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Kratom, the controversial plant consumed for centuries for its stimulant properties, has recently been the topic of an FDA public health advisory addressing the deadly risks of its use. Kratom may help relieve pain, improve mood, combat anxiety and depression, and decrease inflammation. Read on to learn more about the potential benefits and side effects of this plant.

Note: By writing this post, we are not recommending this drug. Some of our readers who were already taking the drug requested that we commission a post on it, and we are simply providing information that is available in the scientific literature. Please discuss your medications with your doctor.

What Is Kratom?

You may know Kratom by its street names: Thang, Kakuam, Thom, Ketum, Biak-Biak, and Krypton (this one also contains O-Desmethyltramadol).

Kratom (Mitragyna speciosa) is an evergreen deciduous tree native to Southeast Asia. It is part of the coffee (Rubiaceae) family [R].

It grows naturally in Thailand, Malaysia, Indonesia, and Papua New Guinea [R].

Kratom leaves have been used for centuries by natives of Southeast Asia for their stimulant properties. Kratom reportedly reduces fatigue during manual labor and extreme heat. It may also treat muscle pain, gut infection, coughing, and diarrhea [R, R, R, R].

In addition, it has been used for self-treatment of opiate addiction [R].

However, kratom has since transitioned to a recreational drug in both Southeast Asian and Western contexts [R].

Kratom inhibits the sensation of pain (anti-nociceptive, sensory neurons block pain stimulus) and has euphoric, anti-inflammatory, anti-depressant, and muscle relaxant properties [R].

Kratom is widely available via online stores in the form of a powder, extract, pill, or dried leaves [R].

A cross-sectional survey in the United States identified the most commonly consumed form to be kratom powder with a beverage or food [R].

Kratom is currently legal in the United States, however, the FDA released an advisory regarding the associated deadly risks in November 2017 [R].

What Are the Effects of Kratom?

Users report that euphoria can be achieved within 5 to 10 minutes of chewing the leaves and can last up to 1 hour [R, R].

Kratom functions as a depressant with reports of “morphine-like” sedation and nausea at high doses and a “cocaine-like” stimulant at low doses [R].

Mechanism of Action

Over 25 compounds have been identified in kratom extract. The active ingredients are mitragynine and 7-hydroxymitragynine [R, R].

Mitragynine is the most abundant alkaloid and a partial opioid receptor activator (agonist). It targets a portion of the brain that responds to opioids, having similar effects to morphine [R, R, R].

The minor alkaloid, 7-hydroxymitragynine, is considered to be more potent than morphine [R, R].

These active alkaloids act on the mu (MOR), delta (DOR), and kappa (KOR) opioid receptors, and the alpha 2 adrenergic and 5-HT2A receptors to produce pain relief (analgesia) and euphoria [R, R, R, R, R].

Kratom extract may also activate dopamine D1 receptors (DRD1) [R].

The activity of these receptors improves mood and lowers anxiety.

Changes in the body in response to these alkaloids include secretion of stomach acid and inhibition of contraction of a portion of the small intestine (ileum) and male reproductive system (vas deferens) [R, R].

Positive Kratom Effects

1) Kratom May Aid with Pain Management

In an online survey of kratom users, pain relief was the most reported beneficial effect of this plant [R].

Although no well-controlled human studies have been published, animal studies show that kratom extract improves various forms of pain.

Mitragynine and 7-hydroxymitragynine relieved and blocked pain (they were analgesic and anti-nociceptive) in animals, with opioid-like effects observed in organ samples [R, R].

Animals given kratom extracts demonstrated decreased (nociceptive) responses to harmful stimuli such as the hot plate, tail-flick, and acetic acid-induced writhing tests [R, R].

High doses of kratom in rats reduce muscle and nerve function by blocking the exposed sciatic nerve response to electrical stimulation at the nerve-muscle junction [R, R].

2) Kratom May Help with Anxiety and Depression

In a 2016 online sectional survey in the US, 66% of the participants used kratom for mental conditions including depression and anxiety [R].

In particular, people report that kratom helps to reduce social anxiety [R].

Both low and high doses of mitragynine in rats effectively reduced anxiety [R].

Antidepressant-like effects are seen in numerous animal models of depression. These are primarily based on kratom’s action on opioid receptors [R, R, R].

Both animal and cell-based experiments show mitragynine also interacting with adrenergic and serotonergic receptors. These non-opioid receptors are common targets of antidepressant drugs and may contribute to the antidepressant effects of kratom [R].

