A Resurgence of Fear: Is Kava Dangerous?

Posted by on Jun 2, 2011 in Kava News | 26 comments

A Resurgence of Fear: Is Kava Really Dangerous?Aloha everyone,

About ten years ago, it seemed that everyone was terrified of kava. Several reports had come out of individuals who were taking kava experiencing liver failure. The medicine was banned in a number of countries, including the E.U. and Canada, and it was considered by many to be fact that kava was dangerous and damaging to the liver. Of course, it was later discovered that the individuals who had been experiencing the liver troubles were taking kava that had been made from stems and leaves of the plant, rather than just from the rhizome, and that this was the cause of the reported cases of liver failure. By 2005, many countries all over the world had lifted their bans on kava, and people didn’t seem nearly as worried any more. A number of studies demonstrating the relative safety of kava came out, it was found to be effective in relieving anxiety and depression, and it seemed as if the terror that had been gripping people in regards to this little plant had been mostly allayed.

At least, that was the case until recently. About a month ago, it was reported that a bicyclist collapsed in New York and was admitted to the hospital with severe muscle weakness and kidney failure. Somehow, the doctors traced his condition to the consumption of kava kava, stating that it reduced blood flow to his muscles and kidneys, causing them to fail. The man said he had consumed two cups of kava and had ridden his bike for several miles before collapsing. We don’t get any information about other health issues the man may have had, other medications or herbs he was taking, whether he consumed alcohol regularly or, well, anything, really. We were just told that kava causes kidney failure and muscle weakness.

As has been mentioned by some of our commenters, it is possible to lose PINTS of water while bicycling. This man was riding for miles during the daytime, just after drinking an undisclosed amount of kava. Kava is a diuretic, meaning it can cause dehydration. It is just as likely that consuming a strong cup of coffee and then riding a bicycle for a significant period of time would lead to these symptoms.

Furthermore, it seems surprising to me that someone would choose to take kava before exercising.  For myself and my family and friends who drink kava on a daily basis, it is something to be taken at the end of the day, when work is done and it is time to relax. I would never consider drinking kava and then exercising, and I don’t know anyone who would.  Perhaps the dehydrating effects of kava should be studied and clarified more fully, but I feel fairly confident in saying that if this individual had taken kava and then had a good night’s rest and proper hydration in the morning, things would not have turned out so poorly.

This one incident seems to have brought fear of kava back in to the spotlight in a pretty big way. Within the last week, I’ve discovered quite a few articles which discuss the terrible dangers inherent in kava and herbal medicines. The first one, which was posted to ABC’s website discusses the risks inherent in taking herbal remedies. Toxicologist Amitava Dasgupta is quoted as stating that “Using kava kava for a few months can cause significant liver damage, including total liver failure”. The toxicologist also lets us know that ephedra and yohimbe can damage the heart and cause high blood pressure, and that bitter orange contains compounds that are similar to amphetamine and can cause heart damage. He states that the FDA should regulate these herbs the way they do drugs such as oxycodone, and although the article admits that the FDA issues warnings on drugs they consider dangerous, it laments the fact that people can go and get these deadly drugs without a prescription.

It’s really hard for me to read something like this without feeling a little angry. Yes, kava can damage the liver in inappropriately high doses, and perhaps individuals who already have serious liver problems will not benefit from taking kava.  However, coffee, aspirin and ibuprofen can also damage the liver, and overdoses of over-the-counter pain medication can easily cause death through liver failure. Furthermore, even if every single case of liver damage that has ever been attributed to kava really was caused by the plant alone, it still works out that in 1 million doses of kava, 0.3 of individuals may experience troubles. This is a rate of serious side effects comparable to many FDA-approved drugs. In the case of painkillers such as Tylenol, the rate of liver failure per dose is much, much higher. According to the CDC, in 2002, Tylenol use resulted in 28,720 visits to the emergency room. “Herbal Products” as a group caused 415 visits.

