Kratom and Liver Health: Investigating the Potential for Hepatotoxicity

Kratom, a botanical product known for its opium substitute qualities and abuse potential, has raised concerns regarding liver health. Research indicates that while kratom is associated with hepatotoxicity, or chemical-driven liver damage, such incidents are relatively rare. The liver metabolizes kratom through the cytochrome p450 system; in regular doses, it is not harmful to hepatocytes, but larger amounts can increase the workload on these liver cells, leading to toxicity. Chronic use, in particular, has been connected with liver damage, exhibiting symptoms like fatigue, fever, nausea, itchy skin, dark urine, and jaundice​​​​ [“”] [“”]. 

A study from the U.S. drug induced liver injury network identified eleven cases of liver injury attributed to kratom, underscoring a recent increase in such incidents. The majority of cases were male, with a median age of 40 years, all presenting with symptoms and developing jaundice within a median latency of 14 days. The liver injury pattern varied, and most cases required hospitalization, although all eventually recovered. Biochemical analysis in these cases revealed the active ingredients of kratom​​ [“”].

This research highlights the importance of caution and moderation in the use of kratom, particularly for individuals with existing liver conditions or those taking other medications that may interact adversely with kratom. The variability in liver injury patterns and the potential for recovery post-cessation of kratom use suggest that while kratom can cause severe liver injury, awareness and monitoring of usage amounts and duration can mitigate risks.

Given the potential for harm and the lack of regulatory oversight on kratom products, which often do not list ingredients or mention possible side effects, individuals considering kratom for any purpose should consult healthcare professionals and consider the current research on its effects on liver health. The lack of conclusive evidence and the variability in individual reactions call for a cautious approach to kratom consumption.

In light of the research indicating potential liver problems associated with kratom use, medical professionals emphasize the importance of caution and informed decision-making. Here are some doctor-advised precautions and reviews regarding kratom consumption, especially concerning liver health:

• Screening and Monitoring: Doctors advise individuals who choose to use kratom to undergo regular liver function tests, especially if they are chronic users or have pre-existing liver conditions. Monitoring liver enzyme levels can help detect early signs of liver stress or damage.
• Moderation: Health professionals stress the importance of using kratom in moderation. Since the risk of liver injury appears to increase with higher doses and prolonged use, limiting consumption can help reduce potential liver damage risks.
• Awareness of Symptoms: Medical experts recommend being vigilant for symptoms of liver damage, such as fatigue, jaundice (yellowing of the skin and eyes), dark urine, itching, and abdominal pain. Early detection of these symptoms can facilitate prompt medical intervention and prevent more severe liver problems.
• Consultation Before Use: It’s crucial to consult a healthcare provider before starting kratom, especially for individuals with existing liver issues or those on medications that could potentially interact with kratom. A healthcare provider can offer personalized advice based on an individual’s health history and current medications.
• Educating on Risks and Safe Use: Doctors often emphasize the importance of educating patients about the risks associated with kratom use, including potential liver injury. They may provide guidance on safe use practices, such as avoiding combining kratom with alcohol or other substances known to impact liver health.
• Alternatives for Pain Management and Opioid Withdrawal: Given kratom’s popularity for pain relief and opioid withdrawal symptoms, medical professionals may suggest exploring FDA-approved treatments that have been rigorously tested for safety and efficacy. This approach ensures that patients receive the most appropriate care for their specific conditions.

Doctors and healthcare providers play a crucial role in guiding and advising patients regarding the safe use of kratom. While some individuals may benefit from its use, it’s essential to weigh these benefits against the potential risks, especially concerning liver health. The lack of regulatory oversight and variability in product composition further complicates the risk assessment, making professional medical advice and regular health monitoring critical components of responsible kratom use.

• To further illustrate the potential liver problems associated with kratom use, let’s explore several case studies that highlight the varied nature of these injuries and the recovery processes involved:
• Case Study from the U.S. Drug Induced Liver Injury Network: This study reported eleven cases of liver injury attributed to kratom, showcasing a notable increase in such incidents. The patients, predominantly male with a median age of 40, developed symptoms including jaundice within a median of 14 days. While the pattern of liver injury varied among the cases, most required hospitalization. All patients eventually recovered, underscoring the potential for severe liver injury but also the possibility of recovery with appropriate medical intervention​​ [“”]
• Case of a 20-Year-Old Man: A young man was found deceased with no signs of trauma but had a history of kratom ingestion. Autopsy findings included pulmonary edema and kratom presence in urine, highlighting the severe and fatal potential of kratom use in some instances​​ [“”].
• Case of a 17-Year-Old Male: This individual was discovered dead with empty bottles and boxes of kratom. The autopsy revealed bilateral pulmonary edema and high blood levels of mitragynine, the active compound in kratom, pointing towards the lethal risks associated with high-dose kratom use​​ [“”].
• Systematic Review of Safety and Efficacy: A comprehensive review concluded a lack of evidence supporting kratom’s clinical indications, with historical uses including analgesic and antitussive purposes. This review suggests the need for more rigorous research to understand kratom’s effects fully and safely​​ [“”].

