Kava Kava - Piperaceae

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From the Rodale book, Dr. Duke's Essential Herbs

http://www.mothernature.com/Library/Bookshelf/Books/54/11.cfm

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Kava Kava - LATIN NAME:

 

FAMILY NAME:

 

How could our society have erred in readily accepting a good-morning

jolt from a cup of java without ever discovering the winding-down

pleasure at day's end with a cup of kava? The two beautifully

balance and complement each other--one to wake up, one to wind down.

 

While I don't often have a problem slipping off to sleep, if a touch of insomnia

does come on, I wouldn't hesitate to take some kava. Usually, though, I reach

for it when I want to mellow out with friends during a social occasion or, at

the opposite extreme, following a stressful event.

 

During a recent journey to the Amazon, for example, I was glad I had some

handy. Whatever could go wrong did go wrong: Peruvian gardens reachable only by

canoes and hour-long walks in the forest; a veritable mutiny among cranky

passengers; people collapsing from

severe dehydration; my sudden promotion to ticket dispenser for the

entire tourist group; and the near loss of a wallet that contained

my credit cards, a passport copy, and the money I set aside to buy a

Peruvian guitar. It was a kava week.

 

Fortunately, kava and I are old friends. If everyone else knew what

I know about this ancient shrub, we as a society would feel much

more at ease about our lot in the world, and fewer of us would know

the dangers of addiction to Valium and other forms of pharmaceutical

sedation.

 

DR. DUKE'S NOTES

Among Polynesians, kava is considered better and more socially

acceptable than alcohol. That's why it's offered to the most honored

of guests. Lyndon Johnson and Lady Bird enjoyed it on state visits

to Pacific Island nations, and so did Pope John Paul II. Hillary

Rodham Clinton drank some kava during a campaign tour of Hawaii, and

the Queen of Great Britain enjoyed " high kava " (as opposed to " high

tea " ) when she stopped in Fiji for an official state visit.

 

 

 

What Kava Is and What It Can Do

 

Science has solidly established kava's ability to relax muscles and

hush harried nerves. No single substance in the plant deserves sole

credit. Responsibility rests with a group of chemicals called

kavalactones. Found in different concentrations in different parts

of the plant, each kavalactone exerts a somewhat different

physiological effect. Based on what I know about how phytochemicals

interact synergistically, I'd say that the kavalactones are more

therapeutic in concert than if soloing separately. In other words,

to bring up again a favorite refrain, there's no single magic

bullet. You need the whole herbal shotgun blast.

 

The Kava Calm

 

One tremendous hurdle along the path toward establishing the

superiority of herbal medicine is the dearth of research directly

comparing the performance of a given plant potion to its

pharmaceutical rivals. Happily, kava is an exception. Unhappily, few

Americans have gotten the word. The bulk of the research has been

conducted in Europe, leaving U.S. scientists, convinced that their

chemistry can outsmart Mother Nature, to lag way behind. Here's what

they--and you--have missed out on.

 

To reduce tension, stress, and anxiety, kava extract clearly and

cleanly wins out over the prescription drugs with which it has been

compared. It's similarly effective as tranquilizers, anxiolytics

(anxiety-reducing agents), and other such medications, yet free of

the side effects so typical of these drugs.

 

In one head-to-head matchup, the herbal extract was compared against

two benzodiazepine tranquilizers, bromazepam and oxazepam, on 172

people with anxiety. After six weeks, researchers concluded that the

natural medicine and the synthetic drug were therapeutically similar-

-but that kava was the obvious safer choice. It neither impairs

mental reaction nor shows a potential for addiction. In fact, aside

from an upset stomach or two, the only " side effect " was that the

study participants' mental functions improved! Though calm of body,

they remained keen of mind.

 

Another study, this one eight weeks long, also concluded that kava

extract was comparable to and safer than benzodiazepines. Two

earlier experiments reached similar conclusions about taking the

shrub for anxiety, tension, and menopause-related psychosomatic

complaints. A 1996 German study of 43 women and 15 men suffering

from anxiety reached the same judgment.

 

Kava's effectiveness and safety persist even after long-term use,

according to a six-month study conducted by researchers at Jena

University in Germany. The trial's 101 participants had been

diagnosed with anxiety that stemmed from a variety of nonpsychotic

causes, including agoraphobia and other specific phobias. Half the

group took 90 to 110 milligrams of a standardized kava extract

containing 70 milligrams of kavalactones; the other half took

placebo pills. No one, not even the researchers, knew who was taking

what. In the end, the kava users' anxiety levels, unlike those who

took the fake pills, improved significantly. They felt less

agitated, experienced no detrimental side effects, and suffered no

withdrawal problems at the end of the experiment.

