Case Report of Cinnamon-Induced Mixed Hepatocellular-Cholestatic Liver Injury in a Young Woman: A Detailed Analysis

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September 27, 2025

A recently documented case highlights a potential link between high cinnamon intake and liver problems in a young woman. The incident,detailed in a medical report,raises questions about the safety of consuming large amounts of this popular spice.

Details of the Case

Medical professionals reported the case of a previously healthy young woman who developed signs of liver damage after regularly consuming cinnamon. Initial assessments indicated a mixed hepatocellular-cholestatic liver injury. This means that damage was observed in both the liver cells themselves and the bile ducts. the patient’s symptoms prompted a detailed review of her dietary habits.

Investigators discovered the woman had been using substantial amounts of cinnamon, largely as part of a social media-driven trend. She was consuming it daily, exceeding typical dietary levels.Following cessation of cinnamon intake, her liver function gradually improved, suggesting a strong correlation between the spice and her condition.

Understanding Liver Injury Types

Liver injury can manifest in different ways. Hepatocellular damage affects the primary liver cells, while cholestatic injury impacts the flow of bile. A mixed injury, as seen in this case, involves both. Such conditions can lead to a range of symptoms, from fatigue and jaundice to abdominal pain and, in severe cases, liver failure.

The Rise of Cinnamon challenges and Health Concerns

the case arrives amid growing concern over “cinnamon challenges,” popularized on social media platforms like TikTok, which encourage individuals to consume large quantities of ground cinnamon. While seemingly harmless, these challenges can pose meaningful health risks. According to the American Academy of Pediatrics,these challenges can cause choking,pneumonia,and lung irritation.

Disclaimer: This article provides general information and should not be considered medical advice.Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Did You know? The U.S. Food and Drug Administration (FDA) has warned against participating in cinnamon challenges, highlighting the potential dangers of aspiration and related health complications. the FDA’s guidance underscores the importance of responsible social media engagement and prioritizing health safety.

Type of Liver Injury	Affected Area	Potential Symptoms
Hepatocellular	Liver Cells	Fatigue, jaundice, nausea
Cholestatic	Bile Ducts	itching, dark urine, pale stools
Mixed	Liver Cells & Bile Ducts	Combination of above

Pro Tip: If you experience symptoms of liver problems, such as persistent fatigue, jaundice, or abdominal pain, seek medical attention immediately. Early diagnosis and treatment are crucial for managing liver conditions effectively.

What Does This Mean for Cinnamon Consumption?

While moderate cinnamon consumption is generally considered safe,this case underscores the potential risks associated with excessive intake. Experts suggest limiting daily cinnamon consumption to reasonable amounts typically used in cooking and baking. Avoid participating in challenges or consuming large quantities of cinnamon for non-culinary purposes.

The incident also highlights the need for increased awareness about the potential adverse effects of seemingly harmless trends on social media. Caution and moderation are key when experimenting with dietary changes or participating in online challenges.

could this case lead to stricter regulations on the sale of cinnamon or increased warning labels on products? What steps can individuals take to ensure they are consuming cinnamon safely?

Understanding Cinnamon Varieties and Potential Contaminants

There are several types of cinnamon available, including Ceylon cinnamon (often called “true cinnamon”) and Cassia cinnamon, which is more commonly found in supermarkets. Cassia cinnamon contains higher levels of coumarin, a naturally occurring compound that can be toxic to the liver in large doses. While the woman’s specific type of cinnamon wasn’t detailed, the potential for coumarin-induced liver injury exists.

Additionally, cinnamon can sometimes be contaminated with aflatoxins, toxic compounds produced by certain molds. Proper storage and sourcing are essential to minimize the risk of contamination.

Frequently Asked Questions about Cinnamon and Liver Health

• Can cinnamon cause liver damage? Yes, excessive consumption of cinnamon, especially Cassia cinnamon, may potentially lead to liver injury due to coumarin content.
• How much cinnamon is safe to eat? Experts recommend consuming cinnamon in moderation, typically amounts used in cooking and baking.
• What are the symptoms of liver problems? Common symptoms include fatigue, jaundice, abdominal pain, nausea, and dark urine.
• Are cinnamon challenges dangerous? Yes, cinnamon challenges are extremely dangerous and can cause choking, pneumonia, and liver damage.
• Is Ceylon cinnamon safer than Cassia cinnamon? Ceylon cinnamon generally contains lower levels of coumarin and might potentially be a safer option for regular consumption.
• What should I do if I think I have cinnamon-induced liver damage? Seek immediate medical attention and inform your doctor about your cinnamon intake.

