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Kava: More than just a ceremonial drink! - About Health | Blog
If you’ve ever visited one of our neighbouring Pacific Island nations, you possibly have seen, or even taken part in a traditional kava ceremony. The drink is prepared using the root and rhizome of Piper methysticum (kava) which is ground into a paste and then mixed with water. It has a somewhat muddy appearance and a bitter, earthy taste. Observed and noted by Captain James Cook during his South Seas travels in 1768, kava has been used for centuries to induce a pleasant mental state, reduce anxiety and to promote socializing – hence it makes a wonderful ceremonial drink. Western herbal medicine has observed the benefits of the traditional use of kava and then started researching it with clinical trials to try to understand just how it generates these benefits.
The main benefits found so far are for our central nervous system (CNS), kava influences our neurotransmitters with the most studied benefit being the reduction of anxiety. Some parts of kava can cause sedation, hence some people may ingest kava to help with sleep. It is thought to be the resins in kava that are most responsible for this action. The kava-lactones when isolated, did not show this same sedative effect. Kava-lactones can relax muscles, reduce pain (act as an analgesic), and help with sleep. As with many plant based medicines, it is important to have the whole plant available, not just singular components extracted. This is true too of kava-lactones. While they are the most studied component of kava, they are better absorbed and utilized by the body in the presence of other compounds from the plant. Any kava supplement should contain the whole plant, though it is common for the kava-lactones to be measured and standardized, this is the part of the plant with the scientific evidence and you want a product with the right dose in order to be effective.
If we delve into the science for a moment, there is clear evidence of the dosage range needed to achieve the best benefit for general anxiety – or to use the research term, GAD – generalized anxiety disorder. GAD is more than just feeling a little nervous, it is characterized by persistent and overpowering anxiety, though those with less severe anxiety certainly still benefit from the use of kava. The lowest dose found to be effective is 70mg of kavalactones per day – a good supplement should have a standardized level of kavalactones on the label, so look for one that is no less than 70mg per daily dose. Of course studies included use of kavalactones at higher doses with 240mg per day of kavalactones at the top of the range. Some studies even found kava (at the higher end of the dosing spectrum) to be as effective as benzodiazepines…..more about benzos in a moment.
At higher doses, generally when consumed as a beverage, kava can cause sedation. Interestingly, when taken as a carefully prepared herbal medicine and at the right dose, kava has the ability to enhance cognitive function whilst simultaneously calming anxiety. It is this unusual combination of benefits that can make kava fantastic for ‘situational anxiety’, a good example of this would be to use a carefully prescribed kava supplement prior to public speaking – if that is something that made you anxious. Specifically visual attention and short-term memory retrieval were found to improve with kava. Other studies did not find the cognitive enhancing benefits, but did find that there were no negative effects on brain function. Unlike pharmaceutical based anxiety medicines such as benzodiazepines that tend to impair cognitive performance.
While there have been concerns in the past about the safety of kava, most studies these days find that there are no significant safety concerns and most people tolerate kava supplements very well. There was some controversy in 2002 about kava supplements causing liver failure, but these findings have not been seen in studies, with some even specifically testing liver enzymes of patients to monitor liver health during the trials. After a brief period of many countries banning the sale of kava supplements, Australia and New Zealand allowed them back on the market with a cap on the kavalactone levels: 125mg per capsule with a recommended daily dose of no more than 250mg. To this day you may note quite a few cautions on kava products, as an industry, everyone is erring on the side of caution, however, the most common adverse effects (seen in 1.5% - 2.3% of test subjects) are gastrointestinal upset and headaches.
Let’s come back to benzodiazepines briefly. This class of prescription drug (commonly abbreviated to “benzos”) are psychoactive and depress or lower brain activity. Benzos are used to treat anxiety, insomnia, panic disorder and seizures. By 1977 they were the most prescribed medications globally. They are still popular today, but no longer hold that title. While benzos help in the short term for the conditions they’re prescribed for, they have an ugly side; they can worsen agitation, panic and aggression when withdrawn and even increase the risk of suicide. Cognitive function is negatively affected by the use of benzos and they can also lead to dependency (addiction).
Now if you need benzodiazepines to get you through a tight spot, then there is no shame in that. Given the risk of adverse effects they really are best used only short term. Natural supplements like kava and other anxiolytics are certainly worth investigating, not only do they carry a much better safety profile including not being physically addictive, but they are also still very effective. Be sure to also work with a professional to get to the cause of your feelings of anxiety, eat well and exercise regularly to give your body and mind the holistic support needed to keep in the best state of mind possible.
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