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The Honolulu Advertiser
Posted on: Monday, April 22, 2002

Scholar disputes warnings on kava

By Jan TenBruggencate
Advertiser Science Writer

LAWA'I, Kaua'i — A federal warning last month about the potential health hazards of kava slammed the industry in Hawai'i and across the Pacific, but a prominent ethno-botanist has said he doubts the claims of liver damage.

Paul Alan Cox said he has seen no problems in native users.

Jan TenBruggencate • The Honolulu Advertiser

Paul Alan Cox, director of the National Tropical Botanical Garden on Kaua'i, will lead a team of physicians and botanists to Samoa next month to confer with native healers about its use.

Many South Pacific islanders use the drug, made from the roots of the pepper relative Piper methysticum, recreationally and ceremonially. In the West, kava is sold as a food supplement to promote relaxation and ease insomnia, menopause symptoms and muscle discomfort.

During his extensive ethnobotanical studies in island groups where the drug is used regularly, Cox said he has seen no evidence of liver problems.

"When I heard of the problem, the first thing I thought was, what other things are these people taking?" he said.

Growers in Fiji have suggested the problem may be with chemicals used to process kava for marketing. Native people generally use the roots of the plant simply pounded with water.

Concerns about the drug surfaced last year in Germany, where officials reported that as many as 25 people suffered liver ailments after using kava — 'awa in Hawaiian — ranging from hepatitis to cirrhosis and liver failure.

The U.S. Food and Drug Administration issued a consumer advisory March 25 that recommended seeing a health professional at signs of liver damage, such as brown urine, yellowing of the skin and eyes, nausea, vomiting, abdominal pain and light-colored stools.

The warning devastated the kava-growing industry. Some European nations removed kava products from stores, while others issued warnings. The drug company Merck announced a permanent halt to sale of its two kava products in Europe.

Hawai'i growers said prices and demand have plummeted. Fijian government officials are calling for an international medical inquiry into the claims of liver damage.

Cox said the indigenous people of the Pacific have used kava longer than anyone in Europe, and if there is a liver threat, they should be suffering from it.

"I think the Polynesians would have figured this out if there were cases of severe liver failure," he said. "I have lived in indigenous villages, and I have not seen this kind of toxicity."

He said he would take a team of ethnobotanists and physicians to talk to natives on Savaii in Western Samoa and the Manua island chain in American Samoa.

"These people know more about kava than anyone in the world," he said.

If there is a toxicity issue, indigenous people may have developed specific restrictions on kava use to minimize the risk, he said.

"I find that indigenous people are very adept at excluding toxic compounds," he said.

A recent study indicated as many as 50 farms on Hawai'i growing kava, and a farm value of hundreds of thousands of dollars.

The FDA did not ban the product, but cited European restrictions and recommended that "persons who have liver disease or liver problems, or perhaps who are taking drug products that can affect the liver, should consult a physican before using kava-containing supplements."

Reach Jan Tenbruggencate at (808) 245-7825 or at jant@honoluluadvertiser.com.