Update on the Alleged Liver Toxicity of Kava

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Posted: Fri Apr 02, 2004 7:26 am

 

Update on the Alleged LiverToxicity of Kava

 

 

 

 

 

Update on the Alleged Liver Toxicity of

 

Kava

 

This article is meant to address the concerns of Herb Pharm's customers about

recent adverse event reports (AERs) which imply than kava products may have a

toxic effect on the liver. The following will give some background and an update

on this ongoing issue.

 

Herb Pharm is still actively working with the Kava Committee of the American

Herb Products Association (AHPA) on determining what more, if anything, needs to

be done to assure the continued safe use of kava products. AHPA has suggested

adding cautionary statements to kava product labels and Herb Pharm is doing

this.

 

Recently AHPA commissioned Dr. Donald Waller, a pharmacologist and toxicologist,

to scientifically review and evaluate all of the kava AERs. Dr. Waller concluded

that there is " no clear evidence that the liver damage reported in the USA and

Europe was caused by the consumption of kava. " The report concludes:

 

" .... kava when taken in appropriate doses for reasonable periods of time has no

scientifically established potential for causing liver damage. However, as with

any pharmacologically active agent, there is always the possibility of drug

interactions, preexisting disease conditions and idiosyncratic or

hypersensitivity reactions, which can exacerbate the toxicity of such an agent. "

 

AHPA has been meeting and working closely with the FDA on the safety of kava

products. The FDA has evaluated the kava AERs but has not declared kava products

unsafe nor taken any actions against them. At this point kava products continue

to be legally sold in the USA.

 

It appears that the German Federal Institute for Drugs and Medical Devices

(BfArM)) is on the verge of making kava a controlled drug in Germany that will

be available only by prescription. However, the Commission E, a special herb

expert committee commissioned by BfArM, has issued a statement that is critical

of BfArM's conclusions and action. The Commission E recently issued the

following statement:

 

" When one examines the reactions in detail, it appears that the BfArM’s

classification of causality linked to kava, is, to a large extent,

incomprehensible, and arbitrary. Moreover, in its evaluation of cases, the BfArM

had not taken into consideration various existing pieces of information, for

example those with regard to other possible causes. One extreme example may be

concerning the aforementioned lethal case: in this instance, it was known to the

Institute that the cause of liver failure was several years of alcohol abuse,

and that kava was not involved in the genesis of the liver symptoms. The autopsy

had shown that the cirrhotic process had already started long before the

administration of kava began. "

A review by Schmidt and Narstadt of eight toxicological studies on kava

extracts, as well as isolated kavalactones, showed no evidence of hepatotoxic

effects.

Careful evaluation of kava AER's show that most were related to the concomitant

use of prescription drugs with potential hepatotoxic (liver toxicity) effects,

alcoholism, or other situations that raise doubts about the validity of the kava

AERs. Also, all of the kava AERs are apparently associated with concentrated

extracts of kava (30- 70% kavalactones) rather than with raw kava root,

traditional kava beverages, or kava tinctures (AKA, liquid extracts). Although

the reports that associate kava and liver damage have not been substantiated the

following information should be considered when taking kava products:

 

A qualified healthcare professional should be consulted before taking kava if

you have or have had liver problems, frequently use alcoholic beverages, or are

taking any medication

 

 

Stop use and see a doctor if you develop symptoms that may signal liver problems

(e.g., unexplained fatigue, abdominal pain, loss of appetite, fever, vomiting,

dark urine, pale stools, yellow eyes or skin).

We should all take the issue of kava safety seriously and work hard at solving

any possible problems. However, while doing so we should also consider kava's

safety record. For over three thousand years kava root has been consumed safely

by millions of people in the South Pacific islands. Also, billions of doses of

kava extract have been safely consumed by millions of people in Europe and the

USA in the past 100-plus years. If, indeed, there is a liver toxicity problem

with the consumption of kava -- and that is yet to be proven -- then it appears

to be a very small and isolated problem.

 

http://www.herb-pharm.com/News/news.html#update

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Posted: Mon Aug 30, 2004 4:45 pm

 

Natural Kava Supplements May Be Safe After All

 

 

 

Natural Kava Supplements May Be Safe After All

 

[Adapted from GUNA Press Release]

 

" Very interesting story of how supplements used for many years suddenly become

so dangerous when pharmaceutical companies discuss them. "

________________________

 

UH scientists may have solved kava mystery

By Kevin Dayton

Advertiser Big Island Bureau

 

HILO, Hawai'i - A team of University of Hawai'i scientists may have solved the

mystery of why some Europeans who used products containing kava extract suffered

severe liver damage, prompting a number of nations to ban sales of the herbal

supplement.

