Does kava offer benefits or risks? Discover the evidence behind the use of this traditional Polynesian plant. Learn about its potential effects on anxiety, liver health, and more.

The Origins and Popularity of Kava

Kava, also known as Piper methysticum, is a shrub native to the South Pacific region. Within traditional Pacific Islander cultures, the root of the kava plant has been used for centuries to promote psychological and physical relaxation, both for medicinal and ceremonial purposes. The root is typically crushed, ground, and combined with water and coconut milk to create a drinkable beverage.

In the 1990s, the naturopathic boom led to kava being touted as a safe alternative to other medications used for anxiety. Today, kava remains a popular supplement, readily available in health food stores.

The Pharmacology of Kava

The root of the kava plant contains 18 different phytochemicals, or plant-based compounds, known as kavalactones. These compounds are believed to be responsible for kava’s effects on the body and brain. Kavalactones have been shown to:

• Alter the conduction of nerve signals
• Decrease excitatory neurotransmitters
• Increase the ability of the amino acid GABA to bind its receptors
• Inhibit the enzyme monoamine oxidase
• Reduce uptake of the neurotransmitters noradrenaline and dopamine

In essence, these actions contribute to kava’s potential to reduce anxiety.

The Evidence on Kava for Anxiety

A 2003 review of 11 randomized controlled trials involving 645 patients assessed the ability of kava supplements to treat anxiety. The studies used varying levels of kavalactones, from 60 milligrams to 280 milligrams – significantly higher than traditional Pacific Islander use. The studies ranged from one to 25 weeks in duration.

Ten of the eleven studies showed a decrease in anxiety compared to placebo. The benefits appeared comparable to the effects of tranquilizers like benzodiazepines and the anxiety drug buspirone. Reported side effects included nausea, stomach aches, drowsiness, and headaches, but no liver toxicity was reported.

Concerns About Liver Toxicity

Despite the potential benefits, kava has been banned in the United Kingdom and within Europe due to concerns over liver toxicity. More than 100 cases of liver toxicity related to kava use have been identified, some leading to liver transplant and even death.

There are several reasons why kava may cause liver damage. It can deplete glutathione, a key antioxidant in the liver, and inhibit enzymes involved in drug metabolism. Many of the reported cases of liver toxicity occurred in individuals with prior liver disease or those who combined kava with alcohol.

The Potential Risks of Kava

Even in the absence of liver disease or medication interactions, kava may still pose risks. A study of 31 regular kava drinkers in Hawaii showed a significantly greater elevation of two liver enzymes compared to non-kava drinkers.

Additionally, studies have found that the consumption of kava supplements can lead to slower reaction times and impairment of motor skills, although there is no evidence of cognitive decline.

Interactions and Precautions

Due to its inhibition of multiple enzymes and its psychoactive properties, kava should not be taken with antidepressants. Additionally, caution is warranted for individuals with liver disease or those consuming alcohol.

Kava prepared with water may be less harmful to the liver than suspensions prepared with acetone or ethanol, but more research is needed to confirm this.

Weighing the Risks and Benefits

In summary, kava may offer short-term relief for anxiety, with benefits comparable to pharmaceutical options. However, the severe potential side effects, particularly the risk of liver damage, make long-term use concerning. Cognitive behavioral therapy may offer a safer and more sustainable approach to address anxiety concerns.

Ultimately, the decision to use kava should be made in consultation with a healthcare provider, carefully weighing the potential risks and benefits based on an individual’s medical history and overall health status.

Ask the Doctors – What are the risks and benefits of kava?

Dear Doctor: What are the benefits and risks of taking kava?

That’s a good question with a complex answer. The shrub kava originates from the South Pacific, where Pacific Islanders used it to promote psychological and physical relaxation for medicinal and ceremonial purposes. Within traditional cultures, the root of the plant is crushed, ground and then combined with a mixture of water and coconut milk to make it drinkable. In the naturopathic boom of the 1990s, kava was touted as a safe alternative to other medications used for anxiety. Today, kava is a popular supplement for anxiety, and various brands can be found in any health food store.

