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Kava Kava

Kava kava is native to the South Pacific region. The root of this plant is used as a medicine.

There are strong concerns about the safety of kava kava. Many cases of liver damage and even some deaths have been attributed to the use of kava kava. As a result, kava kava has been banned from the supplement market in Germany, Switzerland and numerous other countries. This ban has severely affected the economies of the Pacific islands that export kava k ava. Kava kava is used to calm anxiety, stress and restlessness, as well as to treat sleep problems. Kava kava is also used for attention deficit hyperactivity disorder (ADHD), epilepsy, psychosis, depression, migraines, headaches, chronic fatigue syndrome, colds and other respiratory infections, tuberculosis and muscle pain, as well as for cancer prevention. Some people use kava kava for urinary tract infections, uterine pain, uterine swelling, sexually transmitted diseases and menstrual problems, as well as to stimulate sexual desire. Kava kava is applied to the skin for skin diseases such as leprosy to relieve pain and promote wound healing. It is also used as a mouthwash for mouth ulcers and toothache. Kava kava got its name from the explorer Captain Cook, who chose a name that means "intoxicating pepper". Even though Cook gave the plant its name, he did not discover it. Kava-kava has been used for thousands of years by the inhabitants of the Pacific islands. Today, kava-kava is a popular drink in the South Pacific, comparable to alcohol in Western society. Kava-kava still plays a role in rituals and ceremonies.

How does kava kava work?

Kava kava affects the brain and other parts of the central nervous system. It is believed that the kava lactones contained in kava kava are responsible for this.

How effective is kava kava?

Kava kava may be effective for anxiety. The majority of research shows that certain kava kava extracts (extracts standardized to 70% kava lactones) can relieve anxiety and work as well as prescription anti-anxiety medications called low-dose benzodiazepines. However, it can take up to 8 weeks to see improvement.

There is not enough scientific data to make a statement regarding the effectiveness of kava kava for the following uses:

  • Benzodiazepine withdrawal symptoms: Some research suggests that slowly increasing the dosage of kava-kava while reducing the dose of benzodiazepines over the course of a week may prevent withdrawal symptoms and reduce anxiety in people who had been taking benzodiazepines for a long period of time.
  • Cancer prevention: There is some evidence that taking kava kava may help protect against cancer.
  • Insomnia: The evidence regarding the effectiveness of kava kava for people with sleep problems is unclear. Studies have shown that taking 200 mg of kava kava extract (WS1490) reduces sleep problems associated with anxiety disorders. However, another study using a different kava kava product did not show such an effect.
  • Anxiety disorders associated with menopause. Early research shows that taking 300 mg of kava kava extract (WS1490) daily for 8 weeks can reduce anxiety and hot flashes in menopausal women.
  • Stress: New research suggests that taking a single dose of kava kava may reduce the physical changes associated with mentally stressful tasks.

There is also a lack of scientific information on the effectiveness of kava kava for restlessness, attention deficit hyperactivity disorder (ADHD), epilepsy, psychosis, depression, chronic fatigue syndrome, headaches, colds, respiratory infections, tuberculosis, rheumatic joint pain, chronic bladder infections, sexually transmitted diseases and menstrual problems.

Further scientific research is needed to evaluate the effectiveness of kava kava in these applications.

Safety and side effects

Kava kava may not be safe and harmless when taken orally and should therefore not be used. Even short-term use at normal doses has been associated with serious illness. Use of kava kavafor only one to three months has led to the need for liver transplants and even deaths. Early symptoms of liver damage include yellowing of the eyes and skin (jaundice), fatigue and dark urine. If you decide to use kava kava despite all the warnings, you should have regular liver function tests. Use of kava k ava may impair the ability to drive or operate machinery safely. You should not take Kava-Kava if you intend to drive a vehicle.

