Kava

Overview

Kava (also called kava kava) is a drink made from the ground root of a plant that grows in the Pacific Islands. For centuries, Pacific communities have used it in ceremonies and social gatherings, where it helps people feel calm and relaxed. Today, kava is also sold in shops and online as capsules, powders, teas and extracts, usually advertised for anxiety, stress and sleep. Kava is not a proven treatment for any medical condition, and it can affect the liver, so it is worth knowing the facts before you try it.

Kava use is fairly common. Traditional kava drinking is a normal part of life in many Pacific communities, and kava supplements are widely sold for stress and sleep.

Most people who use kava are adults. It is not recommended for anyone under 18, for people who are pregnant or breastfeeding, or for people with liver problems. Older adults need extra care, because kava's calming effect can raise the risk of falls and can mix badly with other medicines.

Symptoms

Common symptoms

• Feeling relaxed, calm or pleasantly numb, often with a tingling or numb mouth and tongue
• Feeling sleepy or mentally slow for a few hours
• Mild upset stomach, headache or dizziness
• With regular heavy use: dry, scaly, yellowish skin, red eyes, weight loss, low mood or low sex drive
• Needing more kava to get the same effect, or feeling anxious and shaky when you stop

Symptoms in children

• Kava is not recommended for children or teenagers under 18. Their bodies and brains are still developing, and there is no good evidence that it is safe for them.
• If a child has swallowed kava by accident, or seems very sleepy, confused or unwell, get medical help straight away.

Symptoms in older adults

• Older adults are more likely to feel very drowsy or dizzy, which raises the risk of falls and injuries.
• Kava can interact with medicines commonly taken by older adults, such as blood thinners, blood pressure medicines and medicines for anxiety or sleep.
• The liver becomes less efficient with age, so the effects and risks may be greater.

Causes

Main causes

• Kava's active ingredients (called kavalactones) act on the brain to create calm and drowsiness.
• Some kava products, especially those made from the whole plant or from poor-quality plant parts, have been linked to liver harm.
• Taking kava with alcohol, sedatives or other medicines can make its effects much stronger and more dangerous.
• People often start using kava to cope with stress, anxiety or poor sleep, which makes it easy to rely on it more and more.

Risk factors

• Drinking alcohol or taking sleeping tablets, strong painkillers or anxiety medicines
• Existing liver disease or a history of liver problems
• Using kava every day or in large amounts for a long time
• Being pregnant or breastfeeding
• Being under 18
• Driving or operating machinery after taking kava
• Buying unregulated products with unknown strength or purity

When to see a doctor

See a doctor urgently if:

• You have yellow skin or eyes, dark urine or severe tiredness
• You feel very drowsy, confused or faint
• You have a fast heartbeat, chest pain or trouble breathing
• You have taken kava with alcohol or other sedatives and feel unwell
• You want to stop kava but feel shaky, anxious or unable to sleep

Book a routine appointment if:

• You use kava regularly and want to check whether it is safe for you
• You take any regular medicines, including blood thinners or medicines for blood pressure, anxiety or sleep
• You are planning a pregnancy, are pregnant, or are breastfeeding
• You feel low or anxious, or you are not sleeping well, and you want to talk about other options

Diagnosis

There is no test that shows whether you have taken kava. If you see a doctor, they will ask about any herbal or plant products you use — so mention kava even if you do not think of it as a medicine. If there are concerns about your liver, they may arrange blood tests.

Tests that may be done

• Blood tests to check how well your liver is working
• Blood pressure and pulse checks
• Questions about your medicines, alcohol use and diet to spot interactions
• In some cases, an ultrasound scan of the liver

What to expect at your appointment

Your appointment is usually a conversation. Be honest about how much kava you take, how often, and in what form — capsules, tea or traditional drink. Your doctor is not there to judge you; they need this information to keep you safe. If your liver tests are normal and you feel well, you may simply be advised to stop or cut down.

Treatment

There is no antidote to kava. Treatment is about stopping kava, letting your body clear it, and managing any effects. If you have been using it to cope with anxiety or sleep problems, your doctor can help you find safer, proven options and support.

Self-care at home

• Stop taking kava, or cut down slowly if you have been using it heavily for a long time
• Avoid alcohol and other sedatives while your body clears the kava
• Drink plenty of water and eat regular meals
• Do not drive or use machinery until you feel fully alert
• Keep a note of what you took, how much and when — it helps your doctor
• Try simple wind-down routines for sleep, such as a fixed bedtime, less screen time and gentle activity

Medical treatments

Care depends on your symptoms. If there are signs of liver problems, you may need blood tests and, sometimes, hospital care and monitoring. If you are struggling with anxiety, low mood or sleep, your doctor can talk you through proven options, which may include talking therapies, structured self-help programmes and, where appropriate, prescribed medicines. Stopping kava suddenly after heavy regular use can cause withdrawal, so ask for advice on the safest way to stop.

When is surgery considered?

Tell your surgeon and anaesthetist if you use kava, especially before a planned operation. Kava can make the effects of anaesthetic and sedative medicines stronger, and it may affect bleeding. You will usually be asked to stop it well before surgery. Always check with your surgical team.

Living with this condition

If you decide to stop kava, the first week or two can feel unsettled — sleep may be lighter and you may feel more anxious for a while. This usually settles. Keep your days structured, tell someone you trust what you are doing, and plan something calming for the times of day when you would normally have taken kava.

Lifestyle tips

• Keep alcohol to a minimum, or avoid it completely while you stop kava
• Check with a pharmacist before starting any new medicine, supplement or herbal product
• Build a regular bedtime and a calm wind-down routine
• Stay active during the day — a daily walk can help sleep and mood
• If you use kava for cultural or social reasons, talk to your community or elders about safer ways to take part

Diet and exercise

There is no special diet for stopping kava, but regular meals and plenty of water help your body recover. Aim for gentle, regular movement — walking, swimming, cycling or anything you enjoy — most days. This supports sleep, mood and liver health. If you drink alcohol, cutting down makes a real difference.

Mental health and emotional wellbeing

Many people turn to kava because of anxiety, stress or poor sleep. Stopping can briefly make those feelings stronger, so it is worth lining up support before you stop. Feeling low, worried or unable to sleep is common and treatable — you deserve help with it. If you ever have thoughts of harming yourself or ending your life, please contact your local emergency number or a crisis line in your country straight away, or tell someone you trust and ask them to stay with you.

Prevention

You can lower the risks from kava by taking it rarely, in small amounts, and never with alcohol or sedatives. Avoid it completely if you have liver problems, are pregnant or breastfeeding, are under 18, or are due to have surgery or an anaesthetic. Buy only from reputable sellers, and tell your doctor and pharmacist that you use it.

Screening programmes

There is no screening test for kava use. If you take kava regularly, or have taken it in the past, it is sensible to ask your doctor whether a liver blood test would be worthwhile.

Complications

If left untreated

• Liver injury, which can be serious and, rarely, life-threatening
• Dependence, where you need kava to feel normal and find it hard to stop
• Withdrawal symptoms such as anxiety, tremor and poor sleep
• Skin changes, weight loss and low mood with long-term heavy use
• Harmful interactions with other medicines, alcohol and anaesthetics
• Accidents caused by drowsiness, especially while driving

Long-term outlook

Most people who stop kava recover well, and the liver is often able to heal, especially when changes are caught early. If you do use kava, the safest approach is to keep the amount low, avoid mixing it with alcohol or sedatives, and let your doctor and pharmacist know. And if you are using kava to manage anxiety or sleep, there is good, effective help available — you do not have to manage alone.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.