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Kava: The Pacific Herb
November 14, 2008
Kava, or Piper methysticum, which means “intoxicating pepper,” has been consumed as a social and ceremonial drink by Pacific Islanders for more than 3,000 years. The first description of this tall lush plant with heart-shaped leaves came to the West from Captain Cook on his celebrated voyages through the South Seas. To this day, when village elders or others come together for significant meetings, they begin with an elaborate kava ceremony. Kava is used to welcome visiting dignitaries: Pope Paul, Queen Elizabeth II, and President Lyndon B. Johnson all were treated to a ceremonial drink at one time. A perfect icebreaker, kava eases tension and allows freer communication. It makes you warm and friendly, and as one early writer put so well, “You cannot hate with kava in you.” Less formally it is drunk daily as a mild after-work inebriant in the islands’ ubiquitous kava bars or “nakamals.”
The root is used both for the drink and, in dried form, for a relaxing herbal supplement mostly for export. Currently, kava is used in Europe and increasingly in the United States to counteract stress, anxiety, and insomnia. But kava is turning out to be increasingly popular, as in the South Pacific, simply as a natural high.
Research shows that kava often works just as well as the benzodiazpines. Unlike these prescription drugs, however, you don’t need to keep increasing the dose to get the same effect, there are no withdrawal problems when you stop taking it and a low daytime dose will relax you without making you sleepy. In fact, kava can actually enhance concentration. Research shows that, on a work recognition test, it improves reaction time and performance.
This makes it easy to use for specific anxiety-producing situations such as a job interview or a final exam, where you want to be both calm and alert. In higher doses, kava is a natural sleep enhancer. Unlike benzodiazepines, though, it does not suppress REM (rapid eye movement, which occurs during dreaming) sleep, essential to our emotional, mental, and physical well-being. And there’s no morning hangover, either.
WHY KAVA IS BETTER THAN ALCOHOL
Like alcohol, kava can help you relax and ease social interactions. But, of the two, only kava allows you to maintain a clear mind, with no hangover.
As novelist and travel writer Paul Theroux says in The Happy Isles of Oceania:
No one ever went haywire and beat up his wife after bringing on yanggona [kava]. No one ever staggered home from a night around the kava bowl and thrashed his children, or insulted his boss, or got tattooed, or committed rape. The usual effect after a giggly interval was the staggers and then complete paralysis.
After the first two hours of use, alcohol can make you nervous and shaky. Kava in contrast, is calming. One four-week study of patients with anxiety found that participants experienced dramatic improvements in their symptoms after just one week of kava use, with improvement continuing through week four. In the largest (101 participants) and longest (twenty-five weeks) study to date, German researcher H.P. Volz and colleagues demonstrated that kava provided significant relief of anxiety versus the placebo, or “dummy” pill, and with minimal side effects.
HOW KAVA WORKS
Kava actually promotes relaxation in two different ways—by acting on the limbic system, which is the emotional center of the brain, and directly on muscles. The muscle-relaxing effects make it particularly useful in treating headaches, backaches, and other tension-related pain.
The active ingredients are the kavalactones, taken from the powdered lateral roots of the plant. Since they are fat-or-lipid-soluble, they don’t dissolve in water but form an emulsion of oil and water in the traditional drink.
Kava is selectively cultivated for specific effects: Certain combinations of the cultivars are more relaxing, others more stimulating, and still others more intoxicating. These cultivars are prized for their ability to alter consciousness in various ways. They are generally kept for island use while the rest are exported, much as vintners will hold on to their prized vintages.
Kava’s specific effect on neurotransmitters is not entirely clear. It appears, though, that in keeping with its relaxant effects, it enhances the receptivity of the brain’s GABA receptors. Unlike alcohol, it neither disturbs blood-sugar balance nor reduces endorphin levels.
HOW MUCH SHOULD YOU TAKE?
Kava is available in various forms—tablets, capsules, and tinctures, and even in sprays. The taste is quite strong, so most people prefer tablets or capsules. The recommended daily adult dose is 60-75 mg of kavalactones, taken two to three times daily. This is equivalent to 200-250 mg of standardized extract containing 30 percent kavalactones, 100-150 mg of 55 percent extract, or 100 mg of a 75 percent extrat. As a sedative to aid sleep, the dose is two to three times that amount. For getting high and chilling out, the dose is quite individual—somewhere between the relaxing and sedating doses, generally twice the dose used to help you sleep.
