Greek) and “castus” (in Latin). Extracts of chaste tree are prepared from the leaves, tender stems, flowers, and seeds and provided as syrup, elixir, powder, or a component of a multiingredient dietary supplement. Chemical components of chaste tree extracts include flavonoids, glycosides, organic acids, alkaloids, essential oils, diterpenoids and sterols, but its active ingredient is unknown. In traditional medicine, chaste tree has been purported to be useful for premenstrual syndrome, menstrual cramps, breast pain associated with the menstrual cycle, and infertility, but it has not been shown to be effective for any of these conditions in adequately controlled, prospective clinical trials. Chaste tree is found in multiple commercial forms including liquid extracts, powders and capsules. The recommended daily dose ranges widely, from 20 mg to 100 mg daily to as high as 1 gram three times daily. Chaste tree is generally considered to be safe and side effects are few and generally mild, but may include nausea, indigestion, abdominal discomfort, itching and headache. Rare instances of hypersensitivity reactions, skin rash and allergic dermatitis have been described.</p></div><div id="ChasteTree.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>In several short term clinical trials, chaste tree in conventional oral doses was typically described as having no or only mild adverse side effects, with no mention of either hepatotoxicity or <a class="def" href="/books/n/livertox/glossary/def-item/glossary.alanine-aminotransferase-alt-/">ALT</a> elevations. Furthermore, in multiple large series of drug and herbal product induced liver injury no cases of chaste tree associated injury have been reported. Single case reports of liver injury with jaundice attributed to chaste tree have been reported to manufacturers, but other possible diagnoses were not adequately excluded. Thus, there is little evidence that chaste tree in conventional oral doses causes clinically apparent liver injury with jaundice in humans. Because of its possible hormonal effects, use of high doses in persons with preexisting liver disease or cirrhosis is discouraged, and its use is not recommended in pregnant or breastfeeding women, or in women on birth control or hormone replacement.</p><p><a class="def" href="/books/n/livertox/glossary/def-item/glossary.likelihood-score/">Likelihood score</a>: E (unlikely cause of clinically apparent liver injury).</p></div><div id="ChasteTree.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>The mechanism by which chaste tree might cause liver injury is unknown. When present in multiingredient dietary supplements, the contribution of other components or toxic contaminants must be considered.</p><p>Drug Class: <a href="/books/n/livertox/HerbalDietarySuppl/">Herbal and Dietary Supplements</a></p><p>Other names: Vitex, Chaste Berry, Lilac Chaste Tree, Monk’s Pepper.</p></div></div><div id="ChasteTree.PRODUCT_INFORMATION"><h2 id="_ChasteTree_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><p>
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<b>REPRESENTATIVE TRADE NAMES</b>
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</p><p>Chaste tree – Generic</p><p>
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<b>DRUG CLASS</b>
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</p><p>Herbal and <a class="def" href="/books/n/livertox/glossary/def-item/glossary.dietary-supplements/">Dietary Supplements</a></p><p>
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<b>SUMMARY INFORMATION</b>
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</p><p>
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<a href="https://www.nccih.nih.gov/health/chasteberry" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Fact Sheet at National Center for Complementary and Integrative Health, NIH</a>
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</p></div><div id="ChasteTree.CHEMICAL_FORMULA_AND_STRUCTUR"><h2 id="_ChasteTree_CHEMICAL_FORMULA_AND_STRUCTUR_">CHEMICAL FORMULA AND STRUCTURE</h2><div id="ChasteTree.Tc" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK588847/table/ChasteTree.Tc/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ChasteTree.Tc_lrgtbl__"><table><thead><tr><th id="hd_h_ChasteTree.Tc_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">DRUG</th><th id="hd_h_ChasteTree.Tc_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CAS REGISTRY NUMBER</th><th id="hd_h_ChasteTree.Tc_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_ChasteTree.Tc_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_ChasteTree.Tc_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chaste Tree</td><td headers="hd_h_ChasteTree.Tc_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135346033" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">91722-47-3</a>
