Psychoactive herb linked to liver toxicity.

• A. Milk thistle
• B. Ginkgo biloba
• C. Ginseng
• D. Kava-kava

Answer: (D)

Psychoactive herbs can affect organ systems, and this question emphasizes the liver-specific risk among common options. Kava-kava has a well-documented history of causing liver injury in some users, ranging from hepatitis and cholestasis to acute liver failure in rare cases, especially with prolonged use, high doses, or existing liver disease or alcohol use. Because of these reports, regulatory warnings and cautions have been issued in various regions, highlighting the potential hepatotoxic risk of this herb.

Milk thistle, by contrast, is often discussed as hepatoprotective rather than hepatotoxic, and is used to support liver health. Ginkgo biloba and ginseng have their own safety considerations, but they are not chiefly recognized for causing liver toxicity. Therefore, the herb most consistently linked to liver injury among these options is kava-kava.