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FA EXHIBIT https 11wwwmountelnal org/eealch-iibrary'hed/kava- � kava#"text =Reports%20in%20thesk20u n Itedet20Statos liver%20fai lure%2C%20a nd%20death) Kava kava Awa, Ava; Piper methysticum; Yagora Kava kava (Piper methysNcurr) has beer used as a ceremonial dr nk in the Pacific Islands for hundreds of years. Some people report en effects are similar to alcohol. The roots are chewed or ground one a pulp and added to co d waterthe resorting thick brew, whicr has been compared to the social equivalent of wine in France Is mffered :O guests and dignitaries visiting the Pacitic Islands. In addition to its ceremonial uses, kava 's des; mown `or Its relaxing qualities. Kava is said to elevate mood, well being, and contentment, anis produce a feeling of relaxation Several studies have found that kava may be r it in the treatment of anx cry, irsomnia, and related nervous dl. However, there is ser crus mrcern teat kava may cause I ver damage More than 30 cases of Ever damage have been reported In Puropehowever, researchers have not been ab e to confirm that kava is toxicto the liver. I1. is net dear whetmer kava iself causes liver damage, or whether taking kava in combination with otherdvgs o, herbs Is responsiole. It is also not clear whether kava is dangerous at oreviously recommended doses, or only at higher doses. Some ccureres have taken kava off the market It remains avadable in me United States But the food and Drug AdminlstraCon (FDA) issued a consumer advisory in March 2002 regarding the "rarebut potential risk of liver failure associated with kava-conta ening omducts- It Is mpossihle to ray what, if any, dose p'kava might be safe. You should not tare kava umless you are undera doom's close supervision. Kava may cause liver damage DO NOT take kava unless you am r.rder a doctor's supervisionevidence suggests kava may hs helpful for the following health. proolems'. Anxiety A number of dinlcal studies, -hough not all, have found kava to be effec-ive it treating symptoms associated wrtic anxiety In. a renew of 7 scient fit studies, researct ers -oncluded -hat a standardized kava extract was significantly more effective than placebo In treating anxiety. Another st.rdy facto that kava substantially Improved symptoms after onre I week of Treat nett. Other studies show that kava may be as effective as some ores<ripnon snt anxiety medications. According m one study, kava and diazepam I u.rr) cause smnilE, rhsrges in brain wave aCivity, suggesting they maywork in the same ways to calm the mind. Research on using kava foranxioty has decreased be, "'re of reports of liver tox city. A2004 wady found that 300 mg o' kava may imprcve mood end cogrlrlve performance. That Is significant hecause some prescription dregs used to treat anxiety, such as benzodi. zcpincs (IIke Val um and alprazolam or Xanax), tend to decrease cognitive function.