Kava Kava

Piper methysticum

Kava refers to both the rootstock and traditional inebriating beverage derived from Piper methysticum Forest. f. (family Piperaceae). A sterile cultivated plant with numerous cultivars (cultivated varieties), it originates from a wild progenitor, Piper wichmannii C. DC., found from New Guinea to the Solomon Islands and Vanuatu. Kava is grown for its large rootstock or stump (often designated as a rhizome, and a matter of intense nomenclatural debate among botanists) cultivated on tropical Pacific Islands, including among others Baluan, Fiji, Futuna, Hawaii, Madang, Pohnpei, Rotuma, Samoa, Tonga, Vanuatu (formerly the New Hebrides), and Wallis. Vanuatu is considered the center of distribution since eighty of the known 118 cultivars of kava occur in this archipelago.

Pacific Islanders normally consume kava beverages at dusk, before an evening meal. Various rituals or ceremonies are associated with the event, depending upon culture. The rootstock is prepared by chewing, grinding, grating, or pounding roots, then soaking and macerating the pulp in cold water to release the active constituents into what is often a thick brew, which has been offered to visiting dignitaries from Lady Bird Johnson to Pope John Paul II. In Pacific Island societies, kava consumption-the kava ceremony-has been likened to the social equivalent of consumption of wine in France.

Kava's strong, somewhat nauseating taste produces localized numbing results from its complex chemistry, with kavapyrones (kavalactones) dominating flavor and biological activity. At least fifteen kavapyrones have been isolated and characterized, the most important of which are kawain (1 to 2 percent), dihydrokawain (0.6 to 1 percent), methysticin (1.2 to 2 percent), dihydromethysticin (0.5 to 0.8 percent),3 in addition to demethoxyyangonin and yangonin, among others. The four kawain-methysticin-type pyrones act as muscle relaxants and anticonvulsants. Pipermethystine, an alkaloid, is a major constituent of the leaves, but is absent from the roots.

Kava, as consumed in a typical Polynesian kava ceremony, is said to induce a state of mood elevation, well-being, and contentment, producing a feeling of relaxation without a narcotic effect. However, excessive consumption may cause photophobia and diplopia, sometimes resulting in oculomotor paralysis, with muscles not responding to normal movement, leading to prostration and unconsciousness. Heavy consumption over a period of several weeks or months can produce drying-up of the skin epidermis, with lesions and skin yellowing, redness of the eyes, loss of appetite, urticarial patches with intense itching, and other symptoms, which abate when kava consumption is discontinued.

The first herb products made from kava appeared in Europe in the 1860s. At the end of the last century, kava extracts were available in German pharmacies. The first pharmaceutical preparations became available in Germany in the 1920s, offered as a mild sedative and hypotensive agent in the form of a tincture. For the most part, Western use of kava has largely evolved in Germany.
The rootstock and its preparations are currently the subject of a positive German therapeutic phytomedicine monograph, which allows it to be used for conditions of nervous anxiety, tension, and agitation. In Europe, kava extracts are often combined with pumpkin seed and used in the treatment of irritable bladder syndrome. The German monograph notes that use is contraindicated during pregnancy, lactation, and depression. Side effects may include temporary yellow discoloration of the skin, hair, and nails or rare allergic skin reactions. Because of its perceived sedative effect, use should be avoided with the consumption of alcohol or with operation of machinery or vehicles. For these reasons, the herb is best consumed at bedtime. One case of driving under the influence of kava has been prosecuted in the state of Utah.

At least six double-blind controlled therapeutic studies have been conducted on kava extracts, though they have been criticized for insufficient inclusion criteria. Test substances have involved extracts standardized to 15 percent kavapyrones (two studies) and 70 percent kavapyrones (four studies). Clinical studies have measured various parameters in the treatment of anxiety, tension, agitation of nonpsychotic origin, climacteric symptoms, and postoperative mood with positive results. The data from controlled clinical studies, along with decades of clinical experience in Germany, can lead one to conclude that kava is a potential herbal alternative to benzodiazepines or other synthetic anxiolytics for mild states of anxiety from various causes. Although side effects of kava abuse are clearly established in the literature, it does not appear to produce physical or psychological dependency, an advantage over some synthetic anxiolytics and tranquilizers.

Kava's tenure in the American market will depend upon responsible manufacturers offering appropriately formulated products in proper dosages that reduce the potential for abuse. They must also refrain from hyperbolic advertising featuring extravagant claims for the herb's psychotropic effects.

