Kava (kavalactones)

Kava is the root of Piper methysticum, a South Pacific pepper plant, and kavalactones are the active fraction. Two facts sit ahead of everything else. It cannot legally be sold in food in England: the Kava-kava in Food (England) Regulations 2002 prohibit it, and a second 2002 order covers medicinal products. And the NIH LiverTox monograph places kava in its highest category for clinically apparent liver injury, with cases appearing 2 to 24 weeks after starting, some ending in liver failure. On effect, a 2003 Cochrane review of 11 trials found kava beat placebo on an anxiety rating scale, but the largest trial since, 171 people over 16 weeks at 240mg of kavalactones a day, found nothing: the small difference favoured placebo, and abnormal liver function tests were more common on kava. Anyone importing it for personal use should be reading their own liver panel, not a marketing page.

Stack Almanac keeps kava on the record with the dose and the date you started, which is the list your doctor will want if a liver panel ever comes back odd.