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Al-Aly Z, Davis H, McCorkell L, Soares L, Wulf-Hanson S, Iwasaki A, et al
99% of Pacific Islanders have sufficient enzyme, Cytochrome P450 2D6 (CYP2D6), to metabolize kava, while from 79% to 88% of Caucasian populations have sufficient enzyme However, a study of 31 people in Hawaii who were regular kava drinkers showed a significantly greater elevation of two liver enzymes compared with people who were not kava drinkers
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The mechanism is distinct from PDE5 inhibitors (which act peripherally on vascular smooth muscle) and from hormonal treatments (which modulate circulating hormone levels)
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