Dr. Michael Tierra L.Ac., O.M.D., Founder of the American Herbalists Guild

The belief that there is an herb for every human condition is attested by the unique virtues of Kava. A member of the pepper family (Piperaceae), it is a large leafed swamp-loving shrub that can grow to an average height of six feet and rarely from ten to twelve feet. The greatest concentration of the active psychotropic constituents called kava lactones is found in the fresh roots and rhizomes.

Kava has four main therapeutic properties. First it is one of the most powerful of all the herbal antispasmodics especially useful for relieving nervous tension throughout the mind and body. Second, it is an anti-anxiety herb that will quickly almost instantly dissipate effects of the many fears and apprehensions that are so much a part of the hectic lifestyle of nineties. Third, it is an effective diuretic with potent anti-spasmodic and anti-pathogenic properties making it useful for a variety of genito-urinary dysfunctions ranging from cystitis, prostatitis, venereal disease (such as gonorrhea), vaginal leucorrhea (including yeast infections), nocturnal urination and general fluid retention. Fourth, Kava is a carminative that improves appetite and digestion. The combination of these properties makes Kava useful for the treatment of arthritic and rheumatic conditions, which is one of its traditional medicinal uses among South Sea Islanders. Topically, kava can be applied as a fomentation or ointment for mild general anesthesia for the local relief of sore muscles. It can also be chewed and kept in the mouth for the temporary relief of toothaches.

Besides the above described properties and uses, among the many traditional medicinal uses for Kava are as follows:

  • anxiety and depression
  • insomnia
  • to relieve fatigue and to increase energy
  • Genito-Urinary tract disinfectant for urinary and reproductive organs infections
  • as a cure for rheumatism
  • for asthma
  • for worms and parasites, a common problem in tropical climates
  • for obesity
  • as a poultice for headaches
  • as a warm sweat inducing tea for the treatment of colds and fevers
  • topically for various skin diseases including fungal infections and leprosy

The safety of Kava is attested to the fact that it was given as a tonic to children who were weak and recovering from disease.

How to Take Kava

Kava is available as a whole root and powder. Kava lactones are insoluble in water and are destroyed by heat. Ideally the herb should be first powdered and then infused only in COLD water for a few minutes. It must then be carefully squeezed through a cloth to release the activity constituents from the root stock fiber. Another method of taking Kava is as an alcoholic extract. In this, not all Kava products are the same the wide difference in price reflects the concentration of kava-lactones in the standardized products. Again the dosage range is wide, ranging from 10 to 30 drops as a single dose of the standardized extract taken as needed or three times daily.

For some, the flavor and strange numbing sensation of Kava is a disincentive for regular usage. My personal perception shared with many of my herbalist friends and colleagues in our spontaneous Kava gatherings, is that the peculiar flavor and sensations of Kava as a shared experience allows a greater sense of rapport and perhaps a feeling that we are partaking in a time honored tradition. However, there are many quality standardized Kava tablets available for those times when the full Kava experience is neither desired or needed.

Proper Dosage

Because of its relative safety, the effective daily dose of kava is wide ranging from 70 mg to 200 mg of kavalactones, which are recognized as the major biochemical anti-anxiety constituents. To promote a deep restful sleep one should take a dose of from 150 mg to 200 mg. approximately 20 or 30 minutes before retiring.

A study of 58 patients in 1991 suffering from anxiety found that the effective daily dose of kava was 70 mg.1 Another study in the same year demonstrated the effectiveness of Kava in relieving some of the discomfort of menopausal women, including hot flashes, insomnia and general nervousness with 100 mg of kavalactones daily.2

Psychotropic Effects

Kava is a very experiential herb. Taking it is like imbibing the soothing, spiritual essence of the South Pacific Islands on a mild warm sunny day accompanied by a pleasant westerly breeze. Its effects when properly ingested are almost instantaneous. In the above doses, it will soon induce an immediate sense of ease, warmth and relaxation that continues to increase over a span of several hours. There is never any accompanied drowsiness or disorientation, just a sense of ease and well being, It does not interfere with one’s ability to focus, concentrate or otherwise navigate. Dr. James Duke, botanist, ethnobotanist, author of the Green Pharmacy (publ by Rodale) nevertheless recommends that it not he taken when indulging in alcohol beverages or when driving. An early observer (Hocart) exclaimed “As I experienced it, it gives a pleasant, warm, and cheerful, but lazy feeling, sociable though not hilarious or loquacious; the reason is not obscured.”3

Toxicity, Side Effects and Contraindications

Moderate use as described has not shown any harmful reactions. However, habitual overuse in high doses, much higher than indicated above, can lead to lack of motivation, weakness, leg paralysis and a peculiar scaly skin rash. It is not habit forming. In all cases studied, all observed symptoms have been found to he completely reversible when Kava consumption is discontinued.

