Giloy was promoted across India as an immune booster during the pandemic. Then liver units started seeing patients. Here is what the reports actually found, and the argument that complicates them.
Giloy, also called Guduchi, is the climbing vine Tinospora cordifolia. It has a long place in Ayurveda, and it was recommended by India’s Ministry of AYUSH for COVID-19 care, after which it was taken by an enormous number of people as juice, kadha and tablets (3).
What followed is one of the more uncomfortable stories in herbal medicine, and it is worth telling carefully, because both the evidence and the objection to it are real.
Key Takeaways
- A nationwide Indian study across 13 centres reported 43 patients with liver injury following giloy use (1).
- The median time from starting giloy to symptoms was about 46 days (1).
- The injury often carried autoimmune features, and the authors concluded giloy can unmask autoimmune hepatitis in people who already had it silently (1).
- Ayurvedic researchers counter that look-alike species sold as giloy, particularly Tinospora crispa, are the likely culprit, and that nobody verified which plant the patients took (3).
- Giloy is not alone: a 2024 review lists it alongside other widely used traditional herbs with documented liver toxicity (4).
- These are case reports and a retrospective study. They tell us this can happen; they do not tell us how often.
What Giloy Is
A climbing vine with heart-shaped leaves, native to the Indian subcontinent. The stem is the part usually used, as fresh juice, as a decoction, or dried into tablets sold as Giloy Ghan Vati. Its traditional reputation includes anti-inflammatory and immune-modulating uses, and, notably for what follows, protecting the liver (3).
The First Reports
In 2021, a Mumbai hospital group described six patients, four women and two men, with a median age of 55, who developed acute hepatitis after taking Tinospora cordifolia. The median duration of use was about 90 days. Their liver numbers were not marginal: a median peak bilirubin of 17.5 mg/dl and a median peak AST of 1,350 IU/ml. Four had a definite and two a probable score for autoimmune hepatitis (2).
A separate group reported the same pattern of autoimmune-like liver injury in the same period (5).
The Nationwide Study
The case series prompted a much larger look. Researchers across 13 centres in nine locations collected cases of herb-induced liver injury temporally linked to giloy, and also ran chemical and toxicological analysis on retrieved giloy samples (1).
| What they found | Detail |
|---|---|
| Patients | 43, more than half of them women |
| Time to symptoms | Median about 46 days after starting giloy |
| How it presented | Acute hepatitis; acute worsening of existing chronic liver disease, which was the most common; or acute liver failure |
| Causality assessment | Probable liver injury in 67.4% |
| Antibodies | Anti-nuclear antibody was the most common |
| Biopsy findings | Autoimmune features, cholestasis, and neutrophilic and eosinophilic infiltration |
The conclusion matters more than any single number. Giloy was associated with acute hepatitis carrying autoimmune features, and appeared able to unmask autoimmune hepatitis in people who had it quietly in the background without knowing (1).
Note what that implies. The people most at risk were not necessarily taking more than anyone else. They were the ones who already had something there.
The Objection, Which Is Not a Brush-Off
Ayurvedic researchers responded, and their argument deserves to be stated properly rather than waved away (3).
- The authentic Guduchi is Tinospora cordifolia
- But Tinospora sinensis and Tinospora crispa are also traded in the Indian subcontinent under the names Guduchi and giloy
- T. crispa is known to cause liver toxicity
- In the reported cases, nobody verified botanically which species the patients had actually consumed
Their reading is that authentic T. cordifolia is unlikely to have caused autoimmune-like hepatitis, and that a wrong species was probably self-administered (3).
That is a reasonable scientific position and it has not been resolved.
Why That Does Not Help the Person Buying It
SaveHere is the part that decides what to do on a Tuesday afternoon in a pharmacy.
If the explanation is species substitution, the plant is innocent and the supply chain is not. Either way, the bottle in your hand is the same bottle. You cannot tell T. cordifolia from T. crispa in a tablet, the label will say giloy regardless, and the people in those studies believed they were taking giloy too.
