Until recently, I'd never heard of kratom, also known as mitragyna speciosa, but a quick search revealed that this stuff is pretty popular online with many people passionate about how well it works. Kratom contains compounds that can have both stimulating and calming effects. It's promoted to help pain, improve exercise, help insomnia and drug addiction among others. After looking at various blogs and videos on this stuff, I got interested. So, is it safe? Is kratom addictive? Any side effects? I'm going to just look at the research I was able to uncover and let you decide. No agendas here. Just science and rational thought. I hope this review will help you decide if kratom is right for you.
What Is Kratom?
Kratom, whose scientific name is Mitragyna speciosa is also known as Kratum and Ketum. It's related to the coffee plant and is usually pronounced either as “Cray-tum” or “Crah-tum.” Kratom is a tree that grows in places like Southeast Asia and the Philippines. In other parts of the world the herb has been used to treat several conditions ranging from helping fatigue to reducing pain.
Kratom Is Also Called…
According to the FDA, kratom is also known by these other names:
|madat||Maeng da leaf||nauclea||Nauclea speciosa or thang|
Other more street slang names for this plant include “herbal Speedball” and “Thom.”
Some companies advertise “organic kratom” although whether or not organic versions of this herb are better or healthier than non-organic versions. is open to speculation.
The leaves of the tree contain various chemicals that are said to have a variety of effects such as increasing energy levels and also helping people feel more calm and at ease.
The degree to which it has either of these effects – and others- is said to be dose-dependant.
In other words, at:
- Lower doses = it has stimulant effects, almost like caffeine.
- Higher doses = it has sedative effects.
See the kratom section of this review for more information.
Kratom Active Ingredients
When someone first hears about Kratom they may also hear about one of the phytochemicals in the plant, called mitragynine (pronounced ma-tra-ja-neen.”). While some call this is the active ingredient, it should be remembered that the plant contains many other chemicals that can have other effects.
A few of the other chemicals in kratom include 7-hydroxymitragynine, paynantheine and speciogynine. Because of this, I don't think it's possible to pin down just one thing and say its the “active ingredient.” Currently, over 40 different compounds in kratom have been identified.
As stated above, at low doses, mitragynine seems to act like a stimulant. This may be why some people say mitragyna gives them more energy. At higher amounts though mitragynine seems to do the opposite and have opioid like /sedative effects effects. These effects may be at the heart of the “legal high” that Kratom is sometimes marketed to provide.
The FDA, using computer analysis to look at 25 compounds in kratom, determined that the chemical structure of these compounds were similar to opioids. They went on to say that 22 of the 25 compounds would bind to opioid receptors.
Kratom Human Research
I searched the National Library of Medicine (Pubmed.gov) for these words:
- Kratom Human
- Mitragyna speciosa human
My hope was that this would reveal human clinical studies involving this herb. I did not uncover much.
Here's a summary of the human research I found:
One investigation, which involved 10 men who regularly used mitragyna. Researchers gave the men either 2 oz or 4 oz of kratom tea for 7 days.
No serious side effects were reported although all the people in the study reported tongue numbness after drinking the tea. All the people in the study also had increased heart rates and blood pressures and these appeared to occur 8 hours after drinking the tea.
Other than this study, I did not locate any other human investigations. The majority of studies I did find involved either lab animals (mice or rats) or isolated human cells that were subjected to the herb. Some of that research, I'll cover below in other sections.
Human cell research is interesting, but since we are more than isolated cells in a test tube, I don't know how well those results translate into showing the effects of this herb in live human beings.
I also found various case reports stemming from emergency room visits, which I'll list below in the side effects section. At this time, I'm forced to conclude that kratom appears to have little published, peer reviewed clinical trials involving people.
Kratom For Opioid Withdrawal
Because kratom contains mitragynine, an opioid-like compound, it's become popular with some people trying to curb addition to opioid drugs such as oxycodone and fentanyl among others. Does it work? In theory, molecules that look like opioids might attach to opioid receptors; this might help with withdrawal.
It sounds plausible however according to an FDA press release dated November 14 2017, “There is no reliable evidence to support the use of kratom as a treatment for opioid use disorder.”
That may be due to a lack of good human research on this.