The root of the kava plant contains 18 different phytochemicals, or plant-based compounds, known as kavalactones. These compounds alter the conduction of nerve signals, decrease excitatory neurotransmitters, increase the ability of the amino acid GABA to bind its receptors, inhibit the enzyme monoamine oxidase, and reduce uptake of the neurotransmitters noradrenaline and dopamine. All of this is a technical way of saying: Kava can help reduce anxiety.

A 2003 review of 11 randomized controlled trials with a total of 645 patients assessed kava supplements’ ability to treat anxiety. The studies used varying levels of the kavalactones, from 60 milligrams to 280 milligrams. These doses are significantly higher than what Pacific Islanders traditionally used. The studies varied from one to 25 weeks. Ten of the eleven studies showed a decrease in anxiety compared with placebo. These benefits appeared to be comparable to the effect of tranquilizers such as benzodiazepines and the anxiety drug buspirone. Side effects included nausea, stomach aches, drowsiness and headaches. No liver toxicity was reported, but then, no liver tests were performed.

Note that kava has been banned in the United Kingdom and within Europe due to liver toxicity. More than 100 cases of liver toxicity related to the use of kava have been identified, some leading to liver transplant and some leading to death. There are many reasons for liver damage. For one, kava depletes glutathione, a chief antioxidant, within the liver. It also inhibits enzymes involved in the metabolism of many drugs. Many of the cases of liver toxicity were seen in people who had prior liver disease or used alcohol in addition to kava.

You may think kava is safe if you don’t have liver disease or are not taking medications metabolized by the liver, but that might not be the case. 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. There is some evidence that kava that is prepared with water is less harmful to the liver than suspensions prepared in acetone or ethanol.

Studies have shown that consumption of kava supplements leads to a slower reaction time and an impairment of motor skills. However, there has been no proof of any decline in cognitive function.

Because it inhibits multiple enzymes and has psychoactive properties, kava likely should not be taken with anti-depressants.

In summary, kava may help relieve anxiety in the short term. However, due to the severe side effects at its current doses, I would be hesitant to use it for the short term and recommend not using it in the long-term. Cognitive behavioral therapy has greater long-lasting benefits.

Robert Ashley, MD, is an internist and assistant professor of medicine at the University of California, Los Angeles.

Ask the Doctors is a syndicated column first published by UExpress syndicate.

Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Kava is a beverage or extract made from the Piper methysticum plant. In the South Pacific, it’s a popular drink that is used in ceremonies for relaxation.

The name “kava” comes from the Polynesian word “awa,” which means bitter. Kava affects the brain and other parts of the central nervous system. Chemicals called kavalactones that are found in kava are believed to be responsible for its effects.

People commonly use kava for anxiety. It’s also used for stress, withdrawal from drugs called benzodiazepines, sleeping problems, and many other purposes, but there is no good scientific evidence to support many of these uses.

Cases of liver damage and even some deaths have been linked to kava use. Because of this, kava was taken off the market in Europe and Canada in the early 2000s. But after reviewing the evidence, most countries have allowed kava to return to the market. Kava was never taken off the market in the US.

Uses & Effectiveness ?

Possibly Effective for

• Anxiety. Taking kava by mouth for at least 5 weeks seems to reduce anxiety and might work as well as some prescription anti-anxiety medications.

Possibly Ineffective for

• A type of persistent anxiety marked by exaggerated worry and tension (generalized anxiety disorder or GAD). Taking kava by mouth doesn’t seem to improve symptoms of GAD.

There is interest in using kava for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Kava is possibly safe when taken for up to 6 months. Using kava can make it difficult to drive or operate machinery safely. Do not take kava before you plan on driving. “Driving-under-the-influence” citations have been issued to people driving erratically after drinking large amounts of kava tea.

People might have heard that using kava can cause liver damage. This seems to be rare and is most often linked to long-term use of very high doses. Most people who have used kava haven’t experienced liver toxicity. Also, past cases of liver toxicity might not be due to kava. Other factors may have contributed to these toxic effects.

