Abstract

Traditional herbal medicines are widely used to manage metabolic diseases (diabetes, dyslipidaemia, nonalcoholic 
fatty liver disease) and organ-specific disorders (hepatotoxicity, nephrotoxicity, neurotoxicity, cardiotoxicity). Many 
phytochemicals demonstrate biologically plausible benefits through antioxidant, anti-inflammatory, metabolic
modulating, and organoprotective mechanisms. However, toxicology concerns intrinsic phytochemical toxicity, 
contaminants (heavy metals, pesticides), adulteration with pharmaceuticals, dose-dependent pro-oxidant effects, and 
herb–drug interactions-remain significant barriers to safe integration. This review synthesizes mechanistic 
rationales for herbal strategies against metabolic and organ-specific disorders, examines representative botanicals 
and formulations with evidence of benefit, and places toxicological risks in the foreground of translational planning. 
We propose a framework for integrating toxicology into traditional-medicine practice and research: standardized 
extracts and quality control, pharmacokinetics and dose-finding, preclinical toxicology screening, herb–drug 
interaction assessment, targeted clinical trials with mechanistic endpoints, and active pharmacovigilance. Practical 
recommendations for clinicians, policymakers and researchers include patient screening for vulnerabilities (hepatic 
or renal impairment, G6PD deficiency, polypharmacy), selecting evidence-grade products, and embedding safety 
monitoring in routine care. With rigorous toxicology-informed approaches, traditional herbal strategies can be 
responsibly evaluated and, where appropriate, deployed as adjunctive tools to prevent or mitigate metabolic and 
organ-specific disorders.