Kava
Common name
kava, kava kava, ava pepper, ava root, kawa
ID
HD0041
Scientific name of the plant
Piper methysticum
Anatomical part for use
root, stem
Human use
Mental stress & mood disorders
Summary
Kava or kava kava (Piper methysticum: Latin 'pepper' and Latinized Greek 'intoxicating') is a crop of the Pacific Islands. The name kava is from Tongan and Marquesan, meaning 'bitter'; other names for kava include ʻawa (Hawaiʻi), ʻava (Samoa), yaqona or yagona (Fiji), sakau (Pohnpei), seka (Kosrae), and malok or malogu (parts of Vanuatu). Kava is consumed for its sedating effects throughout the Pacific Ocean cultures of Polynesia, including Hawaii, Vanuatu, Melanesia, and some parts of Micronesia, such as Palau. To a lesser extent, it is consumed in nations where it is exported as a herbal medicine.
The root of the plant is used to produce a drink with sedative, anesthetic, and euphoriant properties. Its active ingredients are called kavalactones. A systematic review done by the British nonprofit Cochrane concluded it was likely to be more effective than placebo at treating short-term anxiety.Moderate consumption of kava in its traditional form, i.e., as a water-based suspension of kava roots, has been deemed to present an "acceptably low level of health risk" by the World Health Organization. However, consumption of kava extracts produced with organic solvents, or excessive amounts of poor-quality kava products, may be linked to an increased risk of adverse health outcomes, including potential liver injury. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Hepatitis associated with Kava, a herbal remedy for anxiety : (Source)
- Kava hepatotoxicity : (Source)
- [Fulminant liver failure after administration of the herbal antidepressant Kava-Kava] : (Source)
- [Kava-induced acute icteric hepatitis] : (Source)
- Hepatic toxicity possibly associated with kava-containing products--United States, Germany, and Switzerland, 1999-2002 : (Source)
- Acute liver failure after administration of herbal tranquilizer kava-kava (Piper methysticum) : (Source)
- Fatal fulminant hepatic failure induced by a natural therapy containing kava : (Source)
- Acute hepatitis induced by kava kava : (Source)
- Hepatitis induced by Kava (Piper methysticum rhizoma) : (Source)
- Toxic hepatitis after consumption of traditional kava preparation : (Source)
- [Necrotizing hepatitis after taking herbal remedies] : (Source)
Hepatotoxicity Description
The frequency of adverse reactions to kava, particularly liver injury, is not known. Based upon reported cases, the estimated frequency of clinically apparent liver injury due to kava is less than 1:1,000,000 daily doses. However, spontaneous reporting is believed to capture less than 1% of severe adverse events from the use of dietary supplements. Between 50 and 100 cases of clinically apparent liver injury have been published or discussed in the literature. Advocates of the herbal have strongly rejected these numbers, disputing both their accuracy and the causality assessment process. Still, there seem to be convincing evidence in some cases of severe hepatitis ending in fulminant hepatic failure, requiring liver transplantation, and even leading to death. Patients typically present with fatigue, nausea, elevations in serum aminotransferase levels, and jaundice 2 to 24 weeks after starting use of the product. The pattern of enzyme elevations is hepatocellular with marked elevations in serum aminotransferase and minimal increases in alkaline phosphatase levels. In some cases, features of immunoallergic hepatitis (rash, fever, eosinophilia, and recurrence on reexposure) are present. Liver biopsy findings include focal hepatocellular necrosis, lobular inflammation and intrahepatic cholestasis. In more severe cases there is massive or submassive necrosis. (Source: LiverTox)
Traditional medicine
Over centuries, kava has been used in the traditional medicine of the South Pacific Islands for central nervous system and peripheral effects. As noted in one literature review: "Peripherally, kava is indicated in traditional Pacific medicine for urogenital conditions (gonorrhea infections, chronic cystitis, difficulty urinating), reproductive and women's health (...), gastrointestinal upsets, respiratory ailments (asthma, coughs, and tuberculosis), skin diseases and topical wounds, and as an analgesic, with significant subtlety and nuance attending the precise strain, plant component (leaf, stem, root) and preparative method to be used". (Source: Wiki)
