Kava Pro’s and Cons

Kava Pro’s and Cons

April 12, 2023

estimated read time - 14 min

Kava has been used for hundreds of years in sacred ceremonies and traditional medicine by people in the Pacific islands. In today’s generation, kava is well known for its relaxing and calming effects that can help reduce anxiety and stress. It is also often used as an alternative to alcohol.

But, like most natural supplements, kava also has its pros and cons. In this blog, we will talk about the advantages and disadvantages of kava.



Pros of Kava

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Kava May Help with Anxiety and Stress

People experience anxiety and stress every now and then. It is a normal response of the body during stressful situations, but it can be a problem when it starts to become long-term. Too much anxiety and stress may lead to changes in mood swings, headaches, fatigue and even a lack of concentration. There are many treatments to help deal with anxiety and stress, but one of the most common natural remedies with lesser side effects is kava.

How Does Kava Help with Anxiety and Stress?

The kavalactones in kava are known for anxiolytic effects that can help with anxiety and stress. Kavalactones have shown to interact with several neurotransmitters in the brain, which includes GABA (gamma-aminobutyric acid), dopamine and serotonin. These three play an important role in regulating mood, anxiety and stress. Kavalactones are believed to enhance the activity of GABA receptors in the brain, which can result in the reduction of anxiety and stress symptoms.

Kava is also believed to have the ability to reduce inflammation, which is one factor in some chronic illnesses, including anxiety and stress. By reducing inflammation, symptoms of anxiety and stress may also be reduced.

Several studies have shown that kava was effective as prescription medication in reducing symptoms of anxiety. And because of its anxiolytic effects, more people are more drawn in using kava as an alternative. A study published in the Journal of Clinical Psychopharmacology found that kava was effective in treating Generalized Anxiety Disorder (GAD) and comorbid depression(1).

In two randomized double-blind, placebo-controlled studies, participants with GAD and participants with PTSD who consumed kava have shown reduction in their anxiety and PTSD symptoms compared to the participants who had a placebo(7). It was also found that kava has lesser side effects.


Kava May Help Calm Pain Relief

Pains are often caused by several factors, including nerve damage, inflammation and injury. Pain can affect a person’s daily living causing emotional stress. Kava has been used for centuries to ease several health issues, and one of the possible benefits of kava is being able to relieve pain. Kavalactones are shown to have analgesic properties, which makes kava a possible remedy to ease pain.

Kava has shown to possibly be effective in reducing several types of pain. This includes chronic pain, neuropathic pain and acute pain.

  • Chronic Pain- or persistent pain is a pain that can last for more than three months. They are usually caused by arthritis, fibromyalgia, and back pain.
  • Neuropathic Pain- this type of pain happens when your nervous system is damaged or not working properly. This results in conditions such as multiple sclerosis, diabetes, and shingles.
  • Acute Pain- A type of pain that is usually following a traumatic event and can last for a shorter period of time. Acute pains are often caused by injury or surgery but they don't really last long. More often they are immediate sharp pains.

How Does Kava Help with Pain Relief

The ability of kava to ease pain is not clearly known, but it is believed to be because of the analgesic properties that are found in kavalactones interacting with our GABA system. These properties are known for its ability to block pain signals in the brain. The increase in activity of the GABA receptors in the brain caused by kava are possibly involved in pain modulation. Although pain is a real phenomenon (as real as the hard table that may be in front of you) that “pain” varies from individual to individual. This specific interaction in the brain is said to be responsible for a reduction of the perception of pain. This means the signals going to the brain and therefore giving the sensation of pain is slightly dulled or calmed, making kava a potential alternative to alleviate various types of pain.

A study published in the Journal of Clinical Psychopharmacology revealed kava was effective in easing chronic pain for patients with osteoarthritis(1). Another study published in the Journal of Ethnopharmacology involving mice has shown kava's ability to reduce neuropathic pain(4). Kava is believed to have anti-inflammatory properties which can help ease pain and reduce swelling.


Kava May Help Soothe Sore Muscles

Muscle tension is a common condition that can be caused by physical activity, anxiety and stress. It can lead to pain and discomfort when it becomes chronic, affecting daily activities like sitting, standing, and sleeping.

Some studies have shown kava to have muscle-relaxing properties, making it a great natural remedy for muscle tension and muscle pains with lesser side effects. Kava may also be used for conditions such as restless leg syndrome.

Kava may help with several types of muscle pain, such as muscle pain caused by anxiety or stress, muscle spasms and tension headaches.

