Kava Plant History Uses, Health Benefits – Is it Safe to Drink?

The Kava plant, also known as awa, kava kava, and ava pepper among other names, is a shrub found on Pacific Islands. Its origin has been traced back to the island nation of Vanuatu in the South Pacific Ocean.

The root and underground stem system have been used recreationally and medicinally for hundreds of years, both in the South Pacific and Europe and eventually by Australian Aboriginals [1].

Known botanically as Piper methysticum, there are many different strains of this plant grown today, all of which are purported to have different profiles of active ingredients and to produce different effects on the body.

Today, kava extract is readily available online for purchase in the United States. Consumption of beverages prepared from the rootstock of the plant have a relaxing effect and are used both socially and medicinally to reduce feelings of stress or worry.

Consumers can also buy their own live kava plants to grow at home or purchase seeds that they can cultivate on their own.

Kava

Herbal Supplement

Anxiety

Mood

Sleep

How It Works:

• Reduces feeling of anxiety & stress
• Improves feeling of wellbeing
• Shown to improve sleep & insomnia

Dosage:

Between 100 - 300 mg per day

Safety:

Rated Possibly Safe

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Traditional Use of the Kava Plant

Kava plant uses vary greatly and include both recreational and medicinal use throughout history. Historically, it was prepared into beverages by grinding or chewing the roots to release the bioactive compounds.

The roots were then mixed with a small amount of water to produce an extract emulsion of kavalactones. This would then be mixed into beverages that were consumed in social setting such as in religious ceremonies.

In Fiji, a drink called grog was prepared with powdered sun-dried kava roots that were mixed and strained in cold water. The drink would then be consumed from a half coconut shell.

In Western societies, kava supplements are typically taken to alleviate restlessness, feelings of apprehension or to help users unwind after a busy day. It also has anti-convulsant effects and appears to relax muscles and reduce aches and pains.

When used recreationally, kava is mixed into a beverage form and produces results similar to alcoholic beverages. This practice is common in Fiji and other South Pacific countries, where kava rituals and ceremonies bring in in millions of dollars in annual revenue.

Kava extracts may come in powder, liquid, capsule, or paste form and are taken either orally or topically. Kava is used topically for toothache, leprosy, the treatment of wounds, topical pain relief, dental abscesses, and canker sores.

Consumers have used oral kava extract for a vast range of conditions including insomnia, stress, attention deficit hyperactive disorder (ADHD), anxiety, UTIs, inflammation of the uterus, menstrual pain, chronic fatigue syndrome, psychosis, migraines, tuberculosis, bronchitis, pneumonia, sexually transmitted diseases, vaginal prolapse, and cancer prevention [2].

None of these uses have been studied or approved by the Food and Drug Administration and not all evidence supports the efficacy of kava in the treatment of these conditions.

Effects and Uses

There are five different identified chemotypes or varieties of the kava plant, which contain different concentrations of kavalactones in their roots. Some of the active compounds identified in this plant include:

• Methysticin
• Dihydromethysticin (DMH)
• Yangonin
• Dihydrokawain (DHK)
• Kawain

These varying concentrations produce different effects in the user. Some varieties have more analgesic (pain relieving) properties while other varieties are more anxiolytic (anxiety-reducing).

The mechanisms of action for this plant are not well understood. One of the ways that kava plant extracts are believed to work is by facilitating GABA transmission in the brain and by influencing the signalling of other neurotransmitters such as dopamine and serotonin.

Research in animals shows that kava promotes sedation and anxiolysis, but not through the same pathways in the brain involved in the effects of benzodiazepine drugs. Instead of binding to GABA(A) receptors, the effects of kava appear to be mediated by limbic structures in the brain.

There has been some animal research into the medicinal effects of this plant, but not much human research. Clinical research on the natural extract has been slowed due to reports of hepatotoxicity linked to non-water-based extracts of the plant.

However, kava has been studied in terms of its efficacy in treating anxiety in several separate clinical trials. The Natural Medicines Comprehensive Database rates it as Possibly Effective for generalized anxiety disorder (GAD).

