Kava Kava extract by Ray Sahelian, M.D. Kava Kava liver caution and danger

CAUTION: Kava kava is not the type of supplement, like vitamin C, that you take every day. At most use one kava capsule three times a week and take a full week off each month. In fact, it is preferable to use kava no more than two times a week. Kava use on a daily basis can harm the liver. In rare cases, daily kava kava use can lead to severe liver harm that may result in total liver failure. Good Night Rx is a sleep formula that has kava kava and should not be taken together with other kava products. Do not take a kava supplement if you are taking medications that can harm the liver, such as acetaminophen (Tylenol) or statin drugs for cholesterol such as Lipitor, Zocor, and others. Do not take a kava kava supplement if you have any kind of liver disease. Do not take kava if you drink alcohol. For additional and detailed research on kava kava, see kava.

Kava Kava - 30 % Extract, 300 mg

Consider Good Night Rx for a natural product with kava kava that helps to relax and induce sleep. Good Night Rx is formulated by Ray Sahelian, M.D. for those who have occasional sleepless nights or those who wish to relax in the evening after a stressful day.

Kava Kava is an herb that has been widely used for hundreds of years by native South Pacific Islanders. This kava extract is standardized to assure a guaranteed percentage of its active components known as kavalactones.  

Kava Kava Supplement Facts
Kava Kava Extract Root 30% - 300 mg *


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Kava kava questions
Q. I’ve struggled with anxiety (GAD) most of my life, in bouts. I’ll have long periods of time when I feel fine but then will experience a modulator; some uncontrollable event that my mind convinces me is much, much worse than it is and I become extremely fearful and worrisome. I’ve used Kava lava in the past because it allowed me to tackle these periods (usually lasting a few days) without having to be on some pharmaceutical SSRI or anxiolytic drug full time. I’ve been a bit worried (ironic) about Kava kava the last couple years due to the negative reports coming out of Europe (so I quit using it). I also noticed that GNC took kava kava off the shelves and the Arizona Tea company took it out of their RX Stress tea. Can you give me any up to date info on Kava kava?
   A. Kava kava is an herb that appears to be fine when used once or twice a week. Other options for anxiety include 5-HTP, small amounts of ashwagandha, tryptophan, passionflower. Perhaps alternating different herbs and nutrients could be an option to prevent relying too much on one anti anxiety herb and thus reducing the potential side effects.

Q. I am writing to request a little info about the Kava kava supplement available at Physician Formulas. I just wished to know if it is fresh kava rhizome, and are there kava kava extracts from the stems, leaves or bark? I understand kava kava from the Eclectic Institute's 'Kava Nakamal', does not use the stems, leaves or bark.
   A. Dr. Sahelian who developed this kava kava product, is quite aware of the problems of kava kava and he only chooses kava kava root, no stems or leaves.

Q. Hello- I am subject to random drug screens for work- Would Kava supplements appear on a toxicology urine screen as a controlled substance Ie) opiates or benzodiazepines?
   A. As far as we know, kava kava is not tested in routine drug screens for employment.

Q. Hello, Dr. Sahelian, I am e-mailing you about my use of the herbal supplement kava kava. I have just recently started to use 30% kava kava capsules. I have found that it works well when I take one with lunch and one with dinner. I have been using it daily but, at least until I receive a response from you, I am going to cut it back to every other day. I guess my question is, taking two kava kava capsules a day as I am, what is a safe regimen for the use of kava kava? I would not like to stop taking kava kava as it has been the most effective anxiety reduction agent I have used and I always stick with natural supplements. Also, is it unsafe to drink alcohol while on a kava kava regimen if it is only done once a week or less? I figured I could just avoid taking the kava kava on the day I plan to drink.
   A. As a rule we prefer people not use kava kava more than 3 days a week. Drinking a glass or two of wine or alcohol on the days off from kava kava should be fine. Other supplements that can be used on the off days from kava kava in order to help relax could include passionflower, hops, valerian, ashwagnadha and the nutrients 5-HTP and tryptophan.

