In 2015, the University of Hawai’i published a study reviewing kava’s benefits and discussing its toxicity claims. The review was done by researchers from both the Pacific Islands and Western countries to present different perspectives on the claims. These claims of kava toxicity come in response to increased bans and restrictions of kava in Europe in response to reported liver damage caused by kava, which has since been invalidated.
Traditional uses of kava and the changes in modern consumption
Traditionally, kava has been used socially for personal and community traditions in the Pacific islands. It’s prepared into a sort of tea using dried, ground powder from the kava roots submerged in water. This releases the kavalactones, which are the active ingredients of the kava. While the cultural practices and uses continue to evolve, there is a certain awareness and appreciation for the communal and traditional aspects of the drink. As use expands globally, other uses for kava emerge. While it continues to be drunk socially, its health benefits are also becoming well-known. It has been classified as a natural health product in the United States and other countries. Modern kava bars are gaining in popularity, changing how kava is consumed. While almost all kava is grown in the Pacific islands, global demand is adding pressure on local farmers, and adding kava supplements on the market may not be of high quality.
Recent progress in understanding kava toxicity
The study reviewed various studies in both clinical and experimental (animal) settings. The results varied, which could be due to confounding factors and the type of extract used in the study. There was a presented genetic component to the risk of kava toxicology, but more research is needed to understand this. Interaction with other compounds and medications seems to be the highest risk. Due to its calming effects on the brain, there is some concern about drug interactions with medications that work on the central nervous system (the brain and spinal cord). There is already an understanding of the negative effects of combining alcohol with kava. Another big concern is the cultivar and preparation. Traditionally, the kava drink is prepared using only the kava root. It’s been reported that using other parts of the plant (the leaves and stems) can contain less desired kavalactones, leading to negative effects and potential risk of kava toxicity.
The benefits of using kava
There is a long list of health benefits kava has been used for throughout history. In Pacific Island medicine, it’s been to help treat conditions like anxiety, stress, and depression, as well as urinary issues, menstrual problems and menopause symptoms, respiratory illnesses (e.g., asthma and Tuberculosis), gastrointestinal issues, and skin conditions. These traditional uses have indicated that kava cultivar, plant part, and preparation are important considerations in treatment. In Western cultures, kava has been mostly used to help treat stress and anxiety, sleep disorders, mild anxiety, and menopausal symptoms. There have even been clinical trials that show Kava is more effective than placebos in treating anxiety. Some studies have even shown anti-cancer effects, but more research is needed to understand this.
Conclusions of kava toxicity
Connecting Western and Pacific Island perspectives has given us a broad understanding of kava’s toxicity and benefits. The kava cultivar and extraction are key to consider, as they will impact the number and type of kavalactones present. Western kava use suggests toxicity is rare with very low incidence. Most studies that found a toxic effect of kava involved other medications or substances. In Pacific Island cultures, kava toxicity is unheard of, as no reported cases exist. There is a chance that this is due to underreporting or lack of public health data. There is the idea that kava has an “entourage” effect, suggesting there are compounds other than kavalactones that play a role in its poorly understood effects.
While traditional and cultural considerations of kava are important and relevant, Western cultures need to be mindful of how it’s prepared and the type of kava they are taking to reduce the chance of kava toxicity and ensure they have the best experience.
Link to original article:
Contemporary Pacific and Western perspectives on `awa (Piper methysticum) toxicology: https://pubmed.ncbi.nlm.nih.gov/25464054/
*Please note that the majority of kava research pertains to kava extracts, which often undergo significant processing and may contain additional ingredients and fillers that can influence their efficacy. It is crucial to consider this distinction when reading about kava studies. To draw an analogy, enjoying natural kava as a beverage can be likened to experiencing a freshly brewed cappuccino, whereas kava extracts are akin in functionality to a caffeine pill. Both forms have their unique benefits and can cater to different preferences and needs. While it’s helpful to understand research on kava extracts, please view it critically and remember that natural kava offers a uniquely holistic experience.
