Let's talk about adverse effects because we had talked earlier I mean one obvious adverse effect is you could get addicted to it like you could become physiologically dependent on this substance and I actually had someone I had made a post about having kratom as a part of my life and I had gotten somebody else that had said to me that they were felt like they were in a bit of trouble because They were using kratom
And they were using it based on this. Oh It's okay because it's natural blah blah blah this misunderstanding and then all of a sudden they need 10 grams a day Or they feel like they're falling apart Right and it just sort of crept up on them and they didn't think about it because it was no big deal similarly in some sense Maybe as people who don't really Seem to think coffee is a big deal and then they're eating drinking six seven eight cups a day
And if they don't get at least five then they feel like shit and they treat other people like shit But you know coming off of coffee, although painful maybe is less intense than coming off of something that has an opioid Effect in the body but we have this potential danger of addiction or excuse me physiological dependence What are the other adverse effects that are present for?
Kratom that we know of either acutely Since you said it doesn't tend to suppress the respiratory system or chronically so what has been reported in the literature and what we have seen is classical So for one it's it's it's a dose-dependent Adverse effect profile that we see we see constipation as as one of the primary and most reported adverse effects Which you can expect from an opioid or from something that acts on opioid receptors We see nausea and vomiting
That can occur primarily nausea and not so much vomiting the issue with Ingesting or drinking the actual Extract if you just have the powder and you drink it some people use honey or something if a Orange juice anything that makes it a little bit more palatable Because it is rather bitter if you drink it and it's not it's not very well tasting So that can cause just nausea Potentially and there is just a limit of how much you can
drink at a time without having really a very bad stomach experience stomach upset was also a common adverse effect I guess when you take it in pill form you avoid those effects those adverse effects to some degree Then what is a little bit more serious are Potential effects on the liver that have been reported after a few days of ingestion so that can occur within five to ten days
Depending a little bit. That's what I've seen in the literature let's let me let's zoom in on that before you continue because this is sort of like kind of hot I mean it kind of comes and goes was sort of hot right now because there was recently a report that came out from You know like a big organization that talks about liver toxicity of different substances and stuff and liver health and they were suggesting that That oh, there's I think one of the one of them
Headlines I saw which headlines don't mean shit, but it was you know like this association is sounding the alarm on kratom And then when I sent you that report, I mean you said something like this is a very interesting use of data So are we talking like people who take kratom every day for five to ten days in a row at?
You know we'll say maybe five or something grams Usually common is about five to eight grams at a higher dose for people that that causes liver problems Or is it more complex than that is it everybody is it some people is the reports like do we know? Definitively it was kratom is there some sort of genetic predisposition? What do we know like what is what is like the the reasonable assessment of danger around liver toxicity with kratom?
so when we talk about causation something being causative something Being the reason that something else happens so kratom being the reason that we have a liver toxicity We stand on currently we don't stand on very solid ground Yes, we can say that kratom in some cases may contribute to liver a toxicity to liver adverse effects in the report that you sent me and that's what I am Analyzing now they are more reports in the literature, but let me just focus on that one as an example for now
There were seven reports of liver toxicity that were specifically discussed in that one six of them also used alcohol So alcohol is a known liver toxicant So if you combine that with kratom there were also no other Reports of what other medications were these patients potentially on so if we throw in something else like benzodiazepine or Something like acetaminophen something like tylenol that is also liver toxic What our additive effects like so we have a lot of different
Factors that can play into that now I don't I don't want to downplay that some people may be at higher risk of developing liver toxicity with the use with the high Use of kratom with high doses of kratom and they should be careful with using kratom They might want to consider Consulting with a health care professional Or at least checking if not to use other potential liver toxicants such as alcohol
Or acetaminophen if you use it for pain for example, and you also using ibuprofen or acetaminophen In conjunction with kratom then you might be at an increased risk of developing liver toxicity So you have a lot of factors that can play into that in addition and that's another point that I sometimes like to harp on together, but I feel like we have been harping on that as not only as researchers, but also as just I want to say caring individuals, but I maybe I'm
That the issue currently is that since the FDA is saying kratom is no good. We want a gun basically entirely that we don't have any Regulation really regarding what kratom products are entering the United States so we don't have really any quality control of what consumers have access to and therefore there might be kratom products out there that contain pesticides that contain anything heavy metals that Might actually not be healthy that might be
