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Author Topic: Kratom and possible Stomach/Intestinal Upset and Liver problems?  (Read 2575 times)

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Offline Papyrifera

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Browsing on Erowid and I found this experience report where a man had intense stomach/intestinal pain (possibly inflammation?) and elevated levels of certain liver enzymes after ingesting a kratom extract. It sounded a little familiar, I recall someone on here had experienced upleasant and possibly dangerous intestinal inflammation after taking kratom? I was curious if others had similar experiences, and whether this might be an issue with kratom for some?

Personally I have felt that kratom does make the liver work harder to detox it, and so heavy or frequent use may be dangerous for someone with an already overworked or compromised liver. Also, I have gotten mild stomach/intestinal cramps when using kratom frequently, I always thought this had more to do with kratom slowing down digestion than anything though.

https://www.erowid.org/experiences/exp.php?ID=93736
Quote
So I bought this Kratom Extract that is supposed to be the strongest concentration ever, .25g being equal to 10g regular kratom. The reasoning was that it would be easier to drink, since the taste is outright nasty.

I will divide the experience into two. Day 1, took .25g and felt the regularly reported effects; euphoria, slight buzz... I felt good. The day after is when things got ugly: I developed a horrible stomach ache that radiated to my back, I could barely breath. I felt as if I had indigestion and constipation, in an effort to clear my painful intestines I downed some milk of magnesia. The pain had me unable to go to the gym for a week, I was almost bed ridden for these days.

Fast forward to day 2; 2 weeks later, I decide to give Kratom a try again since I didn't think that the pains and Kratom were related. Boy was I wrong. downed .25grams again and same as last time, I got the feeling of euphoria, light buzz and well being set in rather quickly (20 min). I enjoyed this for 3 hours and went to sleep sober at about 11pm. The real fun began at 3am when I was woken up by stomach pains. I woke up and went to the guest bedroom so as not to wake up my wife, and played some X-box waiting for this feeling to pass so I could get back to bed. That didn't happen; 45 minutes later I was on the floor of the bathroom in fetal position gasping for air, it was the same pain that I had two weeks ago, only stronger, it had radiated to my back and I could barely breathe. The pain would last for about 20 minutes, and suddenly go away... only to come back again 5 minutes later. I lasted in this roller coaster all of 5 hours, when I decided to drive myself to the ER.. the pain was so intense I was very worried about crashing on my way there, even if the ER is only 15 blocks away. if I pressed my hands around my gallbladder I felt I was being stabbed.

I got there and I was immediately administered an IV with 1mg dilaudid and that was the best relief I had ever felt in my life. tests and questioning began: EKG, Ultrasound, bloodwork, CAT scan with contrast... doctors did not find anything with the exception of two very elevated liver enzymes, ALT was at 340, AST 250 (6 times normal) so I had to spend the night, with more dilaudid being administered every 3 hours religiously, 1mg at the time. (strong dose)

Next day my liver hormones were trending down, and took a full week 3 days were back to normal. The doctors were all baffled as they had no clue what did this to me, from the ER chief to the Chief of GI/internal medicine. I did not disclose Kratom, as I knew that they had not idea what it was and they'd be quick to blame it. I wanted to get all tests first.

I was released with a 'no raw seafood' warning, since it was my last meal before this (my wife ate the exact same thing I did, and she was fine) as a testament of the doctor's absolute ignorance as to what was wrong with me.

As soon as I got back home, i threw the Kratom away, and vowed to do more research next time I experiment with something. I still have residual pain, I hope it will go away quickly...
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Offline ST1R

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #1 on: March 19, 2012, 12:24:03 pm »
Maeng da from a single supplier always used to make my stomach ache a few hours afterward.
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Offline farmer jack jeebs

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #2 on: March 19, 2012, 12:24:45 pm »
I wonder if the ingestor has an allergy to Kratom, or somthing mixed with the Kratom extract?

My own experiences with the Wheat Allergy were often with a strong stomach pain, nothing  bad enough to go to the ER bad thought about it more than once.