No well-controlled human clinical trials have confirmed these findings.

3) Kratom May Boost Energy (in Low Doses)

In a cross-sectional survey of 293 northern Malaysian users, kratom was used to enhance physical energy by 27 to 28% of medium- and long-term users [R].

Many of these people used kratom to enhance work performance and consumed it as an “energy-boosting drink” [R].

In addition, an online survey identified increased energy as one of the most reported benefits of the substance [R].

According to a review of animal and human studies, kratom causes stimulant effects and holds off fatigue [R].

In rats, a low dose of mitragynine caused non-stop movement (hyperactivity), characteristic of increased physical energy [R].

4) Kratom May Cause Euphoria

In an analysis of 120 journal articles ranging from animal to human studies, euphoria was one of the kratom’s more reported effects [R].

However, only 6% to 12% of 136 active users in northern Malaysia reported euphoria as a reason they use kratom [R].

Euphoria is also connected to kratom’s addiction potential.

In a case report, a 44-year-old patient required a dose increase from 4 g to 8 g twice daily to experience the desired euphoria [R].

5) Kratom May Help in Opiate Withdrawal

Kratom has been used as an opium substitute since the 19th century [R].

At high doses, kratom induces a “morphine-like” effect of calmness (sedation) [R].

Opioid abusers resort to kratom for self-treatment of addiction and to relieve symptoms of withdrawal. For now, kratom is easy to buy, requires no medical prescription, and is less expensive than other opioid replacement treatments (e.g., buprenorphine, methadone) [R].

Mechanistically, kratom (mitragynine and 7-hydroxymitragynine) may reduce symptoms of opiate withdrawal by interacting with opioid receptors (MOR and DOR); descending serotonin, norepinephrine, dopamine (monoaminergic) projections, primarily in the brain stem; and by blocking neuron calcium channels [R, R].

6) Kratom May Promote Relaxation (in High Doses)

Users report feelings of relaxation and tiredness after consumption of a higher dose of kratom [R].

Multiple animal studies show that kratom extract and mitragynine both decrease muscle twitch, highlighting their direct effect on muscle relaxation [R, R].

7) Kratom May Decrease Inflammation

Mitragynine, the main active ingredient of kratom, decreased inflammation (by inhibiting the bacterial endotoxin/LPS-stimulated production of COX-2 and PGE2) in response to an immune stimulant [R, R].

Negative Effects of Kratom

1) Kratom May Impair Learning and Memory

Although no well-controlled human studies have been published, animal studies show that chronic mitragynine treatment impairs learning and memory [R, R].

In mice and rat models, mitragynine caused cognitive impairments. It hindered the ability to avoid a response that routinely leads to punishment (passive avoidance learning), and memory maintenance and retrieval [R].

2) Kratom May Cause Liver Damage

In a case report, a young male kratom user developed jaundice and pruritus and had alkaloids in his urine sample after 2 weeks of use. These clinical signs indicate an inability of the liver to cleanse the body of the alkaloids and correlate with liver damage (intrahepatic cholestasis) [R].

Kratom use may be linked to cholestatic liver injury. In another case report, a middle-aged man who used a low dose of kratom for 3 months developed jaundice and liver abnormalities. Interestingly, his jaundice reversed upon withdrawal and reappeared upon resuming consumption of kratom [R].

Mitragynine inhibits three liver cytochrome P450 enzymes (CYP2C9, CYP2D6, and CYP3A4) necessary for the breakdown of drugs and toxins. Without these, the liver’s alternate detoxification pathways can become overtaxed [R].

Other Side Effects

Side effects of kratom use can include:

With the exception of diarrhea, an online survey of American users shows that all negative effects are dose-dependent. Therefore, lower doses (< 5 g) are less likely to cause negative effects [R].

Risk of Kratom Addiction and Withdrawal

The euphoric feeling of being “high” can urge users to continuously consume kratom, leading to potential addiction [R, R, R].

In animal studies where kratom was administered for 5 days or longer, the animals developed a physical dependence –  addiction. Withdrawal symptoms similar to opioid withdrawal were also observed [R, R, R].

Animals withdrawing from chronic mitragynine treatment had symptoms of opioid-like withdrawal, including movement hypersensitivity to other drugs or stimulation, and enhanced anxiety [R].

