In the healthcare field, there is a myth known as the “magic bullet”. Essentially, it is the holy grail of all therapies, one that heals a disease or relieves symptoms without producing any adverse reactions. Both alternative and conventional therapies have been assigned this designation throughout the years. In the mid-1990′s, an extract from the root of the kava plant (Piper methysticum) was widely considered a magic bullet for mild-to-moderate anxiety. However, as the popularity of kava increased, so did the occasional reports of serious, liver related side effects. And, while these incidents appeared to be very rare, and were often disputed, the perceived threat was great enough for certain countries (Canada, England, Germany, etc.) to call for the removal dietary supplements containing kava from the market. Interestingly enough, the United States did not require that kava be removed from store shelves. However, the FDA demanded that all kava extracts sold in the US carry a warning about the possible liver risk associated with regular kava use. To this day, these very same warnings are carried on the labels of kava products currently available in the United States.

Several new studies emanating from Australia add some new and much needed information to the on-going debate about kava’s safety as an anxiolytic aid. The latest, published in Phytotherapy Research, determined that a twice-daily dosage of kava extract (standardized for a total of 240 mg/day of kavalactones) reduced anxiety in patients diagnosed with generalized anxiety disorder over a 6 week period. Also of note is that no change in liver function/health was documented, and improved sexual function was observed in female participants. Two additional trials from 2012 and 2013 reveal that: a) an acute dose of kava failed to reduce anxiety in the same way as chronic supplementation; b) a single dosage of 180 mg of kavalactones does not seem to impair driving ability, whereas prescriptive anti-anxiety medications sometimes do. All told, these Australian studies are, perhaps, the most accurate and realistic data published about kava in many years.

Although kava is now back on the market, prominent figures in the alternative and integrative health community are still expressing some concern. In fact, some experts are calling for carefully controlled methods of growing and processing kava in order to avoid possible contaminants and hepatotoxins, such as mold. Dr. Tieraona Low Dog, a famed herbalist and colleague of Dr. Andrew Weil, recommends looking for “high quality aqueous extracts” of kava commercially sold by such companies as Eclectic Institute. My personal view is that kava, and most other supplements used to address anxiety, is only appropriate for short-term use, if at all. Good quality kava supplements are unlikely to cause harm, if used on a temporary basis and not combined with alcohol or prescription medications. Nevertheless, it’s far preferable to find a mind-body or psychological approach to reduce chronic anxiety, panic and stress. There are many clinically validated, non-toxic options to choose from, including so-called tapping techniques which go by the popular names, “Emotional Freedom Technique” and “Thought Field Therapy”. I’ve been recommending and using a similar practice recently with very positive results.

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Time Magazine: The Root of Tranquility … (link)

Study 2 - Kava for the Treatment of Generalized Anxiety Disorder RCT … (link)

Study 3 - The Acute Effects of Kava and Oxazepam on Anxiety, Mood … (link)

Study 4 - Does a Medicinal Dose of Kava Impair Driving? A Randomized … (link)

Study 5 – Proposal for a Kava Quality Standardization Code … (link)

Study 6 - Contaminant Hepatotoxins as Culprits for Kava Hepatotoxicity … (link)

Study 7 – Dr. Andrew Weil: Keen On Kava? … (link)

Study 8 – Thought Field Therapy (TFT) as a Treatment for Anxiety Symptoms … (link)

Study 9 - The Effect of Emotional Freedom Techniques on Stress Biochemistry … (link)

Study 10 - The Immediate Effect of a Brief Energy Psychology Intervention … (link)

Measures That May Reduce the Liver Risk Associated w/ Kava Use

Source: Br J Clin Pharmacol. 2011 March; 71(3): 445–448. (link)

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