Liver enzyme levels in users of aqueous kava (Piper methysticum) extract in the Fiji Islands

INTRODUCTION: An aqueous extract of the kava plant Piper methystiGum is consumed in pacific island cultures. Beneficial physiological and psychological effects of this plant resulted in it being used in the herbal medicine market. Liver failure was found amongst users of kava tablets and causative link was suspected. OBJECTIVES: This study aimed to detect alterations in levels of liver enzymes in consumers of traditional kava in the Fiji islands. METHOD: 120 study participants were interviewed regarding their kava consumption habits and had liver function tests performed. Confounders of alcohol consumption and medical diagnosis were controlled for. RESULTS: Current kava users had altered liver enzymes consistent with liver damage as compared to former or non-users of kava, however liver enzymes did not change in relation to dose of kava ingested. CONCLUSION: Traditional kava use may cause altered levels of liver enzymes. The clinical significance of this needs further to be examined, and until such time, the use of kava, both traditionally and in tablet form should be viewed with caution.