Clayton's Health Facts: Kava Kava.

Clayton South, SPN (ISSA), is a recognized expert in the bodybuilding / fitness industry with over 150 bodybuilding, fitness and nutrition publications to his credit.
1. What is it and where does it come from?

Kava Kava is a member of the pepper family and is Native to several pacific islands. The herb has been used widely for over 3,000 years by pacific native populations, and has become popular in Europe and North America.

Kava Kava (Piper methysticum) supplements are produced by using the underground stem of the plant, and the substance in Kava responsible for its effects are Kavalactones.

Kava is also known as: Malohu, maluk, meruk, milik, kew, Rauschpfeffer, sakau, tonga, Wurzelstock, yagona, yangona, yaqona, yongona, ava, ava pepper, ava root, awa, gea, gi, intoxicating pepper, intoxicating long pepper, kao, Piper methysticum, Macropiper, Latifolium, Piper inebrians, kava, kava kava, kava-kava, kava root, kava-kava root, kavain, kava pepper, kavapipar, kawa, kawa kawa, kawa pepper, kawapfeffer, maori kava and rhizoma di kava-kava.

It is important to note that Kava is produced according to certain standards. The standard of highest quality is WS 1490. Not all brand names may meet this standard. When purchasing Kava products, look for this certification.

2. What does it do and what scientific studies give evidence to support this?

Kava is a diverse substance and performs many physiological actions. Kava is best known for its ability to induce relaxation. Kavalactones (the active ingredient), induce physical and mental relaxation, and feelings of well being. These Kava induced feelings of well being and relaxation relax muscles, and help induce sleep.

It is also known to act as a diuretic and an anti-inflammatory, and evidence suggests that kava may be usefull for treating pain, as well as for treating menopause. 1,2

3. Who needs it and what are symptoms of deficiency?

Anyone in good health can benefit from supplementing with Kava. Because of its sedative properties, Kava is often used by persons suffering from anxiety3,4,5 and Menopause.

Bodybuilders may benefit from supplementing with Kava as it may offset overtraining. Bodybuilders using Kava should also supplement with Milk Thistle. Persons supplementing with Kava should be monitored by a qualified medical practitioner.

4. How much should be taken? Are there any side effects?

No rigid dosage procedures have yet been established, but it is recommended that dosage should not exceed 300mg daily.

Side effects of overdose can include: difficulties focusing and temporary dilation of the pupils, skin rashes, hypertension, reduced protein levels, blood cell abnormalities, liver damage, muscle weakness, visual impairment, dizziness and drying or a yellowing of the skin6. Persons experiencing these side effects should immediately discontinue the use of kava products. This product should not be used continuously for a period exceeding three months. 7

Because of its sedative effects kava should not be used by pregnant women or nursing women. Persons consuming alcohol should avoid Kava supplementation8 and, because of its sedative effect, Kava should not be consumed before driving or operating heavy machinery. 7

There have been safety concerns associated with Kava use. Because of a series of deaths linked with kava, German officials are considering banning the supplement9, although a study done on the cases in question showed that of the seventeen persons supplementing kava, five of those persons were shown to have no problems resulting from kava, while the other twelve cases were shown to be complicated by other factors ? thus calling kavas causational role into question. 10

In addition, four case reports linking kava products to liver toxcitity have appeared in scientific literature. 11,12,13It should be noted, however, that all of the case study subjects were also taking other medications that have been linked to liver damage. 15 Thus, no conclusions can be reasonably reached based on the four case studies cited. In the United Kingdom there have been three cases of liver toxicity suspected to be due to kava, but as of this time further data is needed. 16

Breaking research (resulting from unfounded claims that kava is harmfull) has determined that persons suffering side effects from kava (about two in thirty-six) have ?immunologically mediated idiosyncratic mechanisms? and that ?direct toxic mechanism is much less likely.? 17 This suggests that the problems experienced from kava use by a very small segment of the population is due to an immune system dysfunction rather than the kava itself.

Evidence shows that toxicity can be eliminated if the product is manufactured correctly. 18 Further research established that kava rarely causes liver injury. 19 A study done on rats showed that kava extracts had no effect on liver function and were not at all harmfull. 20

The breaking scientific evidence on this product shows that it is safe. Persons considering using kava as a supplement should consult with a physican prior to use.

5. Where can I get it?

There are many different brand names that manufacture supplemental kava.

REFERENCES

1. Huntley AL, Ernst E. A systematic review of herbal medicinal products for the treatment of menopausal symptoms. Menopause. 2003 Sep-Oct;10(5):465-76
2. Sun J. Morning/Evening menopausal formula relieves menopausal symptoms: a pilot study. J Altern Complement Med. 2003 Jun;9(3):403-9.
3. Piscopo G. Kava kava: Gift of the islands. Alt Med Rev 1997;2:355?81 [review].
4. Lehmann EE, Kinzler J, Friedmann J. Efficacy of a special kava extract (Piper methysticum) in patients with states of anxiety, tension and excitedness of non-mental origin. A double-blind placebo-controlled study of four weeks treatment. Phytomedicine 1996;3:113?9.
5. Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders. A randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry 1997;30:1?5.
6. Jappe U, Franke I, Reinhold D, Gollnick HPM. Sebotropic drug reaction resulting from kava-kava extract therapy: A new entity? J Amer Acad Dermatol 1998;38:104?6.
7. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 156?7.
8. Foo H, Lemon J. Acute effects of kava, alone or in combination with alcohol, on subjective measures of impairment and intoxication and on cognitive performance. Drug Alcohol Rev 1997;16:147?55.
9. Stafford, Ned. Germany may ban kava kava herbal supplement. Reuters, Nov. 19, 2001. http://www.reutershealth.com/frame2/eline.html
10. Russmann S, Barguil Y, Cabalion P, Kritsanida M, Duhet D, Lauterburg BH. Hepatic injury due to traditional aqueous extracts of kava root in New Caledonia. Eur J Gastroenterol Hepatol. 2003 Sep;15(9):1033-6.
11. Teschke R, Gaus W, Loew D. Kava extracts: safety and risks including rare hepatotoxicity. Phytomedicine. 2003;10(5):440-6.
12. Escher M, Desmeules J, Giostra E, Mentha G. Hepatitis associated with kava, a herbal remedy for anxiety. BMJ 2001;322:139.
13. Kraft M, Spahn TW, Menzel J, et al. Fulminant liver failure after administration of the herbal antidepressant Kava-Kava. Dtsch Med Wochenschr 2001;126:970?2 [in German].
14. Strahl S, Ehret V, Dahm HH, Maier KP. Necrotizing hepatitis after taking herbal remedies. Dtsch Med Wochenschr 1998;123:1410?4 [in German].
15. Russmann S, Lauterburg BH, Helbling A. Kava hepatotoxicity. Ann Intern Med 2001;135:68?9 [letter].
16. Information provided by the German Federal Institute for Drugs and Medical Devices.
17. Message from Professor A Breckenridge, Chairman, Committee on Safety of Medicines, July 18, 2002, http://www.mca.gov.uk/ourwork/monitorsafequalmed/ safetymessages/kavakava.pdf
18. Schulze J, Raasch W, Siegers CP. Toxicity of kava pyrones, drug safety and precautions--a case study. Phytomedicine. 2003;10 Suppl 4:68-73.
19. Whitton PA, Lau A, Salisbury A, Whitehouse J, Evans CS. Kava lactones and the kava-kava controversy. Phytochemistry. 2003 Oct;64(3):673-9.
20. Singh YN, Devkota AK. Aqueous kava extracts do not affect liver function tests in rats. Planta Med. 2003 Jun;69(6):496-9.