Special Precautions and Warnings

When taken by mouth: Kava is possibly safe when taken for up to 6 months. Using kava can make it difficult to drive or operate machinery safely. Do not take kava before you plan on driving. “Driving-under-the-influence” citations have been issued to people driving erratically after drinking large amounts of kava tea.

People might have heard that using kava can cause liver damage. This seems to be rare and is most often linked to long-term use of very high doses. Most people who have used kava haven’t experienced liver toxicity. Also, past cases of liver toxicity might not be due to kava. Other factors may have contributed to these toxic effects. Pregnancy and breast-feeding: Kava is possibly unsafe when taken by mouth while pregnant or breast-feeding. It might affect the uterus while pregnant. Also, some of the chemicals in kava can pass into breast milk and might hurt a breast-fed infant. Avoid using it.

Liver disease: People who have liver problems should avoid kava. It might make liver disease worse.

Parkinson disease: People who have Parkinson disease should avoid kava. It might make this condition worse.

Surgery: Kava affects the central nervous system. It might increase the effects of anesthesia and other medications used during and after surgery. Stop using kava at least 2 weeks before a scheduled surgery.

Interactions ?

Major Interaction

Do not take this combination

• Kava might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking kava with sedative medications might cause breathing problems and/or too much sleepiness.

Moderate Interaction

Be cautious with this combination

• Some medications are changed and broken down by the liver. Kava might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• Some medications are changed and broken down by the liver. Kava might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• Some medications are changed and broken down by the liver. Kava might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• Some medications are moved in and out of cells by pumps. Kava might change how these pumps work and change how much medication stays in the body. In some cases, this might change the effects and side effects of a medication.

• Kava might harm the liver. Some medications can also harm the liver. Taking kava along with a medication that can harm the liver might increase the risk of liver damage.

• Haloperidol is broken down by the liver. Kava might decrease how quickly the liver breaks down this medication. This might increase the effects and side effects of haloperidol.

• Ropinirole is broken down by the liver. Kava might decrease how quickly the liver breaks down this medication. This might increase the effects and side effects of ropinirole.

• Using kava with alcohol might increase the effects of alcohol on the central nervous system. This might increase the risk for some side effects, such as drowsiness and mood changes. Also, kava might harm the liver. Taking kava along with alcohol might increase the risk of liver damage.

Minor Interaction

Be watchful with this combination

• Some medications are changed and broken down by the liver. Kava might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• Some medications are changed and broken down by the liver. Kava might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• Some medications are changed and broken down by the liver. Kava might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Dosing

Kava is available in many different types of products, including teas and other beverages. Kava extracts have most often been used by adults in doses of 150-400 mg by mouth daily for up to 2 years. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

View References

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

Kava root: more risks than benefits?

Kava root – what is it?

If there was a substance that could fight cancer cells and still have side effects, would you like to know more about it? If yes, then you should get to know the kava root better.

Naturally, you will be wondering if it really will do more good than harm? Let’s look at all the advantages and disadvantages of this controversial medicinal plant in more detail.

What is kava?

Kava, or intoxicating pepper ( Piper methysticum ), is a plant from the Pacific Islands. The name “kava” comes from the Tongan and Marquesas cultures. This plant is also called “aua” (Hawaii), “ava” (Samoa), “yakuona” (Fiji), “sakau” (Pohnpei), and “malok” or “malogu” (Vanuatu regions).

The roots of the plant are used to make a drink with sedative, anesthetic and entheogenic properties. Kava is consumed in all Pacific cultures of Polynesia, including Hawaii, Vanuatu, Melanesia, and parts of Micronesia. Its active ingredients are called kavalactones.

Pepper Root has been used in Oceania for centuries as a medicine, as well as a relaxing and ceremonial drink. However, it is worth knowing that it has a number of features.

On the one hand, it is considered a natural cancer treatment that blocks tumor growth and has a chemopreventive effect. On the other hand, there is evidence of damage and development of liver diseases, as well as deaths, which may be associated with the ingestion of kava root.