Important note

On June 14, 2002, the German Federal Institute for Drugs and Medical Devices largely revoked the marketing authorizations for Kava-Kava and products containing Kavaine. Only homeopathic remedies containing very small amounts of the root extract are exempt (from D5). The decision was based on the severe side effects. In 40 individual case reports in Germany, serious liver damage occurred in connection with kava kava. In six cases, liver failure occurred so that a liver transplant had to be performed. Three patients died as a result of the liver damage. According to the Federal Institute, the severe side effects were not offset by sufficient benefit. According to the Hawaiian scientist C. S. Tang, it was probably the incorrect processing of the Polynesian intoxicating pepper that led to the liver diseases (see news from April 9, 2003). For the kava-containing products sold in Europe and the USA, not only the rhizome but also the leaves and stems of the plant were processed. South Sea inhabitants, on the other hand, only use the rhizome, according to Tang. Tang sees evidence of this in the fact that no liver damage has been reported as a result of consuming the kava drink. It is unclear whether products containing kava will be re-approved in the foreseeable future, as this would require new research, which would cost a lot of money.

Precautions and warnings

Pregnancy and breastfeeding: Pregnant and breastfeeding women should not use Kava-Kava. Kava kava may not be safe and harmless when taken orally. There are concerns that kava kava may affect the uterus. In addition, some of the dangerous chemicals in kava kava may pass into breast milk and harm the nursing infant.

Depression: Kava kava use could worsen depression.

Liver problems: Kava k ava places a heavy burden on even a healthy liver. Taking kava kava is therefore particularly risky for people who suffer from liver disease.

Operations: Kava kava affects the central nervous system. Kava kava may increase the effects of anesthetics and other medications used during and after surgery. You should therefore stop taking kava kava at least 2 weeks before planned operations.

Interactions

Kava-Kava should not be taken in combination with the following medications:

Alprazolam

Kava-Kava can cause drowsiness. Alprazolam can also cause drowsiness and dizziness. Taking kava kava in combination with alprazolam can cause excessive drowsiness. For this reason, kava kava should not be taken in combination with alprazolam.

Sedatives (substances that suppress the CNS)

Kava-Kava can cause drowsiness and dizziness. Drugs that cause drowsiness are called sedatives. Taking kava kava in combination with sedatives may increase drowsiness too much.

Care should be taken when combining kava kava with the following medications:

Levodopa

Levodopa affects the brain by increasing the levels of the brain chemical dopamine. Kava-kava could lower the dopamine levels in the brain. Taking kava kava in combination with levodopa could reduce the effectiveness of levodopa. Drugs that are broken down by the liver (cytochrome P450 1A2 (CYP1A2) substrates, cytochrome P450 2C19 (CYP2C19) substrates, cytochrome P450 2C9 (CYP2C9) substrates, Cytochrome P450 2D6 (CYP2D6) substrates, Cytochrome P450 2E1 (CYP2E1 substrates, Cytochrome P450 3A4 (CYP3A4 substrates) Some drugs are broken down by the liver. Kava kava can reduce the rate at which the liver breaks down certain drugs. Taking kava kava in combination with medications that are broken down by the liver may increase the effects and side effects of some medications. For this reason, you should consult your doctor before taking kava kava if you are taking medication that is broken down by the liver. Drugs that are transported into the cells by pumps (P-glycoprotein substrates) Some drugs are transported into the cells by pumps. Kava-Kava can make these pumps less active and increase the amount of drug absorbed by the body. This could increase the levels of certain drugs in the body. However, there is not enough information to say whether this is a major cause for concern.

Medications that can damage the liver

Kava kava can damage the liver. Using kava kava in combination with medications that can also damage the liver can increase the risk of liver damage. For this reason, kava kava should not be used if you are taking medication that can damage the liver.

Dosage

An appropriate dosage of kava kava depends on various factors such as age, health status and others. At this time, there is insufficient scientific data to determine appropriate dosage ranges for kava k ava. For this reason, you should follow the dosage instructions on the label and/or consult a doctor or pharmacist before use.

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