What are the potential benefits of kava tea for anxiety relief. How does kava affect the brain and central nervous system. What are the main risks and side effects associated with kava consumption. Is kava safe for long-term use or are there concerns about liver toxicity.

What is Kava and How Does it Work?

Kava, scientifically known as Piper methysticum, is a shrub native to the South Pacific islands. For centuries, Pacific Islanders have used kava root to prepare a ceremonial beverage known for its relaxing and mood-altering effects. In recent years, kava has gained popularity in Western countries as a natural remedy for anxiety and stress relief.

The active compounds in kava, called kavalactones, are responsible for its psychoactive effects. There are 18 different kavalactones identified in the kava plant, each contributing to its overall impact on the brain and nervous system.

How do kavalactones affect the brain?

Kavalactones interact with the brain and central nervous system in several ways:

• Altering nerve signal conduction
• Decreasing excitatory neurotransmitters
• Enhancing GABA receptor binding
• Inhibiting the enzyme monoamine oxidase
• Reducing uptake of noradrenaline and dopamine

These mechanisms collectively contribute to kava’s anxiolytic (anti-anxiety) and relaxing effects.

Potential Benefits of Kava for Anxiety Relief

One of the primary reasons for kava’s popularity is its potential to alleviate anxiety symptoms. A 2003 review of 11 randomized controlled trials, involving 645 patients, assessed the efficacy of kava supplements in treating anxiety.

The studies used varying doses of kavalactones, ranging from 60 to 280 milligrams, which are significantly higher than traditional Pacific Islander usage. The duration of these studies ranged from one to 25 weeks.

What were the results of these kava studies?

The findings of the kava studies were promising:

• 10 out of 11 studies showed a decrease in anxiety compared to placebo
• The anxiety-reducing effects were comparable to prescription tranquilizers like benzodiazepines and buspirone
• Benefits were observed in both short-term and longer-term use (up to 25 weeks)

These results suggest that kava may be an effective natural alternative for managing anxiety symptoms. However, it’s crucial to consider the potential risks and side effects before using kava as a treatment option.

Kava Side Effects and Safety Concerns

While kava shows promise in anxiety relief, it’s not without risks. Several side effects and safety concerns have been associated with kava use, ranging from mild discomfort to severe health complications.

What are the common side effects of kava?

The most frequently reported side effects of kava include:

• Nausea
• Stomach aches
• Drowsiness
• Headaches

These side effects are generally mild and may subside with continued use or dose adjustment. However, more serious concerns have been raised regarding kava’s impact on liver health.

Liver Toxicity: A Major Concern

The most significant safety concern associated with kava use is its potential to cause liver damage. This risk has led to the banning of kava in the United Kingdom and several European countries.

More than 100 cases of liver toxicity related to kava use have been documented, with some cases resulting in liver transplants or even death. The mechanisms behind kava-induced liver damage are not fully understood, but several factors may contribute:

• Depletion of glutathione, a crucial antioxidant in the liver
• Inhibition of enzymes involved in drug metabolism
• Interaction with pre-existing liver conditions or alcohol use

A study of 31 regular kava drinkers in Hawaii showed significantly elevated liver enzymes compared to non-kava drinkers, suggesting that even seemingly healthy individuals may be at risk for liver damage with regular kava consumption.

Kava’s Impact on Cognitive Function and Motor Skills

Beyond its effects on anxiety and liver health, kava has been shown to influence cognitive function and motor skills. Understanding these impacts is crucial for anyone considering kava use, especially if they need to perform tasks requiring alertness and coordination.

How does kava affect reaction time and motor skills?

Studies have demonstrated that consumption of kava supplements can lead to:

• Slower reaction times
• Impaired motor skills

These effects are particularly concerning for activities such as driving or operating machinery. It’s important to note that while these motor impairments have been observed, there is currently no evidence of long-term cognitive decline associated with kava use.

Cognitive Function and Kava

Despite the observed effects on motor skills and reaction time, research has not found conclusive evidence of kava causing significant cognitive impairment. However, more long-term studies are needed to fully understand kava’s impact on cognitive function over extended periods of use.

Kava Interactions and Precautions

Given kava’s complex effects on the brain and body, it’s essential to consider potential interactions with other substances and medications. Understanding these interactions can help prevent adverse effects and ensure safer use of kava.

Can kava interact with other medications?

Kava has the potential to interact with various medications and substances:

• Antidepressants: Kava may interact with antidepressants due to its effects on neurotransmitters and enzyme inhibition. Combining kava with antidepressants is not recommended without medical supervision.
• Alcohol: The combination of kava and alcohol can intensify the sedative effects of both substances and potentially increase the risk of liver damage.
• Medications metabolized by the liver: Kava can inhibit enzymes involved in drug metabolism, potentially affecting the effectiveness or increasing the side effects of certain medications.

It’s crucial to consult with a healthcare provider before using kava, especially if you’re taking any medications or have pre-existing health conditions.

