Is Kava Safe? Contraindications and Health Warnings

Kava, also called kava kava, comes from the roots of the Piper methysticum shrub. As a beverage, this plant has been used for centuries in Europe and the South Pacific.

Its most common uses have been for social occasions, ceremonies and for its psychoactive effects. People also take it for anxiety, insomnia and to promote relaxation and restfulness.

Despite its widespread use, Kava may be unsafe for certain people to use. Even at typical dosage levels, serious side effects have been reported. It is important to consult with a doctor before taking Kava to find out if it is safe for you or not.

There may be an increased risk of adverse effects when combining Kava with certain drugs and supplements that are metabolized by the liver. Individuals with a history of liver problems should avoid this herb.

Kava

Herbal Supplement

Anxiety

Mood

Sleep

How It Works:

• Reduces feeling of anxiety & stress
• Improves feeling of wellbeing
• Shown to improve sleep & insomnia

Dosage:

Between 100 - 300 mg per day

Safety:

Rated Possibly Safe

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Kava Kava Dangers

The Natural Medicines Database says that kava is possibly unsafe. This herb is associated with liver problems, including hepatotoxicity (liver damage from toxicity) and liver failure.

These problems have occurred even when people have taken this herb in regular doses for a short period of time. In some instances, individuals have required liver transplants following use of kava for several months.

Nonetheless, kava has also been used safely for periods of time in medically supervised clinical trials. Consult with a doctor to determine if it is appropriate for you or not.

This herb has been associated with other side effects not related to the liver as well, including abnormal muscle movements or spasms, changes in skin color and texture, and drowsiness.

Who is Kava Not Safe For?

Certain groups of people should take particular care with Kava or should avoid this herb completely.

Kava herb is considered possibly unsafe for pregnant and lactating women. Pyrone constituents in the kava might lead to uterine tone loss in pregnant women and might enter breast milk in lactating women. Also, children should not take kava.

Also, this herb could have interactions with a number of medications. These include Xanax, CNS depressants, cytochrome and P-glycoprotein substrates, levodopa and hepatotoxic drugs.

It is best to avoid combining these medications with kava or to talk to a doctor or pharmacist before using them at the same time.

Further, kava could react negatively with herbs and supplements that are hepatotoxic, such as comfrey and red yeast, or that have sedative properties, such as St. John’s wort or valerian root.

This herb also can worsen side effects and increase the chances of hepatotoxicity occurring when taken with alcohol.

Does Kava Cause Permanent Liver Damage?

The National Center for Complementary and Integrative Health says that the FDA issued a warning discussing kava’s risk of causing severe liver damage.

The NCCIH stopped funding studies on kava after this warning was issued. [1] Also, in 2002, the United Kingdom, Europe and Canada restricted the use of kava because of potential liver problems from taking it. [2]

Reports have claimed that kava was the cause of hepatitis, liver failure and other liver problems. Europe has had more than 30 cases claiming that kava lead to liver damage. Some scientists argue that more evidence is needed to establish a definitive mechanism. [3]

Arguments for Kava Tea Safety

A small faction of people questions the warnings and official bans against kava. One commentary in a journal notes how a ban on kava in Germany was lifted by administrative courts.

This commentary and others discuss how there is not a lot of strong evidence linking kava to claims of side effects, note that cultural biases and misconceptions might be at play and warn that some alternatives people take to kava could have worse adverse effects. [4]

Some also argue that there were problems with the research used to support banning or restricting kava; for instance, some used extracts that were of poor quality with the wrong kind of kava. This has led some to question whether certain forms of kava may be safer than other forms.

The University of Melbourne in Australia has leading world kava experts who call for a worldwide guideline for safely producing and using kava.

Their plan includes continued testing on this plant in Australia and methods for bringing it back to countries that have restricted or banned its use. [2]

Safe Dosages of Kava

Kava’s long history of traditional use revolved around drinking this herbal extract as a beverage or a tea. Today, people still drink kava tea but also take this plant in tincture form and as a powder supplement or in capsule form.

A safe dose of kava is not currently known. Some clinical trials have found 300 mg of a high quality kava extract split into three doses is well tolerated.

The group of Australian experts that proposes a safe way of processing and using kava suggests using only the peeled root of kava plants that are five years old or older. Further, production should use a water-soluble extract instead of an alcohol or chemical solution.

The suggested dosage is under 250 mg of kava’s active chemicals, kavalactones, each day when taken medicinally. Further, the guideline recommends strict enforcement of quality control and continuous testing. [2]

More research is needed to determine how kava might affect the liver in particular. This research needs to follow rigorous guidelines for dosing, type of kava and other factors.

At the same time, groups are trying to reintroduce kava for its potential medicinal benefits, including for anxiety. Until more information is known on the safety of kava, people should take care with using it because of its possible adverse effects to the liver.

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