More people have come forward reporting cases of serious liver harm from taking a plant extract called Artemisia annua, leading the Director General of Health to renew a public warning.

Artemisia annua extract (also known as Sweet Wormwood, Sweet Annie or Qing hao) is marketed as a natural dietary supplement for maintaining and supporting joint health and mobility.

The sweet-smelling extract has long been linked to Chinese traditional medicine practices.

An initial health alert about its use was issued in February after there were 14 reports of liver harm linked to the use of Arthrem and other natural products containing Artemisia annua extracts.

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Since then there have been 11 additional reports, including some showing serious harm.

Some of these new reports may have been from people taking these products earlier, but they may also have been from people continuing to take the product, the Ministry of Health said.

Several products containing Artemisia annua extract are available in New Zealand.

Anyone taking these products, should be aware of the risk of harm linked to their use, the Ministry said.

The majority of cases reported to the Centre for Adverse Reactions Monitoring are linked to the use of Arthrem soft gel capsules (Promisia).

Two cases also report use of GO Arthri-Remedy 1-A-Day soft gel capsules (GO Healthy).

GO Arthri-Remedy 1-A-Day was withdrawn after publication of the previous alert.

There remain other products in New Zealand that contain Artemesia annua extract.

Medsafe recommends anyone taking these products to be alert for signs of nausea, stomach pain, pale stools, dark urine, itching all-over, yellow eyes or skin. Anyone with these symptoms should seek medical advice.

Most patients are believed to have stopped taking the plant extracts once they became sick.

Most had also either already recovered from the harm to their livers or were improving by the time they reported the links to the plant extract to authorities.

Visit www.health.govt.nz for more information.