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</td><td headers="hd_h_ChasteTree.Tc_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Herbal</td><td headers="hd_h_ChasteTree.Tc_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not Applicable</td></tr></tbody></table></div></div></div><div id="ChasteTree.ANNOTATED_BIBLIOGRAPHY"><h2 id="_ChasteTree_ANNOTATED_BIBLIOGRAPHY_">ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 20 January 2023</p><ul class="first-line-outdent"><li><div class="bk_ref" id="ChasteTree.REF1">Abbreviations: HDS, herbal and dietary supplements.</div></li><li><div class="bk_ref" id="ChasteTree.REF.zimmerman.1999">Zimmerman HJ. Unconventional drugs. Miscellaneous drugs and diagnostic chemicals. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott,1999: pp. 731-4.<div><i>(Expert review of hepatotoxicity published in 1999; several herbal medications are discussed, but not chaste tree).</i></div></div></li><li><div class="bk_ref" id="ChasteTree.REF.liu.2007">Liu LU, Schiano TD. Hepatotoxicity of herbal medicines, vitamins and natural hepatotoxins. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 2nd ed. New York: Informa Healthcare USA, 2007, pp. 733-54.<div><i>(Review of hepatotoxicity of herbal and dietary supplements [HDS] published in 2007; no mention of chaste tree).</i></div></div></li><li><div class="bk_ref" id="ChasteTree.REF4">Chaste Tree. In, PDR for Herbal Medicines. 4th ed. Montvale, New Jersey: Thomson Healthcare Inc. 2007: pp. 185-7.<div><i>(Compilation of short monographs on herbal medications and dietary supplements).</i></div></div></li><li><div class="bk_ref" id="ChasteTree.REF.lauritzen.1997.183">Lauritzen C, Reuter HD, Repges R, Böhnert KJ, Schmidt U. Treatment of premenstrual tension syndrome with Vitex agnus castus controlled, double-blind study versus pyridoxine. <span><span class="ref-journal">Phytomedicine. </span>1997;<span class="ref-vol">4</span>:183–9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/23195474" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23195474</span></a>]<div>
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<i>(Among 127 women with premenstrual tension syndrome treated with a commercial chaste tree product or pyridoxine for 3 menstrual cycles, symptom scores improved to a similar extent in both groups and adverse event rates were similar; no mention of ALT elevations or hepatotoxicity).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.berger.2000.150">Berger D, Schaffner W, Schrader E, Meier B, Brattström A. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). <span><span class="ref-journal">Arch Gynecol Obstet. </span>2000;<span class="ref-vol">264</span>:150–3.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/11129515" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11129515</span></a>]<div>
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<i>(Among 50 patients with premenstrual syndrome treated with a chaste tree extract [20 mg daily] for 3 menstrual cycles, symptom scores decreased by 42.5% and gradually returned to baseline after stopping; there were no serious adverse events and “laboratory evaluations did not reveal any relevant influence of treatment”).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.loch.2000.315">Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with aphytopharmaceutical formulation containing Vitex agnus castus. <span><span class="ref-journal">J Womens Health Gend Based Med. </span>2000;<span class="ref-vol">9</span>:315–20.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10787228" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10787228</span></a>]<div>
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<i>(In a survey of 1643 women with premenstrual syndrome taking chaste tree supplements, most patients and providers viewed the therapy as beneficial and adverse events were reported in only 1% of subjects, most of which were mild and none were serious).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.stedman.2002.195">Stedman C. Herbal hepatotoxicity. <span><span class="ref-journal">Semin Liver Dis. </span>2002;<span class="ref-vol">22</span>:195–206.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/12016550" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12016550</span></a>]<div>
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<i>(Review and description of patterns of liver injury due to herbals, including discussion of potential risk factors, and herb-drug interactions).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.daniele.2005.319">Daniele C, Thompson Coon J, Pittler MH, Ernst E. Vitex agnus castus: a systematic review of adverse events. <span><span class="ref-journal">Drug Saf. </span>2005;<span class="ref-vol">28</span>:319–32.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/15783241" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15783241</span></a>]<div>
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<i>(Systematic review of adverse events associated with chaste tree identified 33 studies including 5 controlled trials, postmarketing surveys, spontaneous reports to regulatory groups, and information from manufacturers, and concluded that most adverse events from chaste tree are mild and transient, most commonly nausea, headache, gastrointestinal upset, acne, pruritus and rash; along spontaneous reports was a case of Stevens Johnson syndrome and one of hepatitis with jaundice in a 39 year old woman on chaste tree from 60 days which resolved when the supplement was stopped).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.rotem.2007.117">Rotem C, Kaplan B. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study. <span><span class="ref-journal">Gynecol Endocrinol. </span>2007;<span class="ref-vol">23</span>:117–22.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/17454163" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17454163</span></a>]<div>