And then one has to wonder if it did work, what would stop people from becoming addicted to kratom? It would be like going from one addition to another. Indeed, from the comments below, kratom addiction is something some people have been wondering about and trying to take steps to avoid.
If the FDA is correct and kratom ingredients look like opioids and bind to opioid receptors, then this could lend evidence of it's alleged addictive nature.
Kratom And Pain
While kratom seems to have pain-killing effects, it's structure is different than morphine. But, mitragynine, one of the chemicals in the plant, can bind to the same opioid receptors as morphine does. That is likely why some people with chronic pain issues might turn to kratom for help.
Because of this, some have wondered if the plant (or just mitragynine) might one day be used to help people wean off drugs like opiates and heroin. As can be seen from the side effects section below, there is at least one case report of someone doing this. That said, at higher doses kratom might have a stimulant-like effect.
How Much Kratom Is Safe?
Since mitragynine can have both a stimulant effects (at lower dosages) and act like a sedative (at higher doses), one has to ask the question, “How much is a little bit and how much is a lot?”
Dosage instructions for taking mitragyna can be found on the internet. However, given the lack of human research, I have to wonder who is making up these instructions? None of the websites I looked at for this review which discuss how to take kratom showed me scientific studies to back up the dosage instructions they advocated.
Some websites might base their recommendations on asking people how much they took. I'm sorry, but that's poor science. I say this because it does not take into consideration many other things that could be going on. For example:
- What if you have depression/are bipolar and take kratom?
- What if you have high blood pressure and kratom?
- What if you mix kratom and alcohol or other medications?
- How long does kratom stay in the body after you eat it vs. smoke it?
Some websites say people should use a certain amount of mitragynine -like 1-2 grams for example – but again, where are these amounts coming from? Is it trial and error?
Given the lack of human research, I think people should look at dosage instructions skeptically .
What about long term effects? In other words, what are the effects of someone using kratom regularly for years? Unfortunately, I can't give an answer for that. The research needs to be done.
Who Uses Kratom??
I first became aware of kratom from a college student. But students are not the only people experimenting with this stuff. In a 2017 review that included over 8,000 mitragyna users who were given surveys, researchers noted that most people who responded were:
- 31-50 years of age
- Made at least $35,000 per year
The surveys also noted that side effects were most common when people used more than 5 grams per day or were very frequent users (22 doses per week). Side effects were usually gastrointestinal in nature, including constipation and nausea. This is common for many supplements and medications too.
What Is The American Kratom Association?
The American Kratom Association (AmericanKratom.org) is a non-profit advocacy group based in Virginia. The website states the organization was founded in 2014. According to their whois.com file, the website for the organization was created in 2015. Part of their mission, they say, is to educate people on the safety of mitragyna/kratom.
The website also keeps visitors up-to-date on various legal issues relating to kratom and provides email addresses of local government officials who seek to increase government oversight of this herb.
While lobbying government officials and sending emails is nice, the Association, needs to fund clinical research on Mitragyna speciosa. Instead of lobbying, Senators, the best way to prove to Senators and the public that kratom is safe is to do clinical studies on Kratom itself.
Update. The American Kratom Association seems to have changed its name. Visitors going to their website (AmericanKratom.org) are redirected to another site, AmericanBotanicals.org. This site was registered in 2017. Why did they change their name?
Was it because “botanicals” is a more friendly-sounding name? Might this be eventually expand their advocacy to other controversial botanicals, like marijuana? Of course, this is speculation.
Update. Clicking on AmericanKratom.org now takes people to that url (it no longer goes AmericanBotanicals.org). Those typing searching for AmericanBotanicals.org are now redirected to AmericanKratom.org.
What's up with the website shuffle? I have idea.
Is Kratom Legal?
Currently, mitragyna is legal in most US states. When this review was created, US where Kratom is illegal include Alabama, Arkansas, Indiana, Tennessee and Wisconsin. Some states have pending legislation that would criminalize the growth and use of the plant.
The American Kratom Association, provides a list of that US states that the herb is legal, illegal and banned. Around the world, mitragyna is illegal in some countries such as Thialand as well as Australia and Malaysia.