Also one hears alot of talk about parachuting or toss-washing ground leaf material which sounds like a perfect vector for intenstinal parasites.
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Offline Papyrifera

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #3 on: March 19, 2012, 01:03:05 pm »
You make a good point that when getting an "extract" you don't really know what might have been put in it...

Interesting you mention the Maeng da, ST1R, as that is actually a strain that makes me feel gross when I take it, even a few sips gives me stomach cramps.
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Offline ST1R

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #4 on: March 19, 2012, 11:16:21 pm »
Well perhaps you'll find this more interesting. "Maeng Da" (pimp class/grade) is also known as "Riau" depending on the source but for the sake of identification lets refer to it as "spiked leaf". Now as far as I know, there are only 2-3 groups specifically exporting kratom from S.E.Asia to the entheogenic community. Now (I'm gonna be careful not to let this go too close to vender discussion) most vendors are buying from one one of two wholesalers. They have mostly the same product but different names for each so one will call the spiked leaf something else and their purchasers sometimes change the name to appear more exclusive or whatever.

The spiked leaf is more potent than average but with the "maeng da" variety cramping was unavoidable and quite painful, so I simple stopped using it. I think the cramping was the result of increased gas production and decreased motility of the g.i. tract.

I've noticed that kratom (like most opiates) slows my digestion. People don't realize that gas can be extremely painful, because they can usually fart. In fact it can be so painful that it often mistaken for a heart attack!

Now the funny thing is that spiked leaf from the other wholesaler didn't have any negative effect on my digestion.

All kratom variations will have certain properties in common and some slight differences but the maeng da that caused consistent stomach cramps also took longer to peak but didn't last as long as regular leaf. It also gave me loose stools the next morning, something that has never been an issue with kratom.

Previously a fake kratom extract appeared in headshops. It was made of O-Desmethyl Tramadol mixed with caffeine.

The funny thing is it is only the spiked leaf from a single supplier, that left me feeling bad. The spiked leaf from the other wholesalers never gave me that reaction. It is possible that the single harvest had some micro-tourists that decided to come along or that the plant material was sprayed with a fertilizer or something. Back in my poppy pod days I used to "enjoy" the stomach cramps I'd get from trying to salvage bad pods.

I think the doctors figured it was something living too based on this quote,

Quote
I did not disclose Kratom, as I knew that they had not idea what it was and they'd be quick to blame it. I wanted to get all tests first.

I was released with a 'no raw seafood' warning, since it was my last meal before this (my wife ate the exact same thing I did, and she was fine) as a testament of the doctor's absolute ignorance as to what was wrong with me.

And that guy was a dumbass. Always tell the doctors EVERYTHING you know, don't make them guess.
"Chemistry is pornography in disguise, you just have to know which functional group to look at."
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"If we knew what we were doing, it wouldn't be called research."
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Offline Papyrifera

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #5 on: March 20, 2012, 10:47:35 am »
When you say "spiked leaf" are you implying there might actually be something added to the leaf, like kratom extract or a synthetic of some kind? That would be worrying to me.

The "Maeng Da" I got that made me feel gross, it felt more stimulating to me, but lacking any of the warm-fuzziness I associate with kratom. It kind of reminded me almost of amphetamine, just kind of jittery and made me feel almost sick to my stomach after only a few sips. I usually enjoy the more stimulating strains, but that batch just didn't do it for me. I ended up giving it to a friend who sells kratom, and he reported  that my batch was less potent than what they were used to getting (through a different supplier). Confusing...

Last time I had Maeng Da, was at my friends house (with the more potent stuff) and I didn't like it that time because again it made me feel nauseous and kind of gross after a few sips, but he had triple-decocted the stuff into a brew as bitter as hell, so it may be that such strong kratom tea was just too much for me (I usually don't decoct it, but just stir the powder into hot tea to slow down ingestion). Another guy drank kratom with us that night, the equivalent of 12 grams, he had done 8 grams worth the night before and been fine, but 12 grams was too much for him - he puked I think three or four times that night, poor guy.  :-(
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Offline ST1R

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #6 on: March 20, 2012, 02:03:40 pm »
No, "spiked leaf" is a description of the physical difference between the "maeng da/riau" leaf vs. the average koth kratom leaf. The spiked leaf has a small little spikes up the sides. Here I'll attach a pic which should clear up the confusion.

weird it won't let me attach them.

