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kava kava

piper methysticum

 

Kava falls into a class uniquely its own. I know of no other herb like it (nothing I've ever come across could even remotely qualify as a "substitute" for kava), and consider it one of the nature's most exquisite gifts.  Though it’s gained (and lost) immense popularity over the last several years (both lauded as "nature's miracle cure for stress and anxiety" and defamed as hepatotoxic), I've always found myself disdainful of the marketing used to sell it to the public.  While kava kava doubtless holds immense power for relieving stress and tension, its ongoing daily use as a "supplement" has never sat well with me.  I've always felt kava is best enjoyed intentionally, and not as just a part of a daily supplement routine.

Kava is, in my opinion, primarily suited to treating acute stress that settles into the musculature of the body. It is most effective when your mind is overwhelmed and your body is tightly strung from a crazy hectic day and that's what's making you unable to relax.

The best way I can describe the effects of kava kava is to compare it to lying on a sunny beach with nothing pressing to do or think about and being so laid back it feels as if you've sunk halfway into the sand.  Kava puts you there.  What is so distinct about kava kava is that it's so promptly and significantly relaxant; mental stress subsides as a result of relaxation, not sedation.  In fact, while the body lets go, mental acuity remains...you can definitely take kava and still be cognitively functional. This is, however, dose dependent... small doses of kava relax the body and notably clear the mind, medium doses calm the mind and have a much more pronounced relaxant action on the muscles, and large doses still the mind and make the limbs a bit wobbly.  Think of kava after a crazy day at work, traffic all the way home with honking horns, people cutting you off, and an inability to physically let go when you do finally get home (with every bit of your body screaming Yikes!”). It is a perfect replacement for (and a much better option to) the archetypal "after work drink". Kava kava puts the body at peace.

Kava is native to the islands of the South Pacific; Fiji, Hawaii, Vanuatu are all know for their excellent kava kava.  Studying island traditions surrounding the plant reinforce the notion of kava's ability to induce a peaceful spirit.  Kava is regarded as sacred throughout its range, but, for the most part, its use is not solely relegated to ceremony; it has a strong tradition as a recreational beverage consumed freely at social gatherings, where those under the enchantment of kava converse and share their thoughts and stories. Traditionally, kava is given to feuding parties before they talk, in order to diffuse pre-existing hostility.  This use was not solely reserved for the cessation of wars between different island cultures, but was also invoked when spousal or community conflicts had everyone involved all angst ridden to the point where it became difficult to resolve anything.  Kava helps to diffuse the underlying  "Err!" so that feuding parties can come together without being primed for conflict.  Think of it in situations where your approach to settle a dispute involves making it clear that they're wrong and you're right.  It is said that "hate cannot exist in the presence of kava". While this may be an ideological overstatement, kava is clearly a plant of friendship and camaraderie.

So, although it is currently touted as an anti-anxiety herb (which it is), I don't think of kava as an herb to be taken in rote daily doses for chronic anxiety.  Maybe short term, but it’s best, I believe, when taken purposefully because you like and want some (or need some… kava can be helpful in quitting tobacco or other vices), rather than as a "daily supplement" because you are tense all the time.  The problem with using kava on a regular basis is that it is strong, and can become escapist, or used as a crutch. Rather than make changes to address underlying issues that are creating stress and tension, you let the kava melt it away.  One example of this could perhaps be using kava to relax tension and spasms due to magnesium deficiency; it's strong enough to work, but it won't resolve the underlying deficiency.  So, use kava, but also look into underlying issues and be sure to address those in addition to using kava for more immediate relief.

Kava is a member of the pepper family, so, as can be expected, it has a strong and penetrating taste.  It is peppery, bitter-spicy, tingly and numbing (I've sometimes said it tastes like spicy, soapy dirt), and within a minute of taking a kava extract or tea, the mouth will become tingly, then numb.  Though at first not savory, the taste isn't especially bad (you might even get to like it), and (if you don't) the numbing effect makes it tolerable, as you can't taste it within a minute anyway. 

 

But we'd be remiss to neglect (as is so often done) some of the other things kava is exceptional at addressing...