It is absolutely true that not all medicines are appropriate for all people with all conditions. Ephedra and yohimbe DO cause higher blood pressure! For some people, this is not a significant problem. Birth control pills also cause high blood pressure, but millions of women take them every day with no problem. Should people with extremely high blood pressure be taking ephedra every day? Probably not. However, they probably shouldn’t drink several cups of coffee every day or eat at fast food restaraunts, either. If they do choose to do those things, and they become more ill as a result, that is a matter of personal responsibility, and no one would argue otherwise. Why, then, does this article suggest that the FDA needs to regulate natural herbal products? Isn’t that a matter of personal responsibility as well?

Another article from Access RX suggests that holistic medicine CAN KILL YOU and is extremely dangerous. Again, kava and ephedra are listed as tricky, deadly plants. The author bemoans the fact that “herbal dealers” do not have the chemistry background to provide an appropriate level of active ingredients in a medicine, and therefore that it is impossible to take appropriate doses of herbal medicine. The author goes on to state that holistic medicine is based on the placebo effect (AKA it doesn’t really work), and is a waste of money. He finishes up by letting us know that “if you happen to indulge in some of the more potent ‘cures’ on the holistic market, it may be the last decision you ever make’.

Really?

First of all, studies have shown the effectiveness of kava in relieving anxiety and depression. In other words, when kava was given to half of the participants in a study, and a PLACEBO was given to the other half, the individuals who consumed kava reported greater relief of anxiety than those who did not. The other substance which the author lists as deadly, ephedra, also has a very dramatic effect on the mood and metabolism that I don’t think anyone would argue is a mere placebo effect. Furthermore, people all over this planet have gone for thousands of years without experienced chemists to extract and measure out their medicine for them. It is common knowledge that most medicines, including FDA approved ones, can be helpful at an appropriate dosage and dangerous at a higher dosage. It is also common knowledge that not every medicine is good for every condition, and that medicines can have side effects. Of course, these facts are true of kava just as they are for asprin and valium.

So why is it, then, that we are so afraid of plants, and so unafraid of pills? Why is it that we need a government body to tell us how to heal ourselves safely? As an independent adult, I am aware that the things I put in to my body will have an effect. Therefore, before I put something new into my body, I do some research. I figure out whether the medicine I want to take is appropriate for me, given my medical history and the other medicines I am taking, I make sure I know what the appropriate dosage and method of consumption is, and I make very, very sure that I trust the source from which I am getting that medicine. With the massive amount of information available on the internet, there is really no excuse for NOT doing this, regardless of whether it was your doctor or your best friend who recommended that you take something new. It’s my body and I need to be responsible for caring for it and for making sure that I don’t consume substances which might damage it.

Kava is not deadly in the least. Of course, is important to get a high quality kava made from the root-stock. If you have a history of liver troubles or are taking medications that can damage the liver, then perhaps kava is not a good medicine for you. However, if we work with herbal remedies with appropriate respect for the plants and for ourselves, there is very little danger. Is it so difficult to be aware of our own bodies that we need the government to regulate the natural, traditional ways in which we as a global culture heal ourselves? The truly deadly thing here is lack of awareness, lack of knowledge, and lack of respect for the self and for the medicines in question. Kava is no more dangerous now than it was before one man experienced kidney failure after drinking some last month. German researchers estimate that kava produces 0.008 cases of adverse effects per 1 million doses, and that is an incredibly low number, no matter how you look at it. No medicine is safe for every person, so be careful and responsible and only take medicines that you know are right for you. And don’t feel the need to be afraid. There is no more reason now than there ever was.

Aloha no,
Makaira

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26 Comments

  1. Eglyntine,

    You pose a good question, and we have actually had the same one. Yogi teas are known for their commitment to quality. I have spoken with someone in the manufacturing facility for their Kava teas, and they not only presented me with a Certificate of Analysis, they assured me that they wouldn’t dream of using anything but high-quality Kava Root in their tea. These days, I know people often put little stock in what people have to say, but I believe the certificate and what I was told by the person I spoke with.

    I know it’s good enough for the folks at Kava.com to carry; it’s Kava Tea. They’re known for their unrelenting commitment to carrying only the highest quality Kava products, and the only Kava Tea they’ve chosen to carry, is the Yogi Tea brand.

