Kratom: miracle herb or hidden danger?

• Brief and clear — what is kratom?
• What does kratom do?
• Types of kratom
• How kratom works
• What effects does kratom have?
• Kratom during pregnancy and breastfeeding
• Kratom addiction
• Kratom’s Achilles heel: beware of low-quality products
• Kratom products
• Kratom vs. cannabinoids
• Conclusion: What to keep in mind about kratom?
• FAQ

Brief and clear — what is kratom?

Kratom, Latin name Mitragyna speciosa, is a tropical tree native to Southeast Asia; specifically, it grows in Thailand, Indonesia, Malaysia, and Papua New Guinea. Traditionally, people chewed fresh leaves or prepared tea from them, but in our region today we know it mainly as a powder, or you may also encounter it in the form of capsules.

What does kratom do?

Kratom has become popular mainly among young adults, who use it to improve mood, increase energy, and relieve pain — but are these its real effects, or just marketing promises?

Types of kratom

You may have already come across kratom divided into green, white, and red. This classification is based on the color of the leaf veins and is used mainly in commercial product labeling, where different effects are attributed to each color.

Green kratom is usually associated with a balanced, stimulating effect, white with mental performance, while red is often presented as more calming. However, there is currently not enough scientific data to clearly confirm these differences between the individual colors.

How kratom works

The plant contains active alkaloid compounds, especially mitragynine and 7-hydroxymitragynine. These interact with the same receptors in the body as opioids, such as heroin. However, this does not mean that kratom acts exactly the same way as these drugs. 

The alkaloids do not only modulate opioid receptors, but also affect other neurotransmitters. This dual effect explains why some people report mood changes and pain relief, while others describe anxiety or nausea.

Kratom alkaloids are processed by liver enzymes and may interact with many other substances. Therefore, kratom should not be used together with medication, alcohol, or drugs. 

What effects does kratom have?

Because there is still no extensive research, much of the information in the public space is based on user experiences, which vary greatly. 

The resulting effect depends on several factors: on the dose, method of preparation, composition of the specific product, and the sensitivity of the individual person.

The fact that kratom’s effects vary depending on dose size is supported by research from 2024 focused on the effects of mitragynine, which is one of the main active components in kratom. However, this was a very small sample of 15 people, so the study cannot be considered direct proof of kratom’s effects, and further research is needed.

In general, users describe kratom as follows:

• In low to moderate doses: It is said to act primarily as a stimulant. Users describe improved mood, a surge of energy, and better focus. 
• In high doses: It is said to activate opioid receptors and is usually described as having more of a sedative effect. Users speak of calmness, reduced anxiety, or pain relief. The possibility that kratom could relieve pain is supported by a randomized, placebo-controlled study from 2020. However, this was a small study involving only 26 men with an average age of 24.3 years, so the results cannot be generalized to the entire population and need to be verified by further studies.

The most commonly described side effects include:

• drowsiness,
• nausea and constipation,
• dizziness.

Users also rarely mention:

• vomiting,
• confusion,
• tremors,
• high blood pressure,
• slowed breathing,
• seizures,
• liver problems. 

Kratom during pregnancy and breastfeeding

How kratom affects pregnant and breastfeeding mothers is the subject of research. So far, only a few cases have been described in which newborns of mothers who regularly used kratom developed withdrawal symptoms similar to those seen with opioids. These children responded well to the standard treatment used for neonatal abstinence syndrome. 

Kratom addiction

With regular and long-term use of high doses of kratom, the body may develop tolerance – meaning that more and more of the substance is needed to achieve the same effect. This leads to addiction.

If a regular user suddenly stops taking kratom, withdrawal symptoms may appear. Kratom withdrawal symptoms are thought to resemble opioid withdrawal symptoms. These include, for example:

• nausea, sweating, and tremors
• severe anxiety
• irritability, aggression
• intense muscle and joint pain
• insomnia and restless legs syndrome

A study from southern Thailand, which took place between 2011 and 2015, followed a total of 1,118 men over the age of 25, including regular, occasional, and former kratom users, as well as non-users. The research focused on chewing fresh kratom leaves, not kratom powder, kratom capsules, or kratom extract.

The results showed that long-term traditional use was not associated with a higher incidence of common health problems or deaths. However, the study showed that regular use may pose a risk of addiction. People with a higher level of dependence experienced stronger withdrawal symptoms, appearing as early as 1 to 12 hours after the last dose. More than half of regular users also reported intoxicating effects.

Kratom’s Achilles heel: beware of low-quality products

According to Dr. Chris McCurdy, professor of medicinal chemistry at the University of Florida and one of the leading experts on kratom pharmacology, it is essential with kratom to distinguish between the traditional use of leaves and modern products. In particular, extracts may be significantly riskier because they may contain higher or unclear amounts of active alkaloids. This creates a much higher risk of adverse effects and addiction.

