Kratom is another herbal remedy turned into a trend because individuals want to use natural substances to relieve their pain, anxiety, or fatigue. Problems about its safety have accompanied the spread of its use, especially in the area of liver health.
People now start to ask whether the use of kratom may put an additional burden on the liver and damage it, or give rise to more serious issues in the future.
In this blog, we’ll take a close look at what current research says about kratom’s effects on the liver, explore the potential risks and warning signs, and offer some practical advice for anyone considering or already using kratom.
Understanding Kratom and the Liver
The liver plays the main role of metabolizing drugs, supplements, and toxins in the body. The active compounds contained in kratom and mainly mitragynine and 7-hydroxymitragynine, are metabolized by liver enzymes, especially through the cytochrome P450 enzyme family.
Although most substances can be metabolized safely by the liver, there are liver-injuring substances whose use can produce liver injury as a result of longer exposures, excessive doses, or use by those with underlying liver disorders.
Kratom Effects on Liver: What Does the Research Say?
Case Studies and Clinical Reports
There are a few reports of clinical cases and literature reviews on drug-induced liver injury (DILI) related to the use of kratom among them. In a striking case study report conducted in 2023, investigators pointed out that kratom has been demonstrated to induce an acute liver injury and, in exceptional circumstances, an acute liver failure necessitating a transplantation.
A second case collection reported two patients who developed DILI with kratom exposure, apart of whom had asymptomatic elevations in liver enzymes, and the other two developed acute liver failure.
In a study published in 2019 and presented at the annual meeting of the American Association for the Study of Liver Diseases, of 404 cases of supplement-related liver injury, eight involved kratom.
They were mostly hospitalized; however, four of the patients developed the symptoms when they started taking kratom between 15 and 49 days before and recovered when they stopped taking it.
Mechanisms: How Does Kratom Affect the Liver?
Liver enzymes such as CYP2D6, CYP3A4, and CYP2C9 are associated with the metabolism of alkaloids of Kratom. The mere abundance and diversity of alkaloids in kratom could impose an additional burden on the liver, especially on a genetically deficient liver, or a person with a compromised liver condition, or who is using other liver-damaging drugs.
Healthy livers generally metabolize kratom without significant issues.
At-risk individuals (with genetic defects, liver disease, or concurrent use of other hepatotoxic substances) face a higher risk of liver injury.
Is Kratom Bad for Your Liver?
Acute vs. Chronic Effects
- Acute liver injury: The majority of reported incidents entail acute (temporary) liver damage, which can be reversed once kratom is stopped.
- Chronic use: Still, excessive, habitual use of kratom can potentially develop a risk of steady liver injury, the likelihood of which is the same as that of chronic ethanol or acetaminophen consumption.
Severity and Frequency
- Kratom is infrequently known to cause severe liver injury, but it is possible among the majority of consumers who do not have any difficulties related to the liver.
- As with what happens to other parts of the body, in the case of liver injury, it is severity, especially when it leads to an acute hepatitis, jaundice, or, as shocking as, liver failure in some rare cases.
Kratom Liver Damage: Warning Signs and Symptoms
Recognizing early warning signs of liver injury is crucial for preventing serious complications. If you use kratom, watch for these symptoms:
- General itchiness
- Fatigue
- Persistent nausea
- Loss of appetite
- Dark urine
- Jaundice
- Abdominal pain or swelling
- Unexplained weight loss
Elevated liver enzymes (ALT, AST, ALP) and bilirubin levels on blood tests are often the first clinical indicators of liver stress or damage.
Does Kratom Cause Liver Damage?
Evidence and Controversy
Although there have been occurrences of liver injury, with the use of kratom, the overall rate remains minute when compared to the frequency of people using it.
Some experts state caution in generalizing conclusions, and they stated that the majority of people using kratom do not encounter liver issues. But the increasing number of reports indicates that there is a possibility of risk to health, particularly to those with other risk factors.