    Hope this helps!

    Aloha no,
    Makaira

  2. Thanks for the very informative article!
    One day I would like to try kava for for my anxiety, although I am finding it a bit difficult to find in health supplement stores. I have been on anti anxiety medication and can not understand how they are allowed to be prescribed due to the nasty side effects. Weaning from them is a complete nightmare, and I can only imagine how many people end up in hospital due to the side effects. Its too bad FDA seems so quick to ban herbs but continue to allow obviously, dangerous, prescription drugs.

  3. I just recently came across Yogi’s Kava Stress Relief tea and it is amazing. I have been trying to get off prescription sleep medicines for a while now. Going through pretty bad withdrawals I have been trying to find herbal teas, vitamin supplements, etc. to help me through it. I have been drinking a lot of chamomile and green tea which helps quite a bit. I went to the grocery store to restock my teas and I saw this Yogi Kava Stress Relief tea. It smelled divine so I figured I would try it. I was blown away with the first cup. I had literally not slept in 8 days at the time I tried my first cup of this tea. I was instantly relaxed and went to sleep for 4 hours.

    The next day is when I saw the HUGE warning on the box and instantly I started searching around to find out what the big problem was. I know that the medical field has done everything in their power to destroy Chamomile’s reputation as a great herbal medicine so I am trying to give Kava the benefit of the doubt.

    I really LOVE this tea but if it is going to do more damage to me than benefit just like the prescription medicine I am trying to get off of I definitely do not want to go down that road.

    My question is, do you know if Yogi’s Kava tea that states they use the root extract is good quality from the root and not other parts of the plant like you have stated above?

  4. Aloha Alexander!

    I’m so sorry to hear that you have been ill. I’m glad that you are feeling better. I haven’t heard much about kava and heart problems, and that’s something that you absolutely must ask your doctor about! Kava is a fairly strong herbal medicine, after all.

    All the best! I hope you are able to enjoy kava again safely sometime soon!
    Makaira

  5. Aloha!
    I really love kava kava. It really helped me with my anxiety and put me at ease. I started using kava in may 2011, and continued to use it about 3 days a week until september that year. During the whole summer (2011) i felt a small stabbing and pinching sensation in my chest. And in september (2011) i got really sick (I was still using kava by the time) and i found out that I had “Myocarditis” and “Pericarditis” which is a dangerous heart disease.

    I don’t know if it was the kava that developed this desease or not, but I got freightened and haven’t touched it since. I read somewhere before I even started drinking kava, that kava might produce heart problems.

    My heart is thankfully back to normal today, but I still suffer from anxiety and instead of kava I now use tobacco and weed which is bad aswell. I really wish I could start drinking kava again.

    Whats your take on it?

    Thanks for reading!

  6. Aloha Pancho!

    Thank you for your comment! You’re absolutely right – anything in the wrong quantity can be deadly. Similarly, anything taken or prepared incorrectly can be dangerous. However, as you saw in Fiji, it is fully possible to consume kava on a regular basis without causing any harm to body or mind. In fact, I find that regular kava drinking is very beneficial for physical and mental health! 🙂

    Aloha no,
    Makaira

  7. Ha! I spent a month in Fiji on an overseas school trip and had the wonderful opportunity to spend several weeks living in a couple of the villages there.
    If kava consumption causes death, there would be no more Fijians!!
    In the same respect, if Budweiser caused death there would be no more Americans!!
    I’m not saying you can’t drink yourself to death, but those people drink a LOT of kava, and if they all had immediate liver failure because of it… well, let’s just say there are still a lot of elderly Fijians in Fiji!
    Besides, I think with kava, you would drink yourself to sleep before you could drink enough to cause any harm. Then again, you can kill yourself by drinking too much water, so everything in moderation, right?

    Aloha

  8. Another wonderful article, thank you for all of this information to be able to pass along to people back home, always asking about this misunderstood plant. I am very interested in learning more!

  9. Aloha Joyce!

    Thank you so much for your thoughtful comment. It always fills me with inspiration and joy to know that people are receiving healing from my favorite plant, kava!

