Last updated: October 15, 2021

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Do you also suffer from anxiety or restlessness? Would you like a natural remedy that calms you down, relieves tension and brings you balance? Then the effects of the herbal kava kava might sound very tempting to you. There are a few things to keep in mind when taking extracts of this plant, which is why it is worthwhile to take a closer look at the subject beforehand.

In our Kava Kava Test 2021 we have therefore compiled the most important information about Kava Kava. Among other things, you can find out which positive effects of kava kava have been observed in studies so far and whether side effects can occur after taking it.




Summary

  • Kava Kava is a pepper plant from the West Pacific Islands and has been traditionally taken there as a tea for many years. The rhizomes contain, among other things, the kava pyrones.
  • The plant with the kava pyrones is said to have a calming and relaxing effect. Therefore, kava kava is said to help with anxiety or restlessness and can be taken in liquid form as drops or also through capsules.
  • However, there are also indications that kava kava may damage the liver, which is why it is currently only approved as a homeopathic medicine in Germany.

The Best Kava Kava: Our Picks

Buying and evaluation criteria for Kava Kava products

When buying Kava Kava, you can pay attention to different aspects, such as:

By making the right choice for you, you can save money and also ensure that you don't give your body anything it doesn't need. Therefore, always look for high quality and ask to see the manufacturer's certificates if necessary.

Dosage form

Kava kava is classically available in capsules. The capsule shell is often made of gelatine or, more rarely, cellulose. The advantage of capsules is that they have a long shelf life and the exact dosage can be achieved at any time.

The disadvantage of capsules is that they are often somewhat larger than tablets and therefore more difficult for some people to swallow. This makes this form of administration not the most pleasant for everyone.

You can also find kava kava more often in the form of drops. The big advantage of drops is that they are easier and more pleasant to take. This makes drops especially suitable for people who have difficulty swallowing capsules.

However, it is easier to make mistakes when dosing drops than with capsules, for example if the drops come out of the container a little too quickly and you miscount.

Dosage

When making homeopathic kava kava drops or capsules, a dilution or trituration is used. In the dilution for drops, the Kava Kava is shaken with water and alcohol and in the trituration for capsules, the Kava Kava is triturated with milk sugar (lactose). Thus, the Kava Kava is strongly diluted.

Decimal potencies (D-potencies) are given for Kava Kava preparations. In this type of preparation, the medicinal substance is diluted by 1:10. The D-potencies therefore have the following meaning:

  • D1: Dilution of 1:10
  • D2: Dilution of 1:100
  • D4: Dilution of 1:10,000
  • D6: Dilution of 1:1,000,000
  • D8: Dilution of 1:100,000,000

The idea of homeopathy is that these potentisation procedures should enhance the effect of the medicinal substance. However, the effectiveness of these homeopathic procedures has not yet been proven in studies (1).

Since the capsules are already pre-dosed, taking them is very simple in this respect. Depending on the information in the package insert, 1 or 2 capsules are often taken per day.

In the case of the Kava Kava drops, 5 to 10 drops are usually used several times a day. How often they are used also depends on the particular preparation and should be read in the package leaflet.

Package size

Not only the dosage of Kava Kava can differ depending on the product. Sometimes you can also choose between different pack sizes.

The capsules are usually not differentiated according to the weight of the package, but according to the number of capsules. Most often, you will find packs with either 60 or 120 capsules.

For kava kava in the form of drops, there is less choice in terms of pack size. Usually the drops are sold as a 100ml solution. Less commonly, they are also available as a 50ml solution.

If Kava Kava is also available in the form of tea or powder, you will be able to distinguish the pack sizes by weight. Kava Kava tablets are similar to capsules, so that the respective number provides good information about the package size.

Ingredients and tolerance

The quality of the product can also be recognised by the ingredients. Ideally, the product should not contain any colourings or artificial flavourings.

There are advantages and disadvantages to preservatives. On the one hand, they ensure that the preparation has a longer shelf life and prevent the accumulation of bacteria or viruses, e.g. in the containers of the drops, for a little longer. On the other hand, preservatives are rather undesirable from a health point of view.

Some preparations contain lactose or gelatine

Allergy sufferers, diabetics and people with intolerances should check whether the preparations contain fructose or gluten, for example. In addition, some preparations contain lactose as an excipient.

For vegetarians and vegans, it is also worth taking a look at the list of ingredients. It is possible that the preparation contains gelatine. Gelatine is often used for the capsule shell.

For the homeopathic drops, kava kava (Piper methysticum) is often processed with water and ethanol. In general, a short list of ingredients often speaks for a good quality and higher naturalness of the preparation.

Guide: Questions you should ask yourself before buying kava kava products

In order to provide you with comprehensive advice on the effectiveness of kava kava and to give you an understanding of the current state of science, we have summarised all the important information in the following sections.