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<i>(Among 44 women with menopausal symptoms treated with a multiingredient supplement [black cohosh, milk thistle, red clover, ginseng and chaste tree] or placebo for 3 months, symptoms improved more with the supplement, while ALT and AST levels did not change in either group).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.he.2009.99">He Z, Chen R, Zhou Y, Geng L, Zhang Z, Chen S, Yao Y, Lu J, Lin S. Treatment for premenstrual syndrome with Vitex agnus castus: a prospective, randomized, multi-center placebo controlled study in China. <span><span class="ref-journal">Maturitas. </span>2009;<span class="ref-vol">63</span>:99–103.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/19269753" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19269753</span></a>]<div>
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<i>(Among 208 women with moderate-to-severe premenstrual syndrome treated with chaste tree extract [40 mg] or placebo once daily for up to 3 cycles, symptom scores decreased more with chaste tree [from 19.2 to 6.4] than placebo [28.1 to 12.6], adverse event rates were similar [8.5% vs 7.6%] none of which were serious, and no significant differences were found in routine chemical laboratory test results).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.jacobsson.2009.1039">Jacobsson I, Jönsson AK, Gerdén B, Hägg S. Spontaneously reported adverse reactions in association with complementary and alternative medicine substances in Sweden. <span><span class="ref-journal">Pharmacoepidemiol Drug Saf. </span>2009;<span class="ref-vol">18</span>:1039–47.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/19650152" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19650152</span></a>]<div>
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<i>(Review of 778 spontaneous reports of adverse reactions to herbals to Swedish Registry found none attributed to chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.reuben.2010.2065">Reuben A, Koch DG, Lee WM., Acute Liver Failure Study Group. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. <span><span class="ref-journal">Hepatology. </span>2010;<span class="ref-vol">52</span>:2065–76.</span> [<a href="/pmc/articles/PMC3992250/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3992250</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20949552" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20949552</span></a>]<div>
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<i>(Among 1198 patients with acute liver failure enrolled in a US prospective study between 1998 and 2007, 133 [11%] were attributed to drug induced liver injury of which 12 [9%] were due to herbals, including several herbal mixtures, usnic acid, Ma Huang, black cohosh, and Hydroxycut, but not chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.stickel.2011.595">Stickel F, Kessebohm K, Weimann R, Seitz HK. Review of liver injury associated with dietary supplements. <span><span class="ref-journal">Liver Int. </span>2011;<span class="ref-vol">31</span>:595–605.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/21457433" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21457433</span></a>]<div>
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<i>(Review of current understanding of liver injury from herbals and dietary supplements focusing upon Herbalife and Hydroxycut products, green tea, usnic acid, noni juice, Chinese herbs, vitamin A and anabolic steroids; chaste tree is not discussed).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.teschke.2012.1543">Teschke R, Wolff A, Frenzel C, Schulze J, Eickhoff A. Herbal hepatotoxicity: a tabular compilation of reported cases. <span><span class="ref-journal">Liver Int. </span>2012;<span class="ref-vol">32</span>:1543–56.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/22928722" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22928722</span></a>]<div>
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<i>(A systematic compilation of all publications on the hepatotoxicity of specific herbals identified 185 publications on 60 different herbs, herbal drugs and supplements but does not list or mention chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.bj_rnsson.2013.1419">Björnsson ES, Bergmann OM, Björnsson HK, Kvaran RB, Olafsson S. Incidence, presentation and outcomes in patients with drug-induced liver injury in the general population of Iceland. <span><span class="ref-journal">Gastroenterology. </span>2013;<span class="ref-vol">144</span>:1419–25.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/23419359" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23419359</span></a>]<div>
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<i>(In a population based study of drug induced liver injury from Iceland, 96 cases were identified over a 2 year period, 15 of which [16%] were attributed to HDS products, but none were listed as containing chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.bunchorntavakul.2013.3">Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. <span><span class="ref-journal">Aliment Pharmacol Ther. </span>2013;<span class="ref-vol">37</span>:3–17.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/23121117" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23121117</span></a>]<div>
