Kava lactones and the kava-kava controversy

Whitton, Peter A.; Lau, Andrew; Salisbury, Alicia; Whitehouse, Julie; Evans, Christine S.

doi:10.1016/s0031-9422(03)00381-9

Cited by 123 publications

(125 citation statements)

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“…On the other hand, kava has been implicated in a number of human liver failure cases in recent years (42)(43)(44). Whitton et al (45) reported that standardized kava extracts produced in Europe caused many serious health problems including death.…”

Section: Human Datamentioning

confidence: 99%

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Toxicity of Kava Kava

Xia

Guo

et al. 2008

Journal of Environmental Science and Health, Part C

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Kava is a traditional beverage of various Pacific Basin countries. Kava has been introduced into the mainstream U.S. market principally as an anti-anxiety preparation. The effects of the long-term consumption of kava have not been documented adequately. Preliminary studies suggest possible serious organ system effects. The potential carcinogenicity of kava and its principal constituents are unknown. As such, kava extract was nominated for the chronic tumorigenicity bioassay conducted by the National Toxicology Program (NTP). At present toxicological evaluation of kava extract is being conducted by the NTP. The present review focuses on the recent findings on kava toxicity and the mechanisms by which kava induces hepatotoxicity. KeywordsKava; anti-anxiety herbal beverage; top-selling botanical; hepatotoxicity; metabolism; mechanism Kava, prepared from the rhizome of the kava tropical shrub plant, Piper methysticum Forst F., is a traditional beverage used for many centuries, especially at ceremonial activities in the South Pacific (1-6). During recent years, kava has been used in Europe for treatment of anxiety and nervous disorders such as stress and restlessness, and in the United States as a natural alternative to anti-anxiety drugs and sleeping pills (6). Kava sales totaled more than $ 100 million in 1998, being the fifth leading seller of the North American botanicals (7).The association between the use of kava products and hepatotoxicity has prompted many countries, including Germany, Switzerland, France, Canada, and the United Kingdom, to take regulatory actions, ranging from warning consumers to removing kava-containing products from the marketplace. On March 25, 2002, the Center for Food Safety and Applied Nutrition (CFSAN), U.S. Food and Drug Administration (FDA) issued a Consumer Advisory entitled "Kava-containing dietary supplements may be associated with severe liver injury" to the public (8, 9). Kava-containing products remain popular in the United States and continue to be sold in health food stores and ethnic markets regardless of the fact that it Address correspondence to Peter P. Fu, National Center for Toxicological Research, Jefferson, AR 72079. peter.fu@fda.hhs.gov; chanp@niehs.nih.gov. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript was banned in Germany, France, Switzerland, Australia, and Canada (10). In this review, human exposure and metabolism of kava are briefly addressed, recent findings on the toxicity of kava are reported, and possible mechanisms by which kava induces toxicity are described. CHEMICAL COMPOSITIONThe kava plant, belonging to the Piperacae family, is widely cultivated in the South Pacific.Kava is cultivated for its rootstock. Depending upon the amount of kavalactones contained in the resin, the rootstock shows different color, varying from white to dark yellow (2,5,6). Fresh kava rootstock contains about 80% water. Dried rootstock consists of about 43% starch, 20% fibers, 12% water, 3-4% proteins, 3% sugars, 3% minerals, ...

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Section: Human Datamentioning

confidence: 99%

“…Four of these cases have been reported in medical literature (29,30,48,49). (45) determined that Michael reaction between glutathione and kavalactones can destroy kavalactones by opening of the lactone ring, and thus the toxic effects of kava extracts can be reduced. As such, glutathione can provide protection against kava-induced hepatotoxicity.…”

mentioning

confidence: 99%

Toxicity of Kava Kava

Xia

Guo

et al. 2008

Journal of Environmental Science and Health, Part C

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“…(67) For more than 2000 years, south pacific Islanders used kava-kava drink from kava plant without known side effect (72). Moreover, kava has been used by Western as an alcohol replacement to reduce anxiety and give relaxation feeling and as a treatment for sleeplessness, menopausal symptoms and depression (70,73). Rhizomes and roots of kava plant were the most used parts for their psychoactive properties that include sedation, anxiolysis and relaxation (74).…”

Section: Kava (Piper Methysticum)mentioning

confidence: 99%

Hepatotoxic Botanicals - An Evidence-based Systematic Review

Abdualmjid

Sergi

2013

J Pharm Pharm Sci

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-Purpose. Herbal medicines have been increasingly used worldwide. However, the potential harms of these herbs have been noticed most recently following hepatotoxicity with ingestion of herbal remedies. The aim of this review is to evaluate the evidence of hepatotoxic effects linked to use of herbal preparations. Method. Electronic search was performed by searching several databases: PubMed, HerbMed, Google Scholar, Scopus, Cochrane Database of Systematic Reviews and Cochrane Library using both Latin and common names of several herbs. Language was restricted to English and articles were selected for relevance reporting incidence of hepatotoxicity associated with use of herbal products in human. Results. From a total of 565 relevant reviews and articles, 254 met our inclusion criteria and were analyzed.

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“…All solvents were of high-performance liquid chromatography (HPLC) grade from Fisher Scientific (Fairlawn, that these kavalactones exert advantageous physiological functions on humans such as diuretic, soporific, antiepileptic, spasmolytic, analgesic, local anaesthetic, bacteriocidal and antimycotic functions (Whitton et al 2003;Lebot and Lévesque 1996a). Lebot and Lévesque divided the active ingredients of kava into two main groups -major kavalactones and minor kavalactones, and numbered and used only the six major kavalactones (1 = desmethoxyyangonin, DMY; 2 = dihydrokavain, DHK; 3 = yangonin, Y; 4 = kavain, K; 5 = dihydromethysticin, DHM; and 6 = methysticin, M ( Fig.…”

Section: Raw Materialsmentioning

confidence: 99%

“…The kava beverage is traditionally prepared from macerated roots and/or stump with water or coconut water (BHMA 1996;Kilham 1996). It is reported that beneficial effects of the kava beverage include relaxation, euphoria, anti-convulsion, neuroprotection, analgesia and attenuation of menopausal symptoms (Lebot et al 1992;Bilia et al 2002;Lebot and Lévesque 1989;Baum et al 1998;Whitton et al 2003;Schulz et al 2001). The safety of kava consumption has been a topic of debate in recent years (Anke and Ramzan 2004;Russmann et al 2001;Anon 2001;Campo et al 2002;Gow et al 2003;Brauer et al 2003).…”

Section: Introductionmentioning

confidence: 99%

Kavalactone content and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of kavalactones using different solvents

Wang

Bittenbender

et al. 2013

J Food Sci Technol

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The South Pacific islanders have consumed kava beverage for thousands of years. The quality of kava and kava beverage is evaluated through determination of the content of six major kavalactones including methysticin, dihydromethysticin, kavain, dihydrokavain, yangonin and desmethoxyyangonin. In this study, we determined contents of kavalactones in and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of five different solvents including hexane, acetone, methanol, ethanol and ethyl acetate. The six major kavalactones were detected in all kava beverages with Jun Wang and Weiyue Qu contributed equally to this work.

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Kava lactones and the kava-kava controversy

Cited by 123 publications

References 13 publications

Toxicity of Kava Kava

Toxicity of Kava Kava

Hepatotoxic Botanicals - An Evidence-based Systematic Review

Kavalactone content and chemotype of kava beverages prepared from roots and rhizomes of Isa and Mahakea varieties and extraction efficiency of kavalactones using different solvents

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