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Kava Fact of the Day Why we suggest 24 hours between alcohol and kava.

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
Alcohol, Kava, Mast Cells, DAO, and Histamine Intolerance.

The fact of the day yesterday was regarding mast cells, and how they play a part in the “kava allergy” we sometimes see. Today’s fact will be adding ethanol to the equation which, for some people, seems to lower the threshold for acquiring the allergic type reaction we can sometimes see in individuals that combine them. We also open the door to the possibility of histamine intolerance playing an important part.

Kava has been known to cause a rare allergic type reaction in some individuals. This leads to flushing, itching, and hive formation on the skin. This has been traced back to mast cell activation and the release of heparin and histamine by the action of some component in aqueous kava extracts (traditional kava). It has been found that other aggravators can cause this problem in people sensitive to mast cell activation. This sensitivity is known as MCAS “Mast Cell Activation Syndrome”, or Mastocytosis. This is characterized by the accumulation of excess mast cells in various parts of the body in most diagnoses, however some types of MCAS do not present themselves in this manner. The most common form of this is found in the mast cells of the skin, with rarer forms being found in the digestive tract, bones and other areas of the body. This is quite rare, however people with this syndrome can display dermatographia, a condition known for being able to draw on the skin with a dull pencil or pen only to have that area raise up and turn red as if reacting to an allergen or surface abrasion.

The triggers of mast cell activation can be [1]:

  • Heat, cold or sudden temperature changes
  • Stress: emotional, physical, including pain, or environmental (i.e., weather changes, pollution, pollen, pet dander, etc.)
  • Exercise
  • Fatigue
  • Food or beverages, including alcohol (spirits and wine more likely than beer [2])
  • Drugs (opioids, NSAIDs, antibiotics and some local anesthetics) and contrast dyes
  • Natural odors, chemical odors, perfumes and scents
  • Venoms (bee, wasp, mixed vespids, spiders, fire ants, jelly fish, snakes, biting insects, such as flies, mosquitos and fleas, etc.)
  • Infections (viral, bacterial or fungal)
  • Mechanical irritation, friction, vibration
  • Sun/sunlight
As evidenced, the list of triggers for mast cell activation in people who may be sensitive can be numerous, and differing amounts of these can trigger mast cell activation to different degrees. Today we’re theorizing that alcohol when combined with kava can lower this threshold to mast cell activation in combination with DAO reduction and lead to a histamine intolerance which can be expressed in an allergic type reaction.

Histamine Intolerance:

Histamine intolerance is not a sensitivity to histamine, but an indication that you’ve developed too much of it [3]. Histamine from foods is naturally broken down in the body by the enzyme called diamine oxidase (DAO). A deficiency of DAO will cause the body to retain an excess amount of histamine and can also cause the allergy type reactions we’ve seen. Alcohol has been seen to reduce the levels of DAO in the body even in healthy individuals. Ethanol was shown to aggressively attack DAO, so even with normal levels of DAO in the body histamine saturation may occur [4]. Going one level further; alcohol and histamine compete for metabolization because they share the common enzymes aldehyde dehydrogenase and aldehyde oxidase. The metabolites of alcohol can effectively compete with the metabolites of histamine. Alcohol in this scenario can both cause mast cells to release their histamine, and prevent the body from removing it at the same time [5]. This amplification of histamine with alcohol through compounding mechanisms combined with the activity at mast cells that kava can provide gives us a better look into a possible cause of this problem.



[1] Symptoms and triggers of mast cell activation. (n.d.). TMS - The Mast Cell Disease Society, Inc. Retrieved March 18, 2021, from https://tmsforacure.org/symptoms/symptoms-and-triggers-of-mast-cell-activation/

[2] Hamilton Matthew, J. Scarlata Kate. (2020). Mast Cell Activation Syndrome – What it Is and Isn’t. NUTRITION ISSUES IN GASTROENTEROLOGY. https://med.virginia.edu/ginutritio...6/Mast-Cell-Activation-Syndrome-June-2020.pdf

[3] Histamine intolerance: Causes, symptoms, and diagnosis. (2018, August 13). Healthline. https://www.healthline.com/health/histamine-intolerance

[4] DAO blocking foods—Deficitdao.org—Official Scientific Society. (n.d.). Deficitdao_Org. Retrieved March 18, 2021, from https://www.deficitdao.org/en/dao-d...s-in-histamine-metabolism/dao-blocking-foods/

[5] Zimatkin SM, Anichtchik OV. Alcohol-histamine interactions. Alcohol Alcohol. 1999 Mar-Apr;34(2):141-7. doi: 10.1093/alcalc/34.2.141. PMID: 10344773.
(https://academic.oup.com/alcalc/article/34/2/141/192121)
 

Alia

'Awa Grower/Collector
Alcohol, Kava, Mast Cells, DAO, and Histamine Intolerance.