All these numbers may be confusing, but remember, herbs are extracted from natural plants, not manufactured, and the markers (kavalactones, in this case) are given as a percentage of the whole extract. Conveniently, most capsules or tablets are in the range of 60-75 mg of kavalactones each. Then, your dose is an individual matter, depending on your own chemistry. Don’t be too concerned with the exact numbers. Rather, start with one capsule and observe your response. Then you can adjust accordingly. Another warning: the first time or two after taking kava, some people feel a little groggy, so just in case, start on a weekend or evening when you don’t have to be fully alert. After a few doses, your body gets used to the sensation, and you will probably feel wonderfully relaxed but alert. Of course, if you are using it to zone out, just let it happen.
The tinctures are rather bitter, an acquired taste. The will also numb the inside of your mouth for the first few minutes. An advantage to tinctures is the rapid onset. Taken straight, the liquid is quickly absorbed in the mouth and into the bloodstream before you even swallow. If your prefer, you can take the tincture in fruit juice to cover the taste.
KAVA SAFETY
Taken in these typical doses, kava has only mild side effects—occasional skin rashes in sensitive individuals, headache, or mild stomach upset. Chronic high-dose use on the islands (500-2,500 mg of kavalactones every day for years at a time) will sometimes cause a scaly yellow skin rash called “kava dermopathy.” It disappears after intake of the herb is stopped.
Despite its excellent past safety record, kava has recently come under the scrutiny of the United States Food and Drug Administration (FDA), which is acting on reports from Europe that kava may damage the liver. Based on these reports, the U.K. has withdrawn sales of kava products pending further investigation. Closer examination of the German and U.S. reports reveals that the vast majority of cases involved the concomitant use of hepatotoxic (liver) drugs and/or alcohol. Furthermore, a clinical study from Duke University showed no adverse effects from kava on the liver. The fact is, you are far likelier to suffer from liver damage by taking the prescription antianxiety drug Valium, yet it is taken my millions daily with little question—and with no major adverse publicity. The over-the-counter pain medication acetaminophen (Tylenol) also has a high incidence of liver toxicity, responsible for 141 deaths in the United States in 1999 and the leading cause of liver failure in Western countries.
Based on the limited information made available to date, we recommend that consumers of kava should consider the following cautions:
* Kava should not be used by anyone who has liver problems, is taking any drug product with known adverse effects on the liver, or is a regular consumer of alcohol.
* Since the reports so far are associated with chronic use, kava should not be taken on a daily basis for more than the German Commission E’s recommendation of three months.
* Discontinue use if symptoms of jaundice (e.g., dark urine, yellowing of the eyes) occur.
* Do not exceed the recommended maximums fo 125 mg kavalactones per tablet or capsule, 3 g of dried rhizome per tea bag, and 250 mg kavalactones total per day for all forms.
* Kava should not be taken with alcohol or other sedatives because they potentiate each other (that is, they increase each other’s potency). You should never drive after using kava in higher doses. There have already been a few arrests for erratic driving under the influence.
* Because high doses can cause intoxication, there is concern that kava could become an herb of abuse. There have been media reports of young people trying to get high by taking products that they thought contained kava. Exploiting its exotic appeal, people distributed bottles of a product called “fX” and promoted it as kava at a 1996 Los Angeles New Year’s Eve celebration. There were hundreds of adverse reactions, widely reported in the press as “due to kava.” Unfortunately, less attention was paid a few weeks later when the police report revealed that fX contained a highly toxic industrial chemical called 1,4-butanediol—and absolutely no kava.
In conclusion, be aware that herbs are potent medicines and should be treated with appropriate respect regarding interactions with potential toxicity, including toxicity to the liver. However, kava’s margin of safety still far surpasses that of its pharmaceutical equivalents.
KAVA
How it works: Calms the limbic system, the emotional center of the brain; relaxes muscles, likely through an indirect action on GABA receptors.
Positive effects: Relaxes mind, emotions, and muscles, making it useful for headaches, backaches, and other tension; reduces excessive mental chatter; increases mental focus; expands overall awareness; no habituation tolerance; addiction, or hangover.
Cautions: Do not drive or operate heavy machinery after use. Do not mix with alcohol or benzodiazepines, as these substances seem to potentiate each other. Do not take while pregnant or nursing.
Dosage: As a relaxant, 60-75 mg of kavalactones two to three times daily. As a bedtime sedative, 60-250 mg of kavalactones about 30 minutes before bedtime.
-Natural highs : supplements, nutrition, and mind-body techniques to help you feel good all the time / [Hyla Cass and Patrick Holford].
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