A 35-year-old woman is evaluated during a follow-up visit for anxiety. Her symptoms have been well controlled with cognitive behavioral therapy. She drinks kava tea every morning and practices mindfulness daily. Her medical history includes nonalcoholic steatohepatitis. Other supplements she takes are folic acid and echinacea.

On physical examination:
- Vital signs are normal.
- BMI is 36.
- The remainder of the examination is unremarkable.

What is the most appropriate recommendation for this patient?

Question

13-01-2025
Medicine

College

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A 35-year-old woman is evaluated during a follow-up visit for anxiety. Her symptoms have been well controlled with cognitive behavioral therapy. She drinks kava tea every morning and practices mindfulness daily. Her medical history includes nonalcoholic steatohepatitis. Other supplements she takes are folic acid and echinacea.

On physical examination:
- Vital signs are normal.
- BMI is 36.
- The remainder of the examination is unremarkable.

What is the most appropriate recommendation for this patient?

Answer :

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SophiaJudy SophiaJudy · Answer 1 · 2023-08-21T06:36:46-04:00

Final answer:

The patient should stop using kava tea due to its potential to worsen liver injury in the context of her existing nonalcoholic steatohepatitis, and continue with non-pharmacological anxiety treatments and lifestyle modifications to address obesity.

Explanation:

The most appropriate recommendation for a 35-year-old woman with nonalcoholic steatohepatitis (NASH) who is currently consuming kava tea would be to discontinue the use of kava. Kava has been associated with serious liver injury, including hepatitis, cirrhosis, and liver failure, especially in those with pre-existing liver conditions. As she is also practicing mindfulness and undergoing cognitive behavioral therapy (CBT), focusing on these non-pharmacological treatments for anxiety would be safer for her liver health. Additionally, addressing her obesity, as indicated by a BMI of 36, through dietary changes and increased physical activity would also benefit her overall health and potentially help mitigate the symptoms of NASH.