Kava is an increasingly popular alcohol-alternative that's thought to boost your mood and help you feel calm.
But kava can be dangerous, according to a doctor, and has been linked with severe liver damage.
Kava can also interact with prescription medications, like those for anxiety.
Kava, a beverage made from a tropical plant root, has become increasingly popular at bars looking to create a fun gathering space without alcohol.
Sometimes dubbed 'Nature's Xanax,' kava is thought to reduce anxiety, promote relaxation, and improve mood. Outside of bars, it has also emerged as a popular ingredient in canned drinks, and it's sold as a supplement as well.
But in addition to making you feel nauseous, kava can also be dangerous, said Dr. Danielle Belardo, a cardiologist based in Los Angeles. The herbal supplement has been linked with numerous reports of severe liver damage and even liver failure in the US going back decades, and is particularly dangerous to people with existing liver disease and people taking certain medications.
Kava has gained popularity for calming effects
Kava, also called kava kava, is made from the root of the kava plant Piper methysticum.
Kava has been consumed for centuries by Pacific Islanders, and its popularity has grown in the US in recent decades.
Kava — like alcohol — is a depressant, meaning it can slow your brain down and make you feel calmer.
Kava has been linked with liver damage
Although kava may have potentially therapeutic properties, it has also been linked with several cases of liver damage. Evidence from a 2016 report from the World Health Organization suggests that its traditional, water-based preparation is relatively safe for the liver. But kava supplements taken in the forms of extracts, powders, and pills may be more dangerous.
In 2002, the Centers for Disease Control and Prevention issued a warning against using kava, citing cases of liver injury in the United States, Germany, and Switzerland. In 11 cases, patients had to undergo a liver transplant.
"Such liver complications have been observed from as early as several weeks to as long as two years after intake, with the average duration being 4.5 months," Belardo said.
Belardo said that scientists aren't completely sure why kava can sometimes be harmful to the liver, and believe it might have to do with either pipermethystine or flavokavain B — compounds found in kava. More research is still needed, however, and a definitive link hasn't been established.
A 2020 paper on kava found that while liver damage was rare, part of the risk of taking kava is that there is no standard procedure for how it is cultivated, harvested, or manufactured. It also found that the risk of liver injury was possible if kava was taken for longer than 2 months.
In the United States, supplements, including kava, are not regulated with the same scrutiny that medications are by the Food and Drug Administration. As a result, the actual amount of kava in a product may differ from what's listed on the package. It also may contain other undisclosed ingredients, making it difficult to know exactly what you're taking.
Kava may also interfere with prescription medications
On top of risk for liver damage, kava can also interact with prescription medication — like anxiety medications, and medication for Parkinson's disease, according to Cleveland Clinic. It can also interact with alcohol.
When it comes to taking any supplements, Belardo said it's important to weigh the risks against the potential benefits. Belardo also encourages people to check with their doctor first.
October 27, 2023: This story was updated with more context about the safety differences between kava's traditional water-based preparation compared to kava supplements taken in the form of extracts, powders, and pills.
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