These case studies reflect the spectrum of potential outcomes from kratom use, from severe liver injury requiring hospitalization to fatal incidents attributed to its consumption. They underscore the importance of caution, awareness of the symptoms of liver injury, and the need for further research to elucidate kratom’s safety profile fully. Additionally, these cases highlight the critical role of healthcare professionals in guiding patients on the risks associated with kratom and providing alternatives for pain management and opioid withdrawal treatment.

Below is the bibliography for the article on kratom and its potential to cause liver problems, including doctor advice, case studies, and research findings:

• Holler JM, Vorce SP, McDonough-Bender PC, Magluilo J Jr, Solomon CJ, Levine B. “A drug toxicity death involving propylhexedrine and mitragynine.” Journal of Analytical Toxicology, 2011;35:54–9. Available from: PubMed.
• Neerman MF, Frost RE, Deking J. “A drug fatality involving Kratom.” Journal of Forensic Sciences, 2013;58 Suppl 1:S278–9. Available from: PubMed.
• Prozialeck WC, Jivan JK, Andurkar SV. “Pharmacology of kratom: An emerging botanical agent with stimulant, analgesic and opioid-like effects.” Journal of the American Osteopathic Association, 2012;112:792–9. Available from: PubMed.
• Rosenbaum CD, Carreiro SP, Babu KM. “Here today, gone tomorrow… and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines.” Journal of Medical Toxicology, 2012;8:15–32. Available from: PubMed Central.
• Ulbricht C, Costa D, Dao J, Isaac R, LeBlanc YC, Rhoades J, Windsor RC. “An evidence-based systematic review of kratom (Mitragyna speciosa) by the Natural Standard Research Collaboration.” Journal of Dietary Supplements, 2013;10:152–70. Available from: PubMed.
• NavarroV et al. “Liver injury associated with kratom, a popular opioid-like product: Experience from the U.S. drug induced liver injury network and a review of the literature.” Drug and Alcohol Dependence, 2020. Available from: PubMed.

These sources provide a comprehensive overview of the current research and understanding of kratom’s effects on the liver, highlighting both the potential risks and areas requiring further study. The inclusion of case studies and reviews from medical professionals offers a well-rounded perspective on the topic.

10 FAQs on Can Kratom Cause Liver Problems?

• What is kratom?

• • • Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia, with leaves that contain compounds with both stimulant and opioid-like effects, used for various purposes including pain relief and opioid withdrawal.

• Can kratom cause liver problems?

• • • Yes, there have been reports and case studies indicating that kratom can cause liver problems, including hepatotoxicity, especially with prolonged use or high doses.

• What are the symptoms of kratom-induced liver damage?

• • • Symptoms may include fatigue, jaundice (yellowing of the skin and eyes), dark urine, nausea, abdominal pain, and itching.

• How does kratom affect the liver?

• • • Kratom metabolites can exert stress on the liver, and in some cases, the liver may not be able to process these substances efficiently, leading to potential liver injury.

• Are certain individuals more at risk for liver damage from kratom?

• • • Individuals with pre-existing liver conditions, those who consume kratom in large quantities, or use it for extended periods may be at higher risk.

• How is kratom-induced liver damage diagnosed?

• • • Diagnosis typically involves liver function tests, a review of the patient’s substance use history, and ruling out other causes of liver injury.

• Can liver damage from kratom be reversed?

• • • Many cases of liver damage from kratom have shown reversibility upon cessation of kratom use, with proper medical care and monitoring.

• What precautions can reduce the risk of liver damage from kratom?

• • • Moderation in use, avoiding combining kratom with other substances harmful to the liver, and regular monitoring of liver health can reduce risks.

• What should you do if you suspect liver damage from kratom?

• • • Cease kratom use and consult a healthcare provider immediately for evaluation and appropriate treatment.

• Is there ongoing research into kratom and liver health?

• • Yes, ongoing research aims to better understand kratom’s effects on the liver and to identify factors that contribute to the risk of hepatotoxicity.

These FAQs aim to provide a foundational understanding of the concerns regarding kratom use and liver health, emphasizing the importance of cautious use and the need for further scientific investigation into its safety profile.

Jaden

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