Q. A little over a year ago I started taking kava kava in capsule form. I took it because it made me happy. However, I took it in irregular doses, for example I would take about 15 kava kava pills in one day, and then take another 15 or 20 pills a couple months later in one day. I did this about 7 times over the course of a year and a few months. At first it made me happy, but then at about 6 or 8 months I noticed that I was beginning to have no sexual desire. Even my wildest fantasies, whether sexual or just my dreams and goals, seemed pointless and uninteresting. This made me depressed, or the depression could have caused it. But either way I decided I needed to take more kava kava to make me happy again. I took it for a couple more months and my symptoms only worsened. Now I have completely been off kava kava for 4 months and still have no sexual desire and I am somewhat depressed with life. I think the depression is mainley from the lack of sexual desire, but there have been rare instances where I am a little aroused but am still depressed. I am wondering if the kava kava directly gave me these symptoms, or caused liver damage to me that gave me these symptoms, or both, or something else?
   A. Kava kava is known to reduce sexual drive and interest. It is also a good idea to have a medical evaluation to rule out any liver damage and then you can discuss with your doctor regarding the use of natural supplements for libido improvement.

Q. I have a question for you regarding kava-kava. My brother has been long abusing prescription medications (e.g. Klonopin and many others) and has coupled with that a nasty habit of lying and under-reporting to the bitter end what goes into his body. He has sought treatment twice and both times has fallen off the wagon IMMEDIATELY the day treatment has ended. This most recent time, he was doing great for a couple of months and the day treatment ended we could hear the tell-tale signs of his opiate haze. Again, true to form, he swore up and down that he didn't take anything opiate related. Instead he says he took 4 or 5 kava kava capsules each day on Friday, Saturday, and Sunday. Today is Thursday and he STILL sounds terrible (slurred speech, gravely voice, glassy, half-shut eyes, disorientation, not knowing what day it is or sequence of events). He swears he hasn't taken any pills in months OR any kava kava since Sunday. I know he's full of it based on his M.O., but is there any possibility that 4 or 5 kava caps taken four days ago (a total of 12 to 15 for the entire weekend) could still be impairing him in a similar fashion to his opiate symptoms?
   A. It's possible but we cannot be sure.

Q.  A little over a year ago I started taking kava kava in capsule form. I took it because it made me happy. However, I took it in irregular doses, for example I would take about 15 kava kava pills in one day, and then take another 15 or
20 pills a couple months later in one day. I did this about 7 times over the course of a year and a few months. At first it made me happy, but then at about 6 or 8 months I noticed that I was beginning to have no sexual desire. Even my wildest fantasies, whether sexual or just my dreams and goals, seemed pointless and uninteresting. This made me depressed, or the depression could have caused it. But either way I decided I needed to take more kava kava to make me happy again. I took it for a couple more months and my symptoms only worsened. Now I have completely been off kava kava for 4 months and still have no sexual desire and I am somewhat depressed with life. I think the depression is mainly from the lack of sexual desire, but there have been rare instances where I am a little aroused but am still
depressed. I am wondering if the kava kava directly gave me these symptoms, or caused liver damage to me that gave me these symptoms, or both, or something else? I just need some answers, or just some knowledge so that I'm not alone and desperately wondering what is wrong with me.
   A. It is possible that overuse or misuse of kava kava caused these symptoms. You may wish to read the page on libido and discuss with your doctor after a thorough medical evaluation and blood studies. Herbs, such as kava kava, are potent and should be used cautiously.

Q. Are kava kava and methadone safe to take together? I am currently on a daily maintenance dose of 257mgs. of methadone and experience periodic acute anxiety. Am considering kava kava but need to know the safety issues if taken with the Methadone.
   A. We have not seen any studies regarding the safety or dangers of combining methadone and kava kava. In rare cases people taking kava kava have had liver problems. Methadone does not appear to be toxic to the liver but we have no idea what the combination of methadone and kava kava would do.

Q. I’ve reviewed your pages concerning Kava kava which I occasionally have discussions about in my Stress Management and Insomnia classes. I’ve recently written the FDA for updates on their warnings about Kava kava. I haven’t seen any follow-up studies since the initial releases nearly 5 years ago-perhaps you can offer your insights?
Also, you mentioned that one should not take kava if they drink alcohol. Do you mean with the kava kava, or if they consume alcohol on a regular basis-or both?
   A.
To the best of my interpretation of the kava studies, kava kava may potentially harm the liver if used daily for prolonged periods. For this reason, the maximum use of a kava kava supplement should be three times a week with a full week off a month. A kava kava supplement can be taken with a glass of wine in the evening if there will be no driving or using of heavy machinery and the person is just staying home and going to bed. Those who drink a large amount of alcohol on a regular basis may have some liver harm or damage and it would not be advised for them to not use kava kava. This herb is also not advised to those who take stating drugs used for cholesterol or acetaminophen pain killer, or any drug that has the potential to damage the liver.