Kava Safety Update

Enlarge Image Image Gallery Steven Foster

n December 2000, a 14-year-old American girl developed persistent nausea, vomiting, fatigue, weight loss and loss of appetite—a constellation of symptoms that suggested acute hepatitis. She saw a doctor, who prescribed rest and liver-function tests. The test results showed much more liver damage than hepatitis typically causes. The girl was hospitalized with liver failure and received an emergency liver transplant.

Liver failure is extremely rare in otherwise healthy teenagers. This girl did not use alcohol, which in large amounts is toxic to the liver, and she took no medications implicated in liver damage, just ibuprofen occasionally. However, she had taken kava (Piper methysticum) for 44 days to treat anxiety.

Alarming Reports from Around the World

This case was just one of approximately 82 reports from around the world of kava users developing liver disease ranging from mild impairment of liver function (elevated liver enzymes) to jaundice, hepatitis and even acute liver failure requiring a transplant in an estimated 12 patients. Nine of these people died.

By early 2001, these reports generated international headlines. USA Today: “Herb Kava Linked to Liver Problems.” The New York Times: “Questions About Kava’s Safety.” They also prompted several countries to ban the herb: Germany, Austria, Canada, France, Ireland, Singapore, Switzerland and the U.K. Kava was not banned in the United States, but the Food and Drug Administration (FDA) warned consumers about the possibility of life-threatening liver damage.