Is Kava Kava harmful to the liver?

Almost every article about Kava Kava looks similar: Kava is a Pacific drink that naturally relaxes, has anti-anxiety effects, muscle relaxant properties, helps with sleep, and is a great alternative to alcohol… but it may harm the liver. As if everything sounded too perfect. As if it didn’t make sense. So, let’s address the question: is Kava Kava harmful to the liver?

Kava Kava in Germany: the allegation debunked

To the best of our knowledge, the accusation of hepatotoxicity related to Kava Kava first surfaced in Germany in the early 2000s. Despite Germany leading in European Kava Kava consumption (mainly in the form of medications for anxiety), and for many years there were no reported problems with its impact on the liver, cases of severe poisoning suddenly emerged, including the need for transplants. This led to the withdrawal of Kava Kava products from the market.

As a result of in-depth research, it was revealed that associating poisonings with the properties of Kava and the German ban were unfounded. The reports were incomplete and/or referred to ethanol extracts from Kava Kava roots. The ban was challenged by the German Federal Court.

Proper expertise was also provided by German researchers. In one analysis, we read:

The pyridone alkaloid pipermethystine has been considered to be responsible for alleged hepatoxicity of Kava products. Investigation of a series of retain samples of finished products from the German market and self-produced extracts from root and stem material of Piper methysticum clearly showed that pipermethystine (1) is absent from all root and retain samples and extracts, with a limit of quantification of 45 ppm. As a positive control, leaves of P. methysticum showed an amount of 0.2% of 1. Thus, if there is any hepatotoxicity, compound 1 should not be the responsible constituent in the case reports with ethanolic extracts produced in Germany. – SOURCE

You can read more about the German ban HERE.

Kava Kava and alcohol: should not be mixed

Indeed, it is a fact that a negative impact on the liver can occur when mixing Kava Kava with alcohol and antidepressants. A warning about such a risk can be found on every package of a reputable Kava brand.

Therefore, the use of ethanol extracts (in the pharmaceutical industry) should not take place. But how does this relate to the regular consumption of Kava Kava in the form of a traditional Pacific drink? Dr. Andrew Weil recently addressed this:

Kava is perfectly safe. It has no harmful effects on the liver. I find it disappointing that is such a persistent concern – this arose really some time ago from a handful of cases in Germany, that were traced to alcohol extracts of Kava, which are not used anymore. It’s only water extracts that are used and they are perfectly safe.

Also some of the preparations involved made use of above ground parts of Kava in addition to the root and the above ground parts of the plant may have other constituents in them.

Anyway as far as I know all of the Kava products on the market today are perfectly safe and there are no concerns about liver toxicity. – SOURCE

Is Kava Kava harmful to the liver: WHO's stance

After the “German ban,” in 2010, experts from the United Nations Food and Agriculture Organization (UN FAO) and the World Health Organization (WHO) addressed the safety of Kava Kava.

As emphasized in the Codex Alimentarius Commission, for UN FAO and WHO:

A recent WHO risk assessment of kava products has found that “kava has had at least a 1500-year history of relatively safe use, with liver side effects never having arisen in the ethno pharmacological data” and concludes that “clinical trials of kava have not revealed hepatotoxicty as a problem”. This has been confirmed by further studies evaluating the toxicology of kava drink. Based on available scientific information it can be inferred that kava as a traditional beverage is safe for human consumption. – SOURCE

Hepatotoxicity of Kava Kava: Repeating Mistaken Conclusions

As pointed out by Kava Kava expert Jimmy Price, since the controversial cases mentioned above, which occurred 20 years ago, there have been no observed adverse effects related to Kava Kava. More details can be found HERE.

In one of his articles, Price also analyzes a report suggesting the hepatotoxicity of Kava Kava. He exposes its errors (including the fact that the supposedly toxic substance from the mentioned company NEVER EXISTED) and questions the report’s conclusions. However, he also shows how these conclusions are mindlessly repeated in subsequent scientific analyses!

Now, here comes the real awful part of all of this. There have been ~50 individual studies which cite this report as evidence of the liver toxic effects of kava even with traditional preparation.– Jimmy Price, Liver Damage From Kava. A Failure in Logic Perpetuated Through Decades – SOURCE

What are the contraindications for Kava Kava?

Use kava in moderation, no more than 3 times a week. Consultation with your doctor is required if you have liver function problems and if you are taking antidepressants. Kava Kava is not recommended during pregnancy and lactation. Do not mix with alcohol! You will find the serving size on each packet, depending on the form of Kava Kava.