How Much Kratom Causes Liver Damage? | Kratom Monkey

Ultimately, it is difficult to say due to a lack of compelling evidence. Some studies suggest that regular kratom usage can cause liver damage within a few weeks, while other research indicates that there is little to no association between kratom use and liver damage.

Before we delve into the scientific research surrounding kratom and liver damage, let’s begin by learning more about how the substance interacts with the organ. 

The liver is involved with metabolizing and eliminating most drugs and toxins that are brought into the body. The organ metabolizes drugs into water-soluble compounds so they can be easily excreted in bodily fluids such as urine and feces.

Therefore, the liver is crucial to metabolizing and eliminating mitragynine and other kratom alkaloids. Studies show that mitragynine metabolizes into 7-hydroxymitragynine (7-HMG) in vivo, in a process known as hepatic metabolism.

Intriguingly, 7-HMG appears much more potent than mitragynine. Research suggests the alkaloid has a much higher binding affinity to the body’s opioid receptors, which explains its enhanced effects.

Concerningly, kratom usage has been linked to liver damage - so much so that some people avoid consuming kratom. But how worried should you be?

Firstly, kratom alkaloids are not alone in their potential to cause liver damage. Ingesting various drugs can lead to long-term problems, with alcohol perhaps the most famous example.

Working out the truth about kratom and liver damage is difficult if you don’t have a science background. Certain studies have more value than others, and some researchers are keen to push anti or pro-kratom narratives at all costs. None of this is ideal for the layperson.

Case studies are intriguing and often revealing. However, scientific reviews carry more weight. So, I will consider them in that order. Before I start, it is worth noting that kratom research is still limited, and there are plenty of holes in our knowledge. 

As of 2023, hundreds of case studies have linked kratom usage to liver damage. In 2021, the Cureus journal published a paper featuring two cases of kratom-induced liver injury. One patient had no reported medical history, while the other had well-documented health issues.

The patient without a notable medical history denied abusing alcohol or drugs. However, they admitted to taking kratom for two weeks to resolve a foot osteoarthritis issue. Interestingly, a urine drug screen revealed positive tests for opiate and marijuana use.

On this evidence, it seems like a stretch to link the patient’s liver injury to kratom. Excessive opioid use can also cause liver damage. Sure, it could be the kratom, but there is enough doubt to make things inconclusive.

The other patient’s health problems included opioid dependence. However, she denied having taken drugs, alcohol, or prescription medication at the time of the liver injury. But she reported using kratom for several years to tackle opioid abuse and withdrawal symptoms.

Now for a slightly different one. In 2021, the American College of Gastroenterology’s Case Reports Journal published a study on supposed multiorgan dysfunction due to kratom ingestion.

The paper reported acute liver and kidney injury in a 37-year-old woman, with over-the-counter kratom products suggested as the cause. The study’s authors commented that the lack of a standard regulatory mechanism in the kratom industry may increase the risk of such incidents.

Scientific literature reviews are more extensive and critical than case studies. This is why the research community gives them more weight.

In 2020, the Drug and Alcohol Dependence journal published a scientific review that explored liver injury associated with kratom use. The paper analyzed more than 400 cases of liver injury between 2003 and 2019 associated with herbal and dietary supplements.

That sounds like a lot of case studies! However, it averages to just over one per month for the period investigated. And of the 404 examples, only 11 cases of liver injury were linked to kratom use. Most of those patients were hospitalized, but thankfully they all eventually recovered.

Notably, eight of the kratom-induced liver injury cases were recorded in the final three years of the research period. This implies the problem is a small but growing issue.

However, it does not mean that kratom-induced liver injury is more likely. After all, kratom usage increased significantly among Americans during the 2010s.

Patients commonly presented with abdominal discomfort, jaundice, and various cholestatic symptoms. The researchers concluded that kratom use can “cause severe liver injury with jaundice.” 

Science suggests that kratom-induced liver injury is something to be aware of. However, it does not appear particularly common. Many substances have scary but rare side effects - and there is no denying that kratom has its fair share.

But it is crucial to keep perspective. Kratom-induced liver injury is uncommon among all users and probably even less likely in responsible users.

If you are concerned about kratom’s impact on the liver, you can take steps to reduce the risk. However, I recommend taking a broad view of the herb. Don’t become overly focused on liver injury and neglect other kratom dangers which may be more relevant to your situation. 

While kratom's effect on the liver remains somewhat unclear, several factors impact how hard the substance is on the organ.

The more kratom you take, the more metabolizing and eliminating your liver must do. Someone who consumes a couple of grams twice a week will put less strain on their liver than someone ingesting several grams daily.

It's impossible to identify the tipping point that turns responsible kratom consumption into dangerous use. There are too many factors at play, including liver health and kratom product purity and potency.

Let's talk more about kratom purity. Contaminated and adulterated products are going to be more troublesome for the liver.

Impure kratom products could contain bacteria, mold, mycotoxins, heavy metals, pesticides, synthetic alkaloids, and other nasty stuff. Any of these contaminants and adulterants will strain the liver and probably much more than kratom alkaloids.

This is one reason why the American Kratom Association supports industry regulation and getting harmful products off the shelves. Improving product quality across the market will limit the risk of kratom-related health issues.

Kratom is harder on people who have a compromised liver. Those with pre-existing liver issues may not be able to consume as much kratom as people with a healthy liver.

The extent of the effect will depend on the severity of the problem. But a compromised liver may stop you from taking kratom safely.

Consult with a medical professional if you have any concerns.

Taking measures to keep your liver healthy should reduce the strain that kratom puts on the organ. Here is the good news: looking after your liver is relatively easy! It mostly comes down to maintaining a healthy diet, staying hydrated, and exercising frequently.

Diet: Eating the right foods helps support liver health. Maintain a balanced, nutritious diet and limit your intake of processed foods, sugary drinks, and alcoholic beverages. I recommend incorporating a mix of fruits, vegetables, nuts, protein, healthy fats, and fiber into your diet.

Hydration: Give your liver a helping hand by drinking plenty of water during the day. Staying hydrated prevents constipation and dehydration, which can both negatively affect your liver. Drinking water also supports liver health by clearing toxins from the body.

Exercise: Moderate and vigorous exercise gets blood and oxygen pumping around your body, which can support liver health. Running and cycling are excellent activities, but jogging, walking, and other less intense forms of exercise are more beneficial than sitting on the couch.

There is no scientific research on the liver reversing kratom-induced damage. However, the liver is renowned for its resilience and ability to regenerate itself by creating new cells. So, there is a good chance the liver can reverse kratom-induced injury with time.

However, much may depend on the extent of the kratom use and the severity of the liver damage. Liver cells die when filtering kratom from the body. Therefore, the more you kill off, the more difficult it is for the liver to regenerate and come back to full health.

You would also need to make lifestyle changes, including cutting back on or quitting kratom. Eating healthily, staying hydrated, and exercising often would also be important in restoring your liver to tip-top condition.

Kratom-induced liver damage is an issue, but I see no reason for most people to be unduly concerned. Kratom has many rare side effects, and abuse of any substance can strain the liver and cause long-term problems.

However, I recommend being more careful if you have a compromised liver. In this case, even responsible kratom usage could have severe long-term consequences.

It is not for me to determine whether you should use kratom or how much to take. It is your responsibility to make an informed decision based on your circumstances or to seek the necessary professional medical advice.