The Facts Behind Claims of Liver Toxicity and Kava Use
Stress. Anxiety. Panic Attacks. Insomnia. It seems where ever you look people are suffering from more and more stress as a result of our fast paced lifestyle. People feel stressed at home and at work and need to search for ways to relieve the anxiety they feel. Unfortunately a number of people are turning to drugs and alcohol in an attempt to combat these feelings of stress anxiety. The situation is so bad that anti-anxiety drugs are one of the most prevalent drugs being prescribed today (USA Today, 2011).
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Anti-Anxiety Medication and Black Box Warnings
Anti-anxiety drugs have a number of dangerous side effects. In fact, the U. S. Food and Drug Administration has started to place black box warnings on the use of some of these anti-anxiety drugs. Black box warnings are the most severe warnings that can be placed on medication. Some of the warnings placed on various anti-anxiety drugs state that they could cause “sleep driving” or sleep walking as well as fatigue, nausea, vomiting and even respiratory problems (Citizen’s Commission of Human Rights, 2006). Even if you decide to stop taking anti-anxiety problems, you can still run into problems. If you abruptly stop taking your anti-anxiety medication, you can experience insomnia, sweating, increased anxiety, and confusion among other symptoms.
And it’s not just the U. S. Food and Drug administration that has recognized the dangers associated with anti-anxiety medication. The UK Parliament’s Health Committee and the Australian Therapeutic Goods Administration have also issued warnings about various anti-anxiety medication and the dangers with not only taking the medication but also the withdrawal symptoms associated with trying to stop taking the medication (Citizen’s Commission of Human Rights, 2006).
What to Do?
Given the problems associated with anti-anxiety medication, people are in a quandary when it comes to dealing with their stress and anxiety. People are feeling stressed but don’t want to take the prescribed anti-anxiety medication. One methods of dealing with this problem is to look for methods of natural anxiety relief and natural stress relief. Natural methods do not have the same issues as anti-anxiety medication.
One method of natural anxiety relief that you may want to consider is kava (Kava Kava). Kava is a plant from the South Pacific Islands and has been used by the Islanders for centuries for both medicinal and ceremonial purposes. The drug’s ability to relief stress and anxiety has been recognized by a number of people and it has been found to be a method for natural anxiety relief that can have less side effects than traditional prescribed medications for anxiety.
You have probably read up on how there have been isolated instances & claims made about the effects of kava on the liver. The most interesting thing about these claims is recently, as research has progressed, most of the information surrounding them has been called into question. Most notably, the original source of these claims, Swiss and German health officials Interkantonale Kontrollstelle (IKS) & Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), have since overturned their 12 year ban on kava in Germany with the Federal Administrative court finding it both “Unlawful and inappropriate.” The National Library of Medicine has stated “Based upon reported cases, the estimated frequency of clinically apparent liver injury due to kava is less than 1:1,000,000 daily doses.”
You can read the full article here: http://www.radionz.co.nz/international/programmes/datelinepacific/audio/2599447/german-court-overturns-kava-ban
However, unfortunately much of the misinformation and health warnings still remain and top Google rankings scaring off many of those who could benefit from introducing kava into their lifestyle. Much research is being done to understand completely how kava affects the human body and Universities have recently been excitedly publishing results on the possible myriad of benefits from kava root.
Kava root has been used in traditional cultures of the South Pacific for its relaxing qualities for over 1,000 years without any record of causing any liver problems. We believe it has a great benefit to a large population of people whether it is purely for its relaxing characteristics or for those who wish to try it in replacement of pharmaceutical drugs or alcohol.
There has been a concern raised about the safety of kava, particularly in regards to liver toxicity. These concerns came as a surprise to most users given the fact that kava has been used for centuries by South Pacific Islanders without any ill-effect.
Approximately one hundred people worldwide have been diagnosed with liver toxicity associated with kava use. In looking at these cases, a number of problems quickly appear. The biggest problem was that the link between kava use and liver toxicity was not established to a strong degree. The liver damage that these patients suffered may have been the result of other drugs that were taken at the same time as the kava (Ernst, 2007). In fact, in only fourteen of these cases was the liver toxicity s deemed to probably be a result of kava use. To put this in a bit of perspective, this means that there was one possible case of kava causing liver damage for every 100 million doses of kava that were sold (Stevinson, Huntley & Ernst, 2002).
Another problem with trying to link kava with liver toxicity is the concern that the kava which was used during the time that these cases were brought to light was incorrectly harvested and extracted (Richardson & Henderson, 2007). Kava is a slow growing plant and because of its popularity at the time, it is believed that not enough kava was being produced. People are only supposed to use the roots from the kava plant for natural anxiety relief but if there was not enough kava to export, suppliers may have decided to use the leaves and stems of the kava plant as well. The leaves and stems of a kava plant contain alkaloids and are not supposed to be used to produce a kava extract.