Health benefits

Intoxicating Pepper Root is most commonly used to combat anxiety, stress, restlessness, and to treat insomnia. It is also used for symptoms of ADHD, epilepsy, psychosis, depression, migraines, chronic fatigue syndrome, colds and other respiratory infections, tuberculosis, muscle pain, and cancer prevention. Kava root can be effective for urinary tract infections, uterine pain and inflammation, sexually transmitted diseases, menstrual discomfort, and to increase sexual arousal.

And that’s not all. Kava root is applied to the affected areas of the skin in various skin diseases such as leprosy, to speed up wound healing and as a pain reliever. It also helps with eye problems.

Pepper is also used to make toothpaste and medicated mouthwash. It is surprising that with such a wide range of possibilities, kava has not yet become the most popular drug. However, the US Food and Drug Administration (FDA) has expressed concern that the use of kava supplements is associated with a risk of serious liver damage. Therefore, it is important to study all the facts.

1. May fight cancer

Flavocavains are secondary metabolites present in kava root that may have anti-cancer properties. Research has examined the toxicity of kava and monitored the results of cellular adaptation in human hepatocytes.

To study resistance to oxidative stress, the cells were subjected to pretreatment. Some results showed significant cell death. This suggests that kava root may be effective as a chemopreventive and chemotherapeutic agent.

2. May reduce the size of a tumor in the prostate gland

A study published in the journal Oncotarget showed that the compounds in capsicum were able to inhibit the growth of certain defective cell lines. Further studies revealed that dietary feeding of kava to mice with autochthonous transgenic adenocarcinoma of the prostate (TRAMP) inhibited the formation of lesions and adenocarcinomas of the prostate, reduced tumor, and completely eliminated metastasis to other organs.

The results suggest that the agents found in kava may be effective inhibitors in the prevention and treatment of prostate cancer.

This makes kava root a good remedy for improving the condition of the prostate in general and reducing the chance of prostate cancer in particular.

3. Strengthens the immune system

Flavocavain extracts have powerful anti-inflammatory effects. One study sought to find agents that are able to stimulate the immune system without affecting homeostatic balance, while determining the toxicity and immunomodulatory effects of flavocavain A and flavocavain B (agents found in kava root) in Balb/c mice.

As a result, all mice after the treatment period were normal. It is likely that the compounds did not cause any intoxication.

Thus, intoxicant pepper root can be used as an immune booster.

4. Helps fight breast cancer

Kava is reported to have anti-cancer and anti-inflammatory properties. We all know that the state of the immune system and the inflammatory processes that can develop in the body play a key role in the development of cancer.

A study conducted in Malaysia aimed to understand the mechanisms of action of kava root in regulating and strengthening immunity, as well as suppressing inflammatory processes in mice with breast cancer. It is worth noting that the treatment with kava resulted in a decrease in the weight and volume of the tumor. At the same time, the level of inflammation also decreased.

Overall, these results indicate that Pepper Root can not only protect against tumor development, but also prevent inflammation in a carcinogenic microenvironment.

5. Fights anxiety

Generalized anxiety disorder is a chronic condition in which there is a high level of psychological stress. As a rule, it is difficult to treat for a long time. Some studies claim that kava root can treat anxiety without being addictive or hypnotic.

Cochrane International reported on additional research evaluating data on the effectiveness of kava root extract as a natural remedy for anxiety. Twenty-two potentially relevant, double-blind, placebo-controlled randomized trials were identified. Twelve trials met the inclusion criteria and showed that kava extract helped reduce anxiety.

All adverse reactions reported were of moderate severity. These findings suggest that pepper extract may be an effective treatment for the symptomatic treatment of anxiety.

6. Improves sleep quality

Kava began to gain popularity in the 1990s as an herbal remedy for people suffering from insomnia and anxiety. We know that about 50% of the world’s population suffers from insomnia at one time or another. Herbal preparations, including kava root, are becoming increasingly popular when it comes to combating sleep disturbance.

In a study conducted by the School of Medicine and Dentistry at the University of Rochester in the United States, six herbal remedies that affect sleep were studied, including caffeine, chamomile, cherries, intoxicating pepper, L-tryptophan, marijuana, and valerian root. Although no significant results have been obtained, kava and kava-based drinks have shown sedative effects.

