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  • AADD Moderators: swilow | Vagabond696

Kava Kava - Its a recalled substance in Aus - you can't buy it in Herbal Suppliments

S

Soma

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Joined
May 5, 2000
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Taken from http://www.recalls.gov.au/recalls_therapeutic.cfm
Defect details: All medicines containing the herb kava (Piper Methysticum) could cause liver failure.
I wonder just how much you actually need to consume before your liver failed? I wonder if it is the same potential for fucking up your liver as plain paracetamol? I doubt it.
Would this stop you from ordering from overseas (which I will certainly do, Bio Organics Kava Kava Complex is the only thing that will ensure a good nights sleep if my patterns are all over the place
)
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For some reason that link above only seems to work if you cut and paste it into a new browser window. Clicking on it produces an error... :\
 
I agree it's probably reactionist bullshit as most of these complementary medicine recalls are. Look at 5htp - why won't they approve that ... the TGA (Therapeutic Goods Association) are pretty goddamned conservative compared to America.
However there are other supplements you can try, if you haven't already. I find Valerian works a treat for me. I take a supplement called extralife Sleep-Care, which has Valerian, Passionflower, Gentian, Hops, Calcium and Magnesium in it, and two of those and I'm off in zzz land.
SLM
 
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9856112&dopt=Abstract
[Necrotizing hepatitis after taking herbal remedies]
[Article in German]
Strahl S, Ehret V, Dahm HH, Maier KP.
Medizinische Klinik, Fachbereich Gastroenterologie, Stadtische Kliniken Esslingen am Neckar.
HISTORY AND CLINICAL FINDINGS: Two unrelated women, aged 39 and 42 years, had been admitted (at different times) to hospital because of "recurrence of an aetiologically uncertain acute hepatitis". Both patients had a history of acute hepatitis with GPT concentration of 796 and 755 U/l, respectively. Each of them had experienced recurrences of hepatitis, each of them preceded by taking herbal remedies as alternative medication, containing kava or common (or lesser) celandine, respectively. In each patient physical examination had been unremarkable. INVESTIGATIONS: Maximal values of GPT in the two patients were 422 and 350 U/l, respectively. Viral, autoimmune and metabolic causes of the hepatitis were excluded. In each of them liver biopsy revealed the picture of acute necrotizing hepatitis. DIAGNOSIS, TREATMENT AND COURSE: As it was suspected that the hepatitis was medication-induced, the intake of the mentioned herbal preparations was stopped. The liver function tests quickly became normal. CONCLUSION: In view of the rapid response to their withdrawal, a causal connection between intake of the herbal preparations and the recurrences of acute hepatitis is the most likely explanation in both cases.
PMID: 9856112 [PubMed - indexed for MEDLINE]
PubMed has several listings of articles published over the past year, but most have no abstract! I’ll look elsewhere.
I've found several papers but you need a password to access. For purely educational purposes here are a couple of excerpts
Author
Escher, M. Desmeules, J. Giostra, E. Mentha, G.
Institution
Division of Clinical Pharmacology and Toxicology, Geneva University Hospital,
1211 Geneva 14, Switzerland.
Title
Hepatitis associated with Kava, a herbal remedy for anxiety.
Source
British Medical Journal (Clinical Research edition). 2001. 322: 7279, 139. 5
ref.
Abstract
The case of a 50-year-old man, who consulted a doctor because of a one month history of fatigue, jaundice and dark urine, was reported to the Swiss Pharmacovigilance Center in Berne, Switzerland [date not given]. The patient had been taking kava (the rhizome of the pepper plant Piper methysticum) extracts daily for 2 months for anxiety. Liver function tests revealed a 60- and 70-fold increase in aspartate aminotransferase and alanine aminotransferase levels, respectively. Alkaline phosphatase, gamma -glutamyltransferase, lactate dehydrogenase, total bilitrubin and conjugated bilirubin levels were 430IU/litre, 691 IU/litre, 1132 IU/litre, 279.2 micro mol/litre, and 212.3 micro mol/litre, respectively. Prothrombin time was 25%. The patient's condition deteriorated within 48 h. The patient received a liver transplant 2 days later, with note of improvement in his condition. On examination, the liver was atrophic, extensive hepatocellular necrosis.
Kraft, M. Spahn, T. W. Menzel, J. Senninger, N. Dietl, K. H. Herbst, H. Domschke, W. Lerch, M. M.
Institution
Medizinische Klinik und Poliklinik B, Universitatsklinikum Munster,
Albert-Schweitzer-Strasse 33, 48129 Munster, Germany.
Title
Fulminant liver failure after administration of the herbal antidepressant
Kava-Kava. [German]
Original Title
Fulminantes Leberversagen nach Einnahme des pflanzlichen antidepressivums
Kava-Kava
Source
Deutsche Medizinische Wochenschrift. 2001. 126: 36, 970-972. 16 ref.
Abstract
History and clinical findings: A 60 year-old woman was admitted to hospital because of jaundice, fatigue, weight loss over several months and icteric skin. Because of progressive liver failure, concomitant renal failure and progressive encephalopathy, she was transferred to an intensive care unit. Investigations: Biochemical tests revealed acute liver failure with high levels of total and conjugated bilirubin (30 mg/dl) as well as aspartate aminotransferase (921 IU/litre) and alanine aminotransferase (1350 IU/litre) concentrations. Prothrombin time was less than 10%. Serological tests could rule out viral hepatitis, metabolic or autoimmune causes of liver failure. On abdominal computed tomography and ultrasonography no pathological changes were detected. Above all portal vein thrombosis, ascites, focal lesions of the liver and extrahepatic cholestasis could be excluded. Liver histology showed extensive hepatocellular necrosis with intrahepatic cholestasis. Treatment and clinical course: The patient's physical condition deteriorated. She had to be intubated because of respiratory insufficiency and encephalopathy stage IV. Because of progressive liver failure under conservative treatment, the patient received an orthotopic liver transplant 11 days after admission. Conclusions: The exclusion of other causes and the histological diagnosis made Kava-Kava (Piper methysticum root extract) the most likely cause of acute liver failure. This is the 18th case of Kava-Kava induced liver failure reported to the European regulatory authorities.
Perhaps a more reasonable approach is shown in this article
web page
A systematic review of the safety of kava extract in the treatment of anxiety.
………. Data from short-term post-marketing surveillance studies and clinical trials suggest that adverse events are, in general, rare, mild and reversible. However, published case reports indicate that serious adverse events are possible including dermatological reactions, neurological complications and, of greatest concern, liver damage.
……….It is concluded that when taken as a short-term monotherapy at recommended doses, kava extracts appear to be well tolerated by most users.
I’m surprised there are not more articles available. It certainly seems like a knee jerk reaction, but “overlooked” hepatotoxins do tend receive quick attention, especially if they are widely used. Still, can’t deny that for some people even non-chronic use could be detrimental. Personally, I’m not surprised its bad shit…certainly tastes like it.
What would be more sensible would be to investigate what levels of kava present a danger. It could well turn out that low dose preparations are OK, but unless someone does the research we will probably never know for sure. It’s all about dose and predisposition isn’t it? And there’s no mention of what dose of Kava was involved in any of the above cases.
As for panadol, it’s amazing its so freely available, with so little warning given. Perhaps we need an active “Liver Society” like the Heart groups. If something is bad for your heart you certainly hear about it. I guess a list for things bad for your liver would be long, including almost everything ;)
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It was only a matter of time.. I think the reason there aren't more articles available is because they've been published in exclusive (read pay for access) mags for pharmacists, doctors, maybe naturopaths. I summarised one here back in April from a pharmacy mag..
As to the panadol comment above, every package says on it that you must not take more than 8 tablets per day. They also have cautions about long term use (without medical supervision) could be harmful. Most herbal preparations have not gone so far as to mention maximum daily dose or whether continuous use is dangerous etc...
 