Share this article with your friends and family to raise awareness about the potential risks of excessive cinnamon consumption. What are your thoughts on social media challenges that promote potentially harmful activities? Leave a comment below.

What is the TDI of coumarin and how dose it relate to the patientS cinnamon consumption?

Patient Presentation & Initial Assessment

A 23-year-old female presented to our hepatology clinic with complaints of progressive jaundice, fatigue, and abdominal discomfort over a four-week period.Her medical history was unremarkable, with no prior liver disease, alcohol abuse, or known viral hepatitis. Initial laboratory investigations revealed elevated liver enzymes: ALT 450 U/L (normal range: 7-56 U/L), AST 380 U/L (normal range: 8-48 U/L), alkaline phosphatase 600 U/L (normal range: 30-120 U/L), and bilirubin 3.5 mg/dL (normal range: 0.3-1.0 mg/dL). Viral hepatitis serologies (HAV, HBV, HCV, HEV) were negative. Autoimmune markers (ANA, anti-smooth muscle antibody, anti-LKM1 antibody) were also negative, ruling out autoimmune hepatitis. Drug-induced liver injury (DILI) was considered, prompting a thorough medication and supplement review.

Identifying Cinnamon as a potential Culprit: Dietary History

Detailed questioning revealed the patient’s consistent daily consumption of meaningful amounts of cinnamon – approximately 3-5 grams – primarily added to her morning oatmeal, coffee, and baked goods. She reported using Cassia cinnamon, the more common and less expensive variety, for the past six months. The patient was unaware of potential liver toxicity associated with cinnamon intake. This raised suspicion of cinnamon-induced liver injury, a relatively uncommon but increasingly recognized cause of DILI. The term “apple and cinnamon” often evokes pleasant associations, but this case highlights a potential risk.

Diagnostic Workup & Liver Biopsy Findings

Further investigations were undertaken to confirm the diagnosis and assess the severity of liver damage.

* Ultrasound of the liver: Showed mild hepatomegaly and no evidence of biliary obstruction.

* Magnetic Resonance Cholangiopancreatography (MRCP): Ruled out structural abnormalities of the biliary tree.

* Liver Biopsy: The biopsy revealed a mixed hepatocellular-cholestatic pattern of injury. Histopathological findings included:

* Moderate lobular inflammation with predominantly lymphocytic infiltrates.

* Hepatocyte necrosis and ballooning degeneration.

* Cholestasis with canalicular plugging.

* No evidence of fibrosis or cirrhosis.

These findings were consistent with DILI, specifically pointing towards a toxic effect on both hepatocytes and bile ducts.

Cinnamon Varieties & Hepatotoxicity: Understanding the Risk

the hepatotoxicity associated with cinnamon is primarily linked to the presence of coumarin, a naturally occurring compound found in higher concentrations in Cassia cinnamon compared to Ceylon cinnamon (“true cinnamon”). Coumarin is metabolized in the liver, and its metabolites can be hepatotoxic, particularly in susceptible individuals.

* Cassia Cinnamon: Contains 5-10g of coumarin per kilogram.

* Ceylon Cinnamon: Contains less than 0.004g of coumarin per kilogram.

The patient’s high daily intake of Cassia cinnamon likely exceeded the tolerable daily intake (TDI) of coumarin, leading to liver damage. The European Food Safety Authority (EFSA) established a TDI for coumarin of 0.1 mg/kg body weight per day.

Differential Diagnosis & Ruling Out Other Causes

Several other potential causes of liver injury were carefully considered and ruled out:

1. Acetaminophen Toxicity: Patient denied acetaminophen use.
2. Herbal and dietary Supplement (HDS) Induced Liver Injury: A comprehensive review of all supplements revealed no other potential hepatotoxins.
3. Non-alcoholic Fatty Liver Disease (NAFLD): Patient had a normal BMI and no metabolic risk factors.
4. Wilson’s Disease & Hemochromatosis: Ceruloplasmin and iron studies were within normal limits.

Treatment & Patient Management

Upon suspicion of cinnamon-induced liver injury, the patient was instantly advised to discontinue all cinnamon consumption. Supportive care,including hydration and a bland diet,was provided. Liver function tests were monitored closely.

* Follow-up (2 weeks): ALT and AST levels began to decline.

* Follow-up (4 weeks): Significant advancement in liver enzyme levels: ALT 150