Many people are concerned about the effects of the herb kratom (the powdered leaf of the tree Mitragyna speciosa) on their liver and/or their kidney functions. Chronic pain patients are often interested in kratom as a way to avoid the side effects of their current medications, which are often known to cause liver and kidney damage, so they are wise to approach any new herbal product with eyes wide open.
The liver, in particular, is our body’s filtering and detoxifying organ, among other functions, so we should be careful not to consume supplements that may add unusual challenges to its chores. Many chronic pain patients are already aware their prescribed medications may have caused some damage to their liver, so they don’t want to further burden this important organ.
There is not a lot of scientific research that has been done to determine what effect, if any, kratom use at moderate levels will have in healthy people. Much of the research appears to be set up to show what extremely high doses will do to laboratory animals. There appears to be a bias in much of the laboratory research, so — for this article — let’s look at the epidemiological evidence, the results large numbers of kratom users have had over one to fifteen years of use.

In countries, such as Thailand and Malaysia, where kratom has been in use for hundreds of years by as much as 70% of the population in some areas, it should be obvious if there is a typical detrimental effect to the liver and kidneys of the daily users. In reading the literature describing the cultural uses of kratom in southern Thailand and Malaysia, we have found no mention of liver or kidney disease among this population that drink kratom tea or chew the fresh leaves daily. On the contrary, these people seem capable of very hard work in difficult conditions of heat and humidity.

One of the big concerns that stops people with chronic pain from using kratom is the thought that it might be harmful to their liver or kidneys. These are valid concerns when considering any herb or pharmaceutical medicine. Let’s take a look at the experience of a number of regular consumers of kratom who have had their liver and/or kidney functions tested to see how they fared.

Bambi: “I have hepatitis C and autoimmune hepatitis and take kratom daily around 15-20 grams for chronic pain. I spent 16 yrs on opiates. My liver before kratom was causing monthly hospital stays, jaundice, hepatic encephalitis, and massively high enzyme levels. Since last March I have the lowest numbers I’ve ever had. My liver looks great.”

Elizabeth: “After one year of kratom use with kava, I had a physical and all levels are normal. I had seen a different doctor the following year and no different.”

Gary: “I’ve been using it (kratom) regularly since 2004 and have had both checked and they are both healthy.”

Jennifer: “I have been using kratom daily for about a year. I have never had my liver function tested, but had my kidneys tested yesterday because of long-term high blood pressure medication usage. Kidneys are perfectly normal!”

Renee: “I have been using Kratom for over a year, along with Enbrel and Arava for rheumatoid arthritis so I have my numbers checked every three months and all have remained in the normal range.”

Berns: “I had near-fatal liver problems last year and I get regular checks since then. I have been using Kratom for about.. 8 month? now, every day, multiple times. The test results show no negative effect of kratom whatsoever, just the opposite, some things even improved.”

Jenn: “My liver function has actually improved had 2 routine checks went from borderline problem (thank you Tylenol ) to complete healthy. And I take kava as well.”

Donna: “I just had blood work a few weeks ago and everything improved except glucose – I’ve been eating good, a lot of sugar…but my liver and kidney function is great.”

Lisa: “I starting using Kratom in March and my Dr has been following my liver/kidney function and I have not had any issues caused by Kratom. At times I have had medical procedures that called for opiates with Acetaminophen in them and still no problems. I have one drink (of alcohol) a year.”

Jeri: “Someone I know just went through 25yr addiction to major opiates with Kratom. They couldn’t believe it worked, and were so happy.

“But after about a week and a half, eyes turned yellow, abdomen swelled up, got majorly sick! Two trips to ER, liver failure! Severe infection, they didn’t know from what. He’s a dr./ needle phobe. He left hospital against doctor’s orders, before getting all test results. I’m so worried about him. Healthy his whole life. He took some antibiotics and seemed to feel better. I just wonder if it was the Kratom, or stopping the opiates, a bad batch, IDK. He’s not a water drinker AT ALL! Never drinks water! Hospital cat scan said they saw a bunch of matter in upper abdomen. I’m thinking it (Kratom) all just sat there, and didn’t digest or something.”

[Editor’s Comment] There are so many questions about the second-hand testimony above that it’s hard to know where to place the blame for the jaundiced condition of this individual. We all need to adhere to some basic health practices in order to stay healthy. In this case, we hear of a guy who — although he’s taking large quantities of kratom powder to overcome the withdrawal from opioid pain medication — is not drinking any water. That, alone, is an indication that he may have other idiosyncratic behaviors that aren’t conducive to good health, such as eating vegetables and staying regular.

Twenty-five years of staying on narcotic drugs does not bode well for regularity — or a healthy liver. Our body likes for things it eats to keep moving: blood needs to circulate, lymphatic fluid needs to circulate, and the food we eat needs to be digested and assimilated. And the waste then needs to be excreted. How some interruption in the body’s normal rhythm in this individual could have caused an inflammation of his liver is something for his doctors to explain. My non-professional guess is that it had nothing to do with kratom, per se.

Connie: “I sought out Kratom, due to pharmaceuticals having damaged my liver. It took months to wean off the meds using Kratom and a few more using milk thistle and dandelion root to detox my liver (still using Kratom) and get the enzymes back to normal. It’s been another 6 months and my liver tests are still good. Thanks to Kratom I have the ability to parent and teach high school again. I’m no longer attached to my bed, swollen, depressed, miserable, and full of pain.”

Ryan Estevez, MD, PhD, MPH, a psychiatrist and psychopharmacologist in the Tampa area who has worked for years in emergency rooms, community health centers, and prisons, says: “I am well versed in both ‘good’ drugs that help people on a daily basis, and ‘bad’ drugs that are epidemically abused and create a tremendous burden on society. Kratom is [a natural herbal supplement] and not one of these ‘bad’ drugs (I have yet to admit anyone for kratom-addiction) and efforts to ban it are misguided and wasteful. The proposal of an absolute ban of Kratom perfectly illustrates what can happen when hype trumps science, as this plant has been benefiting millions of people for decades of time.”

Here are the conclusions (in part) of the Transnational Institute, which works with the United Nations to make drug policy recommendations:

  • Kratom is an integral part of southern Thai culture. Criminalisation of kratom is unnecessary and counter-productive given decades of unproblematic use.
  • In the absence of health and social harms, decriminalise use, possession and production of kratom…

In conclusion, from this small sample of kratom consumers — and the absence of complaints from the large numbers of others who regularly use the plant for medicinal purposes — kratom would appear not to present any significant threat to liver and kidney  function, as long as normal care is taken for personal health habits.