Severe human side effects associated with withdrawal may occur with chronic use. These side effects include aggression, hostility, anxiety, loss of libido, muscle aches, severe weight loss, and insomnia [R, R].

Confusion and delusion were also reported [R].

Hyperpigmentation of the face and cheeks can occur after chronic kratom use because mitragynine can increase the melanocyte-stimulating substance, melanin [R].

Long-term users appear thin with swollen stomachs, unhealthy complexions, dark lips, and dry skin [R, R].

Drug Interactions

There is potential for drug interaction when mitragynine and 7-hydroxymitragynine are co-administered with drugs that get broken down by P-glycoprotein (e.g. colchicine, tacrolimus, and quinidine) or UG72B7 [R, R].

Lab experiments show that kratom extracts block select CYP enzymes (CYP3A4, CYP2D6, CYP1A2) necessary for drug metabolism, which may result in interactions with prescription and over-the-counter medications [R].

These drug interactions can result in a build-up of the active constituents of kratom and other drugs, contributing to liver damage [R].


Kratom leaves and smaller stems can be consumed fresh by chewing, or dried and smoked, steeped in water, prepared as an extract or a crushed powder in the form of an herbal supplement [R].

Two different leaf varieties are common, the red vein and white vein variety [R].

Originating in Bali, the red variety is recommended to alleviate pain, while white veined varieties originating from Malaysia are reported to generate a strong stimulant effect.

The chemically-based potency of different variants is unknown, given that they are not regulated by the FDA, thus need not be documented.


Kratom effects are dose-dependent [R, R]:

  • Low to moderate (1 to 5 g) doses result in mild stimulant effects
  • Moderate to high (5 to 15 g) doses cause opioid-like effects (analgesia, euphoria)
  • Very high (> 15 g) doses result in sedating effects

Can You Overdose on Kratom?

Kratom is on the DEA’s list of drugs of concern due to its potential toxicity and risk of overdose. An increase from 26 to 263 calls to poison centers associated with kratom use occurred between 2010 and 2015, with more than 40% of the calls ranked as serious or life-threatening cases [R, R, R].

Signs and symptoms of kratom overdose include [R, R]:

The risk of overdose is increased with co-consumption of alcohol and other drugs (ex.: benzodiazepines, narcotics) [R].

Additional substances were present in the blood and urine samples and contributed to the deaths of 9 kratom overdose victims in a study between 2009 and 2010 [R].

An animal toxicity study demonstrated that mitragynine had relatively low toxicity [R].

However, two rat studies that orally administered a high dose of 200 mg/kg of kratom extract resulted in death [R, R].

User Experiences

A qualitative analysis of kratom user’s first-hand experiences highlighted themes of pain relief, better mood, reduced anxiety, and potential for management of opioid withdrawal. Negative response themes were also noted, such as vomiting and kratom dependency [R].

User experiences from online blogs note that kratom is great for pain relief without feeling spacey, and helps maintain a clear head for a few hours. If too large a dose is taken, nausea, vomiting, and sleepiness are common side effects. One user highly recommended kratom for those self-treating opiate withdrawal.

Health Tools I Wish I Had When I Was Sick

At SelfHacked, it’s our goal to offer our readers all the tools possible to get optimally healthy. When I was struggling with chronic health issues I felt stuck because I didn’t have any tools to help me get better. I had to spend literally thousands of hours trying to read through studies on pubmed to figure out how the body worked and how to fix it.

That’s why I decided to create tools that will help others cut down the guesswork:

  • Lab Test Analyzer – a software tool that will analyze your labs and tell you what the optimal values are for each marker — as well as provide you with actionable tips and personalized health and lifestyle recommendations to help you get there.
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  • SelfHacked Secrets – an ebook where we examine and explain the biggest overlooked environmental factors that cause disease. This ebook is a great place to start your journey if you want to learn the essential steps to optimizing your health.
  • SelfHacked Elimination Diet course – a video course that will help you figure out which diet works best for you
  • Selfhacked Inflammation course – a video course on inflammation and how to bring it down
  • Biohacking insomnia – an ebook on how to get great sleep
  • Lectin Avoidance Cookbook – an e-cookbook for people with food sensitivities
  • BrainGauge – a device that detects subtle brain changes and allows you to test what’s working for you
  • SelfHacked VIP – an area where you can ask me (Joe) questions about health topics

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1 Star2 Stars3 Stars4 Stars5 Stars (17 votes, average: 4.76 out of 5)


  • Steve Roth

    Very interesting

  • Kratom User

    I was an opioid addict for several years. I always felt “off” and tried mental health meds which made me feel worse. Opioids made me feel how I imagine everyone else does. I wasn’t constantly high I just felt ok in my own skin. Tolerance, the drug life, costs etc etc turned my cure in to a problem.

