St. Johns Wort + Kava safe?

[Sam Handwich]

Anyone know if continuing to use kava while taking st. John's wort is a good idea? Ive searched the forums for this question and can see that it has come up a few times but there's never really been a solid answer. Not a lot of good info online either. In reading the warnings about st. John's Wort there are quite a few drug interactions, none of which I am on, and it warns against serotonin syndrome if combined with antidepressants. I know that combining kava and some antidepressants can be a bad idea but I am hoping that the action of kava and st. John's Wort are different enough that this will be ok. If anyone has any knowledge or experience I would appreciate the input.

 

[Edward]

I can't answer the question but this does bring up a wider issue. There are a lot of supplements out there and it is next to impossible to know for sure what does and doesn't interact with kava. It would be good if as a community we could come together and compile a list in a dedicated thread of what supplements we are using and whether we have noticed any positive or negative reactions with kava. With any luck then when anyone does a search for the supplement + kava it should hopefully take them to the right post where someone has mentioned both. Another approach to this would be if someone more scientifically minded could put together a summary of what kava actually does in the body, what it affects and what drugs/supplements are known to be unwise to take with kava. That would at least give us a start.

 

[Kojo Douglas]

Unfortunately, there is also a third variable - the user. I've heard people praise coffee/kava combinations here, but if I drink coffee and kava I freak out. Others can't drink Kava and alcohol in the same day, but I have had several strong shells of Kava and then a couple of beers to cap the night.

 

[The Kap'n]

Kavasseur has a good point. The subjective experience of kava alone would make it nearly impossible to predict with accuracy what type of effects you'd have mixing kava and other herbs.

We do have a section that warns against concurrent usage with kava. It's in the "new to kava" section at the top. Link Here

Currently what we have to go on is information regarding the herb or drug in questions breakdown in the liver, and which enzymatic pathway they use.

Suggested against when the drug is using the following pathways.

• CYP2C19
• CYP2C9
• CYP2E1
• CYP3A4

Not so necessarily bad, but caution suggested

• CYP2D6 - Minor

St Johns Wart uses both the pathway
CYP3A4, and CYP2C9

This most likely will cause the active constituents of St Johns Wart to concentrate and stay in your system longer than if you were to take it without kava, leading to whatever problems an excess of the chemicals in St John's Wart can cause.

 

[Bob Chill]

Since I'm on blood pressure meds I always have to go through my own research with supplements and it's tricky. Asking your doctor won't get you straight answers many times either because hard facts are often unknown. Unfortunately, the only way there can be documented interactions is after a class of incidences are studied. Considering the amount of supplements on the market of all types and the vast use of rx meds, the combinations are basically limitless.

Just because 2 or more medications use the same pathway(s) doesn't mean there is a contraindication either. Half life and metabolic processes of supplements and/or drugs add further mud to the equation. Safe than sorry is the typical answer but risk/benefit should also be taken into consideration.

I agree that a list is a good idea but it's still anecdotal based on an individual's experience and lacks the important stuff like blood plasma concentrations and all the other tests that go into contraindications.

I can safely say now that kava and Benicar HCT do not interact based on my blood pressure readings. My baseline is mostly unchanged but seems to have dropped a few points. Probably from being more relaxed and less stressed in the evening and not some chemical process.

 

[Sam Handwich]

Thanks for the replies guys. I guess what I am looking for is if there are any known dangers to this combo. If I start to feel strange or not like the effects I will certainly quit but if the side effect is sudden death then I won't have the chance to make that decision!
I know that different people react differently to various combinations and that the possible combinations are limitless but it seems like this one would be more common. People suffering from anxiety with depression are often prescribed both an SSRI and a benzo and St. Johns Wort and Kava are the most common and most effective natural alternatives to those drugs. I can find some evidence online that some herbalists prescribe the two together but I've not found any scientific articles that have specifically studied the two together. If the worst case scenario is that the effects of the St. Johns Wort will be amplified then I may just start with a small dose and work up if things are going well. I'd ask my Dr. for his opinion but he has already admitted to having never heard of kava. I also have some worries based on the fact that St. Johns Wort is the most widely prescribed antidepressant in Germany and Germany was one of the countries with a higher rate of liver issues back in the day. Maybe nothing there but it is something to consider.

 

[Rick.Sanchez]

I also have some worries based on the fact that St. Johns Wort is the most widely prescribed antidepressant in Germany and Germany was one of the countries with a higher rate of liver issues back in the day. Maybe nothing there but it is something to consider.

I think germany is also known for their beer

I haven't combined the two, but kava seems to be pretty easy on the body. My doctor knows about it and actually suggested I give it another shot. He didn't see any problem with me taking it with K@, but any time your combining supplements, you're kind of shooting in the dark. I think Kapmkrunk is right on the money. Inhibiting these enzymes could substantially increase plasma concentrations of some active chemicals from both plants. I think you would be okay to start very very low with both while you're around other people who could help you if something goes wrong.

Unfortunately I'm just speculating, and that's all anyone can really do here Good luck.

 

[Sam Handwich]

I think germany is also known for their beer.

Good point!

 

[F3TU5]

Good point!

You on hypericin or hyperforin. Was on both kinds in the last couple months and had no interactions

 

[Sam Handwich]

You on hypericin or hyperforin. Was on both kinds in the last couple months and had no interactions

I'm taking Perika SJW, it is standardized to hyperforin, 2%.
Do you mind me asking how much SJW and Kava you used per day?

 

[Zac Imiola (Herbalist)]

I really really don't recommend standardized products with herbs

St johns wort is safest when used as a fresh tincture. It's easy to overdose on the other stuff and get bad reactions

 

[F3TU5]

I'm taking Perika SJW, it is standardized to hyperforin, 2%.
Do you mind me asking how much SJW and Kava you used per day?

Took 2-3 perikas a day. But I'm a lightweight kava drinker so only 4 tablespoons of medium grind at night. Got off it cause I'm out in the sun to much and my skin was getting way to red. good shit though, didn't interact with the kava much at all

 

[Sam Handwich]

That's good to hear, I'm at 3 Perika a day and usually only shake up 2 tablespoons in an Aluball a night. I'm really hopping that this will prove to be a safe and effective combo.