Kava and Liver Enzymes: What You Need to Know About Safety and Risk

When you take kava, a traditional Pacific Island herbal remedy used for anxiety and relaxation. Also known as Piper methysticum, it’s sold as tea, capsules, or tinctures—but it’s not harmless. Some people who use kava regularly show elevated liver enzymes, proteins in the blood that signal liver stress or damage. These include ALT and AST, which doctors check during routine blood tests. When these numbers rise, it means your liver is under strain. In rare but serious cases, kava has been linked to liver failure, leading to hospitalizations and even transplants.

Not everyone who takes kava gets liver problems, but the risk isn’t random. People with existing liver conditions, those who drink alcohol regularly, or those taking other medications that affect the liver—like statins, antidepressants, or certain antibiotics—are at higher risk. The way kava is processed also matters. Extracts made with alcohol or acetone may contain more of the harmful compounds than traditional water-based preparations. And unlike prescription drugs, herbal supplements like kava aren’t required to prove safety before hitting store shelves. That means you might not know what’s in the bottle, how strong it is, or whether it’s been tested at all.

Some studies from the early 2000s led to bans or warnings in Europe and Canada, but kava remains widely available in the U.S. The FDA has issued alerts, but no full ban. That leaves you to decide: is the calm it brings worth the potential cost to your liver? If you’ve been using kava for months or years, get your liver enzymes checked. If they’re high, stop. If you’re considering starting it, talk to your doctor first—especially if you’re on any other meds. There are safer ways to manage anxiety: therapy, exercise, magnesium, or even FDA-approved herbal options like ashwagandha, which has less liver risk. The bottom line: kava isn’t a harmless herb. It’s a substance that interacts with your body in powerful, sometimes dangerous ways. And if you’re using it, you deserve to know exactly what you’re risking.

Below, you’ll find real-world insights from medical reports, patient experiences, and drug interaction studies that help you make smarter choices about kava, liver health, and herbal supplements in general.