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<i>(Systematic review of literature on HDS associated liver injury does not mention chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.navarro.2013.715">Navarro VJ, Seeff LB. Liver injury induced by herbal complementary and alternative medicine. <span><span class="ref-journal">Clin Liver Dis. </span>2013;<span class="ref-vol">17</span>:715–35.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/24099027" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24099027</span></a>]<div>
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<i>(Review of the epidemiology, regulatory status, diagnosis, pathogenesis and causes of liver injury from herbal products with specific discussion of conjugated linoleic acid, ephedra, germander, green tea, usnic acid, flavocoxid, aloe vera, chaparral, greater celandine, black cohosh, comfrey, kava, skullcap, valerian, noni juice, pennyroyal and traditional herbal remedies).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.navarro.2014.1399">Navarro VJ, Barnhart H, Bonkovsky HL, Davern T, Fontana RJ, Grant L, Reddy KR, et al. Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network. <span><span class="ref-journal">Hepatology. </span>2014;<span class="ref-vol">60</span>:1399–408.</span> [<a href="/pmc/articles/PMC4293199/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4293199</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25043597" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25043597</span></a>]<div>
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<i>(Among 839 cases of liver injury from drugs collected in the US between 2004 and 2013, 130 were due to HDS products, including 45 from body building agents [probably anabolic steroids] and 85 from diverse HDS products but no case was attributed specifically to chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.navarro.2014.172">Navarro VJ, Lucena MI. Hepatotoxicity induced by herbal and dietary supplements. <span><span class="ref-journal">Semin Liver Dis. </span>2014;<span class="ref-vol">34</span>:172–93.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/24879982" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24879982</span></a>]<div>
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<i>(Review of the international regulatory framework for HDS products and the epidemiology, clinical presentation, diagnosis and cause of HDS associated liver injury with tables and discussion of the most commonly implicated agents, but does not include mention of chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.depypere.2014.191">Depypere HT, Comhaire FH. Herbal preparations for the menopause: beyond isoflavones and black cohosh. <span><span class="ref-journal">Maturitas. </span>2014;<span class="ref-vol">77</span>(2):191–4.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/24314619" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24314619</span></a>]<div>
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<i>(Brief review of herbal therapies for menopausal symptoms, mentions that chaste tree has not been shown to be effective for menopausal symptoms; no mention of adverse events or hepatotoxicity).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.seeff.2015.517">Seeff LB, Bonkovsky HL, Navarro VJ, Wang G. Herbal products and the liver: a review of adverse effects and mechanisms. <span><span class="ref-journal">Gastroenterology. </span>2015;<span class="ref-vol">148</span>:517–532.e3.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/25500423" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25500423</span></a>]<div>
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<i>(Extensive review of herbal associated liver injury does not discuss chaste tree specifically).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.brown.2017.472">Brown AC. Liver toxicity related to herbs and dietary supplements: Online table of case reports. Part 2 of 5 series. <span><span class="ref-journal">Food Chem Toxicol. </span>2017;<span class="ref-vol">107</span>:472–501.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/27402097" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27402097</span></a>]<div>
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<i>(Description of an online compendium of cases of liver toxicity attributed to HDS products, does not list or discuss chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.medinacaliz.2018.1495">Medina-Caliz I, Garcia-Cortes M, Gonzalez-Jimenez A, Cabello MR, Robles-Diaz M, Sanabria-Cabrera J, Sanjuan-Jimenez R, et al. Spanish DILI Registry. Herbal and dietary supplement-induced liver injuries in the Spanish DILI Registry. <span><span class="ref-journal">Clin Gastroenterol Hepatol. </span>2018;<span class="ref-vol">16</span>:1495–1502.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/29307848" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29307848</span></a>]<div>
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<i>(Among 856 cases of hepatotoxicity enrolled in the Spanish DILI Registry between 1994 and 2016, 32 were attributed to herbal products, the most frequent cause being green tea [n=8] and Herbalife products [n=6], while no case was attributed to chaste tree).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.bessone.2022.e548">Bessone F, García-Cortés M, Medina-Caliz I, Hernandez N, Parana R, Mendizabal M, Schinoni MI, et al. Herbal and dietary supplements-induced liver injury in Latin America: experience from the LATINDILI Network. <span><span class="ref-journal">Clin Gastroenterol Hepatol. </span>2022;<span class="ref-vol">20</span>:e548–e563.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/33434654" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33434654</span></a>]<div>