Kratom And The FDA
From what I can tell, kratom is legal in most states in the US (Tennessee and Indiana appear to be exceptions). That said, in 2014 the FDA sized over 5 million dollars worth of a product from a company in California citing that it deems this to be a compound “that poses a risk to public health and has the potential for abuse.” In January 2016, the FDA sized 90,000 bottles from another company.
The FDA is also detaining shipments of the product that attempt to enter the US. I have not yet seen mitragyna used in dietary supplements. I believe this may because the FDA considers it a new dietary ingredient.
A new dietary ingredient would be something that has not been in the general food supply for a long enough time to determine if it's safe or not. In cases like this, companies have to convince the FDA that new dietary ingredients are safe for humans – and by convince, I mean show them published clinical studies.
While there are regions of the world where mitragyna has been used for a long time, I'm not aware of much in the way published human clinical trials.
Kratom And Exercise
Because mitragyna is supposed to have stimulating effects at low dosages, some might wonder if it would make a good pre-workout drink or something to add to a smoothie. I can tell you that I am not aware of any exercise-related research on this herbal preparation. I can't say if it would make someone last longer in the gym or run faster or longer. Based on that alone, I don't think it's worth spending money on.
As a side note, I'd mention that pre-workout supplements in general are mostly just caffeine and other ingredients that, for the most part, have little proof they work better than caffeine alone.
That said, a quick online search reveals several websites and videos where mitragyna is being marketed to bodybuilders with some saying it can improve
- Mental focus
- Reduce appetite
- Boost metabolism
- Help fat loss
For all these claims and others I can only say that human evidence for them is lacking. There are many different types (strains) of kratom out there. Different strains may have different active ingredients (there is more to kraom than just mitragyna). When human studies are published on its effects on exercise, I'll update this review.
What I can say is to be very careful experimenting that has sedative effects when lifting weights. In theory, the sedative properties of kratom could lead to injuries in the gym.
Kratom overdose , leading to hemorrhagic pulmonary edema, has been implicated in the death of a 27 year old police officer/armature bodybuilder.
Is Kratom Addictive?
If Mitragyna speciosa can be used to help people wean off pain killers and other drugs, one wonders how difficult it might be to stop taking kratom after their withdrawal symptoms from the other drugs go away? In other words, is kratom addicting? The American Kratom Association's website says “Kratom is non-habit forming, unless taken in extremely high doses for extended periods of time.”
The Association goes on to to say that when it is used in excess, “Kratom consumers may experience dependence, similar to caffeine dependence.” I'm not aware of any research to confirm or deny this. Where are they getting this data from?
The science page of the American Kratom Association does not provide any evidence showing withdrawal in humans is similar to caffeine withdrawal. If anyone knows of peer reviewed evidence to substantiate this, let me know and I'll be glad to update this part of the review. See the side effects section below.
There does appear to be evidence that some people have the propensity to become dependent on kratom. In this 2014 report of 293 regular users, it was noted that more than half of those who regularly used kratom more than 6 months, experienced “severe dependence problems.” Researchers also noted that 45% experienced “moderate” dependence.
Doctors in Canada reported the case of a pregnant women who used kratom during pregnancy and up till she delivered. She was taking 18-20g of kratom powder 3 time a day (that's about 2.5 ounces a day). Two days after giving birth, her baby started having withdrawal symptoms including vomiting, irritability, jitteriness and problematic feeding. The baby had to be given morphine and eased off it to reduce the symptoms.
To me, this proves mitragyna is addicting.
Researchers in Malaysia looked at the severity of pain and sleep problems in 170 regular kratom users after they stopped using kraom tea/juice. They noted the following
- 84% experienced moderate pain
- 46% of people reported more sleeping problems
Pain that interfered with sleep was worse in those who consumed 4 or more glasses of kratom tea/juice per day (containing 76-115 mg of mitragynine). These effects were less in those who consumed 1-3 glasses of kratom tea/juice per day. The researchers concluded “cessation from regular kratom tea/juice consumption is not associated with prolonged pain and sleep problems.”
Physical symptoms of withdrawal from mitragyna included muscle spasms and pain, sleeping difficulty, watery eyes/nose, hot flashes, fever, decreased appetite, and diarrhea. In the side effects section below, notice that one man spent $15,000 a year on kratom. That's a lot of money and it makes me wonder if addiction is a possibility, at least for some people. I believe more research needs to be done to better understand kratom addiction.
