REVIEW article
Front. Pharmacol.
Sec. Ethnopharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1620601
The Acute Adverse Health Effects of Kratom: An Evaluation of Case Reports
Provisionally accepted
- 1TRC Companies, Inc., Denver, United States
- 2Paustenbach and Associates, Denver, United States
- 3TRC Companies, Inc., Jackson, United States
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Mitragyna speciosa, commonly known as kratom, has gained popularity in the United States due to its stimulant and analgesic effects. Allegations of kratom-associated adverse health effects, primarily based on case reports/series, have obtained media attention. Thus, a systematic literature search using PubMed was conducted to identify patterns among cases involving kratom use and acute adverse health effects in humans. 95 patients were identified for review. Mitragynine presence was toxicologically confirmed in 55 cases; 35 were deceased (mitragynine blood levels ranged from 3.5 to 7500 ng/ml) and 20 were living (range of 5 to 340 ng/ml). Reported adverse effects included pulmonary, cardiological, brain, liver, kidney, and gastrointestinal effects, as well as seizures, loss of consciousness, lethargy, fatigue, and altered mental state. Toxicology panels revealed confounding substances that could have caused or contributed to the acute adverse effects in 32 deceased and seven surviving cases. Currently, the literature provides insufficient evidence to support the claim that kratom consumption alone increases the risk of serious acute adverse health effects. More research is necessary to isolate the effects of kratom from those of polypharmacy.
Keywords: Kratom (Mitragyna speciosa Korth), mitragynine, case report, review, adverse effect (AE)
Received: 29 Apr 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Smallets, Litvin, Abele, Kirsch and Paustenbach. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sarah E. Smallets, TRC Companies, Inc., Denver, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.