In my own clinical experience I routinely prescribe Kava alone or in combination with such herbs as St. John’s Wort and/or the famous traditional Chinese formula for menstrual irregularities, moodiness and depression, called Bupleurum and Peony Combination (Xiao Yao Wan). These are the major herbs and formulas I have found to effective in most cases of anxiety and depression.

I now always travel with my bottle of Kava extract to lighten up and ease some of the accompanying anxieties of traveling. Many find that it helps tremendously if it is taken before going for a dental appointment. Kava is also useful to as part of a treatment for tobacco, alcohol and drug withdrawal. Women have found Kava to be very beneficial for painful menstruation and menopausal abnormalities.

With all of its positive benefits and virtual absence of negative effects, more than one of my herbalists colleagues have exclaimed, “kava is simply too good to be legal.” The fact of the matter is that it is legal, it is safe and truly a remedy for the stress filled nineties.

Bibliography and Sources:

  • Ellingwood, Finley; American Materia Medica and Pharmacognosy
  • Kilham, Chris; Kava: Medicine Hunting in Paradise, publ by Park Street Press, Rochester, Vermont.
  • Steinmetz, E.F.; Kava Kava, Famous Drug Plant of the South Sea Islands, publ by Level Press, San Francisco 1960
  • Hobbs, Christopher; Kava — Elixir of the Pacific, article by Christopher Hobbs 1996
  • Faust, Robert H. PH.D; Kava-Kava or Awa – a “new” role for an old crop in Hawai’i, Delivered at the First international botanical Conference on Kava and other Medicinal Plants of the South Pacific, sponsored by the American Herbal Products Association and several medicinal companies from May 14-17, 1997.

1 Kinzler, E. Kromer, J., & Lehmann, E. “Clinical efficacy of kava extract in patients with anxiety syndrome: double-blind placebo-controlled study over four weeks,” Arzneimittel-Forsch 41: 584-88, 1991

2 Warnecke, G. “Neurovegetative dystonia in the female climacteric. Studies on the clinical efficacy and tolerance of kava extract WS 1490,” Forschr Med 109: 120-22, 1991

3 Gatty, R. “Kava — Polynesian Beverage Shrub.” Economic botany XX; 241-49.

Kava Formula

  • Kava Pure extract
  • Zizyphus seed extract
  • Poria cocos extract
  • Ligusticum wallichii extract
  • Anemarrhena extract
  • Ginseng extract
  • Licorice extract
  • Essential oil Flavoring if possible, such as vanilla

Dose: 15 to 60 drops one half-hour before retiring.

This formula is useful for insomnia and night-time urination. It also tonifies Qi, relieves nervous anxiety and exhaustion. For symptoms such as insomnia, amnesia, nightmares, rapid heart palpitations and night sweats. It is a combination of Kava and a secret Chinese Shaolin formula called “The Jade Pillow” that is used for nervousness and insomnia with the addition of ginseng to strengthen the body’s essence.


  • most effective anti-anxiety herb (anxiolytic)
  • in the South seas it is regarded as an anti-hate herb and used for conflict resolution
  • a near specific for gonorrhea and urinary tract infections
  • relaxes tension but in moderate dosage will not cause drowsiness
  • contains kavalactones

Zizyphus Spinosa

The most effective herb for calming stress, nervous tension and insomnia. It is the seed from the fruit of a tree and therefore has strengthening and nourishing properties. Actions and indications: Calms heart (mind) and sedates the spirit, nourishes blood and strengthens the liver that is the source of frustration and anxiety.

  • relieves nervous anxiety caused by overwork and worry
  • blood tonic
  • relieves irritability
  • Gentle sedative to the mind and spirit
  • Nourishes the nerves and mind
  • Good for night sweats and abnormal sweating

Chinese studies on dogs and mice have found that the oral dosages of the seeds have a pronounced hypnotic (fixing the mind) and sedative effects regardless whether they were previously given caffeine, It also has a generally antispasmodic effect, relieving the tension from the deep tendons of the body. It also has pain relieving analgesic effects, lowers blood pressure and despite that has a neutral energy will has a generally cooling effect, lowering body temperature when it is too high and even is effective taken both internally and externally for relieving the effects of extensive burns.

