To avoid its toxic adverse effects "Xanthium sibiricum" must be processed. Hepatotoxicity has been reported with products containing "Reynoutria multiflora" (synonym "Polygonum multiflorum"), glycyrrhizin, "Senecio" and "Symphytum". The herbs indicated as being hepatotoxic included "Dictamnus dasycarpus", "Astragalus membranaceous", and "Paeonia lactiflora". Contrary to popular belief, "Ganoderma lucidum" mushroom extract, as an adjuvant for cancer immunotherapy, appears to have the potential for toxicity. A 2013 review suggested that although the antimalarial herb "Artemisia annua" may not cause hepatotoxicity, haematotoxicity, or hyperlipidemia, it should be used cautiously during pregnancy due to a potential risk of embryotoxicity at a high dose.