Active warning — SupplementIndex Safety Review: FDA: avoid oral use. Hepatotoxic pyrrolizidine alkaloids.
Updated: 2026-05-29 · v2.0 · Prof. G. Pkhakadze, MD, MPH, PhDCiteEditorial
📰Read the full Comfrey (oral) evidence review on GMJ News →Complete clinical article, references and updates on news.gmj.ge. This page is the structured safety summary.
5
Avoid
Comfrey (oral)
Symphytum officinale
BannedStrongRestricted
RDA
PROHIBITED orally
Target
N/A
Upper limit
No oral dose safe
Products
Dosage by population group — reference
⚠ DANGEROUS — see overview [1]
ℹ️ Not obtained from food. Not applicable — this substance is not a dietary nutrient and should not be consumed as food.
🔬 Lab interpreter
ℹ️ No validated blood test. There is no established laboratory test to assess status or guide dosing for this ingredient. Clinical response and symptoms are the practical guide.
⚕ For professionals — confirm ranges against your local laboratory.
Clinical verdict
Comfrey is BANNED for oral use in multiple countries due to PA hepatotoxicity/carcinogenicity. FDA advised removal from oral supplements. Topical (short-term, intact skin): may be acceptable for bruises/sprains. ORAL: hepatic veno-occlusive disease, liver cancer. The oral/topical distinction is the entire safety teaching [1].
1 How much do I need?
👤 Adults: Specific dosage data under clinical review
👴 Elderly: Specific dosage data under clinical review
🤰 Pregnancy: See guidance
ABSOLUTELY CONTRAINDICATED orally [1].
👦 Pediatric: See guidance
ABSOLUTELY NOT [1].
🏃 Athletes: Standard dose
⚖️ Obesity: Standard dose
Fat-soluble compounds may require dose adjustment in obesity.
🩺 Renal: Consult specialist
Dose adjustment may be needed in renal impairment.
🌱 Vegan: Standard dose

How to take

🍽 Timing: DO NOT USE [1].
💊 With food: N/A [1].
🚫 Avoid: COMPLETELY [1].
2 Which form?
FormBioavailabilityVeganCost
['See overview', 'restricted/banned', 'See overview [1].']StandardCheck label
3 Common questions
DANGER
Comfrey is BANNED for oral use in multiple countries due to PA hepatotoxicity/carcinogenicity. FDA advised removal from oral supplements. Topical (short-term, intact skin): may be acceptable for bruises/sprains. ORAL: hepatic veno-occlusive disease, liver cancer. The oral/topical distinction is the entire safety teaching [1].
4 Clinical evidence

Strong

See overview [1]. HIGH

Moderate

See overview [1]. MODERATE

Insufficient

See overview [1]. LOW
5 Safety, toxicity & adverse events

Absolute contraindications

✕ Should not be taken orally — hepatotoxic pyrrolizidine alkaloids cause veno-occlusive liver disease and cancer; oral products are banned in many countries
✕ Liver disease
✕ Pregnancy and lactation

Relative

⚠ Even topical use should avoid broken skin and prolonged application

🚩 Red flags

DANGEROUS — see overview [1]
6 Interactions

Drug interactions

See overview Lethal/major
Action: DO NOT USE [1].
7 Cite this page
Vancouver: Pkhakadze G. Comfrey (oral) — safety profile [Internet]. Tbilisi: PHIG; 2026 [cited 2026 Jul 17]. Available from: https://supplement.ge/ingredients/comfrey-oral/
APA 7th: Pkhakadze, G. (2026). Comfrey (oral) — Safety profile. Public Health Institute of Georgia. https://supplement.ge/ingredients/comfrey-oral/
📋 Editorial information
Author: Prof. G. Pkhakadze, MD, MPH, PhD
Affiliation: David Tvildiani Medical University (DTMU)
First published: January 2026
Last reviewed: 2026-05-29
Next review: January 2027
References: 1 cited sources
COI: SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
Process: Systematic literature review
📄 License & reuse
Published under Creative Commons Attribution 4.0 International (CC BY 4.0). You may share and adapt for any purpose with attribution.
Pkhakadze G. "Comfrey (oral) — Safety Profile." SupplementIndex, PHIG, 2026. https://supplement.ge/ingredients/comfrey-oral/ CC BY 4.0.
GP
Prof. G. Pkhakadze, MD, MPH, PhD
Professor of Public Health · Head of Department, DTMU
Editor-in-Chief, Georgian Medical Journal (ISSN 3088-4322)
Chair, Public Health Institute of Georgia · UEMS Public Health Section
Educational and public health purposes. CC BY 4.0. Consult your healthcare provider before starting any supplement. Corrections: info@accreditation.ge. Publisher: PHIG