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Kava Physiology My liver Test Results (A Three Year Overview)

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
These metabolism test results represent years 15-18 of drinking 40g of traditionally prepared kava per day.

You can see my first test was crazy as I had just gotten out of the hospital w/ covid. Wasn’t fun, and those tests reflect it.

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My ALT/AST values were not good. Consequently I actually started BACK drinking kava during the time of that test after my release from the hospital, and you can track the changes to my subsequent test that year (90 days later) with normal ALT/AST values for liver histology.

2020_2.png

Essentially I drank kava even when my liver was in peril and nothing came of it. Remember I am a study of ONE, so this in no way writes the book, but it’s some rather strong evidence that kava in fact did not cause any type of liver stress even on top of a stressed liver.
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2021.png

2022.png

2023.png

As you can see I’ve only had one test where ALP levels were within normal range indicated on the 2nd test from 2020, 3 months after the first. Rises in ALP without corresponding GGT increases (GGT was normal) indicate non-hepatic causes (Limdi et al 2003). Not only this, but the level of increase is/was less than 2 times the upper normal limit, indicating a non-damage condition. Considering there are no rises in GGT, ALT, AST, or Bilirubin we can conclude this has nothing to do with the liver itself, and also is not an indicator of any liver damage (Francher et al 2017). We first thought this was due to my vitamin D levels, which were abysmal. After supplementation for a year my vitamin D levels are now over the upper limit, and my ALP, while lower than last year, is still slightly in the high range. Now, with all of this information in hand, I’m a bit more comfortable saying that this ALP rise is likely an artifact of my kava consumption…possibly. Not a medical doctor, so of course I can’t say for absolute sure. I do take a couple of other prescription drugs, however I was definitely not taking those at the first test. None of the drugs I take regularly have any history of causing this pattern of ALP elevation.

The evidence is tenuous, but Clough et al in 2003 found GGT and/or ALP rises without corresponding AST/ALT, bilirubin, or any other liver damage markers in daily kava drinkers. This was seen in kava consumption at levels of over 118g per week. I fall into this category squarely at 280g per week consumption. Are they connected? Hey, maybe they are. My doctor says it’s nothing to be concerned about and we’ll just watch it.

Clough, Alan R., Ross S. Bailie, and Bart Currie. 2003. “Liver Function Test Abnormalities in Users of Aqueous Kava Extracts.” Journal of Toxicology. Clinical Toxicology 41 (6): 821–29. https://doi.org/10.1081/clt-120025347.

Fancher, Tonya, Amit Kamboj, and John Onate. 2017. “Interpreting Liver Function Tests.” Current Psychiatry 6 (5): 61–68. https://paperpile.com/app/p/94c842a5-c415-049f-9f18-7102b77b940b

Limdi, J. K., and G. M. Hyde. 2003. “Evaluation of Abnormal Liver Function Tests.” Postgraduate Medical Journal 79 (932): 307–12. https://doi.org/10.1136/pmj.79.932.307.
 

mlenny

Kava Curious
ALP really is a marker for bile duct health (think cholestasis). ALT best demonstrates damage to liver cells and bilirubin, albumin, ammonia, and INR (which I don't see) best represent liver function.
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
ALP really is a marker for bile duct health (think cholestasis). ALT best demonstrates damage to liver cells and bilirubin, albumin, ammonia, and INR (which I don't see) best represent liver function.
In hepatic cases, yes, you are correct, however this one is not, and follows a different etiology. My ALP rise is accompanied by no other aminotransferase markers, indicating a non-hepatic origin. If it were ALP from a hepatic origin, there would be other indicators present [1]. My GGT, while not shown in my test, has been tested separately, and has not been elevated.

Also:
"Elevations in ALT and AST in out of proportion to ALP, and bilirubin denotes a hepatocellular disease. An elevation in ALP and bilirubin in disproportion to ALT and AST would characterize a cholestatic pattern. A mixed injury pattern is defined as an elevation of alkaline phosphatase and AST/ALT levels. Isolated hyperbilirubinemia is defined as an elevation of bilirubin with normal alkaline phosphatase and AST/ALT levels."[2]

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[1]

[1] Limdi, J. K., and G. M. Hyde. 2003. “Evaluation of Abnormal Liver Function Tests.” Postgraduate Medical Journal 79 (932): 307–12. https://doi.org/10.1136/pmj.79.932.307.

[2] Lala, Vasimahmed, Muhammad Zubair, and David A. Minter. 2022. “Liver Function Tests.” In StatPearls. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/pubmed/29494096.
 

Orz[EST]

Kava Enthusiast
My grandmum went into hospital for MRI. The conclusion was that her gallbladder was OK. However, her gallbladder had been removed by surgery many years ago before the era of digital storage of medical data...
 
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