Is Kava associated with hepatotoxicity: a review article
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Background: Recently kava has been withdrawn from sale in Germany and France reflecting its perceived association with hepatotoxicity. Aim: This article reviews case reports of liver toxicity associated with the use of kava to determine any significant similarities or differences among these cases. Results: Seven cases of altered liver function tests and/or hepatotoxicity associated with the use of kava are reviewed, Additional cases containing few details are also included. Potential links between kava hepatotoxicity and genetic polymorphism of CYP2D6 enzymes, extraction processes and possible interactions with alcohol and other medications are discussed. Conclusion: No definitive causal relationship between kava consumption and hepatotoxicity was found. Reliable data therefore need to be collected before valid conclusions can be made. Both health professionals and consumers need to be alerted to the possibility of kava-related hepatotoxicity, accompanied by education on identifying and reporting such adverse events.