Editing Kava (section)

==== Concerns ====
Numerous scholars<ref name="teschke16" /> and regulatory bodies<ref name=":2">{{Cite journal|date=2016-05-25|title=Kava: A Human Health Risk Assessment|url=http://www.foodstandards.govt.nz/publications/documents/30_Kava1.pdf|journal=Technical Report Series No 30|access-date=25 May 2016|archive-date=11 February 2016|archive-url=https://web.archive.org/web/20160211001359/http://www.foodstandards.govt.nz/publications/documents/30_Kava1.pdf|url-status=dead}}</ref><ref name=":7" /> have raised concerns over the safety profile of such products.

One group of scholars say that organic solvents introduce compounds that may affect the liver into the standardized product; these compounds are not extracted by water and are consequently largely absent from kava prepared with water.<ref name=":5">{{Cite journal|last1=Kraft|first1=M|last2=Spahn|first2=T W|last3=Menzel|first3=J|last4=Senninger|first4=N|last5=Dietl|first5=K.-H|last6=Herbst|first6=H|last7=Domschke|first7=W|last8=Lerch|first8=M M|date=2001|title=Fulminantes Leberversagen nach Einnahme des pflanzlichen Antidepressivums Kava-Kava|journal=Deutsche Medizinische Wochenschrift|language=en|volume=126|issue=36|pages=970–972|doi=10.1055/s-2001-16966|pmid=11544547|s2cid=260067545|issn=0012-0472}}</ref> For instance, when compared with water extraction, organic solvents extract vastly larger amounts of flavokavains, compounds associated with adverse reactions to kava that are present in very low concentrations in noble kava, but significant in non-noble.<ref>{{Cite journal|last1=Zhou|first1=Ping|last2=Gross|first2=Shimon|last3=Liu|first3=Ji-Hua|last4=Yu|first4=Bo-Yang|last5=Feng|first5=Ling-Ling|last6=Nolta|first6=Jan|last7=Sharma|first7=Vijay|last8=Piwnica-Worms|first8=David|last9=Qiu|first9=Samuel X.|date=December 2010|title=Flavokawain B, the hepatotoxic constituent from kava root, induces GSH-sensitive oxidative stress through modulation of IKK/NF-κB and MAPK signaling pathways|journal=The FASEB Journal|volume=24|issue=12|pages=4722–4732|doi=10.1096/fj.10-163311|doi-access=free |issn=0892-6638|pmc=2992378|pmid=20696856}}</ref><ref name="Kuchta 1647–1653" />

Also, "chemical solvents used do not extract the same compounds as the natural water extracts in traditional use. The extraction process may exclude important modifying constituents soluble only in water".<ref name=":5" /> In particular, it has been noted that, unlike traditional water-based preparations, products obtained with the use of organic solvents do not contain [[glutathione]], an important liver-protecting compound.<ref name=":6">{{Cite journal|date=2003-10-01|title=Kava lactones and the kava-kava controversy|journal=Phytochemistry|language=en|volume=64|issue=3|pages=673–679|doi=10.1016/S0031-9422(03)00381-9|issn=0031-9422|last1=Whitton|first1=Peter A|last2=Lau|first2=Andrew|last3=Salisbury|first3=Alicia|last4=Whitehouse|first4=Julie|last5=Evans|first5=Christine S|pmid=13679089|bibcode=2003PChem..64..673W }}</ref> Another group of researchers noted: "The extraction process (aqueous vs. acetone in the two types of preparations) is responsible for the difference in toxicity as extraction of glutathione in addition to the kava lactones is important to provide protection against hepatotoxicity".<ref name=":6" />

It has also been argued that kavalactone extracts have often been made from low-quality plant material, including the toxic aerial parts of the plant that contain the hepatotoxic alkaloid [[pipermethystine]], non-noble kava varieties, or plants affected by mold {{Ndash}}which, in light of the chemical solvents' ability to extract far greater amounts of the potentially toxic compounds than water, makes them particularly problematic.

In the context of these concerns, the [[World Health Organization]] advises against the consumption of ethanolic and acetonic kavalactone extracts, and says that "products should be developed from water-based suspensions of kava".<ref name=":7">{{Cite book|url=https://books.google.com/books?id=2KXWY6kPESUC&q=%22products+should+be+developed+from+water-based+suspensions+of+kava%22+WHO&pg=PA25|title=Assessment of the Risk of Hepatotoxicity with Kava Products|last=Organization|first=World Health|date=2007|publisher=WHO Regional Office Europe|isbn=978-92-4-159526-1|language=en}}</ref> The government of Australia prohibits the sales of such kavalactone extracts, and only permits the sale of kava products in their natural form or produced with cold water.<ref>{{Cite web|url=https://www.legislation.gov.au/Details/F2011C00587|title=Australia New Zealand Food Standards Code - Standard 2.6.3 - Kava|last=Health|website=www.legislation.gov.au|date=11 July 2011 |language=en|access-date=2018-09-02}}</ref>