Kava

Kava: Overview

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and German authorities have notified manufacturers of kava products that their licenses to market the herb could be withdrawn.

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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, acetaminophen (Tylenol), also has a high incidence of liver toxicity, especially when combined with alcohol.

Function; Why it is Recommended

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 role 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.

Instructions

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.

On This Page

Kava:

Kava can help with the following:

Addictions

Not recommended for

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 anxiety.  [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."

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.

Organ Health

Not recommended for

Reproductive

Not recommended for
Pregnancy-Related Issues

Kava use is discouraged during pregnancy due to possible complications.

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KEY

Moderately useful: often helps with
Moderately useful:
often helps with
Often counterindicated: is often not recommended for
Often counterindicated:
is often not recommended for