Common name
kava, kava kava, ava pepper, ava root, kawa
ID
HD0041
Scientific name of the plant
Piper methysticum
Anatomical part for use
root, stem
Human use
Mental stress & mood disorders
Summary
Kava or kava kava (Piper methysticum: Latin 'pepper' and Latinized Greek 'intoxicating') is a crop of the Pacific Islands. The name kava is from Tongan and Marquesan, meaning 'bitter'; other names for kava include ʻawa (Hawaiʻi), ʻava (Samoa), yaqona or yagona (Fiji), sakau (Pohnpei), seka (Kosrae), and malok or malogu (parts of Vanuatu). Kava is consumed for its sedating effects throughout the Pacific Ocean cultures of Polynesia, including Hawaii, Vanuatu, Melanesia, and some parts of Micronesia, such as Palau. To a lesser extent, it is consumed in nations where it is exported as a herbal medicine. The root of the plant is used to produce a drink with sedative, anesthetic, and euphoriant properties. Its active ingredients are called kavalactones. A systematic review done by the British nonprofit Cochrane concluded it was likely to be more effective than placebo at treating short-term anxiety.Moderate consumption of kava in its traditional form, i.e., as a water-based suspension of kava roots, has been deemed to present an "acceptably low level of health risk" by the World Health Organization. However, consumption of kava extracts produced with organic solvents, or excessive amounts of poor-quality kava products, may be linked to an increased risk of adverse health outcomes, including potential liver injury. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Hepatitis associated with Kava, a herbal remedy for anxiety : (Source)
- Kava hepatotoxicity : (Source)
- [Fulminant liver failure after administration of the herbal antidepressant Kava-Kava] : (Source)
- [Kava-induced acute icteric hepatitis] : (Source)
- Hepatic toxicity possibly associated with kava-containing products--United States, Germany, and Switzerland, 1999-2002 : (Source)
- Acute liver failure after administration of herbal tranquilizer kava-kava (Piper methysticum) : (Source)
- Fatal fulminant hepatic failure induced by a natural therapy containing kava : (Source)
- Acute hepatitis induced by kava kava : (Source)
- Hepatitis induced by Kava (Piper methysticum rhizoma) : (Source)
- Toxic hepatitis after consumption of traditional kava preparation : (Source)
- [Necrotizing hepatitis after taking herbal remedies] : (Source)
Hepatotoxicity Description
The frequency of adverse reactions to kava, particularly liver injury, is not known. Based upon reported cases, the estimated frequency of clinically apparent liver injury due to kava is less than 1:1,000,000 daily doses. However, spontaneous reporting is believed to capture less than 1% of severe adverse events from the use of dietary supplements. Between 50 and 100 cases of clinically apparent liver injury have been published or discussed in the literature. Advocates of the herbal have strongly rejected these numbers, disputing both their accuracy and the causality assessment process. Still, there seem to be convincing evidence in some cases of severe hepatitis ending in fulminant hepatic failure, requiring liver transplantation, and even leading to death. Patients typically present with fatigue, nausea, elevations in serum aminotransferase levels, and jaundice 2 to 24 weeks after starting use of the product. The pattern of enzyme elevations is hepatocellular with marked elevations in serum aminotransferase and minimal increases in alkaline phosphatase levels. In some cases, features of immunoallergic hepatitis (rash, fever, eosinophilia, and recurrence on reexposure) are present. Liver biopsy findings include focal hepatocellular necrosis, lobular inflammation and intrahepatic cholestasis. In more severe cases there is massive or submassive necrosis. (Source: LiverTox)
Traditional medicine
Over centuries, kava has been used in the traditional medicine of the South Pacific Islands for central nervous system and peripheral effects. As noted in one literature review: "Peripherally, kava is indicated in traditional Pacific medicine for urogenital conditions (gonorrhea infections, chronic cystitis, difficulty urinating), reproductive and women's health (...), gastrointestinal upsets, respiratory ailments (asthma, coughs, and tuberculosis), skin diseases and topical wounds, and as an analgesic, with significant subtlety and nuance attending the precise strain, plant component (leaf, stem, root) and preparative method to be used". (Source: Wiki)