In this report from the Wisconson Medical Society, a 37 year old woman started taking mitragyna for carpel tunnel pain. When she tried to cut back on how much she took, she reported experiencing withdrawal symptoms including severe abdominal cramps, sweating, insomnia, depression, weight loss, decreased energy, blurred vision, nausea and diarrhea. She also admitted to hiding kratom around the house so her husband would not know she was still using it.
Kratom Side Effects
Until good human studies are published, it's difficult to know what long term side effects might be. Much of the research involves lab animals and test tube studies. Many of the proposed side effects discussed blow come from case reports of single individuals. I think the side effects – and severity of them – would vary according to a number of factors such as:
- How long someone took it?
- How much active ingredients are in the product?
- What medications (legal and illegal drugs too) are also being used?
- What health conditions you have?
- Does the product contain anything else?
Generally, I would say that people should not drive while using mitragyna. I also don't believe women who are pregnant or breastfeeding should take it. I would not combine it with any prescription medication or illegal drugs or over the counter medications. It's also wise to stop taking mitragyna at least 2 weeks before having surgery.
As I looked over various websites that discussed this topic, I saw people claiming kratom was associated with a variety of side effects ranging from constipation and itching to erectile dysfunction. I was not able to find human research to substantiate most of what I saw however.
|Elevated heart rate||Elevated blood pressure||Trouble sleeping|
|Breathing problems||Liver toxicity||Dry mouth|
|small black feces||Anorexia/weight loss|
Again, the degree to which any of these symptoms are experienced, I believe, can be related at least in part, to the points mentioned above. In November 2017, the FDA reported it was aware of at least 36 deaths associated with this herb.
Here are some potential side effects and case reports that I was able to discover. I provide these in the hopes that they help others doing their own research as to whether this herbal preparation is right for them.
Researchers in Malaysia saw, for the most part, no significant differences in blood chemistry profiles when they tested 77 people (58 regular users and 19 healthy non users). The only difference they noted was that kratom users had higher LDL (bad cholesterol) and HDL (good cholesterol). They also noted that long term use of kratom (more than 5 years) did not seem to negatively impact the blood of users.
This same research group published a paper of 19 regular kratom tea/juice users (more than 2 years) showing no change in testosterone levels when used at 76.23mg to 94.15mg per day.
Doctors in Oklahoma reported the case of a 42 year old man with low sex drive and low energy and low testosterone and elevated prolactin levels. He was also a frequent user of kratom. After he stopped using the product, his testosterone and prolactin levels returned to normal.
At least one cast report notes hepatitis from drinking kratom herbal tea.
News reports linked kratom induced hemorrhagic pulmonary edema to the death of a 27 year old police officer.
There is at least one case report of Posterior reversible encephalopathy syndrome (Leukoencephalopathy) in a man who combined kratom with the ADHD medication, Adderall. Symptoms of this disorder include headaches, elevated blood pressure, seizures and changes in vision. A CT scan revealed a small hemorrhage in his brain.
Mitragynine appears to interfere with an enzyme called “P450” which is involved in the breakdown of many prescription medications. Because of this, people who take medications are highly advised to speak to their pharmacist and doctor first.
It's theorized that kratom may promote hypothyroidism in some people.
Some lab animal and test tube studies have noted that mitragynine might raise blood pressure, impair learning and be harmful to the heart. Whether or not this occurs in people is open to debate and needs more study.
In this case study, a 25 year old man developed liver problems after 2 weeks of use. He started out taking 1-2 teaspoons per day and later increased the amount to 4-6 teaspoons per day (about 14-21 grams a day). It was 5 days after he stopped taking kratom that he started having symptoms.
Doctors in Florida reported the case of liver toxicity in a 38 year old man. His liver symptoms improved after he stopped using this herb.
In this case report, a 64 year old man developed seizures and went into a coma after using kratom tea, which he was using for chronic pain.
This report reviews the deaths of 9 people who took took a special blend called “Krypton” which is a combination of kratom and O-desmethyltramadol. The ingredient called O-desmethyltramadol is a metabolite of a narcotic pain medication called tramadol.
