Kratom (Mitragyna speciosa) is a tropical evergreen tree found in Southeast Asia. For centuries, people in these regions have traditionally used its leaves, often by chewing them or brewing them into a tea. Traditionally, its leaves were used to combat fatigue, alleviate pain, and address conditions like diarrhea. Today, concerns have emerged regarding the potential impact of kratom on liver health.
The Link Between Kratom and Liver Injury
Kratom use has been associated with instances of acute liver injury, though these occurrences are considered rare. This understanding largely stems from medical case reports and series. Reports of liver injury linked to kratom consumption have increased in recent years.
A systematic review in 2022, which examined 53 cases, found that approximately 80% of these presented with a cholestatic pattern of liver injury. This pattern indicates a disruption in the flow of bile from the liver. The onset of liver injury typically occurs within one to eight weeks of starting regular kratom use, with a median time frame of 14 to 22 days. While many cases resolve after discontinuing kratom, some severe instances have led to acute renal injury or, in very rare circumstances, necessitated liver transplantation.
Understanding How Kratom May Impact the Liver
The precise mechanisms by which kratom might cause liver damage are not yet fully understood. The liver is primarily responsible for metabolizing compounds, including the active alkaloids found in kratom, such as mitragynine and 7-hydroxymitragynine. This metabolic process could potentially lead to direct toxicity within liver cells.
Another proposed mechanism involves an idiosyncratic drug-induced liver injury (DILI), where an individual’s unique biological response plays a role. This can manifest as an immune-mediated reaction, or it might involve the production of toxic metabolites during the liver’s processing of kratom. Additionally, the unregulated nature of many kratom products means they can sometimes contain contaminants or adulterants, including heavy metals like lead and nickel, or bacteria such as Salmonella. These contaminants could also contribute to liver issues, though some analyses confirm kratom’s alkaloids without other clear adulterants.
Identifying Potential Liver Problems
Recognizing signs of potential liver problems is important for kratom users. Common symptoms that might indicate liver damage include persistent fatigue, nausea, and generalized itching. Other noticeable indicators can be the development of dark urine or jaundice, characterized by yellowing skin and eyes. Abdominal pain, particularly in the upper right side of the abdomen, may also signal liver distress.
If these symptoms appear, seek prompt medical attention for an accurate diagnosis. Liver damage is assessed through blood tests measuring specific liver enzyme levels. These tests commonly include alanine transaminase (ALT), aspartate transaminase (AST), and bilirubin, with elevated levels indicating inflammation or injury to the liver.
Factors Influencing Liver Risk
Several factors influence susceptibility to kratom-induced liver injury. Higher doses or extended use of kratom elevate the risk of liver problems. Genetic makeup also plays a part, affecting how the liver processes kratom compounds.
Individuals with pre-existing liver conditions, such as hepatitis or fatty liver disease, may be more susceptible to adverse effects. The concurrent use of kratom with other substances, including alcohol or certain medications, can place additional stress on the liver, potentially increasing the likelihood of injury. Varying quality and purity of unregulated kratom products also introduce risk, as some may contain contaminants that independently harm the liver.