Berkeley Herbal Center's Community Clinic

Herbal Honesty: Plant people are lovely, but we're hard to shop for. We're particular about the things we wear, and what we imbibe. We want to be sure that we s...upport local, but don't collect too much because we want to keep a low carbon footprint. We already have lots of plant collection baskets, and our herbal medicine shelves are full of salves and salts and magic already. If you're not sure what to get the plant people in your life, consider offering them a gift certificate to one of our classes or certification programs! We have a ton of online and in person classes lined up in 2021 and we would love to help support the budding herbalist in your friend group. Check it out: https://www.berkeleyherbalcenter.org/product/gift-card/

KAVA and HOW TO USE IT For KAVA, it's ALL ABOUT THE CULTIVAR. Night and day for effects. Some cultivars are very physical and sedating, some are mentally calmin...g, some are rather stimulating either physically or mentally or both. Some lead to side effects such as headache, or light anxiety, especially after drinking excessive amounts. Here is the pdf of this review: https://www.dropbox.com/s/1mjas/Kava%20post%20%2012-20.pdf Preparation, Quality, sourcing, Dose. The preparation makes a difference as well. Tinctures are not my preference, though they are convenient to carry and use. First, they are weak unless an ounce or two are consumed. By international standard, a tincture is made with a 1:5 extraction ratio, that is 1 part of the herb (by dry weight) to 5 parts of the menstruum (or solvent), which is usually some percentage of water to ethanol. For kava, it is better to have mostly ethanol, or about 80% to 20% water. Even straight organic ethanol (95% EtOH to 5% water) is ok. A one-ounce dropper bottle contains about 30 ml or 30 droppersful of tincture. So at a 1:5 extraction ratio, each ounce bottle, or 30 droppersful of tincture is equal to the extractives (active compounds) in 6 grams of herb. That is equal to a soup spoon and a half of root + rhizome powder. By the way, the roots have up to twice the amount of active kavalactones as the thicker rhizome (underground stem). Since my usual effective dose is 6-8 grams (1 to 2 soup spoons), that would be like drinking over an ounce bottle of the tincture for each dose. But then the alcohol will be a problem for some because this amount of pure ethanol will be like tossing back 2 shots or more of whiskey. Whiskey contains 40-50% ethanol. Plus the synergistic effects of kava + ethanol are not always good, it can be overly sedating. I have seen someone that fell down after consuming both with short-term paralysis of the limbs, though they were mentally alert. Having said that, 2-3 ml (droppersful) in water or some lemon balm tea (for instance) does often have a mild calming effect. However, not knowing the cultivar and growing conditions, in my experience, make this form of administration hit or miss. I can’t say enough that for the best and most consistent therapeutic (and recreational) effects of kava, you should know the cultivar, and buy from a supplier that will offer consistent quality and guarantee time of harvest, cultivar, etc. I recommend knowing your supplier so you can interact with them. Since most of us don’t have a chromatography device on hand to check levels of kava lactones, we have to leave that up to a reputable supplier to check every batchalso test for heavy metals, pesticides, herbicides, and other undesirable chemicals. Another pointreputable suppliers are not going to add a lot of inactive fillers and carriers to the kava like maltodextrin. This can be what you get with many commercial capsules because the liquid that results from extracting kava has to be sprayed onto a "carrier" to absorb the liquid and then dried to make a powder that can be sold in bags, capsules, or tablets. Dry extracts or paste should be made with ethanol or super critical carbon dioxide, not hexane and other solvents. Mostly I recommend not using dry extract powders or pastes unless the manufacturer specifies how they were made, what solvents were used, and if testing for impurities was performed. Kava root + rhizome powders (before extraction) generally contain from 3-20% kavalactones. If you see an extract that says 30% kavalactones or higher, then it has been concentrated by some kind of solvents, perhaps CO2 extraction one would hope, but this is not always true. I typically use one to two desert spoonsfull (about 6-8 grams10 grams maximum). You can blend it first in a narrow-mouth pint canning jar with a cup of hot water (hot but not boiling) screwed into your blender blades for a minute or two and then pour the blended mixture into a fine mesh nutmilk bag (best). Or put the powder right in the bag and then in the hot water, soaking for 5 minutes first, and then dipping, kneading and squeezing the bag repeatedly for another few minutes until the liquid is getting dark brown. Squeeze out the bag strongly at the end to get out as much liquid as you can, and use the spent bag in 1 cup of hot water for the last extraction (which is weaker but still worth doing as a chaser after you start feeling the effects, after about 15 minutes). See the pictures. This amount will create a brief period of euphoria, and then relaxation. For best effects, it is best to drink the kava quickly, just short of "chugging" it. The euphoric period will be less noticeable if you sip it over a period of time, and this is the traditional way of drinking kava, not "nursing" it. Often people say "boola" or "boola boola" before, during or just after consuming kava, in a celebratory fashion. Kava is ok to drink alone...and don't worry it doesn't mean you are hiding an addiction, but it is also a social drink. The best noble cultivars like Borogu or Hawaiian Hiwa or Mahakea are competitive in the marketplace and often sold out. These are often side effect-free and also the most widely consumed kava that have a favorable kavalactone profile. The Germans love kava, and their buyers are hovering around Vanuuatu and other islands to buy entire crops, for popular consumption and for the herbal/pharmaceutical trade. However, Borogu seems to be readily available these days, and that is what I have been drinking. These are very smooth, euphoric, and leave very few, if any, effects the next morning. When I hear that people don't like kava, it is always important to know what cultivar was consumed, which isn't always available. Most of the pills and tinctures on the market do not disclose the cultivar, or perhaps it is a mixture. Like wine, not only is the cultivar important, but the year and season harvested as well. Some cultivars like Isa from Papua Guinea, are tudei types, meaning you feel it for 2 days. Believe me, the second day is not pleasant. Some growers have been reported to spike their noble kava. If you get to know a few good noble cultivars and then smell a tudei cultivar, the smell is noticeable, it has a stronger and more resinous smell. In the end, you have to try different kavas and suppliers typically to get one that works the best for your needs. I'm very fussy about these factors, and after one coconut shell, the quality and effects are clear within 30 minutes. A few other caveats. 