Liver Function Test Abnormalities in Users of Aqueous Kava Extracts

  title={Liver Function Test Abnormalities in Users of Aqueous Kava Extracts},
  author={Alan R. Clough and Ross Stewart Bailie and Bart J. Currie},
  journal={Journal of Toxicology: Clinical Toxicology},
  pages={821 - 829}
Abstract Introduction. Hepatic toxicity from manufactured herbal remedies that contain kava lactones has been reported in Europe, North America, and Australia. There is no evidence for serious liver damage in kava‐using populations in Pacific Island societies or in Indigenous Australians who have used aqueous kava extracts. This article presents evidence that liver function changes in users of aqueous kava extracts appear to be reversible. Data from one Arnhem Land community [Northern Territory… 
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Kava hepatotoxicity solution: A six-point plan for new kava standardization.
Kava hepatotoxicity--a clinical review.
Constituents in kava extracts potentially involved in hepatotoxicity: a review.
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Kava hepatotoxicity: a European view.
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Kava hepatotoxicity: pathogenetic aspects and prospective considerations
  • R. Teschke
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2010
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Immunohistochemical analysis of expressions of hepatic cytochrome P450 in F344 rats following oral treatment with kava extract.
A re-evaluation of kava (Piper methysticum).
  • E. Ernst
  • Medicine
    British journal of clinical pharmacology
  • 2007
The UK government prohibited the sale of kava (Piper methysticum), a popular and effective herbal anxiolytic drug, marketed in Britain as unlicensed herbal products or food supplements in 2003, because of an unacceptable risk of hepatotoxicity.


[Necrotizing hepatitis after taking herbal remedies].
A causal connection between intake of the herbal preparations and the recurrences of acute hepatitis is the most likely explanation in both cases.
The effects of heavy usage of kava on physical health
  • W. Douglas
  • Biology
    The Medical journal of Australia
  • 1988
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Psychoactive Substances of the South Seas: Betel, Kava and Pituri
  • J. Cawte
  • Medicine
    The Australian and New Zealand journal of psychiatry
  • 1985
There is no indication that these substances will be espoused by the drug enthusiasts of the West as avidly as other ethno-psychopharmacological agents such as Peruvian coca leaf, the Indian hemp, the Asian poppy, or the American tobacco, but the possibility of some use in the West cannot be discounted.
Kava in Arnhem Land: a review of consumption and its social correlates
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Kava: The Pacific Elixir: The Definitive Guide to Its Ethnobotany, History, and Chemistry
This complete guide to kava summarizes the literature and research on a plant that is now considered comparable or superior to anti-stress prescription drugs, and describes its use in the religious, political, and economic life of the Pacific islands for centuries.
Diversity of substance use in eastern Arnhem Land (Australia): patterns and recent changes.
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Rising cannabis use in Indigenous communities
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The findings of the study suggest that strategies to reduce petrol sniffing should not only focus on education, employment, skills training and recreation, but should further encourage Aboriginal communities to utilize family relationships to dissuade young people from the practice.