    I was clean for 2 years and it was good except for that off feeling. For a year now I been taking kratom. It isn’t perfect. Im tired sometimes when I don’t want to be and definitely have withdrawal symptoms with out it but at $85 a month for a kilogram I don’t have to experience withdrawal. I feel good again
    I don’t mean hi all the time. I feel normal emotions without extreme highs and lows. I feel what I imagine normal is.

    If the FDA decides they know better than me what’s good and bad for me I will be very angry. My tolerance reached a ceiling and stayed where it is since 30 or so days after starting it. I don’t have to steal to get it. I also stopped having ulcer pains. My life is better with it. The Govt shouldn’t get to decide it isn’t.

  • Debra Butler

    Im a 55 yr old female, have been on percocet for a yr now, after taking methadone for 20 yrs and going off that( which took 3 tries to come off that horrible drug) now dr tells me that the he is weining off all his patients and i’ll no longer get that pain med, ive tried neurontin for pain it only helps some for a short time , im not able to work without my pain med, would love to have alternative natural drug. Im a pharmacy tech so i have to remain alert, i have thoracic outlet syndrome,chronic back pain, fibromyalgia, im trying cbd oil for inflamation and anxiety, this kratom sounds like the alternative im looking for but worried about my liver from what i’ve read online, what do i look for as far as ordering the right kratom?

  • Linda Pearson

    Can you take kratom if you are weening yourself off opioids?
    Meaning is it dangerous to start kratom if the opioids are still in your system?
    And what is the withdrawal of kratom like for most people who take a low daily dose?
    Any suggestions on how to make the switch from opioids to keratin?
    Thank you in advance for any input and for information already available on this sight.

  • Jeff Mcloud

    Don’t do Kratom but this article has thoroughly informed me. Great work author!

  • S

    I’ve taken the white vein for several years for my ADHD and it has worked for me (it also helps my fibromyalgia pain just like my old ADHD medication did). I bought bulk and encapsulated it myself. I have ran out before and the only thing that happened was that my ADHD symptoms returned.

    What bothers me is the Poison Control reports. If you take a look at them, in almost all the cases it was a combination of things that the person had ingested. There would be no way to know if it was the Kratom that caused it or something else.

    There is a side affect called “The Woggles” that let’s you know have ingested too much. Your balance does become affected and it does go away after it wears off. I had the same side affect with my prescription ADHD medication, but it happened at my effective dose. Not with Kratom. It happens when you take too much.

    As for weight loss… I could only be so lucky. I’ve steadily gained while taking it. No constipation, still like clockwork every day. No dark lips or darkened skin on my face or elsewhere.

    If you want to know more about it, there are several sites on the internet with truthful information (not that the info here isn’t true, but they are more knowledgeable than the kid at your local smoke shop).

    Just like anything you ingest, it depends upon the person. I can take one type of ADHD medication, but not two others because of the side affects they cause me. Yet other people take the other two medications with great success.

    Too much of a good thing (no matter what it is) is not good for you. Anything…and I mean anything…can be abused. It has become a witch hunt with Kratom.

    Look up and see how many people die from alcohol related deaths. Statistics show that if a heroin addict gets clean, they are highly likely to become alcoholics because it acts in the brain the same way. Alcohol is legal and there are HUNDREDS of deaths each year because of it. We need to address addiction and the spiritual, emotional and physical drivers behind it and help people heal themselves.

  • Janet Aime

    Kratom is an excellent plant, very effective for pain and an awesome antidepressant in my experience but what I also found is that a little kratom goes a long way and chewing the leaves is much preferable to the powdered leaf or extracts. Absolutley NOTHING beats it for social anxiety, depression and for focussing the mind but like anything else, too much can be harmful. Big parma CANNOT get hold of this as they will ruin it all as they have done with so many drugs that they make. It is most useful and most well tolerated by humans in the form it has been taken for thousands of years which is chewing the leaves. Preferably fresh and with the centre vein removed as that is the part that causes nausea.

