For centuries, people have consumed and taken advantage of the amazing properties of Kratom. It has been known to help people battle feelings depression and anxiety, provide pain relief, alleviate swelling and inflammation, and enhance mood. But just recently, the FDA public health advisory has deemed the use of this contentious plant dangerous and even lethal. Let’s explore further in this article, the positive and negative effects of this plant and see for ourselves if the pros outweigh the cons.
Important Note: This article is in no way intended to promote the use of this substance. We are simply providing facts gathered from scientific studies and texts. Please consult your physician with regards to your medications.
Getting to Know Kratom
Biak-Biak, Kakuam, Ketum, Krypton (containing O-Desmethyltramadol), Thang, or Thom – Have you ever heard of any of these names on the streets? These are the many local names of Kratom.
So what is Kratom anyway? The scientific name of Kratom is Mitragyna Speciosa. It belongs to the coffee tree family (Rubiaceae). This plant has existed for centuries and its stimulant properties have been taken advantage of by numerous tribes in Southeast Asia. You can usually find this lush evergreen tree in Indonesia, Thailand, Malaysia, and Papua New Guinea.
Back in the days, they said it was used to lessen fatigue caused by extreme heat and physical labor. It also seemed to cure gut infections, diarrhea, cough, and offered pain relief. Some people even used it to self-medicate their addiction to opiates. But nowadays, its uses in Southeast Asian countries as well as some Western countries have evolved into a more recreational standpoint rather than for healing.
Kratom may come in various forms such as dried leaves, extracts, capsules, and the most popularly consumed form, powder. In the United States, a survey shows that consumers use powder and mix it with their food and/or drink.
The number of Kratom users keep growing. The availability of Kratom has become so widespread in the United States and its use is legal across many states. You can buy it via online stores. But as of November 2017, Kratom has been labeled by the FDA as a dangerous substance and warns people against its use.
Understanding Kratom Effects
Consuming Kratom gives you a feeling of euphoria. Simply chewing the leaves for 5 to 10 minutes can easily give that sensation. It is also a relieves pain from its morphine-like effects when taken in higher doses. In contrast when taken in low doses, produces a more stimulating or “cocaine-like” effect. It also decreases inflammation and a promotes muscle relaxation.
How It Works: Mechanism of Action
The more active and main components of Kratom are the alkaloids, mitragynine and 7-hydroxymitragynine. But all in all, the kratom extract has about 25 or more compounds listed.
The most abundant alkaloid in kratom is mitragynine, which is also partly an agonist or opioid receptor activator. Just like how morphine affects the brain, this alkaloid targets the part of the brain sensitive to opioid. 7-hydroxymitragynine, is less abundant, but is known to be stronger than morphine. Both of these active alkaloids are responsible for producing analgesia and euphoria, since they work on the the 5-HT2A and alpha 2 adrenergic receptors as well as the opioid receptors kappa (KOR), mu (MOR), and delta (DOR).
In addition, the kratom extract also triggers dopamine D1 receptors (DRD1) that are responsible for alleviating anxiety and improving mood. Bodily changes, such as repression of contractions in a segment of the ileum and vas deferens, as well as stomach acid secretions, are common responses from exposure to these alkaloids.
The Good Effects of Kratom
1. It Creates A Feeling of Euphoria
One of the remarkable effects of kratom is euphoria, or that feeling of intense excitement and joy. There are more than 120 articles written in scientific journals, about studies that prove this effect happens not just in animals, but also people. Euphoria is linked to the addiction potential of Kratom, but of the 136 users surveyed in north of Malaysia, only 5-12% of them said they used kratom for its euphoric effects. It’s addiction potential, for example, was observed in one user aged 44, who needed to increase his dosage from 4 grams to 8 grams twice a day, just to get the desired effects of euphoria.
2. It Eases Depression and Anxiety
Many people have been using kratom to combat anxiety and depression. An online sectional survey done in the US in 2016, confirmed that about 66% of the participants took kratom to help with their mental problems. In a study done on rates, it was found that both low and high dosage of mitragynine significantly decreased the subjects’ anxiety levels. In relation to people, it allows a person to cope with the anxiety brought about by society. Since Kratom acts on the opioid receptors of the brain, it creates calming effects similar to other antidepressant medications. This is evident in most studies done on animals.
