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

[The Kap'n]

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

Nah, you'll be fine. The flushing reaction w/ hives and allergy are what you should watch out for. The liver is remarkably adaptable and a few instances of beers the day after kava will have little, if any impact on the physical well-being of your liver.

It's the high alcohol drinks that you should absolutely stay away from if you're a regular kava drinker. Ideally none, but beer isn't going to hurt you in this scenario.

I just wouldn't make a habit out of it.

 

[Fushi88]

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:

Inhibition of Human Cytochrome P450 Activities by Kava Extract and Kavalactones

The herb kava has recently been associated with numerous drug interactions, but its interaction with cytochrome P450 (P450) enzymes has not been investigated. In the present work the inhibition of P450 enzymes by kava extract and individual kavalactones in human liver microsomes (HLMs) was...

doi.org

Can someone explain this to me like 5? I feel dumb for not understanding but I don't and the only way I will is if I ask

 

[The Kap'n]

Can someone explain this to me like 5? I feel dumb for not understanding but I don't and the only way I will is if I ask

Interestingly, I was working on exactly this for Monday's fact of the day so here's a little preview.


Kava, and more specifically kava extracts have been shown to inhibit the chemicals in our liver that break down pharmaceutical drugs. These chemicals are enzymes and they function to metabolize a very wide array of drugs and chemicals into their metabolites in the human liver. (https://en.wikipedia.org/wiki/Cytochrome_P450)

When one or more of these enzymes are inhibited it reduces their ability to work on breaking down other chemicals.

There is thought and several papers have provided evidence that kava can inhibit CYP1A2, CYP2C9, CYP2C19, CYP2D6 (little, if any), and CYP3A4.

Alcohol, from what I'm seeing is broken down by CYP2E1 [1]. I'm not 100%, and it seems neither are these papers, but kava doesn't seem to hit this enzyme [1,2] in an inhibitory fashion. It may actually induce activity at CYP2E1 [3]. There could be other down-process metabolites of ethanol that may interact with kava, but the science is still out in this arena. Yangonin doesn't seem to have been tested in these studies. DHM and Methysticin seem to be the most potent inhibitors in kava.


[1] Peter Guengerich, F, and Narayan G Avadhani. “Roles of Cytochrome P450 in Metabolism of Ethanol and Carcinogens.” Advances in experimental medicine and biology vol. 1032 (2018): 15-35. doi:10.1007/978-3-319-98788-0_2

[2]Anke, J., & Ramzan, I. (2004). Pharmacokinetic and pharmacodynamic drug interactions with Kava (Piper methysticum Forst. f.). In Journal of Ethnopharmacology (Vol. 93, Issues 2–3, pp. 153–160). https://doi.org/10.1016/j.jep.2004.04.009

[3] Tugcu, G., Kırmızıbekmez, H., & Aydın, A. (2020). The integrated use of in silico methods for the hepatotoxicity potential of Piper methysticum. Food and Chemical Toxicology, 145. https://doi.org/10.1016/j.fct.2020.111663

 

[Halibut_Acid]

So I've noticed when I've had a drink later in the day after kava it tends to make me feel an enhanced buzz for ~30 minutes, but then I experience all the negative effects of ethanol more intensely than usual. Then for the rest of the day it's just anxiety and racing thoughts. Wonder what the mechanisms are for this.

 

[jonaspmd]

So I've noticed when I've had a drink later in the day after kava it tends to make me feel an enhanced buzz for ~30 minutes, but then I experience all the negative effects of ethanol more intensely than usual. Then for the rest of the day it's just anxiety and racing thoughts. Wonder what the mechanisms are for this.

General advice against alcohol with kava applies, but specifically to your question, pay attention if you have that drink on an empty stomach. I bet people realise how important is empty stomach on resorption time only when they start drinking kava. But it applies to absolutely all psychoactives that are ingested, including coffee and alcohol and every herbal tea out there. If you drink alcohol on an empty stomach, then the resorption and peak plasma levels are reached much faster, hence the buzz. The elimination is also faster, hence come down effects (let's call them so) of irritability and anxiety.

Something else might be happening as well, as we know that certain kavalactones have different half lives, so there might be some interaction happening, which you experience in your own personal way.

 

[Halibut_Acid]

General advice against alcohol with kava applies, but specifically to your question, pay attention if you have that drink on an empty stomach. I bet people realise how important is empty stomach on resorption time only when they start drinking kava. But it applies to absolutely all psychoactives that are ingested, including coffee and alcohol and every herbal tea out there. If you drink alcohol on an empty stomach, then the resorption and peak plasma levels are reached much faster, hence the buzz. The elimination is also faster, hence come down effects (let's call them so) of irritability and anxiety.

Something else might be happening as well, as we know that certain kavalactones have different half lives, so there might be some interaction happening, which you experience in your own personal way.

Yeah I'm wondering if it's an enzyme thing. I try not to drink alcohol without eating something first. I also try to avoid having alcohol and kava within 24 hours of each other, but it has happened a few times. I can definitely tell the rate the BAC increases has a huge effect on the way alcohol feels. But yeah always trying to continue to cut back on alcohol and consistently becoming more aware of how it affects me at different times. It is rarely all that worth it is the conclusion I'm coming to I simply prefer other psychoactives.

 

[Rami MeloMelo]

I just gotta say I'm loving the input and reactions people are having, it's really exciting to see people take sure in interest in kava, their reactions, and it's own interactions. I feel confident about my choice in pursuing this plant on a more academic setting seeing this level of interest! Maybe I'll get cracking on a book... When I find an extra few hours in the day.

 

[StevenF]

OK, I've read every post here but I'm still confused on how long I give Alcohol and Kava apart.

What (I THINK) I understand is:

Alcohol ---> Kava (Leave at least 24 Hours apart)

Kava ---> Alcohol (Leave at least 24 Hours apart)

I'm I right? Is the above the most recommended apart from (Don't Drink)?

 

[The Kap'n]

OK, I've read every post here but I'm still confused on how long I give Alcohol and Kava apart.

What (I THINK) I understand is:

Alcohol ---> Kava (Leave at least 24 Hours apart)

Kava ---> Alcohol (Leave at least 24 Hours apart)

I'm I right? Is the above the most recommended apart from (Don't Drink)?

As a general rule we suggest 24 hours in each scenario, however if you're a regular kava drinker (as in daily) then Kava ------> Alcohol may need more time as kava has been building up in your system. If you turn red and develop hives then you'll know to double the amount of time between the two. I fully believe the issues are due to a temporary artificial histamine intolerance.

 

[StevenF]

As a general rule we suggest 24 hours in each scenario, however if you're a regular kava drinker (as in daily) then Kava ------> Alcohol may need more time as kava has been building up in your system. If you turn red and develop hives then you'll know to double the amount of time between the two. I fully believe the issues are due to a temporary artificial histamine intolerance.

Thanks very much! I totally understand it now!