ReviewDrugs2020
Kratom (Mitragyna Speciosa) Liver Injury: A Comprehensive Review.
Review in Drugs, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- A systematic review of (pre)clinical studies on the therapeutic potential and safety profile of kratom in humans.Human psychopharmacology · 2022Pooled it
- Kratom Consumption Associated With Herb-Induced Liver Injury and a Pharmacokinetic Interaction: A Case Report.Cureus · 2026Article
- A Review of Kratom Product Evolution and Its Associated Health Outcomes.Substance abuse and rehabilitation · 2026Review
- From kratom to 7-hydroxymitragynine: evolution of a natural remedy into a public-health threat.Pharmaceutical biology · 2025Review
- Associations Between Opioid and Kratom Use in the USA: Differences by Race/Ethnicity and Sexual Orientation.Journal of racial and ethnic health disparities · 2025Article
- An exploratory study of the safety profile and neurocognitive function after single doses of mitragynine in humans.Psychopharmacology · 2025Article
- Kratom safety and toxicology in the public health context: research needs to better inform regulation.Frontiers in pharmacology · 2024Review
- Translating Kratom-Drug Interactions: From Bedside to Bench and Back.Drug metabolism and disposition: the biological fate of chemicals · 2023Review
- Drug testing for mitragynine and kratom: Analytical challenges and medico-legal considerations.Drug testing and analysis · 2023Article
- Traditional medicine consumption in postpartum for HBV-infected women enrolled in the ANRS 12345 TA PROHM study in Cambodia.PloS one · 2023Article
- Social, psychological, and substance use characteristics of U.S. adults who use kratom: Initial findings from an online, crowdsourced study.Experimental and clinical psychopharmacology · 2022Article
- Hepatotoxicity due to herbal dietary supplements: Past, present and the future.Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2022Review
- Article
- Assessment of the possible health risks associated with the consumption of botanical preparations ofEFSA journal. European Food Safety Authority · 2022Article
- [Kratom - a short review for pain medicine].Schmerz (Berlin, Germany) · 2022Review
- Kratom-Associated Mixed Cholestatic-Hepatocellular Liver Injury in a Patient With Long COVID: A case Report.Clinical medicine insights. Case reports · 2022Article
- Herbal and dietary supplement induced liver injury: Highlights from the recent literature.World journal of hepatology · 2021Review
- Multiorgan Dysfunction Related to Kratom Ingestion.ACG case reports journal · 2021Article
- Article
- Case Report: Treatment of Kratom Use Disorder With a Classical Tricyclic Antidepressant.Frontiers in psychiatry · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Kratom (Mitragyna speciosa) leaves contain the mu opioid partial agonists mitragynine and 7-hydroxymitragynine. The US Drug Enforcement Agency considers it a 'drug of concern', and the US FDA is reviewing kratom, but there is a paucity of information regarding health effects. Liver injury is often cited as a potential health consequence, however the same few case reports are repeatedly referenced, without a broader context. Furthermore, reports have largely lacked standardized causality assessment methods. The objective is to evaluate causality in kratom liver injury, through a comprehensive scoping review of human cases, and by reviewing epidemiologic, animal, and mechanistic reports that relate to kratom liver injury. Hepatotoxicity causality was systematically examined using the Roussel Uclaf Causality Assessment Method (RUCAM) for case reports. Biopsy findings, potential pathophysiologic mechanisms, and management options are discussed. This review identified 26 case reports and abstracts, in addition to 7 cases reported from the Drug-Induced Liver Injury Network, 25 in FDA databases, and 27 in internet user forums. Latency periods to symptom onset had a median of 20.6 days and mean of 21 days (range 2-49). Common presenting signs and symptoms were abdominal discomfort, jaundice, pruritis, and dark urine. Histologic findings were predominantly cholestatic, although, biochemically, the condition was heterogenous or mixed; the median R ratio was 3.4 and the mean was 4.6 (range 0.24-10.4). Kratom likely causes liver injury based on the totality of low-quality human evidence, and, in the context of epidemiologic, animal, and mechanistic studies. It remains unclear which subgroups of users are at heightened risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.