 

The culprit may be a compound found in the stem peelings and leaves of the kava

plant - known in Hawai'i as 'awa - but not in the roots that are used to make

the traditional kava drink consumed by Pacific Islanders.

 

Just to be safe, people should avoid tea or anything else made from the leaves

or stems of the plant, according to C.S. Tang, professor of molecular

biosciences and biosystems engineering at UH-Manoa.

 

Bans in Singapore, Germany, Canada, the United Kingdom and elsewhere wiped out

pharmaceutical sales of kava and virtually destroyed it as an export crop in

Hawai'i. While kava supplements are not banned in the United States, the Food

and Drug Administration issued an advisory in March 2002 warning of the

potential risk of severe liver injury from dietary supplements containing kava.

 

The health alarms left farmers in Hamakua and elsewhere with crops that were

hardly worth harvesting.

 

Experts were unable to explain how a plant used in island cultures for 2,000

years could suddenly be so toxic, causing liver damage that was fatal in some

cases.

 

Now researchers led by Tang believe they may have found the key: Peelings from

the stem bark of kava plants apparently were used to create the extract for the

herbal supplements, and may be to blame for liver failure and liver-related

injuries that included hepatitis and cirrhosis.

 

Traditional kava drinkers discard the peelings, but Tang and his team learned

from a trader in Fijian kava that European pharmaceutical companies eagerly

bought up the peelings when demand for kava extract soared in Europe in 2000 and

2001.

 

" Peelings are traditionally avoided by the kava drinkers with good reason, " Tang

said. " If you don't respect the traditional use or people who learn by

experience, if you don't respect that, you might get yourself in trouble. "

 

Supplements containing kava are promoted as remedies for sleeplessness and

menopausal symptoms.

 

Drinking kava has not been associated with liver damage.

 

In Europe, where most of the health problems occurred, kava extract is used in

capsule form, and the cases of liver damage apparently involved people who took

the capsules, the scientists reported.

 

In a research paper accepted for publication in the scientific journal

Phytochemistry, researchers Klaus Dragull, W.Y. Yoshida and Tang report they

found an alkaloid called pipermethystine in tests of stem peelings and kava

leaves.

 

Pipermethystine also was present in lower concentrations in the bark of the

stump but was not found in the root itself. The root is what is used to make the

traditional drink.

 

Preliminary tests by researcher Pratibha Nerurkar show pipermethystine has a

" strong negative effect " on liver cell cultures. If peelings containing the

alkaloid were used to make kava capsules - and the scientists suspect they were

- that could explain the liver damage in some of the people who took the

capsules.

 

The peelings were available during the kava boom because kava drinkers in the

Pacific didn't want them, and the stem peelings contain high levels of

kavalactones, the ingredient in kava that provides its calming effects.

 

The Fijian kava dealer reported the peelings had emerged as a very important

trading item because " it's cheap and it's a waste product by the kava drinkers,

therefore the pharmaceutical companies, they love it and it became part of the

trade, " Tang said.

 

The UH researchers also learned that the analysis method used by some companies

to test plant products could not detect the difference between the alkaloids and

kavalactones, " and therefore they mistakenly thought there's no problem, that

it's similar stuff, " Tang said.

 

" I'm fairly optimistic that we are on the right track, because everything seems

to be falling into the picture because of the use of peelings, " Tang said. " But

like any scientist, I would say that nothing is final until our results are

accepted by the regulatory agencies. "

 

If the researchers are right, kava could again emerge as a viable export crop.

But that could take quite awhile.

 

At its peak in 2001, the state Department of Agriculture estimates there were 65

farms in Hawai'i growing kava, but growers agreed that has dropped off

dramatically.

 

Matthew Archibald, vice president of operations for Agrinom, an agricultural

company in Hakalau on the Big Island, said the UH research is an important step

in resuscitating the kava industry worldwide, but that it could take years and

millions of dollars to rebuild the European market.

 

In August 2001, Agrinom was shipping 50,000 pounds of dried kava a month,

grossing $300,000. That operation collapsed two months later when the German

government banned sales.

 

" The damage has been done, " he said. " For example, we're not going to get into

Germany for a very, very long time. There would have to be some major

development for us to be able to get back in there. But if someone could open up

China, for example, where they're more accepting of herbal medicines in general,

that could be a possibility. "

 

Reach Kevin Dayton at kdayton or (808) 935-3916.

 

The moral of the story is to get information on Herbal Medicines from

experienced clinical herbalists (books or in-person) and to get herbs from

reputable companies

 

http://www.swsbm.com/Resources/ResList.html).

_______________

 

 

JoAnn Guest

mrsjoguest

DietaryTipsForHBP

www.geocities.com/mrsjoguest/Genes

 

 

 

 

 

AIM Barleygreen

" Wisdom of the Past, Food of the Future "

 

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