Anemarrhena (Zhi Mu) — A famous Chinese herb that is anti-inflammatory, relieves irritability and toxins from stress and has an overall calming and soothing effect.

Poria cocos (Fu ling) — the most commonly used Chinese medicinal mushroom which in this formula calms the spirit and regulates inter and extra cellular fluids throughout the body, promotes urination and as with all medicinal mushroom, fortifies the immune system. Think of it as an herb that relieves the feeling one may have of “drowning in cares and worry”.

Ligusticum (Chinese lovage root) — promotes vascular circulation to and down from the brain, carries the properties of Kava, Zizyphus to the brain, Relieves vascular congestion in the brain and moves congested Qi downwards. Think of it in this formula as an herb that helps “relieve confused thoughts and anxieties in the mind.”


LicoriceCalled the “Peacemaker in Chinese Medicine. It is taken in monasteries to calm the mind for meditation. A small amount is in the formula and has generally calming, soothing and mildly nourishing properties.


GinsengA small amount in the formula to nourish all weakness and deficiencies. Think of it as an herb that promotes inner calm and contentment by gently tonifying all deficiencies. When one is too weak and worn out, it is difficult to sleep.





Man, age 43, suffering with severe lifelong anxiety caused by childhood relationship with his father. Chronic, severe lifelong anxiety, depression and subsequent insomnia. He had a very hard time just being still.

I immediately prescribed Kava-St John’s Wort with the Bupleurum Calmative (Xiao Yao Wan) formula for mood swings and depression, about 4 tablets 3 times daily either alone with warm water or an appropriate calmative tea such as chamomile tea which has calmative properties. I also recommended that he stop the use of occasional alcohol and daily use of marijuana that he said he was taking to relieve acute nervous tension. 1 also suggested that he refrain or significantly limit the use of refined carbohydrates (white sugar) that creates unrest in the body.

A combination such as the Kava Formula consisting of 30 drops of Kava extract and a teaspoon of Jade Pillow extract was given about 20 or 30 minutes before retiring each evening with warm water or a cup of warm milk with honey.

Within two weeks he reported that he was able to sleep for longer periods without awakening, he had no disturbing violent dreams which was part of his previous complaint and his general daily anxiety and depression was 30 to 50% relieved. He continues now over several months to implement this regime and is now sleeping soundly most nights and has much longer periods with little or no anxiety and irritability.

Woman, age 38, single mother of two children, ages 6 and 8. Experiences periodic stress and anxiety with subsequent insomnia as a result of a welling up feeling of insecurity. I prescribed a similar diet, limiting refined carbohydrates with a balanced diet of proteinaceous foods, fish, soy, bean and legumes, seitan, and organically raised fowl and meat, grains, vegetables and seasonal fruits. Snacks should be fresh and cooked fruit, seeds and walnuts which strengthen the mind and will.

I recommended that she give Calm Child (also contains Zizyphus) regularly three times daily to her two children, more frequently if needed and take Kava extract three times daily and Jade Pillow elixir which is now combined in Kava Dreams. She is able to take things more in stride, with less anxiety, better focus and sleeps more soundly each night.

Man, Age 53, he works long hours as a computer programmer in San Jose. Of necessity, it is a job that is highly competitive and requires a great amount of nervous and mental activity. He complained of frequent bouts of irritability and anxiety when returning each night with increasing restless nights with difficulty falling asleep. I immediately told him to stop taking the alcoholic beverage each night when he came home because that only created temporary, symptomatic calm and relaxation and that later, it stirred up his liver and contributed to his insomnia. Instead, I suggested that he take two or more Stress Free Tablets three or four times throughout the day. When returning home, he should take the combination of Kava and Jade Pillow formula (Kava Dreams) once upon arrival and 20 or 30 minutes before retiring. It told him to follow this regime 6 days a week with one day rest so that his body would not become overly accustomed to the program. I even advised him to stop the program a week or so every two months when he could substitute other Planetary formulas such as Calm Child, which is also good for adults and Bupleurum Calmative. I prescribed a similar diet to the above. Even after the first week, he felt that he had no need of the alcoholic beverage upon returning, was generally more centered and relaxed throughout the day and was able to sleep more soundly each night.

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