What Is Kava? 10 Must-Know Facts
A few years ago, my wife and I were on Hawaii's big island and walking through a quaint shopping area when I noticed a small, hole-in-the-wall establishment that served kava. For the uninitiated, kava is a relaxing, non-alcoholic beverage made from the root of the kava plant, it's popular in the Pacific islands. I'd heard of it but hadn't tried it and figured it'd be a good opportunity. I walked up, paid $6 for a coconut shell of liquid that resembled dirty dishwater, and down the hatch it went. It didn't take long before I was enveloped in a feeling of clear relaxation and realized why Polynesian culture appreciates it so much.
10 Things You Need to Know About Kava
Kava isn't some big secret, but it's not a mainstream staple on the mainland. So, let's take a look at the top 10 things you need to know about kava.
1. What Is Kava?
Kava, also known as Piper methysticum, kava kava, and 'awa, is a small shrub native to the islands in the South Pacific. The root and stems are made into a non-alcoholic, psychoactive beverage that has been used socially and ceremonially for hundreds of years in Hawaii, Fiji, and Tonga.[1]
Kava is traditionally prepared by placing ground root and stem into a porous sack, submerging in water, and squeezing the juice into a large, carved, wooden bowl. Coconut half-shell cups are dipped and filled – punch bowl style. After drinking a cup or two a feeling of heightened attention combined with relaxation begins to come on. Although it is soothing, it is unlike alcohol in that thoughts remain clear. The flavor is largely inoffensive, but some find that it takes getting used to; it really depends on your preference for earthy flavors.
2. Kava Might Help Anxiety
Kava has been marketed since the early 90s as an herbal remedy for stress, anxiety, and insomnia; its popularity has grown ever since.[2, 3, 4] The excitement is justified, as the clinical evidence supporting its use is quite extensive.[5] Kava contains compounds known as kavalactones, they're responsible for its psychoactive qualities. In the brain, they operate on non-opiate pathways to offer a natural and non-narcotic action against anxiety.[6] Some clinical research even suggests that they're as good or even better than pharmaceutical drugs like benzodiazepines.[7]
According to Duke University Medical Center, kava is beneficial for anxiety and doesn't produce dependency or negatively affect heart rate, blood pressure, or sexual function.[8] In a 75-participant, 6-week, double-blind trial conducted by the University of Melbourne Department of Psychiatry, kava was found to reduce anxiety and, aside from a few reported instances of headache, was well tolerated.[9] It's even been described as a promising candidate for future research into improving attention disorders.[10]
3. Kava Lessens Menopausal Mood Swings
For many women (and men), menopause is a time when hormone levels go haywire and lead to mood swings. Although hormone replacement therapy and mind medicines are frequently used, many women prefer natural therapies. In this regard, menopausal women may find kava to be an excellent option. It is known to help psychological status without affecting the therapeutic action of estrogen – this is especially important when osteoporosis and cardiovascular disease are a concern.[11, 12]
In 2003, a clinical study reported that kava encouraged a healthier, pleasant mood among menopausal women.[13] Coincidentally, or perhaps not, research conducted earlier this year also found that kava significantly increases libido in women.[14]
4. There Are Questions Surrounding Kava & Liver Health
If you start researching kava, warnings about liver damage are the first you'll discover. This is a subject with much contention. While some suggest it is toxic to the liver, most research indicates there is little evidence to support this notion.[15, 16, 17] Both Ohio State University and the South Dakota State University College of Pharmacy conducted animal studies and found that not only was kava non-toxic to the liver, but may even protect the liver.[18, 19] One of the primary arguments is that liver damage from kava is unpredictable, dose-independent, and not reproducible; thus individual metabolic differences are more likely.[20]
5. Kava Might Turn You Into a Fish
Well, not really, but one noted side effect of long-term, heavy, consistent consumption of kava is the development of a scaly skin rash known as dermopathy. There are several hypotheses concerning its cause. Some speculate it may be the result of interference with cholesterol metabolism.[21] Niacin deficiency, which can cause skin changes, has also been examined but cleared as a potential cause.[22] Another idea is that certain metabolites bind to skin proteins and cause an immune response.[23] Regardless, it's often only associated with heavy, prolonged use and is reversible when consumption stops.[24]
6. Kava Is Used as Therapeutic Support for Addiction
Substance abuse is a large and expensive concern in the United States and the chemistry of craving has become a focus within addiction research. Within this realm, kava may have significant value. Kava contains compounds known as kavapyrones that bind to brain locations associated with addiction and cravings. Although preliminary and exploratory, some clinical studies have shown that kava may be able to reduce drug cravings. Hopefully, future investigations will continue to examine these potential benefits![25]