    It is sad that our government looks the other way while millions die from prescription medicine, yet seem to have so much time to demonize herbal medicines. Through my work, I hope to provide people with the information that they need to make informed decisions about what herbs and medicines will work best. Every person is unique and requires unique healing. It is up to each of us to determine what will work best – and it is that sense of personal agency and belief in the power of self healing that will create a true revolution in health. I’m so happy that you have found your path to healing! 🙂

    Aloha no,
    Makaira

  10. Thank you for posting this article. I plan on ordering some Kava from you soon. It is just so sad how drugs and medicine kill 1,000’s of people, yet somebody uses an herb incorrectly and the FDA is all over it. They banned some herb years back from a guy who died in California from using it incorrectly. Come to find out- he was taking an OBSCENE amount and he previously had liver failure. I think his poor system couldn’t handle it.

    I applaud Kava! It helped me get off from prescription pain pills after having numerous surgeries. I could not have done it without it. Since then, I have wanted to find a better source of Kava and I found your site.

    Thank you for for all of your hard work and for providing an optimum and superior Kava. I love Hawaii!

    Aloha!

  11. Dear Danny,

    Thank you for the informative comment. That makes a lot of sense, and I had the feeling this was the case, although I wasn’t sure of the exact science behind it. I definitely try to encourage our customers to avoid taking kava along with pharmaceuticals that have an impact on the liver. Perhaps another good rule of thumb is that if a medication is said to be contraindicated with grapefruit juice, kava should also be avoided.

    Aloha no,
    Makaira

  12. Drinking kava with a drug metabolized by CYP-450 enzymes may inhibit the speed at which those drugs are metabolized, increasing their half life, and increasing the potential of toxic blood syrum levels of the concomitantly-used drug. So, it is not the kava that can kill you, it is the other drug, as a result of the kava. One would likely garner the same results with an equally-inhibitory amount of grapefruit juice.

  13. Dear Lea,

    Some form of community-based regulation would be absolutely invaluable, though I’m not sure how seriously the government would take it. Nevertheless, this is certainly an idea that we in the herbal remedies business should seriously consider. Thank you for your insight!

    Aloha no,
    Makaira

  14. Aloha Kavalife,

    Thank you for your comment! I absolutely agree! The more positive and factual information we can spread about kava, the better! Thank you for all your hard work to bring this beautiful medicine to the people of the world.

    Aloha no,
    Makaira

  15. Hello,, im sure these health matters have been well established to be undeserving for the kava name. Australia’s medical research is well situated here to have given the green to the natural production, waterbased preparation. As i have discussed and shown on my blog, it is as much the type of kava your buy (roots only) powder (if you are into this form of kava) and how it is consumed that is the key.

    What is needed however is public relations. Specifically a public relations framework on a regional, national and hopefully global framework that kava so much deserves. Strengthening the message in a public arena is what will easee the nerves for a public that is new to heavens liquid gift.

    Peace out! Kava lover for 6 years.

  16. Aloha Makaira,
    I found your site after checking for a reference on the best product and I am getting ready to order.
    I used kava – kava in the past from Bee-alive in liquid form when I had anxiety, few drops 2 times a day. It worked fine for me, but it was discontinued in 2000 because it had to be prescribed as you said.
    I agree big Pharma do not want to loose customer to herbal products, but we also have to gather together those like you who produce a good product. Also people need to take responsibility in using the product.
    A solution would be to have a herbalist certification organized not by the state but the herbalist themselves, before the state is involved.
    That could weed out the people who use leaves for example, either we self regulate or government gets involved.
    thanks
    lea

  17. Paula,

    Thank you for your comment! It is wonderful to hear about your friend’s experience. I also find that kava gives me great endurance, while still having a very relaxing and calming effect. The only real danger I’ve ever found with kava is that sometimes I’ll want to stay up far past my bedtime enjoying wonderful conversation with friends and family!

    I’ve not heard anything about kava being used for weight loss, but I have had so many positive experiences with this plant throughout my life that I wouldn’t be surprised in the least! I’m definitely going to look in to that and see if I can find any more information! In the meantime, I am very happy to hear that you are enjoying the wonderful, relaxing effects of kava!