The fact of the day yesterday was regarding mast cells, and how they play a part in the “kava allergy” we sometimes see. Today’s fact will be adding ethanol to the equation which, for some people, seems to lower the threshold for acquiring the allergic type reaction we can sometimes see in individuals that combine them. We also open the door to the possibility of histamine intolerance playing an important part.

Kava has been known to cause a rare allergic type reaction in some individuals. This leads to flushing, itching, and hive formation on the skin. This has been traced back to mast cell activation and the release of heparin and histamine by the action of some component in aqueous kava extracts (traditional kava). It has been found that other aggravators can cause this problem in people sensitive to mast cell activation. This sensitivity is known as MCAS “Mast Cell Activation Syndrome”, or Mastocytosis. This is characterized by the accumulation of excess mast cells in various parts of the body in most diagnoses, however some types of MCAS do not present themselves in this manner. The most common form of this is found in the mast cells of the skin, with rarer forms being found in the digestive tract, bones and other areas of the body. This is quite rare, however people with this syndrome can display dermatographia, a condition known for being able to draw on the skin with a dull pencil or pen only to have that area raise up and turn red as if reacting to an allergen or surface abrasion.

The triggers of mast cell activation can be [1]:

  • Heat, cold or sudden temperature changes
  • Stress: emotional, physical, including pain, or environmental (i.e., weather changes, pollution, pollen, pet dander, etc.)
  • Exercise
  • Fatigue
  • Food or beverages, including alcohol (spirits and wine more likely than beer [2])
  • Drugs (opioids, NSAIDs, antibiotics and some local anesthetics) and contrast dyes
  • Natural odors, chemical odors, perfumes and scents
  • Venoms (bee, wasp, mixed vespids, spiders, fire ants, jelly fish, snakes, biting insects, such as flies, mosquitos and fleas, etc.)
  • Infections (viral, bacterial or fungal)
  • Mechanical irritation, friction, vibration
  • Sun/sunlight
As evidenced, the list of triggers for mast cell activation in people who may be sensitive can be numerous, and differing amounts of these can trigger mast cell activation to different degrees. Today we’re theorizing that alcohol when combined with kava can lower this threshold to mast cell activation in combination with DAO reduction and lead to a histamine intolerance which can be expressed in an allergic type reaction.

Histamine Intolerance:

Histamine intolerance is not a sensitivity to histamine, but an indication that you’ve developed too much of it [3]. Histamine from foods is naturally broken down in the body by the enzyme called diamine oxidase (DAO). A deficiency of DAO will cause the body to retain an excess amount of histamine and can also cause the allergy type reactions we’ve seen. Alcohol has been seen to reduce the levels of DAO in the body even in healthy individuals. Ethanol was shown to aggressively attack DAO so even with normal levels of DOA in the body, histamine saturation may occur [4]. Going one level further; alcohol and histamine compete for metabolization because they share the common enzymes aldehyde dehydrogenase and aldehyde oxidase. The metabolites of alcohol can effectively compete with the metabolites of histamine. Alcohol in this scenario can both cause mast cells to release their histamine, and prevent the body from removing it at the same time [5]. This amplification of histamine with alcohol through compounding mechanisms combined with the activity at mast cells that kava can provide gives us a better look into a possible cause of this problem.



[1] Symptoms and triggers of mast cell activation. (n.d.). TMS - The Mast Cell Disease Society, Inc. Retrieved March 18, 2021, from https://tmsforacure.org/symptoms/symptoms-and-triggers-of-mast-cell-activation/

[2] Hamilton Matthew, J. Scarlata Kate. (2020). Mast Cell Activation Syndrome – What it Is and Isn’t. NUTRITION ISSUES IN GASTROENTEROLOGY. https://med.virginia.edu/ginutritio...6/Mast-Cell-Activation-Syndrome-June-2020.pdf

[3] Histamine intolerance: Causes, symptoms, and diagnosis. (2018, August 13). Healthline. https://www.healthline.com/health/histamine-intolerance

[4] DAO blocking foods—Deficitdao.org—Official Scientific Society. (n.d.). Deficitdao_Org. Retrieved March 18, 2021, from https://www.deficitdao.org/en/dao-d...s-in-histamine-metabolism/dao-blocking-foods/

[5] Zimatkin SM, Anichtchik OV. Alcohol-histamine interactions. Alcohol Alcohol. 1999 Mar-Apr;34(2):141-7. doi: 10.1093/alcalc/34.2.141. PMID: 10344773.
(https://academic.oup.com/alcalc/article/34/2/141/192121)
While all the Kava Fact of the Day's are important, relevant, educational...today's is worth keeping in the forefront and having further discussion.
It may be that today's National Public Radio story about the pandemic and increased use of alcohol in the young and how--even in the young-- alcohol related liver failure is on the rise, prompts my rant. My own "opinion" would be to never drink alcohol. That may sound radical and we know the argument -- moderate drinking, etc. I'd still maintain a firm NO. As for 24 hours? between alcohol and kava maybe acceptable. But how long really does it take to get alcohol completely out of your system? We know alcoholics go through DT's for quite a long time. Excuse my rant but a few cups of fresh made or dry-made kava beverage is a far better candidate for a healthy lifestyle. There was also that study suggesting yangonin actually helps liver function.
 