Precautions for Kava Use

Consider the following precautions when using kava:

1. Avoid use if you have liver problems or a history of liver disease
2. Do not combine kava with alcohol or drugs that can cause liver damage
3. Discontinue use and seek medical attention if you experience signs of liver problems (e.g., yellowing of the skin or eyes, dark urine, abdominal pain)
4. Use caution when driving or operating machinery due to potential impairment of motor skills
5. Avoid long-term use without medical supervision

Kava Preparation Methods and Safety

The method of kava preparation can significantly impact its safety profile and effectiveness. Traditional preparation methods differ from modern extraction techniques, and these differences may influence the potential risks associated with kava consumption.

How is kava traditionally prepared?

In traditional Pacific Island cultures, kava is prepared using the following method:

1. The root of the kava plant is crushed and ground
2. The ground root is mixed with water and coconut milk
3. The mixture is strained to create a drinkable beverage

This traditional water-based preparation method may be less harmful to the liver compared to modern extraction techniques using organic solvents.

Modern Kava Preparations and Safety

Modern kava supplements and extracts are often prepared using different methods:

• Water-based extractions
• Acetone-based extractions
• Ethanol-based extractions

Some evidence suggests that water-based kava preparations may be less harmful to the liver than those prepared with acetone or ethanol. However, more research is needed to fully understand the safety implications of different preparation methods.

Alternatives to Kava for Anxiety Management

Given the potential risks associated with kava use, it’s worth considering alternative approaches to managing anxiety. Several evidence-based methods can effectively reduce anxiety symptoms without the potential for liver toxicity or other serious side effects.

What are some effective alternatives to kava for anxiety relief?

Consider the following alternatives for managing anxiety:

• Cognitive Behavioral Therapy (CBT): A type of psychotherapy that helps individuals identify and change negative thought patterns and behaviors contributing to anxiety.
• Mindfulness and Meditation: Practices that can help reduce stress and anxiety by promoting present-moment awareness and relaxation.
• Exercise: Regular physical activity has been shown to reduce anxiety symptoms and improve overall mental health.
• Herbal Remedies: Some herbs, such as chamomile, lavender, and passionflower, have mild anxiolytic effects without the risks associated with kava.
• Lifestyle Changes: Improving sleep habits, reducing caffeine intake, and maintaining a balanced diet can all contribute to better anxiety management.

These alternatives may provide long-lasting benefits for anxiety management without the potential risks associated with kava use. It’s important to consult with a healthcare provider to determine the most appropriate approach for individual needs.

The Long-Term Benefits of Cognitive Behavioral Therapy

Among the alternatives mentioned, Cognitive Behavioral Therapy (CBT) stands out for its long-lasting benefits in anxiety management. Unlike kava, which may provide short-term relief but carries potential risks with long-term use, CBT equips individuals with tools and strategies to manage anxiety effectively over time.

CBT helps individuals:

• Identify and challenge anxiety-provoking thoughts
• Develop coping mechanisms for managing anxiety symptoms
• Learn relaxation techniques and stress management strategies
• Build resilience and improve overall emotional well-being

While kava may offer quick relief, the skills learned through CBT can provide sustained anxiety management without the need for ongoing supplementation or medication.

Current Research and Future Directions in Kava Studies

As interest in natural anxiety remedies continues to grow, ongoing research into kava’s effects, safety profile, and potential applications is crucial. Understanding the current state of kava research and future directions can provide valuable insights for both consumers and healthcare providers.

What are the current research priorities for kava?

Current and future kava research focuses on several key areas:

• Long-term safety studies: Investigating the effects of prolonged kava use on liver health and overall well-being
• Standardization of kava products: Developing consistent preparation methods and dosing guidelines to improve safety and efficacy
• Mechanism of action: Further exploring how kavalactones interact with the brain and nervous system
• Genetic factors: Investigating whether genetic variations influence individual responses to kava and susceptibility to side effects
• Comparative studies: Assessing kava’s effectiveness against other anxiety treatments, both pharmaceutical and natural

As research progresses, our understanding of kava’s benefits and risks will continue to evolve, potentially leading to safer and more effective applications of this traditional remedy.

The Future of Kava in Anxiety Treatment

The future of kava in anxiety treatment remains uncertain. While its potential benefits are promising, the associated risks cannot be ignored. Future developments may include:

• Development of safer kava formulations with reduced risk of liver toxicity
• Identification of specific kavalactones responsible for anxiolytic effects, potentially leading to more targeted treatments
• Integration of kava into comprehensive anxiety management programs that include lifestyle modifications and therapy
• Improved guidelines for kava use, including appropriate dosing, duration of use, and monitoring protocols

As research continues, it’s crucial for consumers and healthcare providers to stay informed about the latest findings regarding kava’s efficacy and safety profile.

In conclusion, while kava shows promise as a natural remedy for anxiety, its use comes with significant risks and considerations. The potential for liver toxicity, interactions with medications, and effects on motor skills necessitate caution. Alternative approaches, such as cognitive behavioral therapy, may offer safer and more sustainable solutions for anxiety management. As research progresses, our understanding of kava’s role in mental health treatment will continue to evolve, potentially leading to safer and more effective applications of this traditional remedy.

