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Correcting Misinformation Google Link #7 - Kava - University of Michigan Health

Kapmcrunk

The Kaptain (40g)
KavaForums Founder
Google Link # 7
Kava - University of Michigan Health
Link: https://www.uofmhealth.org/health-library/tn7356spec
Process:
  • Opened incognito window
  • Google searched for “Kava”

Hello again, kava lovers. Today we’re tackling link # 7 in google’s first page of “kava” search results. This one stood out to me because their “other works consulted” page is quite bare. 3 sources, and I personally know some of the data coming from this was sourced from that same damn Mathews et al 1988 paper that we’ve been seeing lately. It actually rears its head through their source #2 from Wolters Kluwer Health. This source pulls from Ruze 1994 which then ties into the Mathews et al. 1998 study. As you can see, the misinformation is intertwined with current research when people continue to see it as a viable source of information. I think it may be time for a fact of the day just on this paper alone. Alright, with that in mind, let’s see what this paper has in store.

Section 1:
What is kava?
  • “Kava—or kava kava—is a root found on South Pacific islands. Islanders have used kava as medicine and in ceremonies for centuries.”
    • Lol, “kava kava”. No issues here. I laugh because I use this term as a metric of the author’s understanding. Whenever the term “kava kava” is used without listing other common terms, I know the author only has a surface understanding of kava, if that.
  • “Kava has a calming effect, producing brain wave changes similar to changes that occur with calming medicines such as diazepam (Valium, for example). Kava also can prevent convulsions and relax muscles. Although kava is not habit-forming, its effect may decrease with use.”
    • Well here we go with the first issue. “its effect may decrease with use.” There are no studies which would indicate a tolerance building effect to kavalactones, so this statement is false. Below are some studies saying the exact opposite.

      Scherer, J. 1998. “Kava-Kava Extract in Anxiety Disorders: An Outpatient Observational Study.” Advances in Therapy 15 (4): 261–69.

      Connor, K. M., J. R. Davidson, and L. E. Churchill. 2001. “Adverse-Effect Profile of Kava.” CNS Spectrums 6 (10): 848, 850–53. https://doi.org/10.1017/s109285290000167x

      Kuchta, Kenny, Pietro de Nicola, and Mathias Schmidt. 2018. “Randomized, Dose-Controlled Double-Blind Trial: Efficacy of an Ethanolic Kava (Piper Methysticum Rhizome) Extract for the Treatment of Anxiety in Elderly Patients: Kava Extract for Anxiety.” Traditional & Kampo Medicine 5 (1): 3–10. https://doi.org/10.1002/tkm2.1079
  • “Traditionally prepared as a tea, kava root is also available as a dietary supplement in powder and tincture (extract in alcohol) forms.”
    • Correct

Section 2:
What is kava used for?
  • “Kava's calming effect may relieve anxiety, restlessness, sleeplessness, and stress-related symptoms such as muscle tension or spasm. Kava may also relieve pain.”
    • Yes indeed, no issues here.
  • “When taken for anxiety or stress, kava does not interfere with mental sharpness. When taken for sleep problems, kava promotes deep sleep without affecting restful REM sleep.”
    • Correct.
  • “Kava may be used instead of prescription antianxiety drugs, such as benzodiazepines and tricyclic antidepressants. Kava should never be taken with these prescription drugs. Avoid using alcohol when taking kava.”
    • Correct as well. No argument here.

Section 3:
Is Kava Safe?
  • "Kava may have severe side effects and should not be used by everyone. Kava has caused liver failure in previously healthy people. You should not use kava for longer than 3 months without consulting your doctor."
    • What’s interesting here is that in one of the very sources they list, Connor KM, et al. (2006), it states that researchers were unable to elucidate any negative effects on the liver right there in black and white. Obviously this harm claim is quite convoluted and as of today kava has yet to show any intrinsic toxicity towards any bodily organ.
    • 3 Months. I wonder if they noticed it’s been consumed daily for the last 3 millennia. The 3 months rule is nonsense.

