Kava & Liver: Appears safe but should not be used if liver has issues
Clinical trials of kava have not revealed any hepatotoxicity.
Most experimental studies have not shown that kava has a tendency to have a toxic effect on the liver.
Most clinical reviews of case reports cast doubt on a causal association between kava products and liver problems. The cases have come to regulatory authorities as spontaneous reports. There have been no epidemiological studies and the incidence is not known. - WHO report - 2007/literature review
Risk factors for hepatic reactions appear to be the use of organic extracts, heavy alcohol intake, pre-existing liver disease, genetic polymorphisms of cytochrome P450 enzymes and excessive dose. Also, co-medication with other potentially hepatotoxic drugs and potentially interacting drugs, particularly other anxiolytics, antipsychotics and anti-thrombotics, might lead to harm. - WHO report - 2007
Organic extracts: using solvents (eg. ethanol) to extract active compounds.
Organic extracts refer to kava preparations that use chemical solvents such as ethanol, acetone, or methanol to extract the active compounds (kavalactones) from the plant. Unlike traditional water-based (aqueous) preparations, organic solvent extraction can pull out additional compounds, including potentially harmful alkaloids like pipermethystine, which are found in the leaves and stems of the kava plant. These extracts are often more concentrated and may pose a higher risk of liver toxicity due to their potency and the presence of unwanted substances. The use of organic extracts has been identified as a significant risk factor for hepatic reactions, especially when combined with other contributing factors such as heavy alcohol consumption, pre-existing liver conditions, or drug interactions.
On not using
Kava should not be used in patients with liver disease
Kava should not be used in patients with liver disease or a history of such, or in patients who take excessive alcohol. - WHO report - 2007
Anecdotal reports:
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