Evidence for Kava Safety
A number of studies have shown that kava use is safe. One study (Sarris et al, 2013), showed that there was no difference in liver functioning between the subjects who received kava and the subjects who did not. There were also no symptoms of withdrawal or addiction between the two groups, but there was a significant reduction in anxiety in the group taking kava. Clouatre (2004) reported that compared to other anti-anxiety drugs, the risk-to-benefit ratio of Kava use was very good.
A number of professionals are also coming out in support of kava. Some professionals, such as Dr. Hyla Cass and Jerry Cott, the former Chief of the Psychopharmacology Research Program at the National Institute of Mental Health, report that a person will have a greater chance of experiencing liver toxicity as a result of taking acetaminophen than from taking kava. Anti-anxiety drugs as well as anti-depressants also give a person a higher risk of liver toxicity than kava use.
Even the World Health Organization (2007) has stated that it is rare for hepatic adverse reactions to occur from the use of Kava. Dr. Andrew Thomas Weil, the founder of the Arizona Center for Integrative Medicine at the University of Arizona echoed these findings by stating that kava use appeared safe for use although he did recommend only using it no more than four weeks at a time.
Today Kava Kava remains a sacred herb of the people of the South Pacific Islands including Hawaii and Fiji. This plant is very special in that it is one of the last plants known to mankind that no longer produces seeds and needs human propagation to survive. The Island people cherish Kava so much that they've formed the "Awa" Development Council a non profit 501(c)(3) public charitable organization intended solely to restore Kava's rich history. The ADC is devoted exclusively to educational, science, and cultural activities. Their motto is I Maluhia ka Honua (So that the world may be at peace).
Kava is safe but care needs to be taken to ensure that the kava you are taking is made only from the root and that you take the proper dosage. Concerns about the possibility of liver toxicity from kava use are for the most part a result of improper kava extraction, mixing kava with hepatotoxic drugs or heavy alcohol use. As more education is obtained about this magical plant, Kava's popularity will continue to grow into the Western World, this can be demonstrated by the hundreds of Kava Bar's popping up in major cities like San Francisco and New York in replacement for alcoholic bars. Just Google search "Kava Kava Bar" and visit one in a city near you.
If you are interested in a method of natural stress relief, kava is still one of the best choices given the side effects of prescribed anti-anxiety medication. As with any medication, you need to be aware of what you are taking, how much you are taking and how it reacts with other medications and alcohol. If you keep this in mind, you can take kava safely and enjoy the natural anxiety relief that occurs when taking kava.
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American Botanical Council. (2001). American Botanical Council Announces New Safety Information on Kava. Retrieved from http://cms.herbalgram.org/press/122001press.html
Cass, K. (n.d.). Kava: Is it safe? Healthy.net Retrieved from http://www.healthy.net/scr/article.aspx?Id=2165
Citizen’s Commission of Human Rights, 2006, Drug Regulatory Warnings. Retrieved from http://www.cchr.org/sites/default/files/downloads/drug_regulatory_warnings.pdf
Clouatre, D. L. (2004). Kava kava: examining new reports of toxicity. Toxicology Letters, 150(1), 85-96.
Ernst, E. (2007) A re-evaluation of kava (Piper methysticum). British Journal of Clinical Pharmacology, 64(4), 415–417.
Jamieson, D.D., Duffield, P.H., Positive interactions of ethanol and kava resin in mice. Clinical and Experimental Pharmacology and Physiology, 17, 509–51.
Richardson, W. N., & Henderson, L. (2007). The safety of kava—a regulatory perspective. British Journal of Clinical Pharmacology, 64(4), 418–420.
Sarris, J., Stough, C., Teschke, R., Wahid, Z. T., Bousman, C. A., Murray, G., Savage, K. M., Mouatt, P., Ng, C., & Schweitzer, I. (2013), Kava for the Treatment of Generalized Anxiety Disorder RCT: Analysis of Adverse Reactions, Liver Function, Addiction, and Sexual Effects. Phytotherapy Research, Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/ptr.4916/abstract
Stevinson, C., Huntley, A., & Ernst, E. (2002). A systematic review of the safety of kava extract in the treatment of anxiety. Drug Safety, 25, 251–61.
USA Today. (2011). Report: 1 in 5 of U.S. adults on behavioral meds. Retrieved from http://usatoday30.usatoday.com/news/health/healthcare/health/healthcare/story/2011-11-16/report-1-in-5-of-us-adults-on-behavioral-meds/51241236/1