Kratom: Benefits and Risks

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Clinical Research on Kratom

Kratom is often promoted as a natural remedy for pain relief, increased energy, better mood, and even enhanced male sexual performance. But while the marketing is bold, the science behind these claims is surprisingly thin—especially when it comes to human research. There simply aren’t many clinical studies in people that show kratom or its active compounds provide real, measurable health benefits. Let’s start with the claim that kratom helps with pain relief. This is one of the most common reasons people use it. In one small clinical study involving male participants, those who took kratom were able to keep their hands submerged in ice-cold water slightly longer than those who took a placebo. In other words, they showed a marginally better tolerance to cold-induced pain. However, this doesn’t really tell us much about whether kratom is effective for more common types of pain, such as sore muscles, joint discomfort, or chronic injuries. The kind of pain tested in the study is highly specific and doesn’t reflect the broader experience of everyday pain. Another widely circulated claim is that kratom can improve male sexual health. But again, the research doesn’t support this. One small observational study suggested the opposite effect. Men who took kratom daily for four weeks reported reduced sexual desire, lower orgasm quality, and poorer erectile function. While the authors speculated that this might mean kratom could help with premature ejaculation, the study itself was based on self-reported data from social media platforms like Reddit and Twitter—not exactly a gold standard for scientific research. In terms of other benefits, such as improved energy, mood, stress levels, sleep quality, or physical performance, there is currently no strong evidence from human trials to support these claims. So far, no major clinical research has confirmed any consistent or meaningful health benefits from kratom use. What we do have, however, are growing concerns about potential health risks.

Kratom and Pain Relief

Kratom is derived from the leaves of a tropical tree native to Southeast Asia. Traditionally, these leaves were either chewed or brewed into a tea. Today, kratom is widely available in the form of powders, capsules, and liquid extracts. Its two main active compounds—mitragynine and 7-hydroxymitragynine—are believed to affect the body by interacting with opioid receptors in the brain. These receptors are the same ones targeted by powerful painkillers like morphine. When activated, they can reduce pain and produce feelings of euphoria, which also makes them highly addictive. Mitragynine is the most prevalent compound in fresh kratom leaves. It does bind to opioid receptors but appears to have only mild pain-relieving properties. 7-hydroxymitragynine, on the other hand, is far more potent. It’s believed to be 10 to 13 times stronger than morphine when it comes to activating opioid receptors. However, it’s only present in very small amounts—and only after the kratom leaves have been dried and oxidized. Fresh leaves don’t contain this compound at all; it forms as a result of chemical changes during processing.

Problems with Kratom

But the truth is more complicated—and potentially dangerous. One of the biggest problems with kratom is the lack of consistency. Unlike prescription medications, which are precisely measured and tightly regulated, kratom products can vary wildly in potency. The levels of active compounds—mitragynine and 7-hydroxymitragynine—depend on the strain, processing methods, and manufacturing practices. That means you never really know what you’re getting. Contamination is another serious concern. In 2018, a salmonella outbreak linked to kratom products sickened nearly 200 people in the U.S., with over 50 hospitalized. When the FDA tested multiple kratom samples, they found that about half contained salmonella, revealing widespread problems with product quality. But the issues don’t stop there. Some kratom products have been found to contain dangerous heavy metals like lead, while others were adulterated with synthetic additives such as phenylethylamine—a stimulant linked to serious side effects like brain hemorrhage. While some users are drawn to kratom for its supposed pain-relieving properties, there’s a catch. Even though 7-hydroxymitragynine is significantly more potent than morphine at the molecular level, it’s found in incredibly small amounts—often less than 0.05% of the dried leaf. In practical terms, that means a typical 500 mg kratom capsule might only contain a fraction of a milligram of this compound, far too little to deliver meaningful relief. To feel any effect, users would likely need to take several grams of kratom, which increases the risk of side effects.

Side Effects

And those side effects can be significant. Kratom contains much more mitragynine than 7-hydroxymitragynine, and while it does act on opioid receptors, it doesn’t offer the same level of pain relief. Instead, it tends to bring on the downsides of opioid use—nausea, dizziness, drowsiness, dry mouth, tremors, frequent urination, and constipation. Regular use can also lead to dependence. When people stop taking it, they may go through withdrawal symptoms like muscle aches, irritability, insomnia, and diarrhea. Though usually milder than withdrawal from traditional opioids, these symptoms can still be disruptive. More severe health risks, though less common, have also been reported. These include high blood pressure, a racing heart, and irregular heart rhythms—especially when users take large doses, typically 8 grams or more. In some cases, kratom has been linked to liver damage that developed just weeks after use began. Reports have also mentioned kidney issues and abnormal electrolyte levels, especially when tainted products were involved. On the mental health front, kratom has been associated with anxiety, paranoia, and even hallucinations in certain users.

Lack of Research

One of the biggest challenges in understanding kratom’s true risks and benefits is the lack of solid research. High-quality, large-scale clinical studies simply don’t exist. Without that data, we’re left with anecdotal reports, poorly designed studies, and a lot of unanswered questions. Contrast that with well-established medications like NSAIDs or morphine, which have decades of clinical research behind them. With kratom, we’re still in the dark. And just because we haven’t found all the risks yet doesn’t mean they’re not there.

Regulatory Problems

To make matters worse, kratom’s legal status is all over the map. In some places, it’s banned outright. In others, it’s sold with minimal oversight. That inconsistency makes it hard to trust the safety or quality of what you’re buying. Take Canada, for instance. Kratom isn’t approved for sale as a consumable, but it’s still legal to possess. Sellers get around the rules by labeling it “not for human consumption” or “for research only”—labels that mean very little in practice. Unfortunately, this legal gray area often leaves consumers exposed to unsafe, unreliable products.

Dr. Brian’s Summary

So where does that leave us? Despite all the buzz and the appeal of a plant-based solution, kratom isn’t a reliable or safe treatment for pain—or any health condition, really. The science just doesn’t support its use yet. Most of the studies are too small, too flawed, or too limited to draw clear conclusions. What we do know points to some serious problems: inconsistent potency, contamination risks, opioid-like side effects, and a real potential for dependence and withdrawal. That said, there’s one area where kratom might have some promise. Some researchers and addiction specialists are exploring its potential as a harm-reduction tool, similar to how nicotine patches help smokers quit. If kratom were properly studied, standardized, and regulated, it could one day serve a role in helping people taper off opioids. But until that research is done and those standards are in place, using kratom remains a risky bet.

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Citations

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