This case report reviews that death of a 17 year old man who had a history of drug abuse. The autopsy noted he also had taken over the counter cold medications and sleeping pills too.
In another report, a 43 year old man was using kratom to help him get off opiate pain medications. Since he did not experience any significant alertness from kratom, he decided to combine it with a drug called modafinil , which is used to improve wakefulness. As a side note, this particular man was spending $15,000 a year on kratom. As is reported in this Scientific America report, he suffered only a runny nose after he stopped taking kratom.
It's worth pointing out that it appears that the really bad side effects seem to be associated with combining kratom with other drugs – both legal and illegal drugs. This is something to keep in mind if you try this product.
This case report mentions a possible association between kratom addiction and the development of hypothyroidism.
Doctors in 2018 report how a baby developed withdrawal symptoms 2 days after being born to a mother who used kratom while pregnant.
This 2014 article reports on the death of a 36 year old man from Denver. His autopsy noted his cause of death as “apparent acute mitragynine toxicity.”
In this case report a 44 year old man developed withdrawal symptoms after halting his use of the product. His symptoms included anxiety, restlessness, tremor, sweating and cravings for kratom.
One human study noted tongue numbness with kratom. This same study reported that blood pressures and heart rates appeared to increase about 8 hours after ingestion.
In a 2017 review of kratom clinical studies titled Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom, the researchers noted that while there may be some benefits of kratom, they went on to say:
“it seems that its potential side effects outweigh the benefits, and severe and real health hazards can, insidiously, lead to death. Kratom clinical, psychological, and medical manifestations can be disturbing.”
Long term side effects of using kratom are unknown although the website DrugAbuse.gov does mention these potential outcomes:
|Skin darkening||Dry mouth||Frequent urination|
As can be seen in the comments section below, at least one long time user has reported dramatic problems trying to sleep, after trying to stop taking kratom.
In 2017, FDA has stated that from 2010 -2015, kratom-related calls calls to Poison control centers have increased 10X. Their report goes on to say that “The FDA is aware of reports of 36 deaths associated with the use of kratom-containing products.”
When Forbes writer, David Disalvo, tried various blends of kratom for several weeks, he said he did not notice any significant side effects. See his website for his experiment.
All that said, here are some general precautions for those who use this compound. This list is not complete
- Stop taking kratom at least 2 weeks before having surgery
- Do NOT use kratom while pregnant or breastfeeding (your baby will become addicted)
- If you take ANY medications at all, speak to your pharmacist /doctor first.
- Caution in those who have GI problems.
Can Kratom Kill People?
Again, I'll come back to the lack clinical research. This section will summarize the deaths associated with kraom that I've become aware of
Doctors in 2018 reported on the death of a 28 yr old man who used kratom within 24 hours of going to the ER. Within 12 hours of admittion of the hospital, he died of heart and brain failure.
The death of a 36 year old Denver Colorado police officer was attributed to kratom overdose. His cause of death was attributed to an ““apparent acute mitragynine toxicity.”
How To Find Real Kratom?
As I was writing this review I spoke to a college student who told me he purchased kratom at a gas station! Was he really buying Mitragyna speciosa or something else? I have no idea although I'd be very cautions of buying mitragyna at gas stations or convenience stores.
Odds are that large stores like Walmart, CVS, RiteAid, Target and Costco will not sell this mitragyna. While I have not checked, but smoke and vape shops may sell it. Even then, I still think it may be a challenge to know what you are buying.
There are many brands of Kratom out there.For example just a few include:
- Maeng Da
- Hulu Kapuas
The plant can also be further classified by being red, white or green.
Are they all the same? Some online do discuss “fake kratom” but how prevalent this is, I can't say. So, how do you buy it from company that you can trust to better your odds that you really are getting Kratom and not a bogus or contaminated product? While nothing is foolproof, here are two things you can try that might help you in your research:
1. Google the address of the company. What do you see? Do you see an actual brick and mortar company that has its name atop a building? If yes that might be a good sign. Do you see a PO Box in the address? Do you see a strip mall where many other business reside? If yes, that might not be a good sign.
2. Google the company name and the letters “FDA” and “FTC.” This can sometimes reveal if a company had any run-ins in the past with these agencies. I know not everybody reading this review will be fans of the FDA or FTC however, if you do this, you can read what the problems were. This can help you make you make a more informed decision.