Just do an image search and you should quickly see what I'm saying.
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Offline Papyrifera

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #7 on: March 20, 2012, 02:34:36 pm »
Ahh, so it's actually a variety with a different leaf morphology that's called maeng da? Interesting.

It would be neat to do some scientific studies comparing different varieties/strains of kratom and seeing how they compare chemically, many plants can be split into different chemotype groups, which may or may not correlate with groupings based on other aspects of their morphology.
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Offline ST1R

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #8 on: March 20, 2012, 09:50:33 pm »
Exactly!
I know that region seems to effect the feel too but that could be due to separate subspecies or different fertilizers in the soil being converted slightly different or god know what else.

Oh and BTW "Maeng da" is just one wholesalers made-up name that happened to catch on more than others. "Indo," "Riau" and several other names are the same "spiked" plant material.
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Offline Papyrifera

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #9 on: March 21, 2012, 01:55:37 am »
I had a feeling vendors might just make up cool sounding names for their kratom, as a marketing technique. I used to know a guy who dealt weed, and he would do the same thing. If he got a mystery strain of weed, he would just make up a name for it.

"This stuff is called R.T." he would say,

"Oh yeah? What's that stand for?"

"Reginald Thomas".  :roll:
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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #10 on: June 02, 2012, 08:14:29 am »
You make a good point that when getting an "extract" you don't really know what might have been put in it...

Interesting you mention the Maeng da, ST1R, as that is actually a strain that makes me feel gross when I take it, even a few sips gives me stomach cramps.

Yes, one used to get the extracts off line. However, the cost and such let one to start prepping one's oun extract. That way one can be sure that an 8X is 8X, and the 8X prep'd from leaf was about as strong as the 15X one got off line.
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Offline GaryJ

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #11 on: June 02, 2012, 01:55:39 pm »
Different strains of kratom may have widely different alkaloidal profiles, so be cautious when you try new strains.

Maeng Da is quite different from the 'basic Bali' that most people are used to... most find it more stimulating, some have a contrary reaction and find it sedating.

Kratom does slow down the guts, and you have to be careful with constipation.  Taking 'stool softeners' is a good policy if it is giving you trouble.

I know of no evidence of liver problems associated with kratom use.  Use "pure leaf" kratom, avoid strong extracts to avoid developing tolerance.  Shun adulterated headshop crap. Experiment with different strains and find out what strains work best for you.

Kratom is a wonderful plant-helper tool.  It has helped people treat their withdrawal symptoms and thus get off of opiates.  It can be a great anodyne for fatigue and anxiety, giving energy and a benign uplift of mood.

[Can you tell that I am a kratom fan?  I have been taking it since about 2004, and it has helped me in many ways as a mood and energy management tool that does not have the drawbacks of your usual 'uppers and downers.']

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Offline Papyrifera

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #12 on: May 12, 2013, 08:10:46 pm »
I'm reposting this report from bluelight, another case of liver issues probably related or caused by kratom use. Though these reactions seem rare, I've run across a few such reports and it's good to keep in mind from a harm reduction perspective.

source: http://www.bluelight.ru/vb/threads/676106-Kratom-induced-liver-injury

Quote
Kratom induced liver injury 

11-05-2013 14:17
samsavenger

so basically I'm currently recovering from a bout of hepatic cholestasis (liver injury) brought about by a few recreational doses of powdered kratom. It fucking blows.
 
Just to give some background - test results in the past have suggested that I have a somewhat sensitive liver. My bloodwork showed elevated liver enzymes for a period of about 3 weeks approx 18 months ago during a period of stress induced migraines and subsequent over-use of NSAID’s, though the cause is not completely clear. This was resolved after total cessation of NSAID’s and alcohol, and my blood work returned to normal after a short time. The past 18 months have been fine and my bloodwork has been normal. I'm 26, totally healthy, I don't have a drug habit, I don't smoke and I don't drink excessively or regularly.
 
