A South Pacific root drink with a real but uneven record for brief calming without dulling attention or memory. Sleep and mood signals are thinner. The liver is the main hazard: plant part and extraction method matter, and alcohol or sedatives raise the stakes. Deliberate short use with liver testing changes the picture. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Alanine aminotransferase | 10–20 U/L (women), 10–25 U/L (men) | Most specific marker of liver-cell injury; the primary stop signal |
| Aspartate aminotransferase | 10–25 U/L | Confirms liver-cell injury; paired with alanine aminotransferase, distinguishes alcohol-related patterns |
| Gamma-glutamyl transferase | <20 U/L (women), <25 U/L (men) | Sensitive to both kava and alcohol exposure and to glutathione depletion |
| Alkaline phosphatase | 60–90 U/L | Detects the cholestatic (bile-flow blockage) injury pattern seen in kava case reports |
| Total bilirubin | 0.3–1.0 mg/dL | Rising with raised enzymes, marks the shift from enzyme change to genuine liver dysfunction |
| Albumin | 4.2–5.0 g/dL | Reflects synthetic liver function and the low-albumin state seen with heavy chronic use |
| Lymphocyte count | 1.5–3.0 ×10⁹/L | Heavy kava use is associated with reduced lymphocytes and a theoretical infection risk |
| Anxiety rating score | Below 5 on the 7-item anxiety questionnaire | Turns the benefit question into a measurement rather than an impression |
| Resting heart rate | No kava-specific target; tracked as change from own baseline | Continuous proxy for autonomic load, the physiological side of the tension kava targets |
Cadence: Fasted liver panel before the first dose, at week 4, at week 8 or end of course, then every 8 weeks if use continues; unscheduled draw at any jaundice, dark urine, abdominal pain or unexplained fatigue. Anxiety and sleep scores at week 4.