Really not good. So if we had better regulations in place where we have some kind of just Where consumers knew that they had a good quality kratom product that they have access to with some kind of labeling guideline and some kind of at least internal lab check That we know that good manufacturing practices are followed then we might have had a Better chance to at least reduce a number of kratom Associated liver Incidences now if you compare these seven cases to the annual cases of
Tylenol related liver toxicity I don't know if I can display that in in a graph, but it's like minuscule It's it's really nothing now I don't want to downplay these six or seven cases though because everybody who obviously has adverse effects so we need to be careful need to be aware of that and and Everybody who intends to use kratom should always look at their current medication that they're taking and and should be aware of potential drug interactions
So so what you're saying here is there is absolutely evidence and reason to be cautious around liver toxicity with kratom Although it is not as it is not a oh my god kratom causes liver damage Scenario the way that it's being presented in the report that I sent you where it's you know sounding the alarm on kratom so not I if everybody who was using kratom would have Elevated liver enzyme values as what was reported in this case Then I would definitely say stay away from kratom I would not be
kratom what I don't think that we would have five to sixteen million somewhere in that range of kratom users in the United States So if you are taking kratom in reasonable doses Three to five grams five to eight is already on the high end to be honest three to five grams per dose three doses per day And you you have a good Kratom product that Meets kind of the current labeling guidelines that have been put forward by the American kratom Association
Then I would say that you are probably doing the best you can And you keep in mind potential drug interactions with other drugs that can affect your liver Then you're probably doing the best you can at the moment to avoid liver toxicity I'm not excluding it entirely, but you're probably doing the best that you can hmm yeah, I'm just thinking about the Like the percentage difference between five to seven cases out of fifteen to or five to sixteen million people taking kratom
And how significant that is although when I started doing further research there definitely was multiple reports online of people having liver issues although one person They had expressed they had some sort of credentials to make this statement had Said it had something to do with a genetic predisposition towards how well you detox in your liver or with kratom specifically and and that all the reports that had been discussed on the unlike thredits and stuff
Said that okay, this is what happens after yeah five to ten days your own gets very yellow You start to develop jaundice and there's these other effects and that that every case that had been talked about Was like as soon as kratom was discontinued all those all those effects went away And they went back to normal that it wasn't permanent effect as long as those things were noticed and like kratom use was stopped immediately
Do you have any more information on that or is that sort of like what we know? That is our current knowledge. Yes now If if it's only the liver toxicity if that is the only occurring symptom like you said yondis Then discontinuations obviously the path to go And if I would still advise to consult with a healthcare provider because there might be other issues associated with that
It might not be the kratom. It might be something else that's going on. So It's always good to to seek out a healthcare provider and such situations great We were talking about adverse effects and I am curious if you have more to add before I ask you specifically about what does and does not Sort of count as I think with the recent study from John Johns Hopkins said was a kratom use disorder Is there any other adverse effects you want to mention before we go on to that topic?
So there have been a few reports of particularly lung edema acute lung edema that have been attributed to potentially High metrog It might be something related to the cardiovascular system, so it might have something to do with heart People might be predisposed if they use kratom in very high amounts well above 8 grams per dose If they use it over a long period of time that they may develop Cardiovascular issues so something with the heart something with blood pressure
that then might extend to particularly the lungs and that But it has only been shown in isolated cases so far So that that is something that I have Seen it has been reported in I believe four cases to date postmortem, so Where mitra gynin was detected in the blood of deceased people interesting Any was that the last was that the last one?
That was There are certainly others, but those were the ones that were standing out to me That people I think should be aware of yeah Thank you for tuning in to this micro Micros is a mini series here on the podcast where we share curated sections of various episodes out of the archive This clip came from episode 121 titled all about kratom with dr Oliver grunman if you're interested in listening to the whole interview it is available on whatever podcatcher you are listening on now
And I will link to the show notes to that interview in the description here If you like what you heard please do subscribe to the show to stay informed on new episodes Dropping monthly, and if you found slash our finding value in the show you can reciprocate that value through a one-time PayPal or Bitcoin donation or by becoming my patron on patreon links again are in the description Finally if you would like to stay connected on social media you can find me at James W
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Thanks again for tuning in to adventures through the mind and until the next episode I've been your host, James W. Gesso. Take care, stay curious.