 

Yet again, the natural medicinal compared more than favorably with

Valium and its benzodiazepine brethren, especially because of the

safety factor. Few studies, the researchers pointed out, have

examined the long-term implications of such drugs.

 

I could go on, but you get the idea. As a stress buster and anxiety

antidote, kava deserves a hearty " Brava! Brava! "

 

FROM MY SCIENCE NOTEBOOK

If people have been doing something since time immemorial, odds are

that they have a pretty good reason. As far as ingesting kava is

concerned, they sure do. We now understand chemically why the plant

has acquired such a long-lasting loyal following.

 

I hate to isolate individual compounds in a plant. They cohabitate

for a reason and usually serve us best when working together, not on

their own. Among the more important medicinal ingredients in kava,

for instance, are substances called kavalactones. Each of them--

kawain, dihydrokawain, methysticin, yangonin, desmethoxyyangonin,

and dihydromethysticin--possesses slightly different physiological

effects, but when they work synergistically, they're anywhere from 2

to 20 times more active.

 

With that in mind, I'll note that dihydrokawain (DHK) and

dihydromethysticin (DHM) appear to be the most effective general

relaxants and muscle relaxants of the phytochemical bunch. Together,

they pack the analgesic punch of a typical 200-milligram aspirin.

DHK is the primary sedative, while kawain is more of a tranquilizer.

DHM gently depresses the central nervous system, as does kawain, to

a lesser extent. For the most part, these phytochemicals affect only

the lower central nervous system, which means they leave higher

functions intact. In other words, your body mellows out, but your

mind remains sharp.

 

In low doses, the overall kavalactonic impact is much like that of

Valium or the other benzodiazepines, although it works in a manner

different from this pharmaceutical family. The primary difference, a

couple of studies show, is one of safety. Although physiologically

similar to the benzodiazepines, kava is clearly safer, one study

concluded. The plant displays no addictive potential and threatens

no mental impairment. In fact, for study participants taking kava,

cognitive function actually improved!

 

 

 

How Kava Can Help

 

Something that puts the slack back into a day's worth of high-strung

nerves certainly earns a place at home at night--or whenever else

you might benefit from relaxed muscles, eased pain, and somewhat

numbed nerves. Insomnia is an obvious application, but pay

attention: I think you'll be surprised by some of kava's other

potential uses.

 

Depression. According to folklore, kava can be useful for mild cases

of depression. Maybe. I don't think the evidence is strong. In a

report issued not long ago by the federal Agency for Health Care

Policy and Research, kava earned one passing reference: The report

noted that no depression-related research data existed for it or

another medicinal plant, valerian.

 

Well, perhaps the reason is that kava is more typically associated

with anxiety and stress (and valerian with insomnia). Why would

anyone bother to investigate a secondary use with no strong

foundation? The main therapeutic plant for depression, of course, is

St. John's wort, covered in chapter 13.

 

Genitourinary concerns. For some reason, kava takes a notable liking

to the urinary tract. Its analgesic, anti-inflammatory, muscle-

relaxing qualities bring relief to a range of urinary problems,

particularly in women. Kavalactones also are recognized specifically

for their ability to relax the uterus, which is why the shrub has

been a time-honored treatment for menstrual cramps and dysmenorrhea.

 

For almost any achy, inflammatory urinary disorder, medical folklore

includes kava in the remedy. It's been used against bladder

inflammation, urethral inflammation, vaginitis, gonorrhea, cystitis,

pyelitis, and burning or pain upon going to the bathroom. And while

the plant is a strong diuretic, which helps encourage urination, it

also supposedly helps to treat incontinence.

 

Headaches. Muscle relaxation might be the key here, but then you

don't need to single out a specific reason when the herb also blunts

pain, discourages muscle spasms, settles seething nerves, and cools

inflammation. Two specific kavalactones, dihydrokawain and

dihydromethysticin, together have the analgesic power of a 200-

milligram aspirin tablet.

 

HERB LORE AND MORE

In the Pacific Ocean islands of Polynesia, kava enjoys a special

status that is ages old. Islanders from Hawaii and other southern

Pacific nations relax by chewing on the deep-green, spadelike leaves

of the cultivated plant. They also brew the plant's rhizome into a

strong beverage that's drunk during religious ceremonies, special

celebrations, and social rites.