 

In eclectic medicine, kava was extolled as a reliever of pain, inflammation, tension and spasm in the urinary tract.  Kava is also among the herbs I've seen recommended for interstitial cystitis, with some extolling its virtues, though 7Song has told me that he's seen aggravations caused by it (aggravations being not uncommon in interstitial cystitis).  Eclectics recommended it highly for enuresis, King's stating "It is a remedy for nocturnal incontinence of urine in the young and old, when due most largely to muscular weakness."  Interestingly, many eclectic accounts specifically mention its use for weakness and laxity of urinary tissues, despite its rather marked relaxant effects.  Also indicated for pyuria (mucous/pus in the urine), these uses all suggest an astringency not so strongly noted outside the urinary tract. 

 

Cherokee herbalist David Winston uses kava for fibromyalgia, often combining it with ashwagandha and black cohosh tinctures.  Ellingwood reported of its use in rheumatism, combined with black cohosh as well.  Facial, dental and other neuralgias are another indication.  I've also used it for toothaches.  Pain with restlessness and anxiety is a specific indication.

 

I've heard debate about whether or not kava might be considered an "aphrodisiac".  That is a problematic term, at best, but I can say that if sex, or interest in sex, is inhibited by anxiety and muscle tension, kava could certainly be helpful.  Its spicy flavor also indicates that it stimulates peripheral circulation, which can also be helpful.  So, for cool, tense, anxious people, sounds good.  People already sufficiently mellow have claimed it "puts them to sleep."

 

Ellingwood wrote of its topical use, the tincture diluted either with water of glycerin (1 part kava tincture, 2 parts glycerin), for pruritis of the vulva and anus (my suspicion here is that its acting both by numbing the affected area and also as an antifungal, yeast killer, which would make it useful for itching associated with candida rashes.  I've seen cases people have tried this with extremely impressive results.

 

(I feel obligated, here, to acknowledge that yes, I did tell these women that applying kava tincture - even diluted - in such locales would very likely hurt like hell.  Of course, any alcohol would, but alcohol impregnated with hot spicy kava?  Pretty much everyone agreed, after the fact, that indeed it did.  One woman said that it made her gain a new appreciation for the numbness that sets in shortly after taking it, which, taken orally, she'd never really liked.  So far, no one who's tried it has had anything less than very impressive results.  But, that's not a whole lot of people (it's a bit of a hard sell), though a couple have said that it work so much better than anything else they'd tried that it was worth the momentary agony.  Probably, I'm gonna make up some suppositories with kava infused in coconut oil, which should extract the kava well, but eliminate the YEEOOOWWW!!! of the alcohol.

 

The Physio-Medicalists shunned kava, William Cook wrote in his Compend of the New Materia Medica that "The toxic power of kava kava is pronounced, and it begets a form of drowsy intoxication, for which the natives of New Zealand and other isles use it, and Europeans follow their example. When first taken it produces a burning sensation and an increased flow of saliva and urine, followed by numbness that is marked and a depression of all the functions. It causes complete loss of sensibility in the mouth, throat, eye and other parts to which it may be applied; and constitutionally it produces general insensibility, diminishes and finally destroys reflex action, and causes death by paralysis. It first excites and then reduces the heart action; first stimulates and then diminishes respiration, and ends by paralyzing this function. Its principal effect is upon the spinal cord, and with this the sensory nerves. Any relief it gives is the relief of sensory paralysis."

 

I love you, William Cook, but think your admirable insight missed the mark here.  Evidently T. J. Lyle agreed with me; as he deemed kava "a stimulating and relaxing diuretic, tonic, alterant and nervine."
 

preparations: Personally, chewing small pieces of the root has come to be my favorite way to use it, though admittedly some don't share my appreciation for its flavor.  There are also some rather strong fibers in the root that require spitting out, as they don't break down much as the root does.  Tinctures are extremely useful and effective, and convey kava's virtues quite well.  If using dried root, 65% - 75% alcohol seems best to me; for fresh I use pure 95% grain alcohol.   A steeped tea made with water can be somewhat effective, but doesn't extract the root well.  Decocting the root can help, though this isn't how I generally make water based preparations (and a coconut milk decoction would be superior to water anyway).  I've always considered capsules to be comparatively lousy, though I have met some people who felt they were helpful.  