Groggy

Kava aficionado
Admin
While all the Kava Fact of the Day's are important, relevant, educational...today's is worth keeping in the forefront and having further discussion.
It may be that today's National Public Radio story about the pandemic and increased use of alcohol in the young and how--even in the young-- alcohol related liver failure is on the rise, prompts my rant. My own "opinion" would be to never drink alcohol. That may sound radical and we know the argument -- moderate drinking, etc. I'd still maintain a firm NO. As for 24 hours? between alcohol and kava maybe acceptable. But how long really does it take to get alcohol completely out of your system? We know alcoholics go through DT's for quite a long time. Excuse my rant but a few cups of fresh made or dry-made kava beverage is a far better candidate for a healthy lifestyle. There was also that study suggesting yangonin actually helps liver function.
Kava is a far better substitute than alcohol, I am a strong proponent to what you are saying. If only everyone chose kava over an alcoholic beverage they as well as us (as a whole would be a lot better off). Of course kava would cost north of $100 a pound. Joking aside, it's easier for me to have this opinion since I am an ex drinker going on 7 years. I would go as far as saying that perhaps a lot kava allergic reactions are in fact because of alcohol or some other side effect from some other medication, of course I have no scientific evidence but it is not an entirely outrageous idea.
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
While all the Kava Fact of the Day's are important, relevant, educational...today's is worth keeping in the forefront and having further discussion.
It may be that today's National Public Radio story about the pandemic and increased use of alcohol in the young and how--even in the young-- alcohol related liver failure is on the rise, prompts my rant. My own "opinion" would be to never drink alcohol. That may sound radical and we know the argument -- moderate drinking, etc. I'd still maintain a firm NO. As for 24 hours? between alcohol and kava maybe acceptable. But how long really does it take to get alcohol completely out of your system? We know alcoholics go through DT's for quite a long time. Excuse my rant but a few cups of fresh made or dry-made kava beverage is a far better candidate for a healthy lifestyle. There was also that study suggesting yangonin actually helps liver function.
We share the same opinion. Half-life of ethanol is 4-5 hours so you may be looking at somewhere around 3% of the original dose at the 24 hour mark. I would honestly rather that number be zero. Alcohol DTs are more related to the damage caused to the GABA system during continual activation by ethanol. It takes quite a while for that system to come back into homeostasis.

It really is sad that this plant has been demonized for super-disputed liver issues when you can order up however many glasses of liver death as you so please at the local Applebee's bar and rarely anyone bats an eye.
 

Rami MeloMelo

Berkeley, CA
Kava Vendor
Kava and alcohol should not mix for a number of reasons. There's definitely some play with mast cells, and there's the issue of kavalactones interacting with Cytochrome P450, one of the major enzymes responsible for breakdown of alcohol, as well as metabolism of numerous drugs. Seems certain KLs bind to P450 and can inhibit its function. How well is this studied? Not very, so we can't say definitively if this is the case or not, but from some self-experimentation, this seems to hold water. Curiously, only with certain strains in my case (I guess the different chemotypes play a role?). In Vanu, they call this cement mixing, wherein you have a few shells, and then knock back a beer or two. "Cements" my feet alright. Don't recommend at all, then again, I know a few readers here are the experimental type (that's why you drink kava, no?).

Anyways here's a study for you to chew on:

 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
Kava and alcohol should not mix for a number of reasons. There's definitely some play with mast cells, and there's the issue of kavalactones interacting with Cytochrome P450, one of the major enzymes responsible for breakdown of alcohol, as well as metabolism of numerous drugs. Seems certain KLs bind to P450 and can inhibit its function. How well is this studied? Not very, so we can't say definitively if this is the case or not, but from some self-experimentation, this seems to hold water. Curiously, only with certain strains in my case (I guess the different chemotypes play a role?). In Vanu, they call this cement mixing, wherein you have a few shells, and then knock back a beer or two. "Cements" my feet alright. Don't recommend at all, then again, I know a few readers here are the experimental type (that's why you drink kava, no?).

Anyways here's a study for you to chew on:

Hi Rami!

