Kava kava

Kava kava as it relates to DILI in Health report: Genetics of Antibiotics-Induced Liver Injury

Kava kava, also known simply as kava, is a plant native to the South Pacific islands. It has been traditionally used in ceremonies and for its sedative and anxiolytic properties. However, there have been reports linking kava kava to drug-induced liver injury (DILI).

Drug-Induced Liver Injury (DILI) and Kava Kava

There have been several cases reported where the consumption of kava kava has been associated with liver damage. Symptoms of DILI can include jaundice, fatigue, nausea, and abdominal pain. In severe cases, DILI can lead to acute liver failure, requiring liver transplantation.

Mechanism of DILI with Kava Kava

The exact mechanism by which kava kava causes liver injury is not fully understood. Some studies suggest that certain compounds in kava kava may be toxic to the liver cells, leading to inflammation and damage. Additionally, genetic factors and individual susceptibility may play a role in determining who is at risk for DILI from kava kava.

Regulatory Actions

Due to concerns about the potential for liver injury, several countries, including Germany, Switzerland, France, Canada, and Australia, have restricted or banned the sale of kava kava products. In the United States, the FDA issued a warning in 2002 about the potential risks of kava kava and advised consumers to consult with their healthcare providers before using kava kava supplements.

Conclusion

While kava kava has been used for centuries for its calming effects, it is important to be aware of the potential risks associated with its use, particularly in relation to liver health. Individuals considering using kava kava should consult with their healthcare providers and be vigilant for any signs of liver injury.

Supplements for DILI

Here are some dietary supplements related to the content in this report. Click the shopping cart to purchase the supplement from our partners.

  1. Green tea extract

    Contains catechins which may increase oxidative stress and liver cell damage when combined with hepatotoxic antibiotics.

  2. Greater celandine

    Alkaloids like chelidonine may further impair liver function when the organ is under stress from antibiotics.

  3. Chaparral

    Nordamnacanthal is a quinone that could synergistically increase antibiotic liver toxicity through mitochondrial dysfunction.

  4. Germander

    Diterpenoids may amplify antibiotic liver injury by disrupting bile salt export and causing cholestasis.

  5. Mistletoe

    Contains toxic lectins which could worsen immunological reactions or alter detox pathways of antibiotic metabolites.

  6. Skullcap

    Flavonoids may inhibit pathways involved in hepatic metabolism and clearance of antibiotics from the liver.

  7. Valerian

    Isovaltrate and other constituents thought to directly damage cell membranes, potentially worsening antibiotic hepatocellular toxicity.

  8. Kava kava

    Kavalactones like desmethoxyyangonin may inhibit CYP450 liver enzymes important for antibiotic clearance.

  9. St. John's wort

    Hyperforin alters PXR nuclear receptors and could decrease bile acid transport, contributing to antibiotic cholestasis.

  10. Ginseng

    Ginsenosides may inhibit P-glycoprotein transporters important for antibiotic efflux from hepatocytes, allowing accumulation of toxic levels.

  11. Aloe vera

    Anthraquinone glycosides possibly damage cell membranes and worsen antibiotic-mediated liver cell necrosis.

  12. Ashwagandha

    Withanolides thought to cause oxidative stress which synergizes with redox-cycling antibiotic metabolites.

  13. Andrographis

    Diterpene lactones may reduce bile acid secretion and flow, contributing to cholestatic injury.

  14. Noni juice

    Anthraquinones could impair mitochondrial function and increase antibiotic hepatotoxicity.

  15. Peppermint oil

    Menthol interferes with CYP450s and UGTs involved in antibiotic metabolism and clearance.

  16. Kratom

    Mitragynine and 7-hydroxymitragynine are metabolized in liver and could enhance antibiotic toxicity.

  17. Ephedra

    Ephedrine alkaloids may deplete glutathione and reduce the liver's defense against antibiotic oxidative damage.

It is essential to consult your healthcare provider before starting any of these supplements. They can have side effects, and some may interact with medications or other supplements you're already taking.
Disclaimer