 

A good recipe for a more traditional kava drink is to take a half ounce of ground kava, 2 tablespoons of cream or coconut milk and whisk it up in ¼ cup of water for a minute or two. Strain the mixture through a loose weave strainer (the "pulp" should get into your drink) and squeeze out the wet herb. Add another ¼ cup of water to the kava pulp, whisk up, and strain again, squeezing as much liquid from the kava pulp as possible.  Or you could put about 3 ounces of powdered kava in a loose weave bag (I use a hop bag like they use in homebrewing), and knead that well in about 3 cups of coconut milk and water.  For an extra kick, add a squirt or two of kava tincture per cup. This makes one rather muddy looking, very potent serving. A very authentic traditional recipe involves chewing up a lot of fresh kava kava root, spitting the masticated pulp out into a bowl with a little water, letting it steep a bit, then straining and drinking (sounds real appetizing, eh?).  Actually, this method is the best way I know of to prepare it, though it requires fresh kava root.  I've tried it and loved it; it was the best kava I ever had… though it does make it a difficult thing to offer visiting friends and family... "Oh, hi!  I just chewed up some kava, would you like some?"

 

I also need to wholeheartedly extol the virtues of infused kava oil.  Take roots ground to a coarse powder, and cover them in oil (I don't generally weight or measure for oils, so just eyeball it).  Olive oil is of course OK, but a nice massage blend is 3 parts almond oil and 1 part sesame oil.  I infuse the oil for days; even a week.  It should darken and smell rich and earthy.  Apply liberally.  It's really just flat out incredible.  Credit goes to Rob Montgomery, who was the original purveyor of the cool stuff offered through the Botanical Preservation Corps.  Kava oil really relaxes muscles; its very nice for a massage... kind of takes the fight out of them whenh they just don't want to let go.  But its even better as a daily application if you know you chronically hold muscle tension in an area.  Tight neck and upper shoulders every day?  Apply some kava oil, every day.  Recognize the pattern.  Break the pattern.


considerations and contraindications:  On the whole, don’t use during pregnancy. Don't drive or operate dangerous stuff if you are oversedated by Kava; coordination is markedly impaired at high dosages. This needn’t be limited to “heavy machinery”, a skateboard could be problematic as well. Be responsible, start at low doses and get a feel for how you react to it… some people seem to be especially sensitive to kava and so a little goes a long way.  Also, different kavas can differ in their effect, with some being more mood modifying, while others are more powerful relaxant to the body.  Don't mix with alcohol or other drugs.  Using a lot of kava too often can dry out the skin and induce severe dermatitis; this will go away after kava abuse is stopped. You'd probably have to go way overboard for this to be a concern, though if you already had psoriasis or eczema, you’d be more susceptible to this side effect.

A few years ago, kava was in the news, associated with serious liver disease, failure and even fatalities, and now information on kava is often accompanied by warnings about liver problems. This has had most herbalists rather confused, as the herb has a long history of safe usage with no serious complications. As more was learned about the nature of the "adverse event reports", it became clear than in several of the incidences, alcohol and other drugs (both pharmaceutical and recreational) played a role, and many herbalists based their defense of kava on the known hepatotoxic actions of these other substances. Still, such severe side effects and fatalities are nothing to be shrugged at, and shouldn't be dismissed too readily just because you like an herb.

 

It now appears that the cause was threefold:

 

First (and this is perhaps the main cause), kava leaves and stems were used instead of or in addition to the root, and these parts of the plant contain a liver toxic alkaloid, pipermethystine, not present in the roots. This alkaloid "significantly decreased cellular ATP levels, mitochondrial membrane potential, and induced apoptosis as measured by the release of caspase-3 after 24 h of treatment. These observations suggest that PM, rather than kavalactones, is capable of causing cell death, probably in part by disrupting mitochondrial function  (see more)." In studies comparing the effect of pipermethystine to various kavalactones , toxicity was readily observed in the former, but not the latter. So, basically, big supplements companies were trying to make more money by using the less expensive, discarded leaves and stems, even though traditional south pacific cultures uniformly express that only the root is fit for use.  I know kava growers and distributors who have confirmed that companies were trying to buy these plant parts.  In light of this, declaring kava kava (the plant as a whole) to be toxic would be just like declaring rhubarb (the plant as a whole) to be toxic, rather that recognizing that the roots and leaves of rhubarb are toxic, but the stems aren't in any way.