    Aloha no,
    Makaira

  18. I have a friend who is very sensitive (to alcohol, kava, etc) and when she tried my chocolate kava drink, she said that afterwards she could “dance all night long.” I have heard of it increasing endurance (in Chris Killham’s book PSYCHEDELICACIES, where I first encountered the idea of kava), and have even heard of it being used medicinally to combat obesity (though nothing to support that, or treatment protocols). If there was evidence/case studies to support it, however, that would be an EXCELLENT marketing device. For me, I take kava to relax.

    I agree that ibuprofin is terrible for the liver, as well as alcohol, both of which should not be used in tandem, nor with kava, for that matter.

  19. Brandon,

    Thanks for the thoughts as well as the kind words about the blog! I think I care so much because Kava so much more than a product for me and my family. ‘Awa here is truly a way of life that permeates all parts of our culture, and it touches everyone from farmers like us to royalty! We all share a common love of this beautiful plant and all she’s brought us over the past 3,000 years. That kind of cultural unity seems rare in most parts of the world, and we’re proud of that.

    Anyway, it’s great to see that others are starting to see how the mainstream media operates as well! The hypocrisy in simple examples like tobacco, alcohol, and prescription medication is becoming more and more obvious the more we all arm ourselves with the truth. How many can say that their product has been used safely for over 3,000 years without incident? Tobacco and its related diseases take 477,000 lives per year. Multiply that by 3,000 years, and tobacco would have killed 1,431,000,000 people so far. Numbers that large are impossible to even imagine!

    I hope you enjoy your ‘Awa. It’s truly not for everyone and it can take some patience to get used to taste as well as the effects.

    Aloha no,
    Makaira

  20. Hello Makaira,

    I have haven’t actually tried kava yet (I’m waiting for my order from your website to get here! I just placed it a few days ago and can’t wait for it to arrive!) but, I’ve done a lot of research on it before deciding to purchase some. I just want to point out that the media LOVES to tear apart anything that isn’t mainstream. People who believe in natural remedies and the power of herbal supplements over traditional medicine always deal with this type of negative exposure. I don’t understand why 1 incident that MAY have been caused by kava brings about such a negative response. People get into accidents involving alcohol everyday and while they are reported no one ever freaks out as much as they do when something they aren’t familiar with causes the accident. I think it’s just appalling that the media doesn’t look at things from all sides. I didn’t actually read the article but, I’m sure it failed to mention the relatively low number of kava related incidents. And I’m positive that drinking kava as opposed to alcohol for example, is a much safer alternative. It’s just that people in general are afraid of things that they don’t have much knowledge about. I for one am eagerly awaiting my order to arrive in the mail and can’t wait to try kava for my first time!

    Also, thank you for taking the time to write a blog like this. I’ve never seen anyone take such a personal interest in the product that they sell. It shows that you care about your customers!

    Until next time,
    Brandon

  21. Andrew,

    Thank you for the incredibly informative comment! I’m glad someone else noticed the rise in alarmist articles regarding kava and other traditional remedies. The dehydration hypothesis definitely seems like the most sensible one in this situation, and it makes perfect sense. It also would explain why we haven’t heard very much about other cases of kidney failure related to kava – how many people out there are drinking kava and then going for seven mile bike rides, after all.

    I wasn’t aware that kava inhibits CYP450 enzymes, but that certainly is good to know! It is interesting that the media looks at a case like this and immediately jumps to the conclusion that kava destroys the liver, but we never see any articles warning consumers of the dangers of grapefruit juice. It is strange that so much of modern society seems to have an inherent fear of traditional herbal medicines, so much so that, in a case like that of the man above, all factors other than the traditional medicine are completely ignored. I certainly hope that the scientific community continues to validate the safety of kava and other herbal medicines, as that seems to be the only way in which these fears will be dispelled.