A lot of experiments conducted on animals and even plants display the interaction of mitragynine with the non-opioid serotonergic and adrenergic receptors. Both receptors are the usual target of drugs that produce antidepressant effects, hence the reason why kratom also has antidepressant effects. However, there are no clinical studies on humans to confirm such data.
3. It Aids in Opiate Withdrawal
Even during the 19th century, people have used kratom to substitute the use of opium. Like opium, kratom, when consumed in higher doses, brings about a calming or sedative effect similar to that of morphine. Since the outcome is fairly the same, many opioid addicts turn to kratom for relief or to treat themselves during the withdrawal stage. As of today, you can easily find and purchase kratom without a prescription. It costs less too compared to methadone or buprenorphine (opioid replacement medications) As mentioned above in kratom’s mechanism of action, the alkaloids mitragynine and 7-hydroxymitragynine found in kratom acts on opioid receptors allowing an individual to be relieved of symptoms associated with opiate withdrawal. It decreases projections of dopamine (monoaminergic), norepinephrine, and serotonin in the brain stem, thereby obstructing neuron calcium channels.
4. In Smaller Doses, Produces More Energy
A survey done online reported that one of the main benefits for kratom is to offer an energy boost. When mitragynine was given to rats in a study, they reported hyperactivity even with just a low dose. More studies done on both humans and animals have shown the stimulant effects of kratom that keeps the flow of energy going, so that you won’t feel fatigued.
In another survey, a total of 293 northern Malaysian kratom users were asked why they used this substance. Around 28% of long-term and medium-term users said they consumed it to boost their energy levels. It was primarily prepared as a drink to improve their physical performance at work.
5. In Bigger Doses, Encourages Relaxation
If a low dose of mitragynine produces stimulant effects, a bigger dose does this opposite. A survey showed that users who consumed high doses of kratom reported that they felt tired and relaxed. In many animal studies, they identified a decrease in muscle twitches. This proved that the consumption of kratom containing mitragynine made muscles more relaxed.
6. It Reduces Inflammation
Kratom also claims to have anti-inflammatory properties. The main alkaloid mitragynine, in response to an immune stimulant, is able to inhibit the bacterial endotoxin or LPS-stimulated production of PGE2 and COX-2.
7. It Helps Manage Pain
From an online survey, kratom users claimed that the best benefit of consuming this substance is its ability to alleviate pain. There are still no studies performed on humans, but based on numerous animal studies, kratom addresses different types of pain. It acts as both an analgesic and an anti-nociceptive agent. The tests revealed that the animals that were given kratom extract, which were then subjected to different pain-inducing conditions and harmful stimuli, were not as responsive to it. In rats that were given high dosage, it was observed that there was a reduction in their nerve and muscle function. This because the sciatic nerve is blocked and the electrical stimulation at the junction of both muscle and nerve is then hindered.
The Bad Effects of Kratom
1. It Compromises Memory and Learning
There are no studies with human subjects, it was tested only in rats and mice. But those animal models showed how mitragynine lead to impaired cognitive processes. For example, the mice were supposed to remember not to do something that lead them to be punished. The substance diminished their ability to avoid that action since they couldn’t remember why or what that action would lead to.
2. It Can Result to a Damaged Liver
The use of kratom may lead to liver damage. These two case reports are evidence of its untoward effect on the body. One case showed a young man who developed pruritus, jaundice, and alkaloids in his urine, even with just two weeks of using kratom. The urine sample proves that his liver was not able to remove the wastes and resulted in intrahepatic cholestasis. Another case involved a man in his 40s who had been constantly using low doses of kratom for 3 months. He also developed liver issues and jaundice. The jaundice diminished when he stopped taking in kratom, but when he took it again, it reappeared.
The P450 enzymes namely CYP2D6, CYP2C9, and CYP3A4, that are responsible for breaking down toxins and drugs are inhibited by mitragynine. If these 3 liver cytochromes are missing, you are bound to have liver problems due to overworked alternate detoxification pathways.