 

Second, there may be a problem with the highly concentrated Kava extracts being marketed nowadays. Standardized extracts are sometimes up to 80% kavalactones... imagine what would happen if you were to standardize an orange to 80% vitamin C: It would no longer really be an orange.  The unnatural concentration of one major constituent or group of constituents may present dangers or side effects not found in the plant in its natural state.  I also believe that the process that concentrates the kavalactones in a preparation also concentrates the liver toxic alkaloid found in leaves and stem peelings... I'll have to re-find the source that stated that to post a reference. 

 

Third, European extracts use toxic solvents like hexane and acetone. These can cause serious problems if not entirely removed from the product after extraction. Also, they are entirely outside of the scope of what we know about traditional preparations, which would include those used for hundreds of years in the south pacific, and the alcohol based extracts used by the Eclectics in 19th century American herbalism, and so have no history of safe usage.  You can't make claims about the safe historical usage of a plant and apply it to weird, modern, solvent laden extractions that have never been used before. 

 

Other possibilities have also been explored.  It is possible that roots may have become moldy at some point in the processing (this is far more likely when dealing with the large quantities of roots needed for commercial preparations), resulting in contamination by mycotoxins. Even in smaller quantities (a few pounds) mold on the fresh roots can be common if shipping takes too long (which requires those of us far away from the east coast to splurge on overnight shipping, though I've had kava arrive fine in 2-3 days).  Another theory is that the use of "non-noble" kavas ("noble" kava implies a tried and true time tested strain) may possess constituents that were bred out of noble varieties.     

 

So, stick to real, kava kava root and rhizomes, or herbal extracts that you know are made from these.  If you don't make your own (which would be a shame), HerbPharm's is quite good and readily available.  While I have no fears whatsoever about kava kava, it’s up to each individual to decide for themselves what they feel comfortable with.
 

 

additional links...

Kava and the Risk of Liver Toxicity:Past, Current, and Future (rolf teschke, md)

Herbal hepatotoxicity by kava: Update on pipermethystine, flavokavain B,and mould hepatotoxins as primarily assumed culprits (teschkea, qiub, lebot

W.H.O. Says Kava is Safe! (Kona Kava Farm)
W.H.O. Says Kava is Safe, Australia Bans It  (Kona Kava Farm)
More Evidence Against Liver Toxicity!  (Kona Kava Farm)
Update on the Alleged Liver Toxicity of Kava  (HerbPharm)

Kava-Kava doesn't seem to be liver-toxic at all (guido mase)

Safety of ethanolic kava extract: Results of a study of chronic toxicity in rats

Effects of kava alkaloid, pipermethystine, and kavalactones on oxidative stress and cytochrome P450 in F-344 rats

In Vitro Toxicity of Kava Alkaloid, Pipermethystine,in HepG2 Cells as Compared to Kavalactones

Kava Kava (wikipedia)

Kava lactones & the kava-kava controversy (***note that this appears to have been written before the understanding of adulteration of kava root with leaves/stems)

Kava Kava in King's American Dispensatory (Felter & Llyod)
Kava Kava in American Materia Medica (Finley Ellingwood)
Properties and Uses of Piper Methysticum (John King)
Kava Kava in Boericke's Homeoapthic Materia Medica

The Herbalist's Path: Purple Moi Kava Kava (angie goodloe)
The Herbalist's Path: Kava Kava Massage Oil (angie goodloe)


I have, for many years now, gotten my kava from Rebecca and John Fowler at Nuka Hiva Trading Company, and recommend them wholeheartedly.

 

© jim mcdonald

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