"Before you use kava, consider that it: "

  • "Should not be combined with alcohol or psychotropic medicines. Psychotropic medicines are used to treat psychiatric disorders or illnesses and include antidepressants and mood stabilizers. Alcohol exaggerates kava's sedating effect."
    • This is good, but the term “Psychotropic” medications is a bit too broad. We can narrow that down to medications that primarily use CYP1A2 for metabolization.
    • Correct info about alcohol.
  • "Can affect how fast you react, making it unsafe to drive or use heavy machinery."
    • This, like most similar compounds, totally relies on the amount consumed. Clinically-relevant amounts at around ~200mg as well as some drinking volumes of aqueous kava have shown not to cause issues with reaction times and have even shown an increase in concentration abilities.

      Aporosa, S. 2018. “Improving Road Safety and Health: Understanding Kava’s Impact on Driver Fitness.” University of Waikato. https://researchcommons.waikato.ac.nz/handle/10289/12947

    • When drinking kava heavily, this caution holds true. If you feel you’re in any way compromised, be safe, call an uber/lyft, or have a buddy drive you home.
  • "May gradually be less powerful as you use it."
    • Research does not agree with this statement. My, and many others' personal experience also does not agree with this statement. I’ve been daily drinking kava for the last 16 years without an increase in the amount consumed.
  • "Eventually it may cause temporary yellowing of skin, hair, and nails."
    • Yes, but we should stress the rarity of this condition. We’ve been watching many forums and social media platforms and this “yellowing” condition isn’t something we’ve seen on any of them.
  • "Can cause an allergic skin reaction (rare)."
    • Correct, and this is likely due to the release of histamine from aqueous kava preparations. We’re still not sure if this is due to an allergen contamination or if it is indeed an intrinsic property of kava, but there are the unfortunate few who see hives and other typical allergic skin reactions when they consume and type or quantity of kava. This is something you would notice immediately. There is a condition similar to this that is seen where if a drinker consumes alcohol and kava too close together in succession they could experience these histamine effects such as hives and itching.

"Long-term kava use may result in:"

  • "Liver problems."
    • Again here is where they’re cherry picking on Mathews' incorrect results from 1988. They say “liver problems” but what they’re actually saying here is “increased GGT / Increased HDL cholesterol”. Neither of these indications together or alone would indicate liver damage. AST/ALT liver functions were not imparied, and increased AST/ALT numbers are how you deduce liver damages.
  • "Shortness of breath (reversible)."
    • Again, Matthews 1988, because no other research found this same conclusion. There is no shortage of papers that cite this study to say this, but if we go back to the original we can see this conclusion was flawed at best.
  • "Scaly rash (reversible)."
    • Dermopathy. Similar to Lamellar Ichthyosis, an autosomal recessive congenital disease, when full blown. This is a known side effect of consuming massive (over 1 lb per week dry powder) amounts of kava for long periods of time.

      Peterman, Kaeleigh, and Emily Reynolds. 2019. “Kava-Induced Ichthyosis.” Journal of the Dermatology Nurses’ Association 11 (6): 280. https://doi.org/10.1097/JDN.0000000000000503
  • "Facial puffiness or swelling (reversible)."
    • Again pulling from the same flawed 1988 study. We’ve seen something similar when combining kava and alcohol together, but save for an actual allergic reaction, this isn’t a normal side effect from kava.

Listed References:

  • Connor KM, et al. (2006). Kava in generalized anxiety disorder: Three placebo-controlled trials. International Clinical Psychopharmacology, 21(5): 249.
  • Kava (2013). In A DerMarderosian, JA Beutler, eds., Review of Natural Products, St. Louis: Wolters Kluwer Health.
  • Murray MT (2013). Pliper methysticum (kava). In JE Pizzorno, MT Murray, eds., Textbook of Natural Medicine, 4th ed., pp. 960–965. St. Louis: Mosby.
 
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