What is Kava Kava and how does it work?

Kava kava is a plant of the pepper family and has long been used as a traditional drink by people in the Western Pacific Islands.

kava-kava-test

We are not always as relaxed and balanced as we are on holiday at the beach. In case of anxiety or inner turmoil, kava kava is said to have a calming and relaxing effect. In fact, however, it is not the leaves but the rhizomes of the plant that are used. (Image source: pixabay / Leonardo Valente)

As a medicinal plant or drug, kava kava is controversial. On the one hand, the plant is said to have many positive effects, especially on anxiety and restlessness, but on the other hand it is also associated with stronger side effects such as liver damage.

For this reason, kava kava was no longer approved as a medicine in Germany as early as 2002. In the years that followed, there was a lot of controversy regarding the risk-benefit ratio and there was an interplay of approval and withdrawal of approval (12).

Currently, kava kava is only approved in Germany as a homeopathic preparation. Kava kava is also not approved in some other countries, but in the USA the plant has not yet been banned as a medicine.

Effects on anxiety and restlessness

Kava kava is best known for its apparent positive effect on anxiety and restlessness. This effect has therefore been investigated in several studies. In many cases, a positive effect was found with short-term intake without major side effects (2, 4, 5, 6).

On average, a maximum intake duration of about 4 to 12 weeks and a maximum daily dose of 120 to 250 milligrams was considered safe (2, 3, 4, 5, 6).

While some studies found a significant reduction in anxiety and depression (3), other studies found no significant difference between kava kava and placebo preparations(4). Further and larger studies are therefore needed in this field in order to be able to make a more precise statement (2).

Possible side effects

Kava Kava has been suspected for years to be harmful to the liver, especially with long-term use (6) (7) . At the same time, it is still being investigated whether the possible liver damage is due to the plant itself or to chemical reactions with other substances.

One of the theses is that some of the kava kava cultivated plants (9) could be the reason for liver damage. Another possibility is that kava kava in combination with ethanol or acetone could be harmful to the liver. However, there have been different results in studies on this so far (8, 9, 11).

In one study, tissue breakdown of muscle fibres was observed (10), but so far this is a very rare finding. In addition, it is noted that a very high amount of kava kava was used and it is not clear whether the plant extract was the trigger.

When and for whom is it useful to take Kava Kava?

Due to the currently not yet conclusively clarified effects and the possible liver damage, Kava Kava should not be used by children or pregnant women.

In general, the use of Kava Kava is useful for anxiety or restlessness, but should still be discussed with a doctor beforehand. This way, interactions with other medications can be ruled out and possible side effects can be recognised in time.

What parts of the plant are used in Kava Kava?

The kava plant (Piper methysticum) is mainly cultivated on the Pacific islands, where it is also native and has been traditionally processed into drinks for a long time. The rootstocks of the plant are used for medicines.

The most important constituents of the rhizomes of the kava kava plant are the kavapyrones, which are crucial for the effect on anxiety, tension and restlessness.

The bark and leaves of the plant also contain the piperidine alkaloids in addition to the kavapyrone, but they are not used for medicinal purposes.

How much do kava kava products cost?

Products with kava kava are usually not very cheap, but the prices also differ depending on the type. Most often, the amount of capsules or the amount of drops has an influence on the price.

Type price
Kava Kava drops approx. 20 to 30 euros
Kava Kava capsules approx. 15 to 25 euros

The drops with kava kava are the most pleasant to take, but also the most expensive. The capsules are sometimes available at a lower price, depending on how many capsules are in the package.

What types of kava kava are there?

The Kava Kava plant and its roots are offered in different preparations after processing. You can take the preparations either in solid or liquid form. The most common types are:

  • Kava Kava tea, drops and powder
  • Kava Kava capsules and tablets

Especially in liquid form, there is a larger selection of different preparations. You can find out about the advantages and disadvantages of the two types in the following sections.

Kava kava tea, drops and powder

The dried kava root is usually used for the tea. Fresh kava is even more suitable, although it is less commonly available. For the powder, the rhizome of the kava plant is also used. For the drops, for example, water or ethanol is used for the kava kava extract.

Advantages
  • Easier and more pleasant to take
  • More natural
  • More traditional form of administration
Disadvantages
  • Less easy to dose
  • Some of the drops are not suitable for children/pregnant women or alcoholics
  • Some have a shorter shelf life

Especially the tea and the powder are also the traditional dosage form of Kava Kava. In addition, they are also the most natural variants for taking kava kava, as only the herbal ingredients can be used. All three types also have the advantage that taking kava kava is very easy and pleasant.

The drops with Kava Kava often contain alcohol due to the homeopathic procedures. In that case, they are not suitable for pregnant women, children or people suffering from alcoholism.

