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Do you remember the studies about vitamine C and cancer or the one about creatine and cancer ?
We all should be aware of studies about the danger of nutritional supplements
This artyicle talks about the recent warning about kava
By Jeanie Davis
WebMD Medical News
Jan. 29, 2002 -- Do you take kava? If so, you may want to take a break. Because some European countries have pulled kava from the shelves after reports of possible liver damage, the FDA is investigating whether kava is a health risk.
The FDA has sent out letters to physicians asking them to review all cases of liver toxicity to determine if any may be related to the use of kava-containing dietary supplements.
"Products containing herbal extracts of kava have been implicated in cases of severe liver toxicity in Germany and Switzerland," says the FDA letter. "Approximately 25 reports of [liver] toxicity associated with the use of products containing kava extracts have been reported in these countries. Serious adverse effects include hepatitis, cirrhosis, and liver failure. At least one patient required a liver transplant."
In both Switzerland and Germany, regulatory agencies have prohibited the sale of kava extract-containing products.
The FDA is investigating whether the use of kava-containing dietary supplements poses a similar health hazard in the U.S., according to the letter. The agency has received several reports of serious injury allegedly associated with the use of kava-containing dietary supplements.
A leading U.S. toxicologist is analyzing the German and Swiss reports for the American Botanical Council and several other industry organizations, says Mark Blumenthal, the council's executive director. The American Botanical Council is a nonprofit herbal research and education organization.
Because there is no Freedom of Information Act in Europe, access to the specific case reports will be limited, he tells WebMD.
What he knows thus far: "In 18 of the European cases, people were also taking -- along with the kava -- prescription or over-the-counter drugs that were known to possibly cause liver toxicity. Whether the liver toxicity was related to those drugs, or kava alone, or a combination, may or may not be able to be determined."
In some cases, people were reportedly taking excessive amounts of kava. Also, a history of alcohol use was noted in some cases, Blumenthal tells WebMD.
Autopsy for one reported death showed liver failure before kava was even ingested, he says.
Despite all the controversy and unanswered questions, things may be easing up in Europe. A news report yesterday said that Germany's regulatory agency has approved prescription drug status for kava -- that hasn't been confirmed, Blumenthal says.
"We're advising that certainly the reports from Europe shouldn't be discounted," says Wayne Silverman, PhD, the American Botanical Council's chief administrative officer. "However, there are some mitigating circumstances that make some reports questionable."
The bottom line: "The same kinds of cautions that come with any kind of prescription drug or herbal remedy should apply here," Silverman tells WebMD. "You should consult with a health practitioner. You should be aware of cautionary statements about that supplement."
Roberta Lee, MD, is medical director of the Center for Health and Healing at Beth Israel Medical Center in New York. She has been practicing integrative medicine since 1995 and has lived as a public health physician in the Polynesian islands, where kava is taken on a daily basis. She is in the fifth year of a project involving interviews with traditional healers in Polynesia.
In Micronesian cultures, many people drink fresh kava daily -- but they use water to dilute it, Lee tells WebMD. The process of extracting kava lactones and blending them in a concentration with other ingredients may change the way it affects the body, she says.
"I've never witnessed any evidence of liver toxicity in Micronesia -- and that is a population that drinks alcohol," says Lee.
She considers kava supplements to be safe, but patients must tell their healthcare providers they are taking it. Patients should tell their physicians if they have any history of liver problems or suspect they have liver problems.
People who should not take kava, according the experts:
anyone with a predisposition to liver disease, either because they have hepatitis or some other liver dysfunction
anyone who is taking drugs with known adverse effects on the liver -- like methotrexate for arthritis and statin drugs for cholesterol
anyone who regularly consumes alcohol
If you want to take kava, get your liver function tested on a regular basis, says Lee. "If you're really worried, after two weeks' use, have a blood test for liver function, then have blood tests on a monthly basis. Patients should tell the doctor whether they're feeling terrible, fatigued, notice a dark color in the urine -- those can be warning signs for jaundice."
"Kava as an indication for anxiety is still a valid therapy," says Silverman. "But some people with other medical conditions should be wary."
