Kava (high-dose/extract)

Tier 4 — risky / avoid · Liver toxicity

Kava genuinely reduces anxiety — multiple trials confirm this. However, supplement-form (solvent-extracted) kava carries serious liver toxicity risk. WHO issued a global warning; multiple countries restricted sales. Post-marketing reports have documented dozens of severe liver injury cases including transplants. Traditional water-based kava from the root may be safer, but commercial pills and powders are not. Avoid it in pregnancy and while breastfeeding.

Dose: AVOID supplement-form kava — solvent extraction concentrates toxic compounds; traditional water-based preparation may be safer