Kava: nature's relaxant

by Elaine Gottlieb

Along with St. Johns Wort and echinacea, kava is rapidly becoming one of the most popular herbal remedies in the United States.

At the end of a tough workday, many Americans grab a beer at the local bar. Across the globe, however, South Pacific islanders down an herbal "kava cocktail" served in a coconut shell at a kava bar. Given the burgeoning popularity of this herbal relaxant, there may soon be kava bars all over the United States, where sales of kava have grown from $15 million in 1996 to an estimated $50 million in 1998.

For more than 3,000 years the kava plant has been an integral part of the social and cultural life of the South Pacific region of Oceania, which includes New Guinea, Fiji, Samoa, Tahiti and the Vanuatu archipelago, where kava is believed to have originated. The drink made from the root of the kava plant is consumed at all major rituals and social occasions. Once only chiefs and important people enjoyed kavas relaxing effects; at traditional kava ceremonies today, participants are still served in order of rank.

On Captain Cooks maiden voyage to the South Pacific in 1768, he discovered an active kava culture. A botanist on board named the herb "intoxicating pepper," perhaps based on the fact that kava is derived from a pepper plant. Over the years, many notable personalities have sampled kava during visits to Oceania: President and Lady Bird Johnson in Samoa, Great Britains Queen Elizabeth and Pope John Paul II in Fiji, and Hillary Rodham Clinton.

Introduced in Europe in the late 19th and early 20th centuries where it has been extensively studied, kava contains several psychoactive lactones that affect the central nervous system. Specifically these kavalactones act on the amygdala, a part of the brain that regulates the emotions of fear and anxiety; tranquilizers like valium and Xanax also work on this same brain site.

Unlike psychiatric medications, however, kava does not produce physiologic dependency or side effects or dull the mind. "Whats curious about kava relative to all other known relaxants is that it doesnt diminish cognitive functioning at all," reports Chris Kilham, author of the book Kava: Medicine Hunting in Paradise. "Exactly why thats so we dont know."

Next to the opium poppy, kava is the most potent botanical relaxant in nature. It is used primarily to treat stress, nervousness, insomnia and muscular tension. Nurse practitioner Donna George, co-director of The Marino Center for Progressive Health in Cambridge, Massachusetts, recommends kava for patients experiencing stress or anxiety. "Kava is wonderful for intermittent anxiety caused by an event or particular stress; it helps create the balance that exists except during times of stress."

George relates the story of a colleague who came to a staff meeting "really stressed out over buying a house. I gave her some kava tea and the difference was striking: she calmed right down." George also found kava beneficial to a cancer patient anxious about undergoing radiation therapy.

Kavas immediate effects are unusual among botanicals, reports Kilham. "You cant immediately feel the effect of most botanicals, even ones we know are unquestionably good for us." Only very rarely do plants act so fast; caffeine is another good example. For a culture of people who not only increasingly want natural products, but also want effects fast, "kava really fills the bill," he says.

George believes that kava is most effective for short-term, not severe, anxiety. When anxiety persists longer than a few months, there are deeper issues that need to be explored, she says. That view is shared by Dr. Roberta Lee, an Arizona internist who discovered kava while working in the Pacific. "My hunch is that it [kava] wouldnt be appropriate for someone with very major anxiety," she told the New York Times. Moreover, kava should not be taken with alcohol, antidepressants, tranquilizing drugs or St. Johns Wort, the herbal antidepressant.

When it comes to insomnia, kava is most helpful when sleeplessness is caused by anxiety. It can calm a racing mind and relax twitchy or tense muscles to allow sleep. But kava doesnt induce sleep and may not be as effective as other herbal sleep remedies.

Many women use kava to relieve menstrual cramps, reports Kilham. In a 1991 German study, kava was also shown to relieve unpleasant menopause symptoms, including hot flashes, mood swings, body aches, anxiety and depression.

In the Pacific islands, kava is used in traditional folk medicine to treat urogenital inflammation, cystitis, whooping cough, fungal infections, skin inflammations and gonorrhea. Here in the U.S., the first studies of kava are currently being conducted at Duke University Medical School (for anxiety) and Columbia University Medical School (for post-operative pain).

While European research on kava has been mainly positive, some studies have found skin and liver problems among long-term or heavy kava users. Pregnant or lactating women are advised not to take it.

The traditional way to consume kava is to drink it as a strong liquid brew that numbs the mouth. For anyone wanting an authentic kava experience, Kilham recommends the bottled herbal extracts available at health food stores. However, the easiest way to take kava is in capsule form.

Kilham warns that most of the kava products on the market today are "pure garbage" and contain so little kavalactones "you couldnt take enough, if you took bottles at a time, to get an effect." He advises consumers to check the label to be sure that a standard dose supplies 70 milligrams of kavalactones, the minimum amount shown to produce an effect. Products that claim to have large quantities of just kava, not kavalactones, are not effective.

So the next time your stress level goes off the charts, you may want to find out whether the herb that Kilham calls "the friendly plant that takes the edge off things" works for you.