  • Muscle pain caused by anxiety or stress- emotional stress can cause tension and tightness in the muscles, which can lead to pain.
  • Muscle Spasms- spasms occur when your muscles suddenly contract involuntarily and can’t relax. These conditions may be caused by dehydration, nerve damage and electrolyte imbalance.
  • Tension Headaches- these are caused by muscle tension in the neck, shoulders, and head.

How Does Kava Help in Muscle relaxation

Muscle tensions or at least the perception of them seem to be affected whenever there is an interaction in GABA-A receptors in the brain. The increase in activity of the GABA-A receptors in the brain, can result in the reduction of muscle tension, allowing the muscles to feel relaxed and relieved from pain. Since it has also been found that kava may have analgesic properties specifically on the GABA-A receptors, this means it may also help lessen pain and discomfort caused by muscle tension.

Several studies were done to examine the effects of kava on muscle relaxation. It was found out that kava is effective in reducing muscle tensions in patients with generalized anxiety disorder (GAD). Another study has also shown that kava was effective for muscle tensions and improvement of cognitive performance for those in healthy condition.

Kava May Help Improve Sleep

One of qualities that kava possesses is its sedating effects. This quality makes kava a potential aid for people with trouble sleeping.

There are various types of sleeping disorders that kava may help with. There is insomnia, sleep- related muscle tension and sleep-related anxiety.

  • Insomnia- it is a common sleep disorder, wherein it is difficult to fall and stay asleep.
  • Sleep-related muscle tension- muscle tension can result in discomfort during sleep, causing disrupted sleep quality.
  • Sleep-related anxiety- it is a condition in which your trouble in sleeping is caused by anxiety or stress.

How Does Kava Help in Improving Sleep

The sedative effects of kava may help promote sleep through a few different channels. The kavalactones are believed to interact with the GABA-A receptors in the brain. GABA-A receptors are said to be responsible for regulating sleep and relaxation, making it the target of most sleep aid prescriptions like benzodiazepines. Kava’s effects are believed to produce similar effects with these sleep aids but without the usual risk of dependence and addiction on prescription drugs.

Some sleeping problems are caused by anxiety. People with anxiety may experience difficulty in falling and staying asleep, which can lead to a cycle of poor sleep. Research with kava has shown it to help reduce anxiety making it a potential aid for anxiety-related sleep problems.

In a study conducted for patients with insomnia and patients with anxiety, participants who took kava had improved sleep quality and sleep efficiency. It was also found that kava can help improve the quality of REM sleep. REM sleep particularly plays an important role in memory, emotional processing and healthy brain development. Kava is said to increase REM sleep time and lessen the amount of non-REM sleep.


Cons of Kava

Kava May Increase Chances of Liver Problems

Kava's potential liver problems has been a major concern for many years. Reports dating back to 2002 suggested that kava could cause liver damage, but to this day, the evidence supporting these claims remains uncertain. Some argue that the amount of kava consumed and the frequency of use may play a role, while others attribute the issue to poor quality control at certain manufacturers.

What is liver toxicity?

Liver toxicity is a condition in which the liver is damaged due to exposure to harmful substances like drugs, chemicals, and alcohol. Since the main role of the liver is to metabolize food and drinks and filter toxins from the blood, it can result in damage when it gets overwhelmed by toxins. Many supplements and otc medications we take to this day are known to be toic to the liver, so dosage tracking is considered to be of upmost importance

Kava and Liver Issues

Kava's potential for causing liver damage has been a topic of concern for years. A 2007 study found cases of liver toxicity in people taking kava supplements(6)., and a 2010 study revealed that mixing kava with other liver-harmful substances, such as alcohol or certain medications, could also lead to liver toxicity.

In 2002, reports of liver damage caused by kava began circulating in Europe, prompting some countries to ban or restrict the supplement(6).. At the same time, the US Food and Drug Administration issued a warning about kava's potential to cause liver damage and advised against its use.

Germany, France, and Canada were among the countries that banned kava, while New Zealand and Australia continued to use it as a traditional medicine and supplement. Eventually, the ban was lifted for personal consumption due to a lack of evidence supporting the concerns about liver damage.

Precautions:

Since most countries have lifted the ban on kava, more and more people have become interested in using it to help with managing stress and anxiety. So if you’re considering taking kava it is important to take note of some kava precautions to avoid the risk of potential liver toxicity.

  1. Use only high-quality noble kava from a reliable source.

  2. Do not drink kava with substances that are known to be harmful to the liver. Some examples are alcohol, ibuprofen (advil), Acetametophin (tylenol), cough medicines, etc.

  3. If you have a history of liver disease, it is necessary to consult with your physician first before using kava.


Kava May Interact with Medications

Kava may interact with some medications including sedatives, antidepressants, and other medications for pain. There are several ways on how kava may interact with these medications. One, is when these substances are metabolized in the liver together with kava.