7. Kava Shouldn't Be Mixed With Prescription Drugs
This isn't exclusive to kava, it applies to all herbal therapies. Your body is an ongoing chemistry experiment, and everything you consume can affect it. The metabolizing enzymes that process food and nutritional supplements are the same that metabolize prescription drugs and interactions can occur. If you're taking prescriptions, talk to your prescribing doctor before starting supplemental therapies, including kava.[26]
The South Dakota State University College of Pharmacy warns that kavalactones inhibit several enzymes and block certain receptors and uptake channels. While this is not inherently a concern, it can be if taken with drugs that are metabolized by those enzymes or have similar pharmacological properties.[27]
8. You Should Think Twice About Concentrated Extracts
As explained before, traditional kava preparation involves extracting the active compounds with water; it's very similar to making tea. Some companies, however, have taken the chemistry a step further and offer concentrated extracts that are produced using harsh solvents such as acetone or methanol. Although some studies suggest that extracts are mostly void of toxic effects, others have raised the idea that perhaps extracts are what cause liver damage.[28] Solvents may react with kava to produce harmful, reactive metabolites.[23] Additionally, not only does water extract the kavalactones, but it also extracts glutathione – a compound that promotes liver health.[29] Besides, water is the traditional preparation medium and it's more efficient at extracting the beneficial kavalactones.[30]
9. Some Folks Are Tarnishing Kava's Image
Unfortunately, there is always a seedy side of society that has to pervert the holistic use of herbs like kava. It can't just be left alone and appreciated in its traditional form – some unscrupulous dregs always have to gunk it up. For example, the University of California San Francisco School of Pharmacy discovered a number of questionable online merchants whose marketing efforts have completely discarded the traditional attitudes regarding kava and simply promote it as a "legal alternative" to illegal drugs.[31] Certain brands of "herbal ecstasy" have included kava in the formula.[32] More recently, the antithesis to energy drinks, known as "relaxation drinks" have become available. They contain ingredients such as melatonin, valerian, kava, and tryptophan, which is fine except that they're lamely advertised as smooth, cool sedatives in a can.[33] To really top off the ridiculousness, some "bust enhancing" products even contain kava! (In case you're wondering, they don't work.)[34]
10. Avoid Driving When Enjoying Kava
Concerns have been raised over the effect of sedatives – prescription and herbal – on driving ability. It's a valid concern, safety is extremely important and kava does elicit a certain physically tranquilizing effect. To assess the situation, researchers at the University of Melbourne conducted a driving simulation experiment with 22 adults who were given a "small" serving of kava. Although no impairing effects were observed, researchers cautioned that "small" is relative and the conclusion was, by no means, conclusive; additional research is required before an all-out safety rating can be assessed. The best idea? Play it safe, if you're going to enjoy kava, don't drive.[35]
Supplementing With Kava
References (35)
- Shimoda LM, et al. Pacific island 'Awa (Kava) extracts, but not isolated kavalactones, promote proinflammatory responses in model mast cells. Phytother Res. 2012 Dec;26(12):1934-41. doi: 10.1002/ptr.4652. Epub 2012 Apr 4.
- O'Sullivan HM, Lum K. The poisoning of 'awa: the non-traditional use of an ancient remedy. Pac Health Dialog. 2004 Sep;11(2):211-5.
- Baker JD. Tradition and toxicity: evidential cultures in the kava safety debate. Soc Stud Sci. 2011 Jun;41(3):361-84.
- Stacy S. Relaxation drinks and their use in adolescents. J Child Adolesc Psychopharmacol. 2011 Dec;21(6):605-10. doi: 10.1089/cap.2011.0026. Epub 2011 Dec 2.
- Larzelere MM, et al. Complementary and alternative medicine usage for behavioral health indications. Prim Care. 2010 Jun;37(2):213-36. doi: 10.1016/j.pop.2010.02.002.
- Sarris J, et al. Kava: a comprehensive review of efficacy, safety, and psychopharmacology. Aust N Z J Psychiatry. 2011 Jan;45(1):27-35. doi: 10.3109/00048674.2010.522554. Epub 2010 Nov 15.
- [No authors listed] Piper methysticum (kava kava). Altern Med Rev. 1998 Dec;3(6):458-60.
- Connor KM, et al. Adverse-effect profile of kava. CNS Spectr. 2001 Oct;6(10):848, 850-3.
- Sarris J, et al. Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol. 2013 Oct;33(5):643-8. doi: 10.1097/JCP.0b013e318291be67.
- Sarris J, et al. Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): a systematic review of the evidence. Complement Ther Med. 2011 Aug;19(4):216-27. doi: 10.1016/j.ctim.2011.06.007. Epub 2011 Jul 26.
- Geller SE, Studee L. Botanical and dietary supplements for mood and anxiety in menopausal women. Menopause. 2007 May-Jun;14(3 Pt 1):541-9.
- De Leo V, et al. [Assessment of the association of Kava-Kava extract and hormone replacement therapy in the treatment of postmenopause anxiety]. Minerva Ginecol. 2000 Jun;52(6):263-7.
