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Kava Kava is a best-seller based on its proven ability to relieve stress, anxiety and tension. In late 2001, kava came under the scrutiny of the FDA, which is acting on reports from Europe that kava may damage the liver. Based on these reports, the UK has banned sales of kava products and German authorities have notified manufacturers of kava products that their licenses to market the herb could be withdrawn.
Closer examination of the scant details available on the 30 European cases reveals that the vast majority - 21 cases in all - involved the concurrent use of hepatotoxic drugs and/or alcohol. This is not significant evidence of hepatotoxicity.
The fact is, you are far likelier to suffer from liver damage by taking the prescription anti-anxiety drug, Valium, than you are from kava, yet it is taken by millions daily with little question and with no major adverse publicity. The over-the-counter pain medication, acetominphen (Tylenol), also has a high incidence of liver toxicity, especially when combined with alcohol.
Function; Reasons For Use
Although we don't know exactly how kava functions in the body, its method of action seems to involve brain receptors for a substance known as gamma-aminobutyric acid (GABA). This would make it similar to benzodiazepine drugs like Valium and Xanax. GABA is believed to play a role in anxiety that is somewhat similar to serotonin's rôle in depression, although there are many gaps in our knowledge. Kava Root Extract contains significant levels of kavalactones and six fat soluble synergistic constituents. The kavalactone components of kava probably account for its reported effects on sleep. Kavalactones pass through the blood-brain barrier and can alter the action of other neurotransmitters. A sedative and analgesic, kava helps induce sleep in low doses but in high doses it may cause stupor.
Researchers have identified six major kavalactones (a class of lactones) and another dozen minor ones. Like Valium and Xanax, they may influence GABA, the neurotransmitter that acts as a brake on the central nervous system.
Kava's relaxant properties are related to the lipid-like compounds known as lactones or pyrones.
Kava root is used to calm body and mind and thwart insomnia. It improves low mood, muscle spasms or tightness and anxiety.
According to double-blind studies involving a total of about 400 participants, kava appears to be an effective treatment for symptoms of anxiety. The best study was a 6-month, double-blind trial that tested kava's effectiveness in 100 individuals with various forms of anxiety. Although it took a while for results to develop, by 8 weeks participants who were given kava showed significantly improved scores compared to the placebo group. These good results were sustained throughout the duration of the treatment. Interestingly, previous studies had showed a good response in 1 week, especially in menopause-related anxiety. How fast does kava really work? We will need additional research to know for sure, but you should probably give it a couple of months before deciding whether it works for you.
Directions
Kava is usually sold in a standardized form for which the total dose of kavalactones per pill is listed. The dose used should supply about 40-70mg of kavalactones tid. The total daily dosage should not exceed 300mg of kavalactones. Be patient, because the benefits may take a while to develop. As a sleep aid, the recommended dose is 75-100mg of kavalactones; for a stronger sleep-inducing effect, take 150-210mg on an empty stomach, before bed.
It is supplied in capsules, liquids, and standardized extracts; a few sources offer dried kava in root pieces, cut and sifted and as a powder. For a mildly relaxing, anxiety-relieving effect, an average dose is 200 to 250mg of an extract standardized for around 25% kavalactones, the chemical constituent thought responsible for kava's benefits.
The American Herbal Products Association offers the following advice:
Do NOT use kava if you have liver disease or a history of liver problems or alcoholism; currently take medications or regularly consume alcohol; are under age 18; or are pregnant or lactating.
Continuous use of kava should be limited to 4 weeks and daily consumption of kava should NOT exceed 300mg of kava lactones daily.
Use of kava should be discontinued and medical advice obtained if symptoms such as nausea, fever, dark urine or yellowing of eyes and skin occur.
Side-Effects
Side effects are minimal: Kava is remarkably safe as a relaxant. Occasional and even regular moderate use of kava among Pacific peoples seems to have no noticeable adverse effects on long-term health. Even transient side-effects, such as mild nausea, are rare. High doses of potent kava products, however, can reduce one's motor control and lead to accidents, including fatal ones if one unwisely attempts to drive or operate heavy equipment after taking it. Persistent heavy consumption of kava may cause diarrhea, an overall lethargy and apathy or a scaly skin condition. Eliminating or cutting back on kava consumption reverses these conditions. Taking it in a strong tea causes numbness of the tongue.
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Kava can help with the following: | | | | | Addictions | Not recommended for:
 Alcohol-related Problems |
Mental |
 Anxiety | Kava appears to be as effective as the class of synthetic pharmaceuticals called benzodiazepenes (such as Valium) for treating anxiety, but without their dangerous side-effects of sedation and addiction. Only about 2% of patients taking kava reported minor side-effects, predominantly gastrointestinal complaints, skin reaction, headache and photosensitivity. Other research has shown that kavapyrones act on receptors in the hippocampus and amygdala complexes in the brain to produce measurable changes in brain wave activity and reduce anxieity. [Journal of Clinical Psychopharmacology 2000 Feb;20(1): pp.84-9]
Research has also suggested that anxiety may be related to an increased risk of myocardial infarction and fatal coronary disease. This risk may be due to an impairment of the parasympathetic nervous system with lower vagal control being reported in persons with more severe anxiety. Although preliminary, due to the small sample size, a trial suggests that kava extract (280mg standardized extract per day) may target the baroreceptor pathway and improve Baroreflex control of heart rate (BRC) in patients with generalized anxiety. [J Psychopharmacol 2001;15: pp.283-86] [] |
Panic Attacks| | Germany's Commission E, that country's official herb-regulating body, has authorized the use of kava as a medical treatment for "states of nervous anxiety, tension, and agitation." |
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Metabolic |
Insomnia| | Kava Root Extract has been used by the inhabitants of the Pacific Islands for centuries as an relaxing botanical that also promotes delta-rhythm sleep. Because it potentiates the effectiveness of melatonin, it is the ideal complement in a melatonin complex formula. Kava (piper methysticum) has been proven to be especially effective in treating refractory sleep disorders, including those involving headaches, menstrual cramps, and gastrointestinal disorders.