 

Any way you cut it, the intent remains essentially the same--to

relax body and mind, ease pain, and hasten sleep. Practitioners of

folk medicine have prescribed it against gout, convulsions,

depression, fatigue, muscle spasms, bronchitis, rheumatism,

headaches, and a range of urinary problems. They've also sought its

therapeutic help as a diuretic and a general tonic.

 

 

 

Hyperactivity. Drug treatment for attention deficit/hyperactivity

disorder (ADHD) has been pummeled in recent years because it's given

rise to a generation of school-age children who, under the dutiful

advice of their doctors, pop prescription pills like candy, notably

Ritalin. As I review this very sentence, the local TV news is

running a rather disparaging commentary on how children as young as

two are becoming hooked on these chemicals. Even the federal Drug

Enforcement Administration (DEA) has warned that taking Ritalin

leads to drug addiction. The DEA's concerns, though, aren't shared

by the esteemed The Journal of the American Medical Association. The

house organ for the American Medical Association has said, in

essence, not to worry.

 

Ritalin is actually a stimulant, but it generally (though not

always) calms down kids with ADHD. Caffeine, as odd as this sounds,

also calms many ADHD children, although you will find the occasional

hyperactive kid who's stimulated by a cup of coffee or a can of

Coke.

 

And so it goes for kava. It tames most people, but every once in a

while, it cranks someone up. That's what happened to my secretary's

grandson. Upon taking an extract of the herb, he became even more

hyper.

 

I mention kava to every mother I meet whose child has been diagnosed

with this elusive condition. I'd rather that any hyperactive child

or grandchild of mine at least try kava before acquiescing to a

Ritalin prescription. At the least, kava seems better (and safer).

At the most, it's a safer (and more natural) lifesaver.

 

Some alternative practitioners have praised pycnogenol, an

antioxidant phytochemical in grape seed among other plants, as an

antidote for hyperactivity. Maybe it works. But I'll bet a pound of

kava that the kava kava plant contains similar polyphenols with

similar activities.

 

DR. DUKE'S NOTES

Ritalin may be de rigueur here for treating hyperactive children,

but that's not the case everywhere. In Hawaii and the South Seas,

tradition calls for chewing on kava leaves to settle down anxious,

restless kids.

 

 

 

Insomnia. No need for sleeping pills or nightcaps that whomp you

with an 80-proof wallop. When worries and woes keep you wide awake,

the plant's muscle-relaxing, pain-allaying, tranquillity-inducing

influence is a botanical blessing.

 

Some people claim that kava-influenced sleep is dreamless; others

say that the deep, restful slumber it facilitates is lush with

vivid, epic-length imagery. Your mileage may vary, I suppose. I

don't recall any obvious changes in my dreams. If you need help to

fall asleep, you probably won't care whether you dream or not.

 

Mouth problems. While foraging the forests of Panama some three

decades ago, the very first plant my Indian hosts introduced me to

for a toothache was, like kava, from the Piper family. Time and

distance don't seem to make a difference. Just a few years ago,

again exploring the jungles, the premier plant that Peruvian Indians

showed me also was a Piper.

 

I can't say that kava will deaden the throbbing drumbeat of a

painful tooth. I can tell you, though, that your mouth gets numb

when you chew on a fresh kava leaf. Imagine the possibilities from

there. Jay Ram and Roy Skogstrom, two good friends of mine from

Hawaii and two good kava growers on the big island there, suggest

the plant has much potential for easing, if not treating, any number

of mouth maladies, including a sore throat, sore gums, herpes cold

sores--even, as my Panamanian and Peruvian friends promised, a

toothache. An extract might work quite well as an ingredient in

lozenges, mouthwashes, and toothpaste for sensitive teeth.

 

Other ailments. Research hasn't verified other traditional uses for

kava--not yet, that is, but folklore often has a way of anticipating

what science discovers much later on. One such use for kava might be

against gout. Science already knows that the plant helps to

counteract both tissue swelling and inflammation, two features of

gout. It's just a matter of putting two and two together. Other folk

medicine applications include relieving eye pain, neuralgia of the

middle ear, duodenal ulcer pain, and bronchial or other

complications ensuing from heart problems.

 

I can't offer any particular endorsements for such treatments, but

if you have one of the conditions, you might consider taking some

kava to see if it helps. I doubt that you'll do any harm, but you

might do yourself some good. And whether the condition responds or

not, at least you'll feel more relaxed and sleep better.

