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Research suggests that it is generally safe when used as prescribed

When testosterone encounters 5-alpha reductase in hair follicle cells, it transforms into the more potent DHT molecule

137 The intrinsic reactivity and peculiar chemistry of per-sulphides and poly-sulphides indicate that they might carry out numerous signalling functions that could currently be underestimated mainly owing to the technical difficulties in studying these metabolites in biological milieu

doi: 10.1006/bbrc.1997.6943

The World Health Organization (WHO) subsequently reviewed kava's safety and concluded that moderate consumption of kava in its traditional form, as a water-based suspension of roots, presents an "acceptably low level of health risk"