1-2 tsps is a mild dose and typically can be used daily for nervousness and anxiety for its calming effects (2-4 grams). However, some people still don't do well with kava, especially long-term. Remember it is a member of the genus Piper and so is spicy and warm. The energetics of the person should be considered. However, many people can consume a shell or two of kava with no problems, again depending on the cultivar, and the regularity of use. Using kava regularly, the kava lactones will accumulate to some extent, and your receptor sites that mediate the pleasant or relaxing effect will be used up and over-stimulated so I have found that every other day use is often more effective for calming and sleeping benefits. Typically I drink kava once a week these days, but have consumed it a few days in a row each week. Smaller doses are best (3-4 grams) if you are using it more frequently than 1-2 times a week in my experience. However, each person is different. We have two kava bars in my area of California, and on weekends, many students in Davis, CA gather to drink and socialize. Other kava bars have popped up around the bay area....Santa Cruz, Berkeley (not surprising!), and I have heard from owners that more are coming. Side Effects It is important to note that regular kava use at a more therapeutic dose mentioned above can have some clear side effects. It affects the eyes (in the morning you might notice discharge and a burning feeling, that goes away after washing them out) and can lead to very strange dreams and an unsettled feeling. One can feel quite groggy and low-energy the next day. Very excessive and regular doses can lead to skin rashes and even neurological problems like a funny walking style, even staggering, I'm not kidding. However, again, the cultivars used before noting these effects are often not reported. Euphoria Depending on the kava cultivar and how much euphoria is produced, kava can be addicting, as one can clearly see in northeastern Australia and on some of the south Pacific Islands. The euphoria produced by some cultivars of kava can be amazing, in the sense that for a short time anyway, one has the feeling that no matter what else is going on out there, everything will be fine. It's a sense that all is right with the world. These effects are likely mediated through effects on dopamine release or on the receptors themselves according to some research. This will be a larger topic I will add later after more research. This review will be developed further and will be going up on my website. Summary of Uses and Benefits *diuretic, tonic for the bladder and is often used for urinary tract problems in the South Pacific Islands. *Relaxing beverage for sleeping problems, adjust the dose and cultivar for best effect; some kava cultivars and higher doses can lead to disturbed dreams. Remember that kava is a diuretic, so it can increase the need to get up in the night and pee. *Calming for nervousness and anxiety. Clinical trials are available showing effectiveness for counteracting anxiety, similar in effectiveness to benzodiazepines, but safer and with less side effects (like memory loss, anxiety, etc.). *May be helpful for muscle spasms in my experience. *A number of other benefits have been noted in recent research...pain-relief, antioxidant, and neuroprotective effects. These will be developed more in later versions of this kava essay. Pharmacology Kavalactones act on the functioning of GABA A receptors, increasing GABA activity perhaps similar to benzodiazepines, but kavalactones may only lightly interact with benzodiazepine receptors, meaning fewer side effects and less interference with the natural processes of our body, which is a basic tenet of herbal medicine. Effects on chloride and calcium channels of nerve cells leading to broad inhibition of nerve cell firing also appears to play a role in their psychogenic effects. Other effects on norepinephrine and MAO enzymes are also noted. Liver Toxicity This is a long story. In the 1990s, small clusters of hepatotoxicity in regular kava users was noted. Many years of research has turned up little in the way of direct evidence that noble kava, when used regularly, and especially when water extracted in a traditional way can lead to liver damage, in mice or cultured human liver cells. The early kava liver toxicity was theorized to be due to compounds in the stem of kava which do show liver toxicity in animals, or from industrial solvents used in some of the early extracts. This underlies my recommendation to not use commercial extracts with higher kavalactone (above 10%) levels, and the avoidance of extracts that use any other solvents than water, ethanol or carbon dioxide. Besides, using kava moderately, up to several times/week in recommended dosages, should add to the safety. Still, it is wise to avoid kava if you have pre-existing liver problems (like chronic hepatitis C) and caution is advised when one is already consuming potential liver-stressing or toxic drugs (like acetaminophen), or concomitant alcohol. Pregnancy and nursing The American Herbal Products Association Botanical Safety Handbook recommends not to use kava during pregnancy or nursing. Drug Interactions Kava does affect liver enzymes the body uses to metabolize many drugs, especially affecting CYP450. A few clinical case reports involving kava-medication interactions are available for people taking Alprazolam (Xanax), dopamine agonists like Levodopa and ethanol. Avoid kava if you are taking these drugs, or at least consult your healthcare providers and watch your response to kava carefully. Other drugs have theoretical and speculative interactions (some with little evidence) based primarily on animal and cell research, including anticonvulsant medications like Tegretol, Depakote, MAO-B inhibitors like Deprenyl, proton pump inhibitors like Prilosec, and anticoagulants like Warfarin (Stargrove et al., 2008). Again, regular daily use for long periods is not recommended, except in small, well-tolerated doses. "Moderate consumption of kava in its traditional form, i.e., as a water-based suspension of kava roots, has been deemed as presenting an 'acceptably low level of health risk' by the World Health Organization." (Wikipedia). References Mitchell Bebel Stargrove, N. D., Jonathan Treasure, and Dwight L. McKee. Herb, nutrient, and drug interactions: clinical implications and therapeutic strategies. Elsevier Health Sciences, 2007. Kapalka, G.M., 2010. Anxiety Disorders. In Nutritional and Herbal Therapies for Children and Adolescents. Pedrosa, Elaine Cristina Gurgel Andrade, et al. "Neuroprotective profile of Piper Methysticum (Kava Kava) and its effects on the Central Nervous System: a systematic review." Boola Boola, enjoy a relaxing cup of kava! Christopher Hobbs