We all should be aware of studies about the danger of nutritional supplements
This artyicle talks about the recent warning about kava
By Jeanie Davis
WebMD Medical News
Jan. 29, 2002 -- Do you take kava? If so, you may want to take a break. Because some European countries have pulled kava from the shelves after reports of possible liver damage, the FDA is investigating whether kava is a health risk.
The FDA has sent out letters to physicians asking them to review all cases of liver toxicity to determine if any may be related to the use of kava-containing dietary supplements.
"Products containing herbal extracts of kava have been implicated in cases of severe liver toxicity in Germany and Switzerland," says the FDA letter. "Approximately 25 reports of [liver] toxicity associated with the use of products containing kava extracts have been reported in these countries. Serious adverse effects include hepatitis, cirrhosis, and liver failure. At least one patient required a liver transplant."
In both Switzerland and Germany, regulatory agencies have prohibited the sale of kava extract-containing products.
The FDA is investigating whether the use of kava-containing dietary supplements poses a similar health hazard in the U.S., according to the letter. The agency has received several reports of serious injury allegedly associated with the use of kava-containing dietary supplements.
A leading U.S. toxicologist is analyzing the German and Swiss reports for the American Botanical Council and several other industry organizations, says Mark Blumenthal, the council's executive director. The American Botanical Council is a nonprofit herbal research and education organization.
Because there is no Freedom of Information Act in Europe, access to the specific case reports will be limited, he tells WebMD.
What he knows thus far: "In 18 of the European cases, people were also taking -- along with the kava -- prescription or over-the-counter drugs that were known to possibly cause liver toxicity. Whether the liver toxicity was related to those drugs, or kava alone, or a combination, may or may not be able to be determined."
In some cases, people were reportedly taking excessive amounts of kava. Also, a history of alcohol use was noted in some cases, Blumenthal tells WebMD.
Autopsy for one reported death showed liver failure before kava was even ingested, he says.
Despite all the controversy and unanswered questions, things may be easing up in Europe. A news report yesterday said that Germany's regulatory agency has approved prescription drug status for kava -- that hasn't been confirmed, Blumenthal says.
"We're advising that certainly the reports from Europe shouldn't be discounted," says Wayne Silverman, PhD, the American Botanical Council's chief administrative officer. "However, there are some mitigating circumstances that make some reports questionable."
The bottom line: "The same kinds of cautions that come with any kind of prescription drug or herbal remedy should apply here," Silverman tells WebMD. "You should consult with a health practitioner. You should be aware of cautionary statements about that supplement."
Roberta Lee, MD, is medical director of the Center for Health and Healing at Beth Israel Medical Center in New York. She has been practicing integrative medicine since 1995 and has lived as a public health physician in the Polynesian islands, where kava is taken on a daily basis. She is in the fifth year of a project involving interviews with traditional healers in Polynesia.
In Micronesian cultures, many people drink fresh kava daily -- but they use water to dilute it, Lee tells WebMD. The process of extracting kava lactones and blending them in a concentration with other ingredients may change the way it affects the body, she says.
"I've never witnessed any evidence of liver toxicity in Micronesia -- and that is a population that drinks alcohol," says Lee.
She considers kava supplements to be safe, but patients must tell their healthcare providers they are taking it. Patients should tell their physicians if they have any history of liver problems or suspect they have liver problems.
People who should not take kava, according the experts:
anyone with a predisposition to liver disease, either because they have hepatitis or some other liver dysfunction
anyone who is taking drugs with known adverse effects on the liver -- like methotrexate for arthritis and statin drugs for cholesterol
anyone who regularly consumes alcohol
If you want to take kava, get your liver function tested on a regular basis, says Lee. "If you're really worried, after two weeks' use, have a blood test for liver function, then have blood tests on a monthly basis. Patients should tell the doctor whether they're feeling terrible, fatigued, notice a dark color in the urine -- those can be warning signs for jaundice."
"Kava as an indication for anxiety is still a valid therapy," says Silverman. "But some people with other medical conditions should be wary."