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<i>(Among 367 cases of hepatotoxicity enrolled in the Latin American DILI Network between 2011 and 2019, 29 [8%] were attributed to herbal products, the most frequent being green tea [n=7], Herbalife products [n=5] and garcinia [n=3], while chaste tree was not mentioned).</i>
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</div></div></li><li><div class="bk_ref" id="ChasteTree.REF.ballotin.2021.5490">Ballotin VR, Bigarella LG, Brandão ABM, Balbinot RA, Balbinot SS, Soldera J. Herb-induced liver injury: Systematic review and meta-analysis. <span><span class="ref-journal">World J Clin Cases. </span>2021;<span class="ref-vol">9</span>:5490–5513.</span> [<a href="/pmc/articles/PMC8281430/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8281430</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34307603" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34307603</span></a>]<div>
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<i>(Systematic review of the literature on herb induced liver injury identified 446 references describing 936 cases of liver injury due to 79 different herbal products, the most common being He Shou Wu [91], green tea [90] Herbalife products [64], kava kava [62] and greater celandine [48]; no case was attributed to chaste tree or a vitex species).</i>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK588847/?report=reader">PubReader</a></li><li><a href="/books/NBK588847/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK588847" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK588847" style="display:none" title="Cite this Page"><div class="bk_tt">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. 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<a href="https://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&db=pubmed&pubmedfilters=true&term=Chaste+Tree+AND+Human%5BMH%5D+AND+(drug+induced+liver+injury+OR+jaundice/CI+OR+bile+duct+diseases/CI+OR+liver/DE+OR+liver+diseases/CI)+AND+(%221900/1/1%22%5BEDat%5D:%222999/12/31%22%5BEDat%5D)" ref="pagearea=document-links&targetsite=external&targetcat=link&targettype=uri">Recent References on Chaste Tree: from PubMed.gov</a>
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Epub 2016 Jan 12.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/28243425" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus.</a><span class="source">[Electron Physician. 2017]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Rafieian-Kopaei M, Movahedi M. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Electron Physician. 2017 Jan; 9(1):3685-3689. Epub 2017 Jan 25.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/12809367" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications.</a><span class="source">[Phytomedicine. 2003]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlová-Wuttke D. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Phytomedicine. 2003 May; 10(4):348-57. </em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/28237870" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> The treatment of premenstrual syndrome with preparations of Vitex agnus castus: a systematic review and meta-analysis.</a><span class="source">[Am J Obstet Gynecol. 2017]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> The treatment of premenstrual syndrome with preparations of Vitex agnus castus: a systematic review and meta-analysis.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Verkaik S, Kamperman AM, van Westrhenen R, Schulte PFJ. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Am J Obstet Gynecol. 2017 Aug; 217(2):150-166. Epub 2017 Feb 22.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/11300976" ref="ordinalpos=1&linkpos=5&log$=relatedarticles&logdbfrom=pubmed">Is an extract of the fruit of agnus castus (chaste tree or chasteberry) effective for prevention of symptoms of premenstrual syndrome (PMS)?</a><span class="source">[J Fam Pract. 2001]</span><div class="brieflinkpop offscreen_noflow">Is an extract of the fruit of agnus castus (chaste tree or chasteberry) effective for prevention of symptoms of premenstrual syndrome (PMS)?<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Huddleston M, Jackson EA. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">J Fam Pract. 2001 Apr; 50(4):298. </em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=36745730" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=36745730" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c8de92ab82281a80321b24">Chaste Tree - LiverTox</a><div class="ralinkpop offscreen_noflow">Chaste Tree - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c8de91ab82281a803215c6">Chaparral - LiverTox</a><div class="ralinkpop offscreen_noflow">Chaparral - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c8de90b15b832ebc0572ac">Chamomile - LiverTox</a><div class="ralinkpop offscreen_noflow">Chamomile - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c8de8fa68b6b5afc6a7716">Cevimeline - LiverTox</a><div class="ralinkpop offscreen_noflow">Cevimeline - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c8de8eb15b832ebc05681a">Cetuximab - LiverTox</a><div class="ralinkpop offscreen_noflow">Cetuximab - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
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