Kava Toxicity - All One Need to Know

What Is Kava Kava?

Kava Kava belongs to the pepper family and is found native to the islands of the western Pacific. It has been used as a ceremonial drink in the region for years. The root is made into pulp or chewed and mixed with water. It has also been used in rituals and as a medicine. Apart from ceremonial benefits, it has relaxing effects like mood elevation and promotes contentment and well-being. Certain studies have found kava beneficial in treating insomnia, anxiety, and certain nervous disorders.

Kava is a shrub that produces large, heart-shaped green leaves that grow thickly on the branches. The long and slender flowers develop where the stems and branches meet. The roots are like hairy and woody branches and are the part which is used medicinally. It has different names in different regions.

These are:

• Grog.

• Awa.

• Malak.

• Kawa.

• Lewena.

• Kavain.

• Yaqona. (in Fiji)

• Wati.

The main ingredient in the root of Kava is kavalactones. These include chemicals like methysticum, kawain, etc., which have been studied in animal and laboratory studies. These studies suggest kava helps promote sleep, reduce convulsions, and muscle relaxation. In some parts of the world, the kava root as such is chewed for medicinal benefits. In certain other parts, it may be available in capsule, tablet, or liquid forms or as standardized extracts.

What Are the Uses?

Studies suggest that kava is beneficial in the following conditions:

Insomnia:

Studies suggest that kava improves sleep quality and lowers the time needed to fall asleep. Due to its side effects and the availability of other herbs for treating insomnia, kava is not the treatment choice.

Anxiety:

Studies suggest that kava is effective in treating anxiety symptoms. Research studies suggest kava is more beneficial in treating anxiety symptoms than placebo. Some studies even suggest it to be as helpful as some prescription medications. Another study suggested similar brain wave activity with kava and diazepam. Research studies on kava have decreased due to reported liver toxicity. A 2004 study suggests that 300 milligrams of kava improve cognitive performance and mood. This study is clinically relevant as some prescription medications like benzodiazepine lower cognitive function.

What Are the Effects of Kava on the Body?

The strength of the kavalactones, the active ingredient of kava, varies with growing conditions like soil type, water availability, sunlight, etc.The dose strength also depends on the method of [preparation and the amount of water added. Kava is a depressant that acts on the central nervous system. It can produce symptoms similar to alcohol drunkenness, like slurred speech and difficulty balancing.

The effect of kava on the body depends on:

• General health.

• Body size.

• Amount taken.

• Dose strength.

• Other drugs (can cause drug interactions).

Small doses produce the following effects:

• Muscle relaxation.

• A feeling of well-being.

• Sleepiness.

• Loss of appetite.

• Numbness in the mouth and throat.

Large doses produce the following effects:

• Nausea.

• Red eyes.

• Drowsiness.

• Dilated pupil.

• Reduced muscle control.

• Mild fever.

• Stomach upsets.

Problems linked with the long-term use of kava are:

• Liver damage.

• Kidney damage.

• Breathing difficulties.

• Impaired immune function.

• Loss of motivation.

• Kava dermopathy is characterized by dry, flaky, and scaly yellowish discolored skin.

• Photophobia or sensitivity to light.

• Loss of appetite leads to malnutrition and weight loss.

• Worsening of symptoms of pre-existing mental illness like schizophrenia.

• Mild alterations in blood cells.

• Hair loss or alopecia.

• Partial loss of hearing.

What Are the Possible Drug Interactions?

Kava should not be taken with over-the-counter medications or prescription medications. It should only be accepted if one is under the supervision of a physician.

The following are the possible drug interactions:

• Alcohol - Kava should not be consumed with alcohol as it can increase the chance of liver damage and impairment.

• Diuretics - these are medications that reduce fluid buildup in the body. When taken with diuretics, kava can increase the chances of dehydration.

• Levodopa - it is a medication used for the management of Parkinson’s disease. Interaction with kava is reported to reduce the effectiveness of levodopa.

• Anticonvulsants - Kava may increase the effects of anticonvulsant medications like phenytoin.

• Antianxiety Agents - Kava increases the effects of CNS depressants like benzodiazepine. Benzodiazepines include diazepam, lorazepam, Alprazolam, Triazolam, etc. Benzodiazepines are used for treating anxiety and sleep disturbances.

• Phenothiazine Medications - Kava increases the risk associated with phenothiazine medications like promethazine and chlorpromazine.

• Medications Metabolized by the Liver - As kava causes liver damage, it affects medications metabolized by the liver.

What Are the Contraindications?

Kava is contraindicated in:

• Breastfeeding.

• Pregnancy.

• Children.

• Alcoholics.

• Those taking psychoactive drugs or any prescription drugs.

• Pre-existing lung, liver, or heart disease.

• Patients who undergo surgery, such as kava, may prolong anesthesia effects.

• Those having blood disorders.

• Those having Parkinson’s disease.

What Are the Precautions?

Herbs have been used for a long time for treating various ailments and for strengthening the body. However, it should be noted that these herbs contain components that can trigger adverse effects and can interact with other herbs, medicines or supplements. Therefore, any herbs, including kava, should only be taken under the supervision of a healthcare provider who is also an expert in botanical medicine.

There have been reports in Europe and the United States about kava being associated with liver damage. Liver-related injuries like hepatitis, liver failure, cirrhosis, and even death were reported. But there are many uncertainties related to kava, like the dose that produces liver damage in one may not affect another.

• Avoid taking kava if one is planning to use machinery or drive.

• Avoid kava in all the contraindicated cases, like pregnancy, children, breastfeeding, liver disease, etc.

• Take regular breaks from kava use.

• Seek immediate medical attention if one experiences the following symptoms with kava use:

• Extreme tiredness.

• Abdominal pain.

• Raised body temperatture.

• Unusual bruises.

• Skin discoloration.

• Brown colored urine.

Conclusion

Kava has been used for years for treating various ailments like insomnia, anxiety, etc. There have been cases of liver injury and other side effects associated with kava. Therefore, it should only be taken under the supervision of a qualified physician with expertise in botanical medicine. Though it is reported to produce effects similar to alcohol, it does not have withdrawal symptoms or dependence.