Gilbert et al. [148] described acute liver failure requiring transplantation in a 43-year-old woman who consumed a polyherbal formulation containing 12 herbs, including Astragalus. Teschke and Bahre [149] described severe hepatotoxicity in a 64-year-old woman using multiple Ayurvedic products, including Bacopa monnieri, leading to jaundice and enzyme elevations, with ALT reaching 601 U/L and aspartate aminotransferase (AST) at 663 U/L (normal reference ranges are typically ≤40 U/L for ALT and ≤35 U/L for AST, depending on the laboratory). Here, GPT is linked to acute liver failure.