Newsletter #09

Kava Guidelines

by Braddock Ray

An herbal superstar, kava (Piper methysticum) has a long history of safe use--and has become popular for relieving anxiety and stress. Recent reports of adverse effects in Europe, however, are making American herbalists more cautious in their recommendations for kava. Twenty-nine cases of liver problems associated with kava use have been reported in Germany and Switzerland. However, in 21 of those cases pharmaceutical drugs linked to liver damage and/or alcohol were also involved. "This is not significant evidence of hepatotoxicity," says Hyla Cass, MD, associate professor of psychiatry at UCLA, and co-author of Kava, Nature's Answer to Stress, Anxiety, and Insomnia. Ironically, concern over possible liver damage comes just after a small clinical study conducted at Duke University, which found no adverse effects from kava on the liver. And last year, a major review of seven clinical trials reported no incidences of liver toxicity with kava.

Safety First

Based on the information available to date, Mark Blumenthal, founder and executive director of the American Botanical Council, suggests caution in using kava if you take any medications with reported adverse effects on the liver or if you are a regular consumer of alcohol. Nor should anyone who has a history or develops symptoms of liver disease (yellowing of the eyes, dark urine) use kava. To be on the safe side, Blumenthal suggests limiting kava on a daily basis to no more than a month.

Natural Alternatives

Since many pharmaceutical drugs that consumers avoid by taking kava have even more significant side effects, consider using kava in supplement formulas, where synergistic action may make a lower dosage effective. Or try other herbs. Roy Upton, founder and executive director of the American Herbal Pharmacopoeia, recommends the following nervous system tonics:

*Ashwagandha (Withania somnifera) can help relax you and is also useful in arthritis.

*Hawthorn (Crataegus spp.) calms both the mind and nerves.

*Reishi mushroom (Ganoderma lucidum) increases resistance to external stressors.

Also, consider fresh liquid extracts of wild oats (Avena fatua) and skullcap (Scutellaria lateriflora), plus Siberian ginseng (Eleutherococcus senticosus) to enhance resistance to stress.

Selected Sources

*"American Botanical Council Announces New Safety Information on Kave," ABC

*Prescription Alternatives by Earl L. Mindell, RPh, PhD

ADVERSE DRUG EFFECTS

Drugs that are hard on the liver are too numerous to list. Here are some that are best not used with kava:

*Acetaminophen

*Analgesic painkillers

*Anesthetics (used in surgery)

*Antibiotics

*Anticoagulants

*Antihistamines

*Anti-inflammatory drugs

*Blood pressure medications

*Chemotherapy drugs

*Cholesterol-lowering medications, including the poplular "statins"

*Oral diabetes drugs

*Heart medications

*Oral contraceptives

*Parkinson's drugs