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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Benefits, Side Effects and Dosage – Drink-Drink

Compared to placebo, this significantly reduced participants’ perceived anxiety.

Investigators also noted no withdrawal or addiction-related side effects, while these effects are seen with other drugs commonly used to treat anxiety. 14).

Since this study, several other studies have demonstrated the benefits of kava for anxiety. A review of 11 of these studies found kava extract to be an effective treatment for anxiety.16).

Moreover, another review of a specific kava extract came to a similar conclusion, reporting that it could be used as an alternative to some anxiety medications and other antidepressants (17).

Recent studies have continued to find evidence that kava is effective for anxiety.18, 19, 20).

Lack of sleep is associated with many health problems, including high blood pressure, diabetes, depression, obesity, and cancer.21, 22, 23, 24).

Realizing this, many people turn to sleeping pills to improve their sleep. Like medications used to treat anxiety, sleeping pills can be addictive, leading to physical dependence.25).

Kava is commonly used as an alternative to these sleeping pills due to its calming effect.

In one study of 24 people, kava was found to reduce stress and insomnia compared to placebo. 26).

However, both investigators and participants knew whether they were receiving kava or placebo. This could have caused a bias that affected the result.

Despite these shortcomings, a subsequent higher-quality study found that kava was more effective than placebo in improving sleep quality and reducing anxiety.27).

Interestingly, the effect of kava on insomnia may be related to its effect on anxiety.

Stress-induced insomnia is common in people with anxiety. Thus, in cases of insomnia, kava may treat anxiety, which may help people sleep better (27).

It is not known how kava affects sleep in those who do not have anxiety or stress-induced insomnia.

In addition, it may cause drowsiness but does not affect the ability to drive (28).

Conclusion Kava is a natural

alternative to prescription sleeping pills. Although it is effective in treating

stress-induced insomnia, its effect on healthy people is unknown.

Kava Forms

Kava can be taken as a tea, capsule, powder or liquid.

With the exception of kava tea, these products are made from a concentrated mixture prepared by extracting kavalactones from the root of the plant with ethanol or acetone (3).

Plan Tea

Tea is the most common method of taking kava for anxiety as it is readily available.

It is sold alone or with other herbs advertised for relaxation and is brewed using hot water.

Be sure to look for kava tea that lists kavalactone as well as other ingredients.

Avoid teas that list ingredients as “proprietary blends”. With these products, you won’t know how much kava you’ll get.

Kava tincture or liquid

This is a liquid form of kava sold in small bottles ranging from 2 to 6 ounces (59–177 ml). You can take it with a pipette or mix it with juice or other drink to hide its whiskey-like taste.

It is important to take only a small dose as the kavalactones are concentrated making the kava tincture and liquid more effective than other forms.

Kava Capsules

Those who do not like the taste of kava can take it in capsule form.

As with kava tea, look for products that list kavalactone content. For example, one capsule may contain 100 mg of kava root extract, which is standardized to contain 30% kavalactones.

Knowing this information will help you avoid taking too much or too little kavalactones.

dosage

Experts recommend that the daily dose of kavalactones should not exceed 250 mg (29, 30).

The effective dose of kavalactones is 70–250 mg (18, 19, 20).

Kava supplements may list kavalactones in milligrams or as a percentage. If the content is given as a percentage, you will need to calculate the amount of kavalactones it contains.

For example, if one capsule contains 100 mg of kava root extract and contains 30% kavalactones, it will contain 30 mg of kavalactones (100 mg x 0.30 = 30 mg).

To achieve an effective dose in the 70-250mg range of kavalactones, you need to take at least three capsules of this particular supplement.

Most kava root extracts contain 30-70% kavalactones (3).

Conclusion Kava is available in

many forms. Avoid products with “proprietary blends”. Look for 9 instead0003

products that tell you the kavalactone content per dose or percentage

kavalactones for which the product is standardized.

Side Effects

Although kava can be helpful for anxiety, many people are concerned about its potential side effects.

In the early 2000s, several cases of kava-related liver poisoning were reported.31).

Later, the US Food and Drug Administration warned of the risk of liver damage associated with products containing kava.32).

Its use has even been banned or restricted in many countries, including Germany, Switzerland, France, Canada and the UK.

However, the ban was later lifted in Germany due to lack of evidence of associated risks (33).

Kava is believed to harm the liver in a number of ways, one of which is how it interacts with certain medications.

Liver enzymes that break down kava also break down other drugs. Thus, kava can bind these enzymes and prevent them from breaking down other drugs, causing them to accumulate and harm the liver.34).

Adulteration is another reason why kava products are considered unsafe (35, 36).

To save money, some companies use other parts of the kava plant, such as leaves or stems, instead of roots. The leaves and stems are known to be harmful to the liver (37, 38).

However, several analyzes of studies on this topic found no evidence of liver damage in people who took these supplements for a short period of time, or for 1–24 weeks.16, 17).

Thus, people without liver damage and those not taking medications that affect the liver can safely consume kava at appropriate doses for about one to two months (3).

Conclusion Although kava may be

safe use in the short term is associated with liver problems. This is the best

consult your doctor before taking kava as it may interact with

some drugs.