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Herbal Medicine: Kava: Is It Safe?   Share   Hyla Cass MD © Clarifying FDA Allegations The Medwatch site contains numerous "kava toxicity" reports of cases due to a product sold at a 1996 New Years Eve rave (dance) event, alleged to contain kava, but in fact, contained a highly toxic industrial chemical, called 1,4-butane-diol -- and absolutely no kava. The Los Angeles police department toxicologists within weeks published a report to this effect. Nonetheless, these spurious claims against kava have remained on the FDA website ever since. In general, anyone can report anything to Medwatch: no proof of actual content is required for a posting, which does not protect the public from the truly bad products, but may, as in this case, wrongfully malign others.

In conclusion: More thorough investigation is needed before we can draw any conclusions about kava's potential toxicity. The entire issue also points out the importance, and vulnerability of the liver, the chemical factory that is the site of metabolism of many of the essential body compounds, and the detoxification center for ingested chemicals. Ironically, while the topic here is the potential hepatotoxicity of an herb, the plant kingdom provides us with such life-saving liver-protective herbs as milk thistle. In fact, in my own clinical practice, I will add it to the regimen of those who are or have been on drugs that affect the liver, for protection and restoration of its vital function.

The current situation does point out that the liver is affected by many substances, including prescription and non- prescription drugs, as well as alcohol, which is a major cause of liver damage.

We must be aware that herbs are potent medicines, to be treated with the appropriate respect regarding potential interactions and toxicity, including to the liver. On the other hand, kava's margin of safety far surpasses that of it's pharmaceutical equivalent. Nothing would be gained by previously satisfied consumers of kava, out of fear of these potential side effects, switching to a more toxic prescription medication, such as a benzodiazepine, in the mistaken belief that they were making a safer choice.

Hyla Cass, MD
Author of Kava: Nature's Answer to Stress, Anxiety, and Insomnia

i Lichtwer Pharma AG Formulation data sheet, November 1998 Lebot V. et al.,Kava: The Pacific Drug, Yale University Press, 1992, Page 200

ii Volz et al., 1997, Kava Kava extract WS 1490 versus placebo in anxiety disorders - a randomized placebo controlled 25 week outpatient trial', Pharmacopsychiatry 30(1), p1-5.

Dr. Cass is a board-certified psychiatrist, nationally recognized expert and frequent keynote speaker on holistic medicine, with a focus on enhancing mind, mood, energy, and weight loss. She appears regularly on TV......more