Due to insufficient regulation, questionable products with unclear composition and concentration enter the market. Some may contain heavy metals or unnaturally high amounts of mitragynine or 7-hydroxymitragynine, which, according to the expert medical review StatPearls, has 46× higher affinity for opioid receptors than mitragynine and about 13× higher affinity than morphine. It is precisely impure composition, high concentration, and combination with other substances that are the main factors associated with cases of serious adverse effects and widely reported poisonings.

Testing of 30 kratom products by the FDA found that some analyzed products contained elevated levels of lead and nickel, which, with long-term daily consumption, may exceed safe limits.

An investigation by the Tampa Bay Times states that in Florida, over the past decade, more than 580 deaths linked to kratom were recorded. Most cases involved a combination of kratom with other substances, but 46 deaths were attributed by the investigation to kratom alone.Testing as part of the investigation revealed that the content of active substances varied significantly between products, and some extracts had high concentrations of mitragynine or 7-hydroxymitragynine. Some of these commonly commercially available products also had no information about composition and concentration listed on the packaging at all.

The lack of regulation is also highlighted by a 2024 review study. The study shows that kratom is a complex and still insufficiently researched substance that should not be presented as a safe natural product without risks, but at the same time it cannot simply be classified among classic opioids. According to the authors, serious adverse effects and deaths associated with kratom are low in the available data compared with many other recreationally used substances. The authors therefore emphasize the need for clear rules on purity, composition, labeling, and warnings on packaging.

Kratom products

On the market, you will mainly encounter three types of products:

• Fine powder: Ground leaves, most often mixed with water or juice.
• Kratom in capsules or tablets: Powder from dried and crushed leaves processed into capsules or tablets for precise dosing.
• Kratom extract: A highly concentrated liquid or powdered form that has many times the strength of ordinary leaf material.

Leaf powder and capsules are less concentrated and the onset of effects is gradual and longer-lasting. Capsules also ensure precise dosing. The body develops tolerance more slowly, making it easier to reduce the dose or stop kratom completely.

Kratom extract has a high content of active alkaloids and therefore a strong and rapid effect. However, this multiplies the risks of side effects and increases the chance of addiction.

Kratom vs. cannabinoids

Like cannabinoids, such as CBD, CBG or THC, kratom is often presented as a natural substance with potential benefits. In reality, however, these are very different groups of substances.

While kratom alkaloids act mainly on opioid receptors, cannabinoids primarily influence the endocannabinoid system, which is involved in regulating various processes in the body.

The main cannabinoids, especially CBD and THC, are substantially better researched than kratom and are also more clearly regulated in many countries. As a result, legally sold products have clear information about composition and concentration, usually supported by laboratory testing.

There is not enough data on combining kratom with cannabinoids, so it is not possible to assess how safe or risky this combination is. Both groups of substances act on different systems in the body, but they are processed by liver enzymes and their effects may influence each other. Therefore, they definitely should not be used together.

	Kratom	Cannabinoids
Main effect on	opioid receptors	endocannabinoid system
Research	limited	depends on the cannabinoid; the main cannabinoids are well researched, while there is little data on minor cannabinoids
Forms	powder, capsules and tablets, extract	oils, capsules and tablets, flowers, hashish, vaping, food and drinks, cosmetics

Conclusion: What to keep in mind about kratom?

Kratom is a tropical tree native to Southeast Asia, where its leaves were traditionally chewed. On our market, it is found mainly in powder form. 

According to current research, kratom acts mainly on opioid receptors. Users seek it out to improve mood, increase energy, and relieve pain, and although current research does not clearly confirm or disprove these effects, it does point to significant risks, especially the development of addiction.

The biggest problem today is mainly insufficient market regulation. Some products do not clearly state their composition and concentration and may contain heavy metals or unnaturally high amounts of active alkaloids.

Kratom deserves further research and clearer rules. Until it is completely clear how it works, it should be approached with maximum respect and caution. 

  

Sources:

• https://nida.nih.gov/research-topics/kratom
• https://www.sciencedirect.com/science/article/abs/pii/S0278691524004794
• https://link.springer.com/article/10.1007/s00213-024-06734-2 
• https://eurekamag.com/research/072/030/072030583.php
• https://pure.johnshopkins.edu/en/publications/the-health-impact-of-long-term-kratom-mitragyna-speciosa-use-in-s/
• https://www.youtube.com/watch?v=gyE6Z4GLEeM
• https://www.ncbi.nlm.nih.gov/books/NBK585120/ 
• https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1403140/full 
• https://project.tampabay.com/investigations/deadly-dose/kratom-overdose-deaths-florida-mitragynine-testing/ 
• https://www.fda.gov/news-events/public-health-focus/laboratory-analysis-kratom-products-heavy-metals

 

Author: Elena Moreau

 

 

Photo: AI

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