Common Side Effects of Kratom Use
Here’s a list of the common reactions to kratom:
- Posterior reversible leukoencephalopathy syndrome
- Respiratory depression
- Liver toxicity
Based on an online survey in America, the side effects you experience are dependent on the dose. The higher the dose, the more negative effects you encounter. The lower the dose, the lesser chances of experiencing these side effects. This holds true for all except for diarrhea.
Addiction and Withdrawal Risks
Kratom leaves its users in a state of euphoria. This is why it has a very high potential for addiction. Studies conducted on animal models showed signs of dependence and addiction to kratom after it was given more more than 5 days straight. Consequently, when it was stopped, the animals also displayed withdrawal symptoms comparable to opioid withdrawal.
Hypersensitivity to stimulation or other medications, as well as heightened anxiety are among the symptoms seen in the animals that were withdrawn from their long-term mitragynine exposure. In humans, muscle pains, severe weight loss, anxiety, insomnia, loss of libido, hostility, and aggression are among the side effects are evident for chronic users. Some also reported being confused and at times, delusional.
As for physical appearance, chronic users may have hyperpigmented patches on different areas of their face, especially the cheeks. This is cause by the over production of melanin which is triggered by the alkaloid, mitragynine. You’ll also notice them with unhealthy and dry skin, darker lips, and larger than normal stomachs.
Kratom and Other Drug Interactions
The active alkaloids present in kratom can affect the interaction and efficacy of other drugs you take. When mitragynine and 7-hydroxymitragynine are taken together with other types of drugs such as quinidine, tacrolimus, and colchicine (drugs that can be broken down by P-glycoprotein or UG72B7).
Kratom has the potential of blocking a few CYP enzymes that are important in drug metabolism. If the CYP Enzymes like CYP1A2, CYP3A4, and CYP2D6 are inhibited, it may cause liver damage.Instead of doing their role and removing the wastes from them body, they alkaloids build up in the liver.
There are 2 common varieties — the red vein kratom and white vein kratom. These two strains have different effects. The red vein, which originally comes from Bali, acts as a pain reliever. While the white vein from Malaysia has more of a stimulant effect. Each variety has differing potencies. But since this substance is not approved and regulated by the FDA, the details are not known.
When you’re in the market for kratom, you’ll find that there are different forms. There are smoked or dried leaves that can be made into a tea, fresh leaves that can be eaten or chewed directly, and extracts or powders that you can easily mix together with your meals or beverages. Some even sell the powder in capsules for easy consumption.
Kratom Dosages and Its Effects
Since the effects of kratom rely totally on the amount you take in, it’s good to know the dosage and its corresponding effects:
- 1 to 5 grams – for low doses, expect mild stimulant effects
- 5 to 15 grams – medium to high doses produce analgesic and/or euphoric effects
- > 15 grams – Huge doses generate sedative effects
Is Kratom Overdose Possible?
As a matter of fact, Kratom has a high risk potential for toxicity and overdose, that is why it falls under the list of drugs of concern of the DEA. Between 2010 to 2015, there has been a surge in emergency calls to poison centers due to kratom toxicity. About 40% of these calls were grave and life-threatening.
If you see any or all of these signs and symptoms in a person using kratom, it could mean they have overdosed:
- Agitation or irritability
You are at a higher risk for overdose when you take kratom together with contraindicated drugs (narcotics or benzodiazepines) or alcohol.
Those that died from kratom overdose had other substances present in their urine and blood samples, according to a study conducted in 2009 to 2010. Also, a study on animals showed that mitragynine in itself had low toxicity. But when it was given orally with a very high dose of 200 mg/kg of kratom extract, the rats died.
Feedback from Kratom Users
There are varying feedback from users of kratom. Some have reported positive results such as improved mood, decreased pain and swelling and lesser anxiety. It also helped opium addicts manage their withdrawal symptoms. Although some also reported that it created a dependency to the substance. It also induced nausea and vomiting in some users.
The contents of this article is merely for educational purposes only and is not intended to replace the professional opinion and care of a physician. Furthermore, this has not been approved by the FDA or any medical entity. Please do not use the product without proper consultation and consent of your doctor, most especially for people with existing medical conditions, are under medications, or if you are pregnant and/or nursing.