I almost made my fact of the day on this one about the P450s and alcohol because of that study, however it looks like another study was performed precisely on the mechanism in question here which found quite a different conclusion (No kavalactone affected ADH inhibition by more than 10% even at the highest concentrations in vitro)


Be that as it may, I still think there is something to be said about this avenue of action in the P450 group. I had one reddit member say that every time they mix alcohol and kava too closely together it feels exactly like the combination of antabuse and alcohol.
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
Whats your thoughts on like kombucha with kava?
The only way you would probably gain adverse effects with that combination is if you're already extremely (and I mean EXTREMELY) predisposed to having allergy issues. It's likely the kombucha or kava alone would cause it if you were that sensitive. Kombucha on the store shelf has such a low content of ethanol that it shouldn't cause any issues for 99.9999% of people.
 

PurimGrogger

Because "Shell Silverstein" was already taken
Hi Rami!

I almost made my fact of the day on this one about the P450s and alcohol because of that study, however it looks like another study was performed precisely on the mechanism in question here which found quite a different conclusion (No kavalactone affected ADH inhibition by more than 10% even at the highest concentrations in vitro)


Be that as it may, I still think there is something to be said about this avenue of action in the P450 group. I had one reddit member say that every time they mix alcohol and kava too closely together it feels exactly like the combination of antabuse and alcohol.
Yes. I've never had antabuse, and still enjoy an occasional stiff drink. But doing so within 12-15 hrs of some kava, or within 24 of the known strong kavas, has been disastrous. A beer or two has been fine. The spirits, more than a couple, oh man. Several hours later, it'll remind you how dumb of you that was . . .
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
Yes. I've never had antabuse, and still enjoy an occasional stiff drink. But doing so within 12-15 hrs of some kava, or within 24 of the known strong kavas, has been disastrous. A beer or two has been fine. The spirits, more than a couple, oh man. Several hours later, it'll remind you how dumb you that was . . .
That's what I've been hearing as well. For some people if they even approach that 24 hour limit it's hive city time.
 

Alia

'Awa Grower/Collector
Hi Rami!

I almost made my fact of the day on this one about the P450s and alcohol because of that study, however it looks like another study was performed precisely on the mechanism in question here which found quite a different conclusion (No kavalactone affected ADH inhibition by more than 10% even at the highest concentrations in vitro)


Be that as it may, I still think there is something to be said about this avenue of action in the P450 group. I had one reddit member say that every time they mix alcohol and kava too closely together it feels exactly like the combination of antabuse and alcohol.
Please note-- "a folkloric beverage". Has a nice ring to it.
 

Aceofwands9

Kava Enthusiast
The only way you would probably gain adverse effects with that combination is if you're already extremely (and I mean EXTREMELY) predisposed to having allergy issues. It's likely the kombucha or kava alone would cause it if you were that sensitive. Kombucha on the store shelf has such a low content of ethanol that it shouldn't cause any issues for 99.9999% of people.
Good to know- i've got some kombucha in the fridge that i've been scared to drink.
Would you say the same thing is true for using herbal tinctures?
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
Good to know- i've got some kombucha in the fridge that i've been scared to drink.
Would you say the same thing is true for using herbal tinctures?
I would. I don't recommend alcohol based tinctures just because, well, they usually aren't all that great, but unless you're drinking the entire bottle, it wont be enough ethanol to cause effect.
 

Nirad

Kava Curious
This all makes sense! At the start of the pandemic I had trouble getting Kava and old habits came in, I would break out in crazy itchy blotched skin after a couple beers that I could only get under control with an antihistamine. After a few weeks this stopped and I consumed (way more than I should have) beer without issue. Now that I am at a place with an actual mailbox and can get Kava again (long story ask me later :) ) when I started transitioning back from booze to Kava I had a the same histamine reaction.
 

jonaspmd

found kava
Some on this forum compared kava flush to Asian flush caused by defective ADH, which is not an allergic reaction per se, but the accumulation of the aldehyde causes histamine release. No experience with this, but antihistamine Pepcid (the indication of which is stomach acid production) is apparently used to manage the Asian flush. I wonder if anyone tried it for Kava flush.
 

Aceofwands9

Kava Enthusiast
The only way you would probably gain adverse effects with that combination is if you're already extremely (and I mean EXTREMELY) predisposed to having allergy issues. It's likely the kombucha or kava alone would cause it if you were that sensitive. Kombucha on the store shelf has such a low content of ethanol that it shouldn't cause any issues for 99.9999% of people.
Yeah, I drank a kombucha after having some kava. No problems.
 

Fushi88

Kava Enthusiast
I'm not concerned about Hives so much as if I have Kava tonight and drink a few beers tomorrow afternoon/evening will my liver explode lol
 
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