An unresolved dispute about which species caused the harm is not reassurance. It is a reason to treat the product with more care, not less.
Giloy Is Not the Only One
A 2024 review of liver toxicity in traditional Indian medicine makes the broader point. Beyond contamination and adulteration, some widely used herbal components have inherent liver toxicity, and the review names giloy alongside ashwagandha, turmeric and bakuchi, with others such as Garcinia cambogia and noni fruit flagged as emerging concerns (4).
It also records the thing worth remembering: most reported herb-induced liver injuries are self-limiting and settle when the herb is stopped, but some progress to acute liver failure, which carries high mortality (4).
Stopping early is therefore the whole game, and that depends on recognising it.
Warning Signs Worth Knowing
If you are taking giloy, or any herbal supplement regularly, these are the signs to stop and ask for liver blood tests:
- Yellowing of the whites of the eyes or the skin
- Dark urine, or unusually pale stools
- Persistent nausea or loss of appetite
- Pain or discomfort under the right ribs
- Unusual tiredness that does not fit anything else
- Itching without a rash
Because the gap between starting and falling ill was around six weeks in the larger study (1), people rarely connect the two on their own. Tell whoever is treating you exactly what you have been taking, including anything herbal. That single sentence is often what makes the diagnosis.
Who Should Be Most Careful
- Anyone with existing liver disease, which was the most common presentation in the nationwide study (1)
- Anyone with autoimmune hepatitis, diagnosed or suspected
- Anyone already taking medicines processed by the liver, where a doctor should be the one to weigh it
- Pregnancy and breastfeeding, where there is no safety data
- Anyone planning months of daily use rather than a short course
Frequently Asked Questions
Does giloy damage the liver?
In some people it has been associated with liver injury. A nationwide Indian study across 13 centres described 43 patients whose liver problems followed giloy use, and a separate case series described six more. That is not the same as saying giloy damages everyone’s liver: these are reports of people who became ill, not a measure of how often it happens among the many who take it without trouble.
How long does it take for giloy to affect the liver?
Longer than most people expect, which is part of why the link is easy to miss. In the 43-patient study the median time from starting giloy to the first symptoms was about 46 days. In the earlier case series the median duration of use was around 90 days. This is not a next-day reaction, so people rarely connect the two themselves.
Is it the giloy or a different plant?
That is a genuine scientific dispute and it is not settled. Ayurvedic researchers point out that true Guduchi is Tinospora cordifolia, but Tinospora sinensis and Tinospora crispa are also traded as giloy in India, and T. crispa is known to be hepatotoxic. In the reported cases the botanical identity of what people actually took was not verified. The practical problem is that a buyer cannot tell which species is in the bottle either.
What are the warning signs to stop and see a doctor?
Yellowing of the eyes or skin, dark urine, pale stools, persistent nausea, pain under the right ribs, unusual tiredness, or itching without a rash. These are signs of liver trouble whatever the cause. If you are taking giloy and any of them appear, stop and get liver blood tests rather than waiting to see whether it passes.
Is giloy safe to take daily?
Nobody has established a safe daily dose or duration, and the reported cases involved weeks to months of regular use rather than occasional use. If you take it, the sensible approach is short courses rather than an indefinite daily habit, with a doctor’s involvement if you have any existing liver condition. Anyone with liver disease, including silent autoimmune hepatitis, is the group the studies flag most.
The Bottom Line
Giloy is not a poison and this is not an argument against Ayurveda. Many people have taken it without any trouble, and the studies here describe people who became ill rather than a rate among everyone who took it.
What they do establish is that a herb sold specifically as a liver protector has been associated with serious liver injury, that the injury took about six weeks to show, that it hit hardest in people with something already there, and that the question of which species was in the bottle remains open.
The sensible response is not panic. It is short courses rather than indefinite daily use, caution if your liver is already involved, telling your doctor what you take, and knowing the warning signs well enough to act on them early.
This article is for information only and is not medical advice. Do not stop or start any treatment on the basis of a web page. If you are taking giloy and feel unwell, speak to a doctor and mention the supplement by name.
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