Kava improves sleep by relaxing the body, reducing mental worry and anxiety, and reducing pain. Although no scientific evidence exists that kava can help insomnia, anecdotal stories tell us that traditional healers have prescribed it for insomnia for centuries. Kava-based products are prescribed as medicines for relaxation in France, Germany, Switzerland, and other European countries.
Although we don't have a definitive study on the effectiveness of kava as a treatment for insomnia, we can look into some studies of kava as an indication that it might be helpful in sleep. A small double-blind placebo-controlled study suggested that synthetic kavain (a kavalactone found in kava) enhances brain activity that favors restorative sleep. At weekly intervals, subjects randomly received placebo; 200, 400, or 600mg of kavain; or 30mg of the benzodiazepine Clobazam. Pulse, blood pressure, EEG, psychometric tests, and side effects were noted at the outset and then at 1, 2, 4, 6, and 8 hours after receiving the medication.
EEG activity showed that kavain increased the alpha-1, theta, and delta brain waves that are associated with sleep while decreasing beta waves, which are a sign of wakefulness. Furthermore, these effects increased with higher dosages. At 600mg, kavain produced sedation comparable to 30mg of Clobazam.
Unfortunately, this rather theoretical study looked at brain waves rather than true effects on sleep. Also, it used isolated kavain rather than the whole-kava extract as you might purchase it. Much better research needs to be performed before it can be said that scientific evidence exists for using kava in sleep disorders. |
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Organ Health |
Not recommended for:
Cirrhosis of the Liver |
Uro-Genital |
Not recommended for:
Pregnancy-Related Issues| | Kava use is discouraged during pregnancy due to possible complications. |
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KEY | | Likely to help | | | Reasonably likely to cause problems |
GLOSSARY
Analgesic
Agent which relieves pain without causing loss of consciousness.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Central Nervous System (CNS)
A collective term for the brain, spinal cord, their nerves, and the sensory end organs. More broadly, this can even include the
neurotransmitting hormones instigated by the CNS that control the chemical nervous system, the endocrine glands.
Commission E
The body of scientists and panel of experts that provides advice on herbal treatments and evaluates the safety, effectiveness and dosage of medicinal herbs; Germany's equivalent of the FDA.
Cramp (Cramping, Cramps)
A sudden, involuntary, painful muscular contraction.
Diarrhea
Excessive discharge of contents of bowel.
FDA
The (American) Food and Drug Administration. It is the official government agency that is responsible for ensuring that what we put into our bodies - particularly food and drugs - is safe and effective.
Gamma-Aminobutyric Acid (GABA)
An amino acid derivative that is a calming substance. Tranquilizers such as valium and Librium owe their soothing effects to the fact that they stimulate GABA receptors in the brain.
Gastrointestinal (GI, GI Tract)
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Hepatotoxic (Hepatotoxicity)
Being toxic or destructive to the liver.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hippocampus
Brain structure that forms the edge of the cortical mantle of the cerebral hemisphere.
Lactation (Lactate, Lactates, Lactating)
Production of milk; period after giving birth during which milk is secreted in the breasts.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Melatonin
The only hormone secreted into the bloodstream by the pineal gland. The hormone appears to inhibit numerous endocrine functions, including the gonadotropic hormones. Research exists on the efficacy of melatonin in treating jet lag and certain sleep disorders. Dosages greater than l milligram have been associated with drowsiness, headaches, disturbances in sleep/wake cycles and is contraindicated in those who are on antidepressive medication. It also negatively influences insulin utilization.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Nausea
Symptoms resulting from an inclination to vomit.
Nervous System
A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.
Neurotransmitters (Neurotransmitter)
Chemicals in the brain that aid in the transmission of nerve impulses. Various Neurotransmitters are responsible for different functions including controlling mood and muscle movement and inhibiting or causing the sensation of pain.
Over-The-Counter (OTC, Over The Counter)
A drug or medication that can legally be bought without a doctor's prescription being required.
Parasympathetic
Usually Parasympathetic nervous system: Portion of the autonomic nervous system that is generally associated with increasing digestion and intestinal muscle activity; decreasing blood circulation and respiration.
Placebo (Placebos)
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Sedative
Calming, quieting; drug that quiets nervous excitement.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Synergistic
Having the property that the total combined effect of two or more factors exceeds the sum of their individual effects.
TID
Three times a day.
Last updated: Oct 08, 2008
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