International trade and use restrictions on products containing the South Pacific herb kava (Piper methysticum G. Forster) due to several cases of liver disease linked to ingestion of the botanical may be founded on inadequate information, according to a review article in the March 2011 issue of the AHPA Report, published by the American Herbal Products Association (AHPA), Silver Spring, MD. In the article, Rolf Teschke, MD, one of the world’s foremost experts on kava—a traditional botanical used in natural remedies and products—says the few cases of toxicity related to ingestion of kava products were “most probably a consequence of poor-quality raw kava material employed in the manufacture of a few kava extracts.”
 
“Toxicity was associated with ingestion of traditional aqueous kava extracts, acetonic and ethanolic kava drugs, and kava dietary supplements in kava-herb mixtures,” he said. “These adverse reactions emerged unexpectedly in the face of the apparent safe traditional use of kava for thousands of years.”
 
According to Steven Dentali, PhD, AHPA chief science officer: “Teschke’s article underscores the fact that there isn’t enough information to say that the safety issue with kava is likely supposed toxicity associated with its constituent kavalactones, a possible purported basis for many of the bans and restrictions on kava products.” 
 
Dr. Teschke reinforces the connection between the source and quality of the botanical and the safety and efficacy of the finished herbal product. Scientists and manufacturers alike must carefully attend to the type of kava used as well as to other potentially influential factors stemming from harvest, handling and processing of the kava plant, the article notes.
 
“To minimize hepatotoxic risks due to kava use, efforts have to be undertaken to improve kava quality standards and to establish strict regulations for kava cultivators, farmers, harvesters, manufacturers and physicians treating patients for anxiety, tension and restlessness,” Dr. Teschke said.