Kava root and kratom

Another plant, kratom, has properties similar to those of kava, which we discussed above. Kava and kratom are often compared to each other, as both plants have a relaxing effect. However, kratom is better known for its ability to energize and calm the mind. While kava is popular for its intoxicating and euphoric effects.

Both plants grow in southeast Asia. For medicinal purposes, kava root and kratom leaves are used to make tea.

Since plants have different mechanisms of action, taking them together has a stronger effect, since they both:

• cause a feeling of euphoria
• give satisfaction
• increase attention
• reduce stress

Here’s how each plant works:

Kava:

• Moderate intoxication
• Improve mood, relieve anxiety and increase sociability
• Effects on GABA receptors
• Dopamine receptor stimulation
• Use of plant root

Kratom:

• Small dose stimulant and higher dose sedative
• Removing anxiety
• Stimulation of μ(mu)-, δ(delta)-opioid receptors
• Effects on serotonin and norepinephrine receptors
• Use of plant leaves

How to cook

Now, to make a drink from intoxicating pepper, the root is ground or rubbed, and then soaked in cold water or coconut milk. In the past, the root was chewed, spit into a bowl, and poured into water or coconut milk. For hygienic reasons, this method is, of course, no longer used.

On the market, kava root is available in dry form, powder, capsules, tablets, tea, or tincture. Western experts recommend purchasing standardized kava extracts that contain at least 70% kavalactones.

On the other hand, a report made in April 2002 by the UK Medicines Safety Board claims a large number of side effects due to the high concentration of plant compounds in standardized extracts. The report states that traditional methods of preparing kava make it safer. It is likely that controversy regarding the safety of this plant will still continue.

Side effects and risks

When choosing kava in any form, it is important to consider all the risks. During pregnancy and lactation, and if you are taking any medications, it is better to avoid kava, or consult your doctor before using it. The plant may have an effect on the uterus.

If you have symptoms of depression, kava may aggravate your condition. Since pepper intoxicants affect the central nervous system, it can enhance the effect of anesthesia or other drugs used during or after surgery. The use of the plant should be discontinued at least two weeks before surgery.

It is also very important to follow the correct dosage. It depends on a number of factors, including age, health status, and symptoms. The quality of kava products should be discussed with a doctor or pharmacist before use.

Addictive

Since kava has a significant relaxing effect, the plant can be addictive. However, the likelihood of this happening is quite low. In many countries, intoxicating pepper is considered a plant anxiolytic and is used in large doses to restore the body in the tribes of the Pacific and Australian Aborigines.

The recommended dosage for the treatment of non-psychotic anxiety is 105 to 210 mg per day for 3 to 4 weeks. Among the most common adverse reactions are dizziness, headache, drowsiness, depression, diarrhea, and rarely skin rash.

Precautions to be taken

Viral resistance

Health care professionals have so much information regarding herbal and laboratory drug interactions that it is sometimes difficult to distinguish between a likely interaction and a clinically significant one. Thus, for pharmacotherapy in HIV/AIDS, reliable data are still insufficient.

A review by the University of Mississippi School of Pharmacology, USA, provides evidence for a potential interaction of medicinal plants with specific antiretrovirals. And some herbal preparations can have a significant effect on the human body.

This study suggests that many herbal medicines such as St. John’s wort, black pepper, grapefruit juice, yams, ginkgo, garlic, ginseng, goldenseal and yams should not be taken in combination with some antivirals. This is important to know in order to avoid the influence of herbal preparations on laboratory preparations, which can lead to viral resistance.

Liver injury

Oral ingestion of intoxicating pepper may not be safe. Even a short-term intake of the plant at the recommended dosage can cause the development of a number of serious diseases, including liver damage. It has been reported that taking kava for 1-3 months can lead to the need for a liver transplant and even death. The first signs of liver damage include yellowing of the whites of the eyes and skin (jaundice), fatigue, and dark urine.

We advise you to monitor the condition of the liver while taking kava. The severity of liver damage ranges from mild elevation of enzyme levels to acute liver failure. In most cases, the effects of liver damage resolve within 1-3 months after the herbal product is stopped. However, there are data on liver transplantation in some patients.

