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Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisited.
Br J Clin Pharmacol. 2012 Feb; 73(2):170-4.BJ

Abstract

Kava, a Pacific herb consumed worldwide for medicinal, recreational and cultural purposes, has been associated with rare hepatotoxicity, and there is currently a critical need to determine this causation. The previously proposed Pacific kava paradox was based on the theory that kava hepatotoxicity was not observed following use of traditional aqueous extracts in the Pacific region, but was restricted to use of Western acetonic and ethanolic extracts. Subsequent cases analyzed by the World Health Organization and published case reports revealed that traditional aqueous extracts used in New Caledonia, Australia, the USA and Germany may also be hepatotoxic; thus, there is no longer a basis to sustain the previously proposed Pacific kava paradox. It appears that the primary cause of toxicity may reside in the time before the preparation of the various kava extracts, possibly attributed to poor quality of the raw material caused by mould hepatotoxins. Rigorous testing of kava raw material is urgently advised, in addition to Pan-Pacific kava manufacturing quality standards.

Authors+Show Affiliations

Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Teaching Hospital of the Goethe University of Frankfurt/Main, Hanau, Germany. rolf.teschke@gmx.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21801196

Citation

Teschke, Rolf, et al. "Kava Hepatotoxicity in Traditional and Modern Use: the Presumed Pacific Kava Paradox Hypothesis Revisited." British Journal of Clinical Pharmacology, vol. 73, no. 2, 2012, pp. 170-4.
Teschke R, Sarris J, Schweitzer I. Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisited. Br J Clin Pharmacol. 2012;73(2):170-4.
Teschke, R., Sarris, J., & Schweitzer, I. (2012). Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisited. British Journal of Clinical Pharmacology, 73(2), 170-4. https://doi.org/10.1111/j.1365-2125.2011.04070.x
Teschke R, Sarris J, Schweitzer I. Kava Hepatotoxicity in Traditional and Modern Use: the Presumed Pacific Kava Paradox Hypothesis Revisited. Br J Clin Pharmacol. 2012;73(2):170-4. PubMed PMID: 21801196.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisited. AU - Teschke,Rolf, AU - Sarris,Jerome, AU - Schweitzer,Isaac, PY - 2011/8/2/entrez PY - 2011/8/2/pubmed PY - 2012/5/2/medline SP - 170 EP - 4 JF - British journal of clinical pharmacology JO - Br J Clin Pharmacol VL - 73 IS - 2 N2 - Kava, a Pacific herb consumed worldwide for medicinal, recreational and cultural purposes, has been associated with rare hepatotoxicity, and there is currently a critical need to determine this causation. The previously proposed Pacific kava paradox was based on the theory that kava hepatotoxicity was not observed following use of traditional aqueous extracts in the Pacific region, but was restricted to use of Western acetonic and ethanolic extracts. Subsequent cases analyzed by the World Health Organization and published case reports revealed that traditional aqueous extracts used in New Caledonia, Australia, the USA and Germany may also be hepatotoxic; thus, there is no longer a basis to sustain the previously proposed Pacific kava paradox. It appears that the primary cause of toxicity may reside in the time before the preparation of the various kava extracts, possibly attributed to poor quality of the raw material caused by mould hepatotoxins. Rigorous testing of kava raw material is urgently advised, in addition to Pan-Pacific kava manufacturing quality standards. SN - 1365-2125 UR - https://www.unboundmedicine.com/medline/citation/21801196/Kava_hepatotoxicity_in_traditional_and_modern_use:_the_presumed_Pacific_kava_paradox_hypothesis_revisited_ L2 - https://doi.org/10.1111/j.1365-2125.2011.04070.x DB - PRIME DP - Unbound Medicine ER -