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healthcare professional, should never be used above recommended doses, and should
be avoided by people with liver problems and by those taking drugs that affect the
liver."
Reports from health authorities in Germany, Switzerland, France, Canada, and the
United Kingdom have linked kava use to at least 30 cases of liver toxicity, including
hepatitis, cirrhosis, and liver failure. Kava is banned in Germany, Canada and
Switzerland. The US FDA issued a consumer advisory in 2002, which is still in effect.
The FDA cautions: Persons who have liver disease or liver problems, or persons who
are taking drug products that can affect the liver, should consult a physician before
using kava-containing supplements.
In view of the evidence of liver toxicity, four of the seven sources consulted for this
section of this outline, Lake and Spiegel, Mischoulon and Rosenbaum, the Natural
Standard, and Weil, counsel that kava should be avoided in individuals with a history
of liver disease or alcohol use, and in those who are taking concurrent medications
with potential liver toxicity. Anyone who uses kava should do so under physician
supervision, which should include regular monitoring of liver function tests,
particularly ALT, GGT and ALP. If any abnormalities are found, then kava should be
discontinued immediately and liver enzymes should be retested in about two weeks, by
which time they should return to normal.
The other three sources, Fugh-Berman, Brown et al. and Consumer Reports, dissent
and counsel complete avoidance of kava.
If you use kava without medical consultation, get help right away if you start feeling
bad. FDA urges consumers and their health care professionals to report any cases of
liver and other injuries that may be related to the use of kava-containing dietary
supplements. Adverse events associated with the use of dietary supplements should be
reported as soon as possible to FDA's MedWatch program by calling their toll-free
number (1- 800 - 332 - 1088) or through the Internet.
Other side effects include dystonia (abnormal muscle spasm or involuntary muscle
movements), gastrointestinal upset, allergic reactions, headache, light sensitivity and