Kava in pregnancy and breastfeeding

What NCCIH says about safety

Various kava products have been linked to rare cases of liver injury, some of which have been serious or even fatal. The first reported cases involved medicinal or dietary supplement products that had been extracted with alcohol or acetone, but other cases have involved kava beverages prepared with water. It has been suggested that the use of undesirable varieties (cultivars) of kava plants or inappropriate parts of the plant may be responsible for liver toxicity; other possibilities include the consumption of kava together with alcohol and the adulteration or contamination of kava products. It has also been suggested that genetic differences among people might influence their susceptibility to liver toxicity and that consumption of kava in large amounts or for prolonged periods of time may increase risk. Kava can cause digestive upset, headache, dizziness, and other side effects. Long-term use of high doses of kava may cause kava dermopathy, a condition that involves dry, scaly, flaky skin with reddened eyes and temporary yellow discoloration of the skin, hair, and nails. Kava should not be used together with other substances that have sedative effects, such as benzodiazepines or alcohol. If you take any type of medicine, talk with your health care provider before using kava or other herbal products; some herbs and medicines interact in harmful ways. Kava may have special risks if taken during pregnancy or while breastfeeding because of the presence of harmful pyrone constituents.

Quoted in full from NCCIH so nothing is lost in summarising. Where they say “little is known”, that means the studies do not exist — not that the herb is known to be safe, and not that it is known to be harmful.

How much is actually known

There has been a fair amount of research in people on the use of kava for anxiety, but few studies have been done on other conditions. There has also been substantial investigation of rare but sometimes severe cases of liver injury associated with the use of kava.

What the research has found

Kava supplements may be helpful for anxiety, but they may need to be taken for several weeks to produce an effect. Kava does not appear to be helpful for symptoms of generalized anxiety disorder. There isn’t enough evidence to show whether kava is helpful for any other conditions.

Before you take this

Dose and form change the answer completely. A culinary amount of a spice, a cup of tea, and a concentrated supplement extract are three different things, and most research is done on the last of them.

Supplements are also not regulated like medicines, so strength and purity vary between products. Bring the actual bottle to your midwife, doctor or pharmacist — that conversation is worth more than any page, including this one.