BHC alumna and faculty member Francisca Santibanez is offering her life-affirming and life-changing Plant Spirit Talk course again in 2021. It usually fills up pretty quickly, so don't hesitate too long if you're interested. Learn more about this profound experience with plant spirit here: https://plantspirittalk.com/2021-plant-spirit-talk-course

For those near and far....

From our annual Student Medicine Show

Now up on Berkeley Herbal Center website, as a free on-line course. Please share this will people you love.

Wildfires are raging all around us, the night skies are orange, and the days are smoky, grey, and ashy... at best. In light of this, we decided to add a class t...o our roster for this week. It's called The Wildfire Herbalist's Tool Kit - and we're teaching what you can do right now to help your communities heal from the 2020 fire season. This class is offer free of charge. It's Thursday at 6pm Pacific time, and it's online so you can join from anywhere. Sign up here: https://mailchi.mp/berkeleyherbalcenter/wildfire-class

Politics and economics of evidence, how science became a tool for duping the public.

MEET YOUR HERBALIST: ASHLEY Ashley treats both acute and chronic focusing on diet & lifestyle as well as spiritual & emotional wellness. Some of her specific in...terests include blood sugar regulation, PCOS, GI wellness, and anxiety & depression. She also teaches classes on Western herbalism, medicine, making, and the magic & folklore of plants. Ashley is a second year clinician at our community herbal center so to make an appointment with her, you can email her directly! You can contact Ashley directly at [email protected] to schedule an appointment.

Interested in learning about medicinals herbs?? This course is a great place to begin, and is on line for the next month!!