In addition, the dosage of Kava Kava, especially with tea or powder, is more difficult and sometimes somewhat less precise than with capsules or tablets.

Kava Kava capsules and tablets

When one thinks of medicines, tablets or capsules usually come to mind. They also have some advantages, such as quick, accurate and easy dosage, as it does not have to be done by oneself, as is the case with tea.

Advantages
  • Optimal and easy dosage
  • Long shelf life
  • Tasteless
Disadvantages
  • More unpleasant to take
  • Less natural
  • Capsules partly with gelatine

Another advantage of tablets or capsules is that they have a long shelf life. A tea, on the other hand, especially one made from fresh kava roots, can exceed its best-before date much more quickly. Moreover, capsules and tablets are usually more sterile and pure.

For anyone who doesn't like the typical taste of kava kava, tablets and capsules are even more suitable. They allow you to ingest kava kava without the taste of the plant.

A bigger disadvantage compared to the liquid versions is in taking them. Especially with the capsules, some people have problems swallowing and find this unpleasant.

If what you like about kava kava is that it is a natural plant, then tea or powder may be more suitable for you. You can take them in a very natural form. With capsules and tablets, kava kava is more processed, which could rob you of the natural feeling.

In addition, some capsules also have a disadvantage for vegans or vegetarians. This is because the shell of the capsules is often made on gelatine.

How should Kava Kava be dosed?

When it comes to the dosage of Kava Kava, the Australian Government and the Department of Health through the TGA had made the following recommendations regarding dosage in 2005 (13):

Type Dosage
One tablet or capsule May not contain more than 125 milligrams of kava pyrones
One tea bag May not contain more than 3 grams of dried kava pyrones
All products containing kava pyrones May not contain more than a daily dose of 250 milligrams of kava pyrones

In Germany, however, only homeopathic preparations with a final concentration of kava kava not higher than the fourth decimal potency (D4) are currently permitted (12).

What alternatives are there to Kava Kava?

In nature, there are other natural alternatives besides Kava Kava that are said to have a calming and relaxing effect. These include, for example:

Alternative Ingredients
Ashwagandha Is also known as sleeping berry and belongs to the nightshade family. The roots are very often used in Ayurvedic medicine. More precise studies are still lacking, but Ashwagandha is said to have many positive effects(14), including on anxiety states
Theanine is considered the counterpart to caffeine and is contained in some types of tea, such as green and black tea. It is said to help relax the body and calm anxiety (15).

Which of the three natural herbal remedies will help you best will always depend on your individual symptoms. If you have severe anxiety or restlessness, it makes sense to consult a doctor.

Picture source: 123rf / Ivan Stajkovic

References (15)

1. Ernst E. The truth about homeopathy. Br J Clin Pharmacol. 2008 Feb;65(2):163–164. doi: 10.1111/j.1365-2125.2007.03007.x.
Source

2. Ooi SL, Henderson P, Pak SC. Kava for Generalized Anxiety Disorder: A Review of Current Evidence. J Altern Complement Med. 2018;24(8):770-780. doi:10.1089/acm.2018.0001
Source

3. Sarris, J., Kavanagh, D.J., Byrne, G. et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum . Psychopharmacology 205, 399–407 (2009). https://doi.org/10.1007/s00213-009-1549-9
Source

4. Sarris J, Byrne GJ, Bousman CA, et al. Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled study. Aust N Z J Psychiatry. 2020;54(3):288-297. doi:10.1177/0004867419891246
Source

5. Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Database Syst Rev. 2003;(1):CD003383. doi:10.1002/14651858.CD003383
Source

6. Smith K, Leiras C. The effectiveness and safety of Kava Kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials. Complement Ther Clin Pract. 2018;33:107-117. doi:10.1016/j.ctcp.2018.09.003
Source

7. Fu PP, Xia Q, Guo L, Yu H, Chan PC. Toxicity of kava kava. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2008;26(1):89-112. doi:10.1080/10590500801907407
Source

8. Sorrentino L, Capasso A, Schmidt M. Safety of ethanolic kava extract: Results of a study of chronic toxicity in rats. Phytomedicine. 2006;13(8):542-549. doi:10.1016/j.phymed.2006.01.006
Source

9. Teschke R, Genthner A, Wolff A. Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixtures. J Ethnopharmacol. 2009;123(3):378-384. doi:10.1016/j.jep.2009.03.038
Source

10. Bodkin R, Schneider S, Rekkerth D, Spillane L, Kamali M. Rhabdomyolysis associated with kava ingestion. Am J Emerg Med. 2012;30(4):635.e1-635.e6353. doi:10.1016/j.ajem.2011.01.030
Source

11. Li XZ, Ramzan I. Role of ethanol in kava hepatotoxicity. Phytother Res. 2010;24(4):475-480. doi:10.1002/ptr.3046
Source

