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The Honolulu Advertiser
Posted on: Sunday, January 13, 2002

Hawai'i kava growers hit by health concerns

By Tanya Bricking
Advertiser Staff Writer

A German report linking liver disease to kava pills has advocates emphasizing a distinction between the pill form and the drink form. They say further bad press in Germany could taint the reputation of the nonalcoholic drink.

Deborah Booker • The Honolulu Advertiser

Hawai'i kava growers may be needing a dose of their own herbal remedy to relieve anxiety about a problem threatening the future of their industry.

A German report that links the pill form of the stress-relief herb kava to liver disease already has halted the plant's export from Hawai'i — without any real proof that kava is dangerous, its defenders say.

The herb, known in the Hawaiian language as 'awa, has grown so popular in health-food circles as a natural tension reliever that sales of the herbal supplement topped $30 million nationwide in 2000, according to the nonprofit American Botanical Council.

But recent news could dry up international demand for one of Hawai'i's cash crops.

While no serious side effects have been documented in the United States, Switzerland and Germany began halting kava sales two months ago because of reports of liver damage tied to kava pharmaceutical products.

"We haven't been able to ship anything to Germany," said Jay Ram, president of Agrinom, a Big Island company specializing in natural product ingredients and tropical agriculture production.

Agrinom has contracts with two German pharmaceutical companies and usually ships 16,000 to 32,000 pounds of kava each month for about $12 for every 2.2 pounds. Now Ram expects to hold off on harvesting.

"We're just basically waiting for the government to see how they're going to regulate it," he said. "If this thing in Germany goes bad, it's just destroyed the market. If Germany ends up banning this, then other could follow suit, even the FDA."

Findings under dispute

Nearly 50 pharmaceutical companies have appealed a preliminary decision by Germany's Federal Institute for Drugs and Medical Devices to ban the sale of kava, except in products that contain only minute amounts.

The German government announced a ban two months ago after it became alarmed about nearly 30 reports in Germany and Switzerland of severe liver toxicity with suspected links to kava consumption. While German officials did not release details about the backgrounds of the people who reported liver disease, it emphasized the seriousness of the reports: One person died and three underwent liver transplants.

Several companies, including Germany-based Merck, one of the world's largest pharmaceutical companies, voluntarily discontinued the sale of kava products in Germany as a precaution.

In the United States, the Food and Drug Administration sent out a "Dear Doctor" letter last month, asking health professionals to review their cases of liver disease "to determine if any may be related to the use of kava-containing dietary supplements."

A 75-page appeal by the drug companies asks Germany to halt the ban, saying there is no evidence to link kava to the cases of liver problems. The appeal contends that in some cases, patients were taking drugs other than pharmaceutical kava, and there was no proof that kava caused their liver problems.

While German officials decide what to do next, the American Herbal Products Association, the American Botanical Council and the Council for Responsible Nutrition are among organizations pushing for further study about kava and its effects on the liver.

The researchers want to review medical case reports and scientific literature to determine the scope of the problem and make sure kava is labeled properly, said Mark Blumenthal, founder and executive director of the American Botanical Council, a research organization in Austin, Texas.

The United States has no known reports of liver problems related to kava, but there is a caveat: Clinical trials have not been conducted on it.

Growers and researchers in Hawai'i say it's safe in its traditional form. But they have questions about the way kava has been processed in Germany, and whether additives or some kind of herbal fungus could have caused a liver reaction in the small number of cases reported.

Local advocates respond

Ed Johnston, project coordinator on the Big Island for the Association for Hawaiian Kava, is an herbal advocate pushing for answers. He drinks kava at least four nights a week and said it has never made him sick.

"The local growers think that it isn't the herb, the root or the stump of 'awa that may or may not be causing problems," he said. "It's the processing."

Ram wonders whether kava's niche as a natural alternative to anxiety drugs might have something to do with the controversy.

"I think it's very clear that some of the drug companies are trying to get this off the market because they're afraid it will cut into their Valium sales," he said.

While answers are still awaited, Hawai'i kava growers are feeling stung because Germany's problems with kava may have nothing to do with what's grown here.

"I think it's fair to apply Western science to this plant. No previous studies have shown it causes liver damage," said Jonathan Yee, a farmer who grows kava on the Big Island and O'ahu, and teaches classes about the plant's history and use.

Early Polynesians brought kava to Hawai'i, and for thousands of years, Hawaiians have used it with no reports of liver problems, he said. Yee likens the kava controversy to a study a few years ago by Hawai'i scientists who linked Alzheimer's disease to tofu.

Dr. Lon White of the Pacific Health Research Institute reported in 1999 that his study of local Asian American men, participants in the long-term Honolulu Heart Study, were more likely to suffer cognitive loss or Alzheimer's disease if they ate tofu more than twice a week.

The study touched a nerve for Hawai'i tofu fans, who claimed White's theory was flawed.

Some kava farmers are looking at this the same way, Yee said.

"There's a lot of junk science out there," he said. "But I think it's a fair thing that some studies are going to be done."

Lots of Hawai'i kava farmers will be waiting for the results. More than 50 farms in Hawai'i and 80 acres of land were devoted to commercial kava cultivation in 2000, the Hawai'i Agricultural Statistics Service estimated. Sales of fresh kava totaled 85,000 pounds and generated $119,000 in farm revenues.

Yee estimates there were twice that number of commercial kava farms last year, but last year's statistics have not yet been compiled.

At Hale Noa, the state's first kava bar, owner Jason Keoni Verity buys from a Moloka'i grower who can grow more than Verity can afford to buy for his Waikiki hangout.

Most growers want to sell kava for pharmaceutical use. Verity, who opened the bar about two years ago, buys the gnarly root, making it into a chocolate-milk-colored, muddy-tasting beverage.

The regulars are still bellying up to his bar, and Verity is assuring patrons that the nonalcoholic drink with a tongue-numbing buzz is completely safe. During his down time, he wades through his e-mail, which has been flooded with messages about the uproar in Germany.

"It is a concern that perhaps the growers will not be able to stay in business," he said. But he thinks the whole controversy has been overblown.

The stigma, cost and inconvenience of kava might make it a tough sell for the regular bar crowd, he said.

"It's much, much easier to pop a top on a beer bottle or mix a drink," Verity said. But he also said he hopes kava will find its place and make a resurgence in island culture, as hula has. Kava bars already have cropped up on the Big Island and Maui since Hale Noa opened, and Verity would like to see more.

If kava can make a comeback, what has to happen first is for people to make a clear distinction between the kava drink and the kind of kava that comes in a pill bottle, said Jerry Ooka, a University of Hawai'i associate plant pathologist.

Bad press for the pill in Germany could taint the reputation of the plant back here, he said.

"If this ban goes through and 'awa the traditional drink becomes associated with it, we're not going to be able to revive the product here," he said. "It probably has already stopped the small growers from planting."

Right now, there's nothing to do but hold out for the FDA's findings, said H.C. "Skip" Bittenbender, a UH extension specialist for coffee and kava.

And Bittenbender, a fan of kava's calming qualities, said he sees no harm in tipping back a mug or two during the wait.

Reach Tanya Bricking at tbricking@honoluluadvertiser.com or 525-8026.