Why has kava kava been withdrawn from sale?

Kava is traditionally used for the treatment of stress, anxiety, and insomnia. Recently, however, German and Swiss health authorities identified approximately 30 cases of sometimes-serious liver toxicity, including four cases requiring transplantation and one death, which are believed to be associated with kava consumption. As a result, many (but not all) manufacturers and suppliers of kava have voluntarily withdrawn kava from sale here in the UK.

There is not much in the way of detail available regarding the 30 cases of liver damage reported in other parts of Europe. However, it is known that in 21 cases, kava was used with alcohol and/or potentially liver-damaging drugs. Kava has a long tradition of use in the South Pacific at often considerably higher doses than those used in Europe, with few reported liver toxic effects. Its safety and toxicity has been studied extensively in recent years. Studies have found that kava is generally safe and it has not been associated with liver toxicity.

While a question mark hangs over kava's head in terms of safety, it is far from clear whether this herb is the true cause of the liver problems associated with its use. In Germany, kava remains on sale while the evidence is properly reviewed. In my practice, I am continuing to recommend kava though, as a precaution, I am advising against its use in individuals who regularly drink alcohol, are taking medication known to be toxic to the liver and/or have known liver disease.

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