  • J Hagedorn

    I do believe that the FDA / pharmaceutical companies want it banned so that they can monopolize it , and as I said in my comment above , it does relieve withdrawal symptoms quite well! Now I’m afraid they want to monopolize marijuana ( don’t think they can though as it’s a plant) . I loathe the corruption in the FDA & pharma companies.

  • J Hagedorn

    Kratom worked great for me to ease off of the pain meds I’d been on for years for my health issues ( at that time in 2016 I also had to retire and could not afford health insurance ) so my neighbor told me about Kratom. So I got some knowing my medications would run out. I never felt addicted to opiates , in the years I was on them , I was pretty much on the same dose . But I also realized that there would possibly be physical dependency, hence I tried the kratom. It worked! I actually really like it but I felt addicted to the Kratom almost in the first week. I would get withdrawal symptoms after 3-4 hrs of taking it , but it just felt like a gnawing feeling and wouldn’t last more than 30 minutes. . But I figured it was just temporary. It did help with the pain too. The negative is that I lost a bunch of my hair! Was that due to the Kratom or my body going into shock from just abruptly stopping pain meds after 15 yrs of taking them on schedule daily? Well I stopped the Kratom ( after two months ) it did affect my liver , I’m better now though & my hair eventually came back although it’s thinner than it used to be ( could be something age related). But I found out online that kratom does seem to cause hair loss in some people. Now that I read the part about memory loss ., no way will I ever take it again! It didn’t state whether or not the memory problem would cease when not taking it but I wouldn’t want to take the chance at my age! I think it should be used cautiously. Also I took about a teaspoon of the red vein powder 4-5 times a day( found out that that amount is a bit excessive) Since it isn’t regulated, one has to go by what a kid in a smoke shop tells you what he thinks you should take.. it’s a gamble, or trial & error. I won’t be taking it again . Now I’m on Medicare , but my doctor said to try marijuana, so I am using this oil that people call RSO ( ethos brand extract) for the first time ever I can actually sleep through the night ( indica type helps with sleep & pain) I feel better in the morning too. But I I tried a marijuana brownie at first & it was bite size .. I guess I was only supposed to take a tiny piece of it , I actually got very high on it for hours . Live & learn. I just stick to the oil at night – works great with only a tiny amount. I don’t take it during the day as I’m afraid I may feel self conscious that I sound ” high” . But my health issues seems to be improving with this marijuana oil.

  • Don

    I’ve been taking kratom daily for 2 years.

    Like the article said kratom is great for relieving pain, anxiety, focus, sleep, depression and fatigue. Some strains can feel more like coffee (not coke). Higher doses feel more sedating, but not like opiates in my experience. Just more of a mood lift and euphoria. With low doses I still get a mood lift, euphoria and focus. While others strains (green) are balanced and relaxing with mood lift. It truly is an amazing tree. Negatives are slight constipation, sleepiness with higher dose and nausea if you take too much.

    I don’t think I could live without having it in my toolbox as it is so versatile. It can turn a bad day into a good one. I see no reason for kratom to be banned, other than it competes against pharmaceutical companies profits. Kratom doesn’t get you high. No one can even tell when I am on kratom.

    If you don’t need to use kratom daily, don’t do it. It looses the initial magic, but still works great. Then, you’ll have to deal with withdrawals if you stop cold turkey. They can be minimized by tapering. Though they’re some that don’t get withdrawals. It is best to use it 2-3 days a week with a lower frequency of dosing.

    Kratom is simply amazing and a great alternatives to pharmaceuticals. It can replace all mine. That’s why they want it banned.


  • DG

    Replaced naproxen for pain relief. I use only 2-3 grams/day. No side effects noted.

  • MA2

    I have a left hip that is frequently painful. I found this plant was not effective at lower doses and also not at all habit forming at a lower dose spread across 3 meals.

    It must help some people if the FDA wants to make it Schedule 1, like cannabis. Not sure it is more healing than cannabis CAN be for some. F is correct about the reason the FDA wants to stop its OTC sales.

  • Hard Work

    Would advice against it. At the write dose will give you motivation and energy but if you dose wrongly might just make you sleepy. I’m worried about the long term usage effects that’s why stopped using it – it hasn’t been studies properly so it’s not worth the risk of your health if you don’t really need it. For example I’m fine without it but I don’t have any medical conditions – was just taking it to increase productivity/mood enhancement.

  • F

    There are several patents on synthetic analogs of kratom ingridients surfacing out now. Real reason for FDA ban is pharma lobby pushing their agenda of scarcity and artificial upregulation of price.

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