 

How to Take It and How Much

 

Though traditionalists more commonly use kava's roots, if you had

your own nature's " farmacy, " you could snip off a leaf or two

whenever you wanted to take the edge off the day. I'm proud of my

greenhouse kava plant, the one People Weekly photographed for its

February 1, 1999 issue, and I certainly don't want to uproot it or

pick it apart. Instead, I have a cache of the powdered extract that

I bring out to share with special people on special occasions or

even just lazy afternoons. I host my own version of a kava tea

ceremony.

 

Supplements. For you, though, standardized supplements are the way

to go. On the label, look for a statement attesting that the

capsules therein contain a standardized extract that provides a

specific amount of kavalactones per dosage. You don't want just a

certain one; you want the whole kavalactone complex.

 

Percentages and milligrams will vary among manufacturers. Most of

the clinical studies used an extract standardized for 70 percent

kavalactones at a daily dosage of 210 milligrams. The Protocol

Journal of Botanical Medicine suggests taking an extract

standardized at 40 to 70 milligrams of kavalactones twice a day for

up to four to six months, while Commission E (a German panel of

experts roughly equivalent to the U.S. Food and Drug Administration)

recommends 60 to 120 milligrams of kavalactones daily for no more

than three months.

 

Tinctures and extracts. Other suggested dosages I've seen include 1

to 3 milliliters of kava tincture daily, 2 to 4 milliliters daily of

a liquid root extract, or 10 to 30 drops four times a day of an

alcohol extract.

 

Dried root. Still another recommended dosage is 1.5 to 3 grams of

dried kava root.

 

The right dosage for you will depend on a handful of factors,

including your weight, your individual body chemistry, and your

sensitivity to the kavalactones. But then, the same can be said of

any substance, natural or synthetic. What you can reliably count on

is that the more kava you take, the more you'll feel its effects.

 

Another factor to consider is timing. For stress relief or muscle

aches during the day, you might want to take a smaller amount. In

the evening, you could try a little more, if necessary, for general

relaxation. And for help with insomnia, take it an hour or so before

bedtime.

 

Useful Combinations

 

If kava can't ease your weary, worried brow, nature offers hundreds

of recourses that you can try alone or along with kava. None of the

ones I recommend possesses the side effects or addictive potential

of prescription and over-the-counter tranquilizers.

 

But before seeking out a particular herb, I think I'd start off by

exercising a little more, walking a little more, cutting back on

afternoon caffeine consumption (I always switch to decaf after a few

cups of the " hard " stuff), and eating more foods that provide the

essential amino acid L-tryptophan, a main nutrient for mental

serenity and relaxation.

 

Relaxation and Insomnia

 

Chamomile. Like Hawaiians, who balance their morning Kona coffee

with afternoon kava, Latin Americans have an end-of-day counterpart

to their eye-opening brew. They call it manzanilla, but you know it

as chamomile. Apigenin is one of the active ingredients in this

plant, which you can drink as a very gentle tea right before turning

down the covers.

 

Foods. All plant (and probably all animal) foods contain some amount

of natural tryptophan. Among the better sources are almonds, barley,

mung beans, kidney and lima beans, sesame seeds, pumpkin seeds,

spinach, evening primrose seed, and watercress.

 

If that doesn't do it for you, try some of the other plants

suggested here, either alone or in combination.

 

DR. DUKE'S RECIPES

Cream of Serenity Soup

 

Here's a kava option or accompaniment--a suggested soup to help you

sleep, or at least wind down at the end of a stressful day.

 

Start with mung beans, kidney beans, and/or limas--all rich in

natural tryptophan, a substance which promotes serenity and

relaxation. Toss in some celery and some tomato, which contains nine

different sleep-inducing chemicals, then flavor the concoction with

any of the spices--ginger, basil, thyme, cinnamon--that are rich in

natural sedative compounds.

 

Truly a recipe for relaxation!

 

 

 

Lavender. The numerous compounds in this plant and its purple

blossoms slow nerve impulses and calm the central nervous system--

if, that is, you get the right species and variety. Some types,

particularly Spanish lavender, exert the opposite effect. Tinctures

and teas are worthwhile, but the most potent form is the essential

oil, which you should use only externally. Do not ingest the oil.

Instead, dilute it with almond oil and rub some on your skin, or add

a little bit, along with some lemon balm, to your bath water. I

predict you'll fall asleep more easily and sleep solidly. But do not

sleep in the tub.