    Thank you again for the fascinating information!
    Aloha no,
    Makaira

  22. Justin,

    Wow! Thank you for your insight. I didn’t even think of the fact that kava was a diuretic when I read the original article, but that’s an excellent point. I’ve always viewed kava as something to be consumed once the day is over and it’s time to relax – I would never think to drink kava and then exercise just afterwards. Just another reason why people need to research before putting ANY new substance in to the body!
    And I, too, find it frustrating that the original article focused so much on the kava the man took and made no mention of other substances he may have consumed, other medical conditions he may have had, or, well, any of the other circumstances surrounding his hospitalization, really. It is interesting how quick we are to demonize plant medicines, and how forgiving we are of the dangers posed by substances such as alcohol and pharmaceutical drugs. Hmmm….

    Aloha no,
    Makaira

  23. I remember reading the article mentioned. I looked up the diagnosis that the man suffered (rhabdomyolysis) and found a similar story involving an individual who had drank alcohol the night before a run. What do kava and alcohol both have in common? They are diuretics. Dehydration alone can cause rhabdomyolysis. As this article mentioned, little information was given about the patient. With how much fluid did he drink the kava kava? Was he sweating significantly during the ride? The original article states that the man was riding a normal distance, but was he riding under normal levels of temperature?

    If have found that, if I drink a significant amount of kava kava (even with what I feel is an adequate amount of fluid, usually coconut juice), the next morning I might find myself dehydrated. Probably a bad time to go on a bike ride.

  24. Thank you for this article!

    I too have been seeing plenty of alarmist articles since the bicyclist event, and was not sure if it was just because I was paying keener attention, or if there has been an uptick.

    I am not an MD/physician, and do not have all patient information from the case, but my hypothesis on the bicyclist incident is simple: The kidney failure was likely a result of dehydration. Dehydration has been known to do a job on your kidneys, and if the subject drank ONLY kava, which has exhibited diuretic properties, and not water… yes, the kava could definitely have contributed to the organ failure. But, it is also likely that a similarly-diuresing dose of coffee or beer would have yielded the same results. Keep in mind, this was what, 7 miles of riding? On a hot day, you can lose PINTS!

    Additionally, I am aware of studies that demonstrate kava has an inhibitory effect on the Cytochrome-P450 family of liver enzymes. This family of enzymes is responsible for metabolizing LOTS of organic contaminants. (Ethanol/alcohol is one of them, and there is actually a spike in CYP450 enzyme levels after alcohol consumption, which is why mixing kava and booze is a dangerous proposition.) Many benzo-based drugs are CYP450 metabolized, and basically, almost any drug that has the warning on the script bottle “Do not drink grapefruit juice with this medication” as well. It is for the same reason: grapefruit possesses CYP-450 “neutralizing” compounds.

    Drinking kava with a drug metabolized by CYP-450 enzymes may inhibit the speed at which those drugs are metabolized, increasing their half life, and increasing the potential of toxic blood syrum levels of the concomitantly-used drug. So, it is not the kava that can kill you, it is the other drug, as a result of the kava. One would likely garner the same results with an equally-inhibitory amount of grapefruit juice.

    So, yes, kava IS dangerous to the liver… but in the same way as grapefruit juice is, and it is dangerous to your kidneys in the same way that coffee and tea are.

    We should all be totally terrified.

    Thanks again!

    Sincerely,
    Andrew Procyk
    Asheville, NC
    [email protected]

  25. Debbie,

    The response we’re seeing to this issue is the kind of alarmist responses we’re unfortunately used to, so thanks for your comment. I feel for that person, but please don’t drink Kava or coffee or alcohol or smoke cigarettes before going on a bike ride, especially without bringing water or getting water in your system before doing any physical activity. ANY of those can remove water from our system or constrict our blood vessels. Speaking of, where’s the cry to take caffeine off the market, especially since it reportedly just killed a British man as reported by ABC News in “Massive Dose of Caffeine Kills British Man“?

    Aloha no,
    Makaira

  26. Well I have read the article but still am looking forward to your catalog. I suffer from panic attacks and so far all the drugs they give me cause me issues. I have used the kava before but the health store took it off their shelves and now I can’t get any. Hopefully I will get the catolog soon.

    Sincerely,
    Debbie S Scholefield

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