Is kava supplementation safe for individuals with pre-existing liver conditions or at risk of liver injury?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 14, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

Kava supplementation is not safe for individuals with pre-existing liver conditions or those at risk of liver injury, and they should completely avoid kava products in any form. The risk of liver damage associated with kava use is a significant concern, particularly for those with compromised liver function due to conditions such as hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease, or cirrhosis 1, 2, 3, 4.

Key Considerations

  • Kava contains compounds called kavalactones that have been linked to severe liver damage, including hepatitis, cirrhosis, and liver failure requiring transplantation 1.
  • The liver damage mechanism appears to be idiosyncratic, meaning it's unpredictable and not necessarily dose-dependent, making it impossible to establish a "safe" dose for vulnerable individuals 2, 3.
  • Even short-term use can potentially trigger liver problems in susceptible people, and the risk is not worth any potential benefits for anxiety or other conditions that kava is commonly used to treat 5.
  • Those taking medications that stress the liver (including acetaminophen, statins, and certain antibiotics) should also avoid kava due to the increased risk of hepatotoxicity 2, 3.

Recommendations

  • Individuals with pre-existing liver conditions or those at risk of liver injury should avoid kava products in any form, including teas, supplements, extracts, or traditional preparations.
  • Healthcare professionals should be aware of the potential hepatotoxicity of kava and advise patients accordingly, particularly those with compromised liver function or taking medications that stress the liver.
  • The use of kava should be carefully monitored, and patients should be educated on the signs and symptoms of liver damage, such as jaundice, dark urine, and abdominal pain, and seek medical attention immediately if they experience any of these symptoms 4.

References

Research

Acute hepatitis induced by kava kava.

Journal of toxicology. Clinical toxicology, 2003

Research

Kava hepatotoxicity--a clinical review.

Annals of hepatology, 2010

Research

Kava hepatotoxicity: pathogenetic aspects and prospective considerations.

Liver international : official journal of the International Association for the Study of the Liver, 2010

Research

Kava extracts: safety and risks including rare hepatotoxicity.

Phytomedicine : international journal of phytotherapy and phytopharmacology, 2003

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.