This comes as no surprise to me - there was discussion about kava kava and liver damage in Health q & a back in January, see kava kava dangerous?
The difference between this and the liver damage associated with paracetamol IMHO, is that with paracetamol we know what amount causes problems. Herbal supplements often don't contain the amount of active ingredient claimed on the pack - you may be ingesting more or (more likely I imagine) less than you think.
I have found kava kava gives me vivid dreams, which wake me up, defeating the purpose of using it as a sleep aid. I prefer passion flower for this reason. Soma: see
Substances controlled under the customs import/export legislation, in particular appendix b - kava is listed, but I wonder whether they are talking about it in it's crude form? There is an email adress there - you may be able to get more info there.
 
It never ceases to amaze me just how quick and to what extent people will pick up topic and run with it. You all rock.
I wonder if this has been taken off the market pending trials? I gather that if they take it off the market because there may be a problem, surely logic dictates that the perceived problem will be investigated buy that authority to make sure that the people that market this product are not disadvantaged?
Is that the role of the authority or does industry come up with supportive research (fat chance in this case because it is a herb and therefore non patantable therefore no $$$)
Strawberry_lovemuffin: I might look into some alternatives. Do you have a brand name?
The particlar suppliment we were taking had not only Kava but St. Johns and other ingrediants as well. It worked well for me, and worked well for my girlfriend.
We are a week and a half into some interesting sleeping patterns caused by our European holiday (oh woe! ;) ) - it hit my girlfriend a lot harder than me who suffers anxiety when not sleeping.
Stilnox(tm) from the doc didn't help (except made for some amazing dreaming) and trusted temazapam (at least at the 10mg-20mg doses) that she got a week later still doesn't cut it.
 
I have been informed by a local Adelaide kava specialist retailer that only concentrated kava products in capsule form are affected by the recall, and they are still allowed to sell the powdered root form.
 
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