Not recommended for driving

Do not use intoxicating pepper if you are driving vehicles or machinery. Do not take kava if you plan to drive. Large amounts of kava tea can lead to erratic driving and an accident on the road.

A study by the University of Auckland School of Public Health in New Zealand analyzed the available literature examining the association between kava consumption, car accidents and driving style. However, no studies have been conducted to determine the extent to which kava affects driving ability or related injuries.

Four experimental studies using driving simulators examined the effect of pharmacological doses of cavalactors on cognitive and visuomotor functions. The results showed a slight slowdown in the reaction. But one study found a significant deterioration in visuomotor function when kava was taken with alcohol.

History

The kava plant, which means “intoxicating pepper”, got its name from explorer James Cook. However, he did not open it. The plant has been used by the Pacific Islanders for thousands of years.

Today, in the South Pacific, kava is a popular drink that can be compared to alcohol. However, it still plays an important role in various rituals and ceremonies. One study found that kava consumption is heavily associated with many ceremonial, social, and cultural aspects of Tongan culture.

Kava has healing properties, promotes communication and building relationships between Tongan men (an alternative to alcohol). However, men interviewed for the study also reported negative effects of kava. For example, they mentioned feeling lazy, tired, and very expensive in New Zealand.

However, the plant is one of the most important social pillars of Melanesian society. For more than 1000 years, it has been used at various social events to prepare drinks with a relaxing effect. During the period of colonization, the plant became known in Western countries, and the extracts began to be used for medicinal purposes. However, after the publication of a series of case reports, liver toxicity in 1999-2000, the plant began to cause serious concern.

Interesting facts

Kava is a tropical shrub native to the Pacific Islands. The plant belongs to the Pepper family and is also known as the intoxicating pepper. The shrub grows on average up to 1.5 m in height, has large heart-shaped leaves, reaching 25 cm in width.

Pacific Islanders drink kava at social, ritual and ceremonial occasions to feel relaxed and euphoric. It is enjoyed at meetings by village elders, it is used as an offering to the gods, to treat illnesses, and to welcome guests of honor (among them were Pope John Paul II, Queen Elizabeth II of Great Britain and American politician Hillary Rodham Clinton).

It is believed that the chemical compounds present in the intoxicating pepper have anxiolytic, analgesic, relaxing and anticonvulsant effects mediated by effects on the limbic system (the part of the brain associated with emotions). Studies have shown that the concentration of kava in the product, the type of preparation, the pyrone content of the kava, and the plant variety used can affect the effectiveness of the drug.

The plant is found in the Western and South Pacific and is most commonly referred to simply as “kava”, meaning “bitter”. The active ingredients are kavapirones (kavalactones), which, like alcohol, promote relaxation and sociability while maintaining mental clarity. Kava has been proposed as an anxiolytic for use by patients with anxiety disorders, as well as to combat insomnia, premenstrual syndrome, and stress.

Given all its possibilities, it is not surprising that cases of abuse of kava have been recorded. However, when used at recommended dosages, this happens very rarely. Recently, the safety of intoxicating pepper products has been in great doubt due to reports of its effects on the liver and cases of death. The use of kava has been banned or restricted in many countries, including Germany, Switzerland, France, Canada, and the United Kingdom.

Data on the hepatotoxicity of the plant is still insufficient, although a small number of convincing cases have been recorded. Despite this, kava is still available in pharmacies and online in many forms, from pills to powders.

Conclusion

• Kava Root helps fight cancer, reduce the size of prostate tumors, boost immunity, fight breast cancer, reduce anxiety and improve sleep quality.
• Side effects of kava include addiction, viral resistance, liver damage, and effects on driving ability.
• Kava and kratom are often compared to each other, as both plants have a relaxing effect. However, kratom is better known for its ability to energize and calm the mind. While kava is popular for its intoxicating and euphoric effects. Since plants have different mechanisms of action, their combined use has a stronger effect.
• Experts still argue about the safety of kava root, but the benefits of taking it (at the recommended dosage) still outweigh the risks. It is important not to abuse the products and strictly follow the instructions for use, as kava is addictive.