In seven separate clinical trials, data demonstrated that kava effectively improved the symptoms of anxiety when compared to patients receiving a placebo. Some studies compared the effects of kava to the effects of prescription anxiety medications and found that they were comparable.

However, it is important to note that not all studies agree; some studies have shown no improvement of anxiety symptoms with the use of kava [3].

Dosages and How to Use

Kava dosage and administration depends on the indication and should be overseen by a physician or qualified healthcare provider:

• General use of kava is typically 300mg orally per day divided into three or more equal doses
• When using depression, the most common dose used in research studies is five 50mg tablets per day, divided into three doses (the first two are 100mg and the third is 50mg)
• When used for insomnia or sleep disorders,100-120 mg daily has been taken in research studies delivered in a single dose before bedtime
• 100mg of kava in a single daily dose daily is typically used in research studies for hot flashes
• For stress relief and anxiety, daily doses up to 400mg, divided into three doses, have been used in clinical trials

Users can develop a tolerance to the effects of this herb. If you feel tolerance developing, do not increase the dosage to achieve stronger effects. Instead, it is recommended to take a break from the substance to allow your tolerance to reset.

Most commercially available kava products are standardized to contain 30% kavalactones, the active ingredients in the kava root. When used topically, kava paste is applied one to three times daily to the affected area.

Kava is not safe for children and should never be administered to people under the age of 18 due to a lack of evidence and potential risks and side effects [4].

All patients should seek advice from a medical provider before beginning a kava regimen to ensure safety and prevent drug interactions.

Risks and Side Effects

Kava use may be accompanied by side effects, including a numbing sensation of the tongue, decreased motor coordination, slow reaction times, nausea, stomach upset, headaches, diarrhea, skin rashes, dizziness, drowsiness, and changes in mood.

Previously, the medical community was concerned about a possible link between kava use and liver damage or liver failure. There have been reports of individuals experiencing significant adverse reactions from using alcohol-based tinctures of the kava plant that contained aerial parts of the plant.

The Food and Drug Administration previously issued warnings about this herb and some kava studies were suspended due to concerns about hepatoxicity, which may result in death [ 5].

However, large-scale research reviews suggest that the risk is not due to kava itself, but rather to low-quality preparation methods used by some manufacturers. High-quality water extracts from the roots of the herb are not believed to have adverse effects on liver function.

The risk of hepatotoxicity or liver toxicity only applied when kava is consumed orally; topical use does not produce the same risk. Some of the additional side effects that have been associated with heavy use of this plant include:

• Yellow, scaly skin (dermopathy)
• Dry eyes or dry skin
• Dystonia, or involuntary muscle movements and abnormal muscle spasms
• Hepatoxicity, hepatitis, liver failure, and/or death

This plant extract may interact with Levodopa, a drug used to treat Parkinson’s disease. This may be linked to kava’s antagonism of dopamine receptors.

Kava has been shown to inhibit p-glycoprotein drug efflux and could interfere with medications that are substrates for this cell membrane pump. This could cause greater accumulation of drugs like digoxin, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, Ioperamide (Imodium), quinidine and others.

It should not be combined with Alprazolam or medications that act as Central Nervous System depressants. Do not use this plant extract in combination with hepatotoxic drugs or medications that are metabolized by the liver.

Supplement Reviews

Kava is legal and available for purchase in the United States. Kava root extract can be found in numerous forms on the internet.

Consumers should carefully research any natural remedy or supplement and speak with a healthcare provider before beginning a new regimen; the best resources cite data from scholarly journal articles.

Many patients claim substantial muscoskeletal pain relief, improvement in sleep routine, and improvement in anxiety and/or depression symptoms after taking kava plant products:

• “When I feel an anxiety attack brewing, I take two 425mg Kava Kava capsules and my anxiety dissipates.”
• “I have used freshly prepared kava tea for about six years to control my anxiety before speeches, flights, and exams with good results.”
• “The best herb hands down for anxiety.” [6]

These statements have been made by consumers who have used kava and have not been evaluated or by the Food and Drug Administration. To determine whether this plant is appropriate for you to use, it is important to check with your doctor.

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