Kava Kava Warning From Germany

Healthfacts, Jan, 2002 by Maryann Napoli

A warning has gone out in Germany regarding kava kava, an herbal remedy that is also very popular in the U.S. Twenty-four cases of liver damage have been linked to this product which is taken for anxiety, stress, restlessness, and panic attacks. As with all herbal products, kava kava is defined by the U.S. Food and Drug Administration (FDA) as a dietary supplement. This means that the manufacturers are not required to prove safety or efficacy, as would be the case with prescription drugs. All dietary supplements can be purchased without a prescription.

The German equivalent of the FDA, called the Federal Institute of Drugs and Medical Devices, recently announced the warning about kava kava; and a formal withdrawal of all products containing this herb was planned for this month. Of the 24 cases of liver toxicity reported to the German agency, one was fatal and three people required liver transplants. Injuries associated with ingestion of kava kava products included acute liver failure, cholestatic hepatitis or cirrhosis of the liver. The mechanism causing the toxicity is unknown, according to the arznei-telegramm, a German drug bulletin with no pharmaceutical advertising.

The warning applies to all products containing kava kava, including the much-diluted homeopathic preparations. The lowest concentrations at which toxic liver reactions may be expected would be in the range of a homeopathic dilution D6, explained Dr. Peter Schoenhoefer, co-editor of arznei-telegramm, in an e-mail interview. This may be enough, he said, to induce liver damage over time.

Several pharmaceutical companies that make kava kava products have appealed the preliminary decision by the German Federal Institute of Drugs and Medical Devices to ban the sale of their products, with the exception of the homeopathic preparations. The controversy spilled over to the U.S. several weeks ago, when the FDA announced that it is investigating the use of dietary supplements containing kava kava.

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Maryann Napoli is the associate director of the Center for Medical Consumers in New York City.