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Kava Kava – A Natural Herb with Promising Calming Properties｜ iHerb Blog

The information on this blog has not been verified by your country’s public health authority and is not intended as a diagnosis, treatment, or medical advice.
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What is kava?

Kava (kava kava or intoxicating pepper) is a plant with a long history of use in a wide variety of ceremonies among the peoples of Oceania. The traditional drink was made from kava roots by soaking in cold water. Consumption of kava usually has a pronounced relaxing effect, not accompanied by intoxication or hallucinations, although vomiting or headache may occur if consumed in excess. Traditional ways of consuming this plant remain popular in Oceania to this day.

Healing properties of kava

Calming effect

Kava contains substances known as kavalactones. Although we do not currently have a complete understanding of the nature of this effect, kava appears to perform a specific set of actions that explain the plant’s relaxing effect.

Like other traditional sedatives such as valerian, passion flower, lavender and lemon balm, kava also acts on gamma-aminobutyric acid (GABA), a well-known neurotransmitter. GABA is the main inhibitory neurotransmitter in the central nervous system, slowing down brain activity. Although kavalactones bind very poorly to GABA receptors, they appear to be very good at enhancing the binding capabilities of other molecules. Through increased binding of these molecules, kavalactones likely enhance GABA activity.

However, unlike other common sedatives, kava can also affect voltage-gated sodium channels (PVCs). PZNA are channels found in cell membranes and play an important role in the functioning of the nervous system. Electrical signals travel through nerves when sodium channels are open, producing a nerve impulse. Kavalactones can block sodium channels, reducing the overall activity of the brain and nervous system. This effect, combined with increased binding to GABA receptors, likely explains the calming effect of kava drinks.

Anti-inflammatory and anti-clotting effect

Early studies in the 1960s initially showed a pronounced anti-inflammatory effect of this plant. The study showed a reduction in inflammation when consuming kava when exposed to various substances and ultraviolet radiation.

Tumor necrosis factor-alpha (TNF-alpha) is a major inflammatory signaling molecule. In several autoimmune diseases, standard medical treatment involves suppression of TNF-alpha activity. Some kavalactones in kava can suppress TNF-alpha. Endotoxins are substances found in the outer membrane of Gram-negative bacteria that greatly increase inflammation. In a mouse given a lethal dose of endotoxin, kava helped with a normally fatal inflammatory response.

This anti-inflammatory effect is also manifested in the ability to reduce the likelihood of blood clotting due to inflammation. This appears to be due to the suppression of inflammatory mechanisms provided by arachidonic acid, an inflammation-promoting fat.

Improved sleep

Anxiety treatment often helps with insomnia and vice versa. While there are exceptions, such as melatonin, which should only be used for sleep problems, most natural remedies for anxiety and insomnia problems are interchangeable. Standard medications are used to treat sleep problems that are often prescribed for people with anxiety disorders.

Thus, it is not surprising that a number of clinical studies on the effects of kava on improving sleep have proven the effectiveness of this plant. A preliminary study of kava and valerian for the treatment of stress-induced insomnia showed positive effects when both plants were taken. Stress levels and insomnia decreased as a result of taking kava and valerian.

The effect of kava on sleep disturbances in anxiety disorder was evaluated in a double-blind, placebo-controlled clinical trial. Scientists found that taking kava over a 4-week period improved sleep and reduced anxiety. A large web-based study found that kava was marginally better than placebo in treating insomnia, although this may be due to the very high efficacy of placebo treatment. Both kava and placebo were able to nearly halve the severity of insomnia during the study.

Further research is needed to fully evaluate the effects of kava on insomnia. However, while recognizing that kava has strong anti-anxiety abilities, the published study suggests that kava may improve some of the symptoms in at least a subset of patients with sleep disorders.

‌‌‌‌Studies on the effects of kava on anxiety levels in humans

Studies on the benefits of kava for anxiety in humans seem to show fairly consistent results. The first recommendations for the therapeutic use of this plant for the treatment of anxiety appeared more than 100 years ago and were based on examples of traditional use.

