Kratom Effects on Liver

We thought it might be time for a short article exploring kratom effects on liver tissue. Can kratom harm the liver? With many people using kratom as an alternative to narcotic pain medications, a class of drugs known for taking a toll on liver functions over time, we feel this is a very pertinent question to answer.

The short answer is no: kratom does not harm the liver. Scientific and case studies on kratom’s properties have found no harmful kratom effects on liver tissue. To get a better idea of why this might be, let’s look at how the liver works to process chemicals, nutrients, and toxins.

The liver is part of the digestive system and is one of the body’s largest organs. Its job is to filter toxins from the blood and break down nutrients from food, such as carbohydrates, proteins, and fats. Certain medications, drugs, alcohol, and some foods place a higher metabolic load on the liver, which means the liver must work harder to break these compounds down. If the liver is exposed to compounds which place a high demand on its metabolic functions, over time they can cause damage to liver cells. For instance, cirrhosis (scarring) of the liver is caused by long-term alcohol abuse.

It’s likely that concerns about kratom effects on liver arose because kratom is commonly used for pain relief instead of conventional prescription opiates. Conventional opiates are known to be hard on the liver, especially when they’re used in high doses and/or over a long period of time. Unfortunately, this is exactly how many physicians prescribe them for the management of chronic pain. Issues of tolerance can exacerbate the problem as well: as patients habituate to one dose of an opiate, their prescribing physician has to raise the dosage, and the cycle repeats, placing a greater metabolic load on the liver and eventually leading to cell damage.

However, though kratom is also used for pain relief, it is not an opiate. Kratom leaves contain alkaloids (primarily mitragynine and 7-hydroxymitragynine) that have sedative, analgesic, and anxiolytic effects on the brain but do not cause the mental “fogginess” or respiratory depression that can happen with conventional opiates. Many people find kratom to be a viable alternative for pain relief, as well as easing the withdrawal symptoms associated with stopping use of a conventional opiate, such as diarrhea, anxiety, nausea, vomiting, and headaches. Furthermore, kratom has a much smaller potential for habituation, on about the same level as coffee: any kratom tolerance can be eliminated by abstaining from kratom for a few days or switching to a different strain of kratom. Unlike conventional opiates, you don’t have to keep using more kratom to achieve the same effect, which is an important part of protecting your liver from metabolic overloading.

So, what is a safe dose to avoid harmful kratom effects on liver tissue? Luckily, kratom’s therapeutic range is fairly broad: a threshold dose is 1-3 grams of plain leaf (note: for stronger extracts these amounts will need to be adjusted downward); 5-7 grams is a medium dose; and 10 grams is an experienced dose. If you’re new to kratom, we recommend titrating the dose up from the smallest effective dose until you find the amount that seems right for you. That said, it’s pretty hard to burden your liver with kratom: you’re likely to run into unpleasant effects like nausea and vomiting long before you reach a dose that would cause adverse effects on your liver.

Kratom has an undeniable effect on the body and should be treated with respect like any herbal medicine. However, if you use it in the recommended doses and take regular breaks, kratom effects on liver tissue are negligible: it does not place undue strain on the liver or cause liver toxicity. There is exactly one case in the literature of kratom apparently causing liver problems: a 25-year-old German man developed intrahepatic cholestasis—a condition where the liver stops secreting bile to break down fats—after taking extremely large doses of kratom for two weeks [1]. The alkaloids in kratom are processed through the liver just like all the compounds from the foods we eat and medicines we take, so in large doses it may put strain on the liver; but these doses are far higher than anything you would need to take to enjoy the benefits of kratom.

1. Kapp, FG et al. September 2011. “Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa)”, Journal of Medical Toxicology 7(3): 227-31.