12. Kuchta K, Schmidt M, Nahrstedt A. German Kava Ban Lifted by Court: The Alleged Hepatotoxicity of Kava (Piper methysticum) as a Case of Ill-Defined Herbal Drug Identity, Lacking Quality Control, and Misguided Regulatory Politics. Planta Med. 2015;81(18):1647-1653. doi:10.1055/s-0035-1558295
Source

13. Therapeutic Goods Administration (TGA) Australia. Kava fact sheet. 22.04.2005
Source

14. Pratte MA, Nanavati KB, Young V, Morley CP. An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). J Altern Complement Med. 2014;20(12):901-908. doi:10.1089/acm.2014.0177
Source

15. Ogawa S, Ota M, Ogura J, Kato K, Kunugi H. Effects of L-theanine on anxiety-like behavior, cerebrospinal fluid amino acid profile, and hippocampal activity in Wistar Kyoto rats. Psychopharmacology (Berl). 2018;235(1):37-45. doi:10.1007/s00213-017-4743-1
Source

Wissenschaftlicher Artikel
Ernst E. The truth about homeopathy. Br J Clin Pharmacol. 2008 Feb;65(2):163–164. doi: 10.1111/j.1365-2125.2007.03007.x.
Go to source
Wissenschaftlicher Review
Ooi SL, Henderson P, Pak SC. Kava for Generalized Anxiety Disorder: A Review of Current Evidence. J Altern Complement Med. 2018;24(8):770-780. doi:10.1089/acm.2018.0001
Go to source
Wissenschaftliche Studie
Sarris, J., Kavanagh, D.J., Byrne, G. et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum . Psychopharmacology 205, 399–407 (2009). https://doi.org/10.1007/s00213-009-1549-9
Go to source
Wissenschaftliche Studie
Sarris J, Byrne GJ, Bousman CA, et al. Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled study. Aust N Z J Psychiatry. 2020;54(3):288-297. doi:10.1177/0004867419891246
Go to source
Wissenschaftlicher Review
Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Database Syst Rev. 2003;(1):CD003383. doi:10.1002/14651858.CD003383
Go to source
Wissenschaftlicher Review
Smith K, Leiras C. The effectiveness and safety of Kava Kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials. Complement Ther Clin Pract. 2018;33:107-117. doi:10.1016/j.ctcp.2018.09.003
Go to source
Wissenschaftlicher Review
Fu PP, Xia Q, Guo L, Yu H, Chan PC. Toxicity of kava kava. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2008;26(1):89-112. doi:10.1080/10590500801907407
Go to source
Wissenschaftliche Studie
Sorrentino L, Capasso A, Schmidt M. Safety of ethanolic kava extract: Results of a study of chronic toxicity in rats. Phytomedicine. 2006;13(8):542-549. doi:10.1016/j.phymed.2006.01.006
Go to source
Wissenschaftliche Studie
Teschke R, Genthner A, Wolff A. Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixtures. J Ethnopharmacol. 2009;123(3):378-384. doi:10.1016/j.jep.2009.03.038
Go to source
Klinische Studie
Bodkin R, Schneider S, Rekkerth D, Spillane L, Kamali M. Rhabdomyolysis associated with kava ingestion. Am J Emerg Med. 2012;30(4):635.e1-635.e6353. doi:10.1016/j.ajem.2011.01.030
Go to source
Wissenschaftlicher Review
Li XZ, Ramzan I. Role of ethanol in kava hepatotoxicity. Phytother Res. 2010;24(4):475-480. doi:10.1002/ptr.3046
Go to source
Wissenschaftlicher Artikel
Kuchta K, Schmidt M, Nahrstedt A. German Kava Ban Lifted by Court: The Alleged Hepatotoxicity of Kava (Piper methysticum) as a Case of Ill-Defined Herbal Drug Identity, Lacking Quality Control, and Misguided Regulatory Politics. Planta Med. 2015;81(18):1647-1653. doi:10.1055/s-0035-1558295
Go to source
Dosierungsrichtwerte Kava Kava
Therapeutic Goods Administration (TGA) Australia. Kava fact sheet. 22.04.2005
Go to source
Wissenschaftlicher Review
Pratte MA, Nanavati KB, Young V, Morley CP. An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). J Altern Complement Med. 2014;20(12):901-908. doi:10.1089/acm.2014.0177
Go to source
Wissenschaftliche Studie
Ogawa S, Ota M, Ogura J, Kato K, Kunugi H. Effects of L-theanine on anxiety-like behavior, cerebrospinal fluid amino acid profile, and hippocampal activity in Wistar Kyoto rats. Psychopharmacology (Berl). 2018;235(1):37-45. doi:10.1007/s00213-017-4743-1
Go to source
Reviews