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 U.K. has banned sales of kava products and German authorities have notified manufacturers of kava products that their licenses to market the herb could be withdrawn.
Closer examination of the scant details available on the 30 European cases reveals that the vast majority – 21 cases in all – involved the concurrent use of hepatotoxic drugs and/or alcohol. This is not significant evidence of hepatotoxicity.
The fact is, you are far likelier to suffer from liver damage by taking the prescription anti-anxiety drug, Valium, than you are from kava, yet it is taken by millions daily with little question and with no major adverse publicity. The over-the-counter pain medication, acetominphen (Tylenol), also has a high incidence of liver toxicity, especially when combined with alcohol.
Dosage
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.
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. Kava extracts inhibit the activities of liver detoxifying enzymes increasing the suspicion that kava may cause significant drug interactions.
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, yellowing of eyes and skin, occur.
Kava can help with the following
Alcohol-related Problems
Kava alone has little effect on reported condition and cognitive performance, but appears to potentiate both perceived and measured impairment when combined with alcohol. [Drug Alcohol Rev. 1997 Jun;16(2):147-55]
In other words, when taken together with kava, alcohol increases the risk of impairment from this herb.
Upcoming Surgical Procedure
Prolonged use or large doses of kava may increase the effects of anesthesia or contribute to liver problems.
Anxiety
Kava seems to be as effective as the class of synthetic pharmaceuticals called benzodiazepenes (such as Valium) for treating anxiety, but without their dangerous side effects of sedation and addiction. Only about 2% of patients taking kava reported minor side effects, predominantly gastrointestinal complaints, skin reaction, headache and photosensitivity. Other research has shown that kavapyrones act on receptors in the hippocampus and amygdala complexes in the brain to produce measurable changes in brain wave activity and reduce anxieity. [Journal of Clinical Psychopharmacology 2000 Feb;20(1): pp.84-9]
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.”
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.
Possible Pregnancy-Related Issues
Kava use is discouraged due to possible complications.
Key
| Likely to help |
| May have adverse consequences |
| Reasonably likely to cause problems |
Glossary
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
FDA
The (American) Food and Drug Administration. It is the official government agency that is responsible for ensuring that what we put into our bodies - particularly food and drugs - is safe and effective.
Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hepatotoxic
Being toxic or destructive to the liver.
Over-The-Counter
A drug or medication that can legally be bought without a doctor's prescription being required.
Milligram
(mg): 1/1,000 of a gram by weight.
TID
Three times a day.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Nausea
Symptoms resulting from an inclination to vomit.