- Cagnacci A, et al. Kava-Kava administration reduces anxiety in perimenopausal women. Maturitas. 2003 Feb 25;44(2):103-9.
- Sarris J, et al. Kava for the Treatment of Generalized Anxiety Disorder RCT: Analysis of Adverse Reactions, Liver Function, Addiction, and Sexual Effects. Phytother Res. 2013 Nov;27(11):1723-8. doi: 10.1002/ptr.4916. Epub 2013 Jan 24.
- Rowe A, Ramzan I. Are mould hepatotoxins responsible for kava hepatotoxicity? Phytother Res. 2012 Nov;26(11):1768-70. doi: 10.1002/ptr.4620. Epub 2012 Feb 8.
- Teschke R, Lebot V. Proposal for a kava quality standardization code. Food Chem Toxicol. 2011 Oct;49(10):2503-16. doi: 10.1016/j.fct.2011.06.075. Epub 2011 Jul 3.
- Grace RF. Kava drinking in Vanuatu--a hospital based survey. Pac Health Dialog. 2003 Sep;10(2):41-4.
- Singh YN, Devkota AK. Aqueous kava extracts do not affect liver function tests in rats. Planta Med. 2003 Jun;69(6):496-9.
- DiSilvestro RA, et al. Kava feeding in rats does not cause liver injury nor enhance galactosamine-induced hepatitis. Food Chem Toxicol. 2007 Jul;45(7):1293-300. Epub 2007 Jan 26.
- Teschke R, et al. Contaminant hepatotoxins as culprits for kava hepatotoxicity--fact or fiction? Phytother Res. 2013 Mar;27(3):472-4. doi: 10.1002/ptr.4729. Epub 2012 May 14.
- Norton SA, Ruze P. Kava dermopathy. J Am Acad Dermatol. 1994 Jul;31(1):89-97.
- Ruze P. Kava-induced dermopathy: a niacin deficiency? Lancet. 1990 Jun 16;335(8703):1442-5.
- Olsen LR, et al. Constituents in kava extracts potentially involved in hepatotoxicity: a review. Chem Res Toxicol. 2011 Jul 18;24(7):992-1002. doi: 10.1021/tx100412m. Epub 2011 May 3.
- Gounder R. Kava consumption and its health effects. Pac Health Dialog. 2006 Sep;13(2):131-5.
- Steiner GG. Kava as an anticraving agent: preliminary data. Pac Health Dialog. 2001 Sep;8(2):335-9.
- Bressler R. Herb-drug interactions: interactions between kava and prescription medications. Geriatrics. 2005 Sep;60(9):24-5.
- Singh YN. Potential for interaction of kava and St. John's wort with drugs. J Ethnopharmacol. 2005 Aug 22;100(1-2):108-13.
- Teschke R, et al. Kava extracts: safety and risks including rare hepatotoxicity. Phytomedicine. 2003;10(5):440-6.
- Whitton PA, et al. Kava lactones and the kava-kava controversy. Phytochemistry. 2003 Oct;64(3):673-9.
- Kubátová A, et al. Comparison of subcritical water and organic solvents for extracting kava lactones from kava root. J Chromatogr A. 2001 Jul 20;923(1-2):187-94.
- Dennehy CE, et al. Evaluation of herbal dietary supplements marketed on the internet for recreational use. Ann Pharmacother. 2005 Oct;39(10):1634-9. Epub 2005 Sep 13.
- Yates KM, et al. "Herbal Ecstasy": a case series of adverse reactions. N Z Med J. 2000 Jul 28;113(1114):315-7.
- Stacy S. Relaxation drinks and their use in adolescents. J Child Adolesc Psychopharmacol. 2011 Dec;21(6):605-10. doi: 10.1089/cap.2011.0026. Epub 2011 Dec 2.
- Fugh-Berman A. "Bust enhancing" herbal products. Obstet Gynecol. 2003 Jun;101(6):1345-9.
- Sarris J, et al. Does a medicinal dose of kava impair driving? A randomized, placebo-controlled, double-blind study. Traffic Inj Prev. 2013;14(1):13-7. doi: 10.1080/15389588.2012.682233.
†Results may vary. Information and statements made are for education purposes and are not intended to replace the advice of your doctor. If you have a severe medical condition or health concern, see your physician.
Dr. Edward Group, DC
FOUNDER | HEALER | ADVOCATEDr. Group, DC is a healer and alternative health advocate, and an industry leader and innovator in the field of natural health who is dedicated to helping others. He is a registered doctor of chiropractic (DC), a naturopathic practitioner (NP), and proud alum of Harvard Business School and MIT Sloan School of Management. Dr. Group, DC is the founder of Global Healing – a mission and vision he has shared through best-selling books and frequent media appearances. He aims to spread his message of positivity, hope, and wellness throughout the world.