Medications that Interact with Kava

It is found that kava can interact with medications that affect the central nervous system, like sedatives and antihistamines. When taken together, the sedative effects from kava and these medications can increase which may lead to excessive drowsiness, dizziness, and impaired motor function.

Kava has been found to slow down drug metabolizing enzymes in the liver resulting in increased drug levels in the body. The following are some medications that can interact with kava: benzodiazepines, antidepressants, antipsychotics, oipioids, barbiturates, some otc medicines for pain such as ibuprofen.

The possible interactions are mostly known for something called the "compounding effect", which means the effects of these medications may intensify when used together with kava and may result in possible harmful side effects, such as increase in sedation, stress on liver, and cognitive impairment to name a few.

Precautions:

If you’re considering using kava while taking medications, keep in mind the following precautions to avoid negative side effects.

  1. Avoid using kava if you’re taking medications that are metabolized in the liver.

  2. Do not drink kava while taking medications that can affect the central nervous system

  3. Always seek the advice of a health professional if you are considering using kava.


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Kava May Cause Cognitive Impairment

Several studies have found that kava may temporarily cause cognitive impairment. Kava, like many other sedatives in nature, are said to affect a person’s concentration, memory and decision making. These effects are usually temporary but can be more serious when kava is taken in higher dosages and used for a longer period of time.  

What is Cognitive Impairment?

Cognitive impairment is when a person experiences trouble in understanding, solving problems, remembering, decision making and paying attention. This can be caused by several factors which include neurological disorders, brain trauma and age.

How Does Kava Causes Cognitive Impairment

High doses of kava were reported to have caused cognitive impairment to some individuals. It is believed that the psychoactive effects from kavalactones affecting the GABA channels can impact the speed of some of the brain functions. This is typical of the respond when someone drinks too much kava and hence why we recommend to not operate heavy machinery after drinking it.

Some studies were conducted to look into the possible link between kava and cognitive impairment.   Researchers have found that heavy and long term use of kava was associated with impairment in working memory, attention, and visual perception. Another study revealed that kava was linked with weakening of cognitive function, especially in the areas of memory and attention. We think this may have more to do with buildup of kavalactones in your central nervous system over time. Hence why we always recommend to cycle on and off from time to time. Too much of anything is never a good idea!

Precautions:

To minimize the risk of temporary cognitive impairment, it is best to use only high quality noble kava, follow the recommended kava dosages and to not mix with alcohol. Also, it is important to monitor your cognitive functions to be able to stop using kava right away when you start to feel the symptoms.

While several studies show that kava may affect cognitive functions, the evidence is limited and inconsistent. Keep in mind that kava works uniquely for everybody. Some may be more sensitive to the effects than the others.


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Kava May Lead to Psychological Dependency

While kava is not typically thought of as addictive, long-term use may cause dependence and withdrawal symptoms. This is very similar to the addictive and dependency feelings one may get from social media. Symptoms of kava withdrawal may include anxiety, insomnia and irritability.

What is Kava Dependance

Kava dependance is when a person becomes psychologically or physically dependent on kava which may lead to withdrawal once they stop using it. While kava dependence is a very rare condition, it may happen to people to use way too much kava long term. This is usually believed to be caused by the psychological dependence from the properties in kava more than a physical dependence as seen in normally accepted drugs like alcohol of coffee.

Symptoms of kava dependance:

  • Headaches or nausea

  • Cravings for the "kava head change"

  • Anxiety

  • Difficulty sleeping without kava

What is Kava Addiction

Although kava addiction is rare, it is possible for a person to develop addiction to kava. Addiction is a persistent, relapsing brain disorder marked by obsessive drug-seeking behavior despite negative outcomes.

Symptoms of kava addiction:

  • Too much use of kava

  • Neglecting negative effects of kava

  • Neglecting responsibilities

  • Loss of interest

  • Relationship and financial problems

How to Avoid Kava Dependency and Addiction

To avoid the possibility of kava dependency and addiction, it is necessary to follow the recommended dosage for kava. It is also important to take breaks from kava every couple weeks to give the body time to reset.

If you’re still worried about the possibility of dependence and addiction, it is best to speak with a health professional to help guide you on the proper kava dosage that is safe for you.

How to Treat Kava Dependence and Addiction

If anyone is already in these conditions, it is highly recommended to seek help immediately. Treatment for kava dependence and addiction includes therapy, prescribed medication or a combination of the two.  

It is crucial to work with a health professional who specializes in addiction treatment and to build a specific treatment plan.