Kava (or kava-kava) has an important place in the cultures of many islands of the South Pacific. Traditionally, it was painstakingly prepared and consumed with great ceremony and considered a sacred drink. It was also used to greet important visitors and in other ceremonial occasions, but elders in the community also drank it in the course of the day. The name kava carries the meanings of "sour," "bitter," or "sharp," which may be some indication of the taste of the beverage. Kava's pharmacological activity has led to its increasing popularity in the United States, where the Oceanic steps of chewing or pounding are eliminated, and it is taken in capsule form. In the Pacific, kava is considered to reduce anxiety without dulling the mind. The part of the plant used is the rhizome. Human saliva makes the effects stronger, which is why traditional preparation techniques started with chewing.

A great deal of chemical research has been done on kava, but plants grown in different places appear to vary in composition. The principal ingredients are alpha-pyrones: methysticin, kawain, dihydromethysticin (DHM), and yangonin, as well as derivatives of these compounds. There are also pigments. The leaves contain an alkaloid, pipermethystine, which is found in only trace amounts in the roots. Kava alpha-pyrones do not work on the same pathways as narcotics, because the effects can't be blocked by naloxone.

Although Hawaiian healers used kava for dozens of purposes, there is no question that its use to induce relaxation is not culture-specific. Tests on animals show that extracts of the drug-but no single identified compound-cause muscle relaxation to the point that animals fallout of revolving cages. Methysticin and DHM protect animals from muscle convulsions due to strychnine. Kava was used in Hawaii to reduce anxiety, bring on sleep, counteract fatigue, and treat asthma, arthritis pains, and urinary difficulties. Kava appears to act as a diuretic, and the root was even used as a weight loss agent. Medical tests suggest it may be helpful in treating psychosomatic symptoms in menopause. Kawain acts as a local anesthetic, numbing the lips and mouth. Food eaten after ingesting kava drink cannot be tasted.

Parts used

Root.

Uses

Traditional aphrodisiac - Kava kava is valued in the South Sea Islands as a calming and stimulating intoxicant. Taken in large quantities kava kava produces a euphoric state, which is probably why it has long been considered an aphrodisiac.
Narcotic - Experience in the Pacific Islands and among the Aborigines in Australia has shown that if taken to excess kava kava has a narcotic effect, inducing stupor.
Antiseptic - Kava kava has an antiseptic action and in the past it was used specifically to treat venereal disease, especially gonorrhea. Although kava kava is no longer generally employed in this way, it is a valuable urinary antiseptic,. helping to counter urinary infections and to settle an irritable bladder.
Pain relief - With its tonic, strengthening, and mildly analgesic properties, kava kava is a good remedy for chronic pain, helping to reduce sensitivity and to relax muscles that are tensed in response to pain.
Arthritic conditions - Kava kava's analgesic and cleansing diuretic effect often makes it beneficial for treating rheumatic and arthritic problems such as gout. The herb helps to bring relief from pain and to remove waste products from the affected joint.
Relaxing remedy - Kava kava is a safe and proven remedy for anxiety that does not cause drowsiness or affect the user's ability to operate machinery. Kava kava may be taken long term to help relieve chronic stress, and its  combination of anxiety- relieving and muscle-relaxant properties makes it of value for treating muscle tension as well as emotional stress.
External uses - The herb makes a useful analgesic mouthwash for toothache and canker sores.

Habitat & cultivation

Kava kava is an indigenous Polynesian vine and grows throughout the Pacific Islands as far east as Hawaii. Kava kava is cultivated commercially in the US and Australia. Kava kava is propagated from runners in late winter or early spring and is usually grown on frames. Kava kava needs well-drained stony soil and a shady position. The root is harvested at any time of year.

Research

Lactones - The kava lactones have a depressant effect on the central nervous system and are antispasmodic. Research shows that kawain, in particular, is sedative. The kava lactones also have an anesthetic effect on the lining of the urinary tubules and the bladder.
Relieving anxiety - The results of a clinical trial in Germany published in 1990 revealed that kawain is as effective as benzodiazepene in helping to relieve anxiety.

Constituents

Kava lactones, also known as kava pyrones, specifically kavain, methysticin, yangonin, dihydromethysticin, dihydrokavain, 5,6 - dehydromethysticin and desmethyoxyyangonin. The kava lactones make up 3% to 20% of the root by dry weight.

How much to take

Many people take kava extracts supplying 140-210 mg of kava-lactones per day. Alternatively, 1-3 ml of fresh liquid kava tincture can be taken.

Side effects

In recommended amounts, the only reported side effects from kava use are mild gastrointestinal disturbances in some people. Long-term consumption of very high doses of kava may turn the skin yellow temporarily. If this occurs, people should simply discontinue kava use. In rare cases, an allergic skin reaction, such as a rash, may occur.
Kava is not recommended for use by pregnant or lactating women. Kava kava should not be taken together with other substances that also act on the central nervous system, such as alcohol, barbiturates, antidepressants, and antipsychotic drugs.

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