Risk Factors for Kratom Liver Toxicity
- High or prolonged doses
- Preexisting liver disease
- Concurrent use of other hepatotoxic drugs or supplements
- Genetic enzyme deficiencies
- Contaminated or adulterated kratom products
Kratom Side Effects
While liver toxicity is a serious concern, kratom can cause other side effects, including:
- Nausea and vomiting
- Constipation
- Dry mouth
- Weight loss
- High blood pressure
- Dizziness and drowsiness
- Hallucinations
Liver-related side effects are less common but more severe, making it essential to monitor for symptoms and seek medical advice if they occur.
Kratom and Liver Function: What Do Lab Tests Show?
Routine liver function tests (LFTs) can detect early signs of liver stress or injury. These tests measure:
- ALT (alanine aminotransferase)
- AST (aspartate aminotransferase)
- ALP (alkaline phosphatase)
- Bilirubin
Elevations in these markers—especially more than five times the upper limit of normal—may indicate drug-induced liver injury from kratom or other causes.
Kratom Liver Enzymes: What’s the Connection?
The primary metabolic pathway of the main alkaloid, mitragynine, in kratom is performed by the CYP2D6 enzyme, but there are also other enzymes involved, such as CYP3A4 and CYP2C9.
You might be more vulnerable to kratom-induced liver injury in case you have alterations in the genes that make these enzymes/or take medicines that block or compete with these pathways.
Kratom and Fatty Liver
The studies of kratom effects on fatty liver disease are scarce. Nevertheless, what may aggravate already existing fatty liver diseases is anything that strains the liver. Persons having fatty liver must use kratom very carefully, and they must inform their medical professional before onset or proceeding with their use.
Can Kratom Cause Liver Problems? Who Is Most at Risk?
Yes, kratom can cause liver problems, particularly in those with:
- Preexisting liver disease
- Genetic enzyme deficiencies
- High or prolonged kratom use
- Use of other liver-toxic substances
Most cases of kratom-induced liver injury resolve after stopping use, but severe cases may require hospitalization or, rarely, a liver transplant.
Is Liver Damage from Kratom Reversible?
Liver damage caused by kratom is usually reversible in the majority of the reported cases, and early identification and a stop in the use of kratom reverses liver damage.
It can take some weeks to recover, and supportive care (Hydration, nutrition, and in some cases medications) can help in the recovery process. But when liver damage is severe or long-lasting, it may be irreparable or lead to failure.
How to Protect Your Liver if You Use Kratom
- Limit frequency and dose: Use the lowest effective dose and avoid prolonged daily use.
- Monitor for symptoms: Watch for early warning signs of liver injury.
- Get regular blood tests: If you use kratom regularly, periodic liver function tests can catch problems early.
- Avoid other hepatotoxic substances: Don’t combine kratom with alcohol, acetaminophen, or other drugs that stress the liver.
- Choose reputable sources: Contaminated kratom may pose additional risks.
What to Do If You Suspect Kratom Liver Damage
- Stop using kratom immediately.
- Contact your healthcare provider for evaluation and blood tests.
- Report all supplements and medications you are taking.
- Follow medical advice: You may need supportive care or, in severe cases, hospitalization.
Kratom Effects on Liver: Key Takeaways
- Kratom can cause liver injury, especially in susceptible individuals or with high/prolonged use.
- Most cases are reversible if kratom is discontinued early.
- Warning signs include jaundice, dark urine, fatigue, and unexplained abdominal pain.
- Routine monitoring is advised for regular users, especially those with risk factors.
- Consult your doctor before using kratom if you have liver disease or take other medications.
Final Thoughts
Despite the possible benefits of kratom, we cannot overlook its effect on the health of the liver. The use of kratom has been connected with acute liver damage and, in some extremely rare incidences, liver collapse, although the majority of those who take it do not encounter any issues, particularly when they do so moderately and infrequently, and their liver is healthy.
Risks increase at high doses or steady use or possession of a susceptibility or simultaneous consumption of other liver-damaging substances. By using kratom, one must be cautious and observe the health signs and be ready to consult with a doctor at the earliest possible stages of trouble.
Further research will keep describing the health aspects of kratom on the liver in detail, but caution and moderation are your greatest protection.