Frequently Asked Questions

How much kava is safe?

The amount of kava a person can take depends on certain factors such as tolerance, body weight, metabolism and your body's sensitivity to the effects. But, the World Health Organization recommended a limit of only 250mg kavalactone content per day. Also, healthcare professionals advised not to take kava for more than three months to avoid the risk of potential side effects. Although some kava enthusiasts take way more than the approved limit, we always recommend to stick to the recommended dosage set by the WHO to be safe.

Please keep in mind that kava does not work equally for everyone. What work for some may not work for you.

You can also check out our kava dosage blog for more information on how much kava you should take .

How much kava is safe?

The amount of kava a person can take depends on certain factors such as tolerance, body weight, metabolism and your body's sensitivity to the effects. But, the World Health Organization recommended a limit of only 250mg kavalactone content per day. Also, healthcare professionals advised not to take kava for more than three months to avoid the risk of potential side effects. Although some kava enthusiasts take way more than the approved limit, we always recommend to stick to the recommended dosage set by the WHO to be safe.

Please keep in mind that kava does not work equally for everyone. What work for some may not work for you.

You can also check out our kava dosage blog for more information on how much kava you should take .


Conclusion

In conclusion, using kava has both possible advantages and disadvantages. On one hand, it may effectively alleviate anxiety, pain, muscle tension, and improve sleep. On the other hand, there are potential risks associated with using kava. Kava may interact with other substances and medications, and although reports of liver damage caused by kava lack conclusive evidence, it is still a possibility that should not be dismissed (ie: We are not medically trained physicians and nothing here should be substituted for medical advice)

However, it is possible to reduce the risks associated with kava by using high-quality kava from reputable sources. Similar to how ibuprofen or acetaminophen (Advil and Tylenol, respectively) can have rare negative effects on the liver, kava may also have the potential to cause liver damage, especially when used in conjunction with other substances that are metabolized in the liver, such as alcohol or certain medications like the ones mentioned above.

It is important to consult with a healthcare professional before using kava and to follow the recommended dosage guidelines. It is also essential to use kava in moderation to avoid the risk of negative side effects. We recommend using kava in the traditional manner.

References:

  1. Sarris, Jerome MHSc, PhD; Stough, Con PhD; Bousman, Chad A. PhD, MPH; Wahid, Zahra T. BPsych (Hons); Murray, Greg MPsych, PhD; Teschke, Rolf MD; Savage, Karen M. BSc(Hons); Dowell, Ashley BSc; Ng, Chee MD; Schweitzer, Isaac MD. Kava in the Treatment of Generalized Anxiety Disorder: A Double-Blind, Randomized, Placebo-Controlled Study. Journal of Clinical Psychopharmacology 33(5):p 643-648, October 2013. | DOI: 10.1097/JCP.0b013e318291be67.

  2. Boerner RJ, Sommer H, Berger W, Kuhn U, Schmidt U, Mannel M. Kava-Kava extract LI 150 is as effective as Opipramol and Buspirone in Generalised Anxiety Disorder--an 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients. Phytomedicine. 2003;10 Suppl 4:38-49. doi: 10.1078/1433-187x-00309. PMID: 12807341.

  3. Sarris J, Stough C, Bousman CA, Wahid ZT, Murray G, Teschke R, Savage KM, Dowell A, Ng C, Schweitzer I. Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol. 2013 Oct;33(5):643-8. doi: 10.1097/JCP.0b013e318291be67. PMID: 23635869.

  4. Singh, Yadhu N. Kava: an overview,Journal of Ethnopharmacology,Volume 37, Issue 1,1992, Pages 13-45.
  5. Ooi SL, Henderson P, Pak SC. Kava for Generalized Anxiety Disorder: A Review of Current Evidence. J Altern Complement Med. 2018 Aug;24(8):770-780. doi: 10.1089/acm.2018.0001. Epub 2018 Apr 11. PMID: 29641222.

  6. Fu PP, Xia Q, Guo L, Yu H, Chan PC. Toxicity of kava kava. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2008 Jan-Mar;26(1):89-112. doi: 10.1080/10590500801907407. PMID: 18322868; PMCID: PMC5868963.

  7. Savage KM, Stough CK, Byrne GJ, Scholey A, Bousman C, Murphy J, Macdonald P, Suo C, Hughes M, Thomas S, Teschke R, Xing C, Sarris J. Kava for the treatment of generalised anxiety disorder (K-GAD): study protocol for a randomised controlled trial. Trials. 2015 Nov 2;16:493. doi: 10.1186/s13063-015-0986-5. PMID: 26527536; PMCID: PMC4630875.



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