A member of the pepper family, kava (or kava-kava) is a natural tranquilizer that soothes jangled nerves and eases anxiety with few of the mind-dulling effects of prescription relaxants. Its Latin name, Piper methysticum, means "intoxicating pepper," and indeed, on the South Pacific islands where it is grown, kava is made into a traditional beverage that is drunk at ceremonies and on social occasions--as alcohol is in other societies--to relax people and induce a sense of well-being.

Doctors in Europe have long prescribed kava as a gentle alternative to prescription tranquilizers. But things are changing quickly. Recent news about kava has not been good. In Europe, approximately 40 reports of liver damage among kava users have surfaced over the past two years. Six of these people required liver transplants, and the three died. This was sufficient evidence for the governments of Germany and Switzerland to call for an immediate ban on kava products; Canada and Great Britain shortly followed suit.

In Europe, herbal therapies are carefully monitored by governmental agencies comparable to the Food and Drug Administration (FDA). This situation is quite different in the United States. Here, most herbs can be taken without physician supervision, and problems may never get reported at all. Because the FDA classifies kava as a nutritional supplement rather than a drug, the agency can't act on "adverse event" reports from physicians by recalling it. Rather the FDA simply issues a "warning," which it has done in the case of kava.

The lack of medical supervision regarding herbal therapies is currently reflected in the U.S. data on kava, with only a single case reported so far:a woman who developed liver failure while using the herb. Given the widespread use of kava, it is statistically quite likely that more people had or even still have kava-induced liver toxicity but remain unaware of it. When abnormalities in liver function do occur with kava, they usually clear up within weeks of discontinuing the herb.

Herbalists in the United States seem to be divided equally about the use of kava. One group recommends no official withdrawal of the herb, but carefully considered use instead. Cautions would include taking the herb for no more than one month, not exceeding dosage recommendations, and avoiding it altogether if there is pre-existing liver disease or if drinking alcohol or taking any medication associated with liver toxicity. They contend that combining kava, acetaminophen(Tylenol), and alcohol would be an extremely dangerous mix, for example. Other herbalists are willing to abandon kava altogether and recommend alternative relaxing herbs such as valerian, passionflower, chamomile, and the amino acid GABA (gamma aminobutyric acid).

Kava's active ingredients are found in the plant's dense, fleshy roots (some weigh up to 22 pounds), which contain kavalactones and other components that can have a therapeutic effect. Scientists believe that kava works by acting on the limbic system, an ancient part of the brain that controls emotions, among its other functions. Unlike prescription tranquilizers, kava doesn't appear to dull the mind, and, according to some studies, it can even improve alertness and reaction time. Before the current warnings, European physicians prescribed it frequently because it's generally not addictive, and those who take it aren't likely to build up a tolerance to it.

Specifically, kava may help to:

Ease stress-induced anxiety and panic. Several studies have shown that kava is very useful for relieving anxiety and the symptoms associated with it, such as nervousness, restlessness, and dizziness. It can also relieve the heart palpitations and intense periods of anxiety associated with panic attacks.

 

Combat anxiety associated with depression. Kava can be used alone, or with St. John's wort, ginkgo biloba, or 5-HTP to relieve anxiety in those with mild to moderate depression.

 

Induce sleep in people with insomnia. Insomniacs often find that kava relaxes them sufficiently to enable them to fall asleep. Kava is often rotated with other sedating herbs, such as chamomile, passionflower, and valerian.

 

Relieve muscle aches and chronic pain. Kava is thought to have muscle-relaxing properties, and may therefore help reduce muscle spasms. Proponents suggest it can be useful in treating the chronic muscle pain and stiffness associated with fibromyalgia.

 

Calm those trying to stop smoking or drinking. Kava has a relaxing effect on those trying to stop tobacco or alcohol use.

 

Control epileptic seizures. In cases where stress and anxiety are known to trigger epileptic attacks, kava may serve to prevent seizures as effectively as certain prescription anticonvulsants. Never stop or reduce the dosage of a prescription medication without consulting your doctor first, however.

 

Improve recovery from stroke. Very early studies indicate that kava may help stroke patients recover by minimizing the amount of permanent brain damage that can occur.

Forms tincture tablet softgel liquid dried herb/tea capsule

Special tips:

--Buy kava extracts standardized to contain at least 30% of the herb's primary active ingredient, kavalactones.

--Look for products extracted from the root of the plant rather than kava with only purified kavalactones (some herbalists believe that the root extracts contain other beneficial substances in addition to kavalactones).

--Use only products made solely from kava root. And avoid products that contain any other parts of the kava plant--leaves, stem, and so on. Manufacturers of kava products believe liver toxicity occurred because either the whole plant was used (the aboveground parts are toxic) or because of chemicals added to the root during processing.

For the ailments mentioned: Take 250 mg of a standardized extract two or three times a day.

Be sure to check our our Dosage Recommendations Chart for Kava, which lists therapeutic dosages for specific ailments at a glance.

Always look for a standardized product. The kava should contain the amount of active compound--kava pyrones--used in most studies to date: 60 to 120 mg, takendaily. Or look for products containing 30% kavalactones, which is how the active compound is identified by some sources.

 

Consider fresh, freeze-dried kava. Some herbalists believe that flash freeze-drying fresh kava root is the best way to capture all of the plant's healing compounds without adding any chemicals in the processing. They also believe some benefits of kava may be lost when extracting the so-called active ingredients. Keep in mind that the milligrams of kava root in each freeze-dried capsule will be numerically larger than what you'll find in extract products; after all, the capsule contains a condensed version of the root.

 

Pay attention to the issue of liver toxicity. Don't take more than the recommended dose.

 

Take kava only on a short-term basis (less than one month) or only use it intermittently--as needed--for anxiety.

 

Consider alternatives for long-term use. Most people begin to feel kava's relaxant effect almost immediately. A major study conducted at several European medical centers showed, however, that patients who suffered from severe and long-term anxiety required up to eight weeks before experiencing any significant benefit. Because of this eight-week effect, if you have especially severe anxiety, you're better off selecting a different herb or having your doctor prescribe conventional medications.

 

Drugs that affect the central nervous system could cause excessive drowsiness if taken with kava. These include antidepressants, psychiatric drugs (such as antipsychotics or buspirone), sedatives, and tranquilizers.

 

Definitely do not use kava if you are drinking alcohol or taking any medication known to effect liver function. The most well-known of these is acetaminophen (Tylenol), but ask your doctor about others.

 

Nutritionally oriented doctors in the United States sometimes recommend a short course of kava to take in combination with the antidepressant herb, St. John's wort, an herb that takes about four weeks to start working against depression. The kava, which is immediately effective for anxiety-related depression, can be stopped at this point.

Possible Side Effects

Cautions