 

Lemon balm. You'll put a churning stomach to rest, too, if you use

this plant to relax. Also called melissa, it makes a great before-

bed tea. Some of its active tranquilizing compounds, known as

terpenes, appear in such herbs as ginger, basil, clove, and juniper,

though perhaps not in quite the right blend that gives this weed its

good sleep-promoting reputation.

 

Passionflower. In Great Britain, several dozen over-the-counter

sleep nostrums contain this natural relaxant. If you can't find a

tincture, you'll have to take the whole herb (anywhere between four

and eight grams). Low doses ease anxiety; higher doses work more

like a sedative. Even Germany's Commission E approved it for nervous

restlessness and noted its lack of side effects, interactions, and

contraindications. Passionflower is native to America. Too bad it's

better studied and more frequently used overseas.

 

Valerian. This herb stinks--quite literally. But it's probably the

most powerful of the other plant options I've listed, a key

ingredient in some 80 British sleep aids. If you cannot or will not

acquire a taste for it as a tea, get a tincture or a supplement that

contains a root extract. Again, don't settle for an extract of just

one or two of the plant's active ingredients. None is necessarily

better than the others. This time-tested stress buster and sleep

promoter contains more than a dozen sedative-like chemicals, and

they work best synergistically, not by themselves. Always remember

Duke's Dictum: The whole phytochemical potpourri is almost always

better than the sum of its parts.

 

Oral Assistants

 

Kava helps deaden the pain associated with toothaches and other

mouth-related woes. If you don't feel any relief, you have a couple

of alternatives:

 

Clove. As an oil that's rubbed directly on the affected tooth, clove

proves superior to all other ingredients commonly found in toothache

remedies, according to a group of scientists reporting to the Food

and Drug Administration (FDA). In fact, it was the only substance

that effectively and safely brought temporary relief from pain.

 

Willow. I've occasionally chewed on a piece of willow bark to soothe

a throbbing tooth. Once softened, wad up the bark and gently press

it into the site of pain.

 

Other herbs that might help anesthetize an aching tooth include

ginger, prickly ash, and the aptly named toothache tree. Or sink

your teeth into a capsaicin-rich hot pepper or black pepper (the

latter is related to kava). Capsaicin has an outstanding reputation

for relieving pain. I've never investigated its use for a toothache,

but it might take your mind off the pain for a while.

 

Don't forget that the relief these herbs provides is only temporary.

See a dentist as soon as you can.

 

Cramp Control

 

Of the genitourinary problems that kava has been used against,

dysmenorrhea responds most reliably. For stronger alleviation from

monthly menstrual pain, you can combine kava with a few other herbs:

 

Black haw. You'd expect that something more commonly called " cramp

bark " would live up to its name, and this herb certainly does. For

menstrual pain, I'd recommend it as a first resort. At least four of

its compounds help to relax the uterus. Viburnum opulus, which is

right now flowering in the Green Farmacy Garden, has the same

effect.

 

Ginger. Another reliable remedy for menstrual pain, ginger has six

anticramp chemicals and at least another six pain-assuaging

substances. It has a long history as a dysmenorrhea treatment and a

worldwide reputation for helping to induce menstruation.

 

So reliable is the latter effect that pregnant women might wish to

avoid taking ginger, although my guess is that it would take a lot

more than the normal medicinal dose to cause any problems.

 

Raspberry. We're not sure what the active ingredients are, but

raspberry leaf tea has racked up a nice record for soothing

menstrual cramps. It works well against pregnancy-related uterine

discomfort, too, according to women herbal experts. Blackberry,

boysenberry, and wineberry, I suspect, could serve as similarly

effective substitutes.

 

Caution: Contraindications, Interactions, and Side Effects

 

If you brewed up a big, big batch of kava and drank roughly 13

liters a day, your skin eventually could turn scaly and yellow, your

eyes might get red, and some hair might fall out. You also might

lose a little muscle coordination and have some difficulty

breathing.

 

I trust that no one capable of reading this book is foolish enough

to consume such a large amount, which is about 100 times greater

than the typical therapeutic dose. I do, however, appreciate

inquisitive scientists' concern about the impact of such profligacy,

wildly unrealistic as it might be.

 

Beware the Bum Rap

 

Even when used in far more rational ways, kava has been the victim

of a bum rap. Excessive consumption is alleged to be intoxicating,

and some of our supposed guardians of public health have gone as far

as to classify the shrub as a narcotic and a hypnotic. Perhaps

they're confusing drunkenness with relaxation or have put too much

stock in Polynesian lore. They need to calm down.

 

In truth, kavalactones are not hallucinogenic, nor do they act like

a narcotic. They are definitely not addictive,

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