Handbook of Medicinal Herbs

(Dana P.) #1

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MAB; MAD; PH2); Gout (f; APA; PNC); Headache (1; APA; CRC; FNF; MAD); Heart (f; CRC);
Hemorrhoid (f; MAB); Herpes (f; MAD); Hot Flash (f; BGB); Hyperactivity (1; APA; WAM);
Ichthyosis (f; MAD); Incontinence (f; MAB); Infection (1; CRC; MAB); Insomnia (2; APA;
FNF; KOM; MAB; PHR; PH2; WAM); Leprosy (f; MAB); Leukorrhea (f; CRC; MAB); Meno-
pause (1; APA; BGB; MAB); Menstrual Cramp (1; FNF); Migraine (1; APA); Myalgia (1; MAB);
Mycosis (1; CRC; MAB); Nephrosis (f; CRC; MAB); Nervousness (2; APA; FNF; KOM; PHR;
PH2; WAM); Neuralgia (f; MAB); Neurasthenia (f; CRC; MAD); Obesity (f; PH2); OCD (1;
WAF); Ophthalmia (f; MAB); Pain (1; APA; BGB; CRC; FNF; MAB; MAD; PH2; WAM);
Palpitation (1; APA); Prolapse (f; MAB); Prostatosis (f; MAD); Psoriasis (f; MAD); Pulmonosis
(f; CRC); Restlessness (2; APA; KOM); Rheumatism (1; CRC; FNF; PH2; PNC); Sore Throat
(f; MAB); Stomachache (1; APA); Stress (2; APA; KOM; PH2; SHT); Syphilis (f; PH2); Throm-
bosis (1; PH2); Toothache (1; MAB; MAD); Tuberculosis (f; CRC); Urethrosis (f; CRC; MAD;
PH2); UTI (f; BGB; MAB); Vaginosis (f; CRC; MAB); VD (f; APA; CRC; MAD; PH2); Vertigo
(f; MAB); Water Retention (1; APA; MAB; MAD; PNC); Wet Dream (f; CRC).

Dosages (Kava) — 1 tsp cup/night (JAD); 1.5–3 g dry root/day (MAB); 100–300 mg root several
×/day (MAD); 2–4 g powdered root 1–3 ×/day (AHP; PNC); 2–4 ml liquid root extract (PNC);
3–6 ml fluid extract (1:2)/day (MAB); 1–3 ml tincture/day (SKY); 60–600 mg kavalactones/day
(AHP); ca 250 ml kavalactones/day (24–70 mg 3 ×/day) (APA); 180–210 kavalactones 1 hour
before bedtime (APA); 1 (525 mg) capsule (StX with 250 mg certified potency kava-kava root
extract with at least 75 mg kavalactone) 3 ×/day (NH).

Contraindications, Interactions, and Side Effects (Kava) — Class 2b, 2c, 2d. Contraindi-
cated for endogenous depression (AHP). Maximum tolerated doses for dogs was 60 mg/kg,
for rats 320 mg/kg StX (70% kavapyrones). Perversely, if the authors didn’t misspeak, the
dogs tolerated 24 mg/kg/day. Of >4000 patients taking 105 mg/day StX (70% kavapyrones),
1.5% had objectionable side effects (allergy, dizziness, GI distress, and headache). At levels
100 times the therapeutic dose (roughly 13 liters kava beverage a day or 300–400 mg rhizome
per week) caused anorexia, ataxia, dyspnea, hair loss, red eyes, skin rash, visual problems,
and yellow skin. “There is no potential for physical or psychological dependency. Use should
not exceed 3 months.” (AHP) Germans limit use to 1–3 months (AHP). Commission E reports
contraindications: esophageal and gastrointestinal stenoses; adverse effects: allergic reactions
(rarely). Other sources report intestinal obstruction (AEH). Many reports suggest a yellowing
of the skin in chronic users. “Chronic ingestion may lead to ‘kawism’ characterized by dry,
flaking, discolored skin, and reddened eyes” (LRNP, May 1987). Persistent rumors suggest
that overdoses can cause intoxication. Commission E warns against the concomitant use of
kava with barbituates, antidepressant medications, and CNS agents. Lactating or pregnant
women should not use kava (WAM). “Not permitted as a non-medicinal ingredient in oral use
products in Canada” (Michols, 1995). Abuse by Australian Aborigines suggest links to hema-
turia, infectious disease, neurological abnormalities, pulmonary hypotension, nephrosis, visual
disturbances, ischemic heart disease, thrombosis, and sudden heart attacks (MAB). The fol-
lowing quote might scare abusers, as it should, “Full consciousness is maintained with even
fatal doses” (APA, quoting Weiss, 1988).

Extracts (Kava) — Increase GABA in the synaptic cleft by increasing GABA secretion and
inhibiting its reuptake (SHT). LD50 dihydrokavain = 920 mg/kg orl mouse (MAB), LD50
dihydromethysticin = 1050 mg/kg orl mouse (MAB), LD50 StX (70% kavalactones) = 16,000
mg/kg orl rat, 1800 mg/kg orl mouse, 370 mg/kg ipr rat, 380 mg/kg ipr mouse (MAB). This
indicates that the mix is safer than the individual lactone, at least orally in rats and mice
(MAB). Kava slows hyperactivity in mice, but not as much as antipsychotic drugs. When
chewed, the root produces numbness in the mouth similar to what one would experience with
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