One of the first double-blind studies was conducted in Germany in 1991. The study authors found a marked reduction in anxiety levels as early as one week after starting treatment, and symptoms continued to improve within one month. The agent was very well tolerated by the participants and did not cause adverse reactions. A larger study from 1997 lasted a full 25 weeks and found a large number of benefits along with a minimum number of side effects.

A separate, double-blind, placebo-controlled study evaluated the transition from the standard medication, benzodiazepines used to treat anxiety disorder, to kava as an alternative. They concluded that kava was more effective, well tolerated, and better at managing anxiety.

Although one small study on the use of kava for the treatment of general anxiety disorder showed no significant improvement, the placebo response was very marked. Participants with an anxiety disorder responded well to kava, as did people who received a placebo. A separate small study in post-menopausal women found that taking kava for one month improved anxiety symptoms, with even better results after three months. One of the most interesting was the results of a study using web resources, according to which the effect of taking this plant was minimal.

A large study using a lower dosage of half the standard amount of kavalactones also showed some results in the treatment of neurotic anxiety. However, when using a lower dosage, the effect was less pronounced than in previous studies. The authors of a slightly more recent study attempted to evaluate the possibility of using small doses of kava for the treatment of various anxiety conditions. Even at low doses, the treatment was still effective in reducing anxiety and did not cause side effects.

Although there are a number of studies with negative results, reviews generally confirm that kava can reduce anxiety, and one of the authors noted that kava has an “uncompromising calming effect.” According to recent assessments, while further research is needed, kava has promising anti-anxiety potential and may be used as a convenient option for short-term anxiety treatment of 4-8 weeks.

‌‌‌‌Safety and Toxicity

Any discussion of the medical use of kava must include a discussion of its safety. Although the traditional use of kava has not been associated with possible harm to the liver, rare cases of liver damage, liver failure, and even death have been reported as a result of certain kava extracts. While these data are troubling, it must be understood that these events are rare, much less common than liver toxicity from standard medications such as antibiotics, anticonvulsants, and anti-inflammatory drugs (NSAIDs).

The World Health Organization evaluated data on cases of hepatotoxicity in 2008. There are reports of 93 cases of hepatoxicity, and only 8 of them could be caused by kava with a high probability, and in another 53 cases, kava was recognized as a possible, but not the only cause.

During case evaluation, it was noted that drinking alcohol while taking kava can cause liver damage. Anyone who takes kava is advised to refrain from drinking alcoholic beverages at the same time.

It is also possible that the drugs causing the problems were produced in a different way from the traditional way and using plant species not intended for human consumption. The traditional way to consume this plant is to steep the roots of the “noble” kava in cold water.

Noble Kava and Two Day Kava

Incidents of hepatotoxicity may also be associated with a change in the type of kava grown and exported. The noble kava has been used in traditional ceremonies and takes four years to grow until it is harvested. Unfortunately, due to high demand, one of the main exporters of kava extract began to look into other types of kava growing on the commercial kava island of Vanuatu.

After chemical analysis, the exporter’s experts concluded that the “two-day” kava grows much faster and contains more kavalactones. This type of kava has been banned from export as a product for human consumption and has never been used in traditional ceremonies. However, this prohibition was ignored and the plant began to be used for the production of kava extracts. Shortly thereafter, the first cases of hepatotoxicity appeared.

Clinical studies of kava, which proved the safety and effectiveness of this plant, in almost all cases used alcoholic extracts of noble kava. All 14,114 clinical study participants who received kava products did not experience any signs of hepatotoxicity. Studies have generally confirmed the safety and good tolerability of kava. Despite all of the above, for added safety, people with known liver problems should avoid taking kava products. Also, under no circumstances should the recommended dosage be exceeded.

Conclusions

Kava is an amazing herb with a long history of safe traditional use. Studies show marked efficacy in reducing anxiety levels, although only short-term use is recommended. With the right plant species and proper processing, kava is effective.

Although cases of hepatotoxicity are quite rare, information in the medical literature has associated such cases with the use of 2-day-old kava species in the form of acetone extracts, which are prohibited for export and human use. As with other herbal products, purchasing herbal products from reliable manufacturers is important to minimize risk.

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