Reputable company or not, I want to say that I do not feel Mitragyna speciosa should be used a recreational drug to get a “legal high.” I know this stuff is being marketed to students in high school and college to help them to have more fun at parties. I know this is true because this was how I first learned about kratom.
Don't assume that because some stranger on a YouTube video says it's safe and natural means it is. I really tried to find human research on Kratom. What you read in this review is all the human evidence I could locate. I left nothing out to help you make the best decision for you.
Kratom & Salmonella
Adding to the controversy, there have been several recalls of kratom supplements because of salmonella contamination.
Here are some FDA press releases of brands which were recalled:
- Viable Solutions recalls kratom powder (4/20/18)
- NextGen Botanicals (NGB Corp) recalls Maeng Da Kratom possible salmonella contamination (4/19/18)
- Nutrizone Recalls Multiple Kratom Dietary Supplements (4/18/18)
- Club 13 recalls Kratom Maeng Da Red Powder and Capsules (April 5 2018)**
- FDA Issues Mandatory Recall of Triangle Pharmanaturals kratom (April 3rd 2018)
- Tamarack Inc. recalls kratom (march 23rd 2018)
- PDX Aramatics DBA Kraken Kratom expanded kratom recall (March 22 2018)
** Kraken Kratom also goes by the names Phytoextractum and Soul Speciosa
On 4/3/18 The FDA ordered a mandatory recall of all powdered kratom from Triangle Pharmanaturals LLC. The FDA issued the mandatory recall after “Triangle Pharmanaturals refused to cooperate with FDA despite repeated attempts to encourage voluntary recall.”
Recalls happen on a variety of products. I hesitated adding this section to this review until several recalls started showing up. This makes me wonder if the demand for this herbal supplement might be greater than the ability of companies to ensure a safe product.
Either way, don't buy kratom based on fancy- sounding business names. Investigate who you do business with.
If you need help, leave a comment below about the company you want to know about and I'll investigate the company for you.
Does Kratom Contain Psilocybin ?
Psilocybin (say, sil-a-psy-been) is a psychedelic (causes hallucinations) compound found in some types of mushrooms. People use this stuff to get high. While I dont believe there is any psilocybin in kratom, people wonder if they can use both at the same time (or kratom and pot for that matter). While I think this combination may be harmful, I'm not aware of any research on this topic. People do discuss this question online and give opinions on what “worked for them” but it must be remembered that following the dosage instructions from people you don't know may not be safe.
For the person reading this who wants to try this combination, the question you should ask yourself is why do you want to do this? Are you looking for a “better high” than either botanical would provide by itself? If yes, then, you may you may want to consider that you have a drug addiction problem.
Kratom And Drug Testing
Kratom contains many different compounds. So, I think whether or not it would show up on a drug test, would depend on if the drug test is specifically screening for any of the compounds in kratom.
Several websites I saw that discuss this say that kratom does not show up on most urinalysis drug screening tests. To me, most means it might show up on some. For what it's worth, this Ireland drug information website, notes that Kratom can show up on urinalysis tests for at least 6 hours.
If drug testing is something you are worried about, I'd personally steer clear of this stuff. If you are going to use it anyway, you should ask whoever does the testing if they screen for kratom or its metabolites.
Does Kratom Work?
There is not a lot of human research published on Kratom. Even though kratom does appear to offer some potential to help some people with pain and drug addiction, this research is in its infancy. As such, I think there a lot of unanswered questions about how kratom works, how much works, and what its side effects might be. From the research I was able to uncover, I do believe kratom has effects that can range from improving wakefulness to making people feel more calm. These effects appear to be based, in part, on how much one takes. But, how much is right for you is a question nobody really understands yet. For me, that's disturbing. Based on what we have learned from autopsies of people who have died using this herb, combining kratom with any type of medication (stimulants, depressants etc.) is just stupid.
I know that kratom is being marketed to high school and college students as a way to get a “legal high” or to try to make them feel better, more likable, sleep better, etc. As proof of it's safety, these people will tell you how kratom has been used for centuries. I won't preach. I've shown you the research. I'll simply leave you with these words: You are not an experiment.