I first used fresh Kratom in Thailand with no adverse effects. A local friend of mine bought a bag of fresh leaves from a truck driver and gave me a couple. It was very mild and not particularly noticeable. A couple of weeks later, a guy I met in a rural area offered me some pungent red liquid he’d brewed with homegrown kratom. I really felt the effect this time, but again, no adverse effects.
 
When I got back home to the Netherlands, I found a reputable online vendor and promptly ordered a small amount of finely powdered “thai”, “bali” and “borneo white” strains. The smell was slightly familiar, but quite different to the fresh kratom I’d had overseas. I first tried 3 grams of the thai just to get a feel for the dose. was comparable to the second time I had it in Thailand. A couple of days later I tried another few of grams with much the same effect. It was mostly unremarkable, but pleasant. I figured I’d experiment more when I had the time and put the rest aside for a rainy day.

3 weeks later, my girlfriend and I cooked up a batch of “bali” strain in a pot with boiling water (about 10 grams each, or whatever 3.5 teaspoons is). The taste was awful, the texture worse... but to my pleasant surprise, it was highly enjoyable. We spent the night sitting around listening to records in a state of euphoric sedation. It was still quite mild in comparison to heavy opiates, we were still 100% lucid and coherent. A glass of wine and a joint amplified things a great deal though. Very interesting body feeling, incredible warmth and fantastic dream-like ‘nods’ reminiscent of a moderate dose of opiates. Closing my eyes for a moment would take me into incredibly vivid dreams about my childhood home, platters of spinning colours or rolling green fields with familiar faces laughing and flying kites... This was great. awesome, cheap, relatively non-addictive organic opiate-like herb. right up my alley. I thought I’d hit the jackpot.
 
A few nights later, I repeated it exactly. The effects were the same. Just wonderful stuff I thought. The next week I had a little more. There was definitely no craving or sense of longing for the feeling, but it was certainly an enjoyable thing to relax after a big day. Over the course of about 2 weeks, I took kratom about 5 times - around 10 grams each time, never dosing more than once in a 48 hour period. Throughout this period I was using no medication, no drugs aside from weed and barely drinking alcohol.
 
After a usual enjoyable night with kratom and a glass of wine, I awoke the next morning feeling incredibly nauseated. I figured I was getting sick and carried on with my day. Eventually I was overcome with overwhelming nausea and went home. I couldn’t eat and I couldn’t shit. I tried eating a banana and puked almost instantly.

I dragged myself to the doctor the next day, dehydrated and in poor shape. They took a blood test and found that my liver enzymes were through the roof. I was sent home with strict orders to go to hospital if symptoms worsen.

A couple of days later I became incredibly jaundiced and could do nothing but lie in bed shaking and sweating. The itching was fucking unbearable. My shit was like sharp grey rocks. My piss was brown, cloudy and burned like a motherfucker. My kidneys were radiating pain throughout my body and I had barely eaten a thing in 3 days. I was admitted to hospital that night. After extensive blood tests and several ultrasounds, I tested negative for all common liver diseases and showed no signs of gallstones, bile duct obstruction or anything else likely to cause such a reaction. My liver enzymes were literally off the charts.
 
Doctors in the Netherlands tend to take a fairly neutral and objective approach to drug use, so I was open and straightforward with the specialist about using kratom, which is quasi-legal here like most other things. He'd come across it before and was convinced that it was probably benign, just as I was. All the doctors were very baffled. In the absense of all known liver diseases, alcoholism, NSAID use and with gradually subsiding symptoms after cessation of kratom use - over the course of the week the doctors painstakingly and reluctantly isolated kratom as being the cause of my condition. Samples of the powdered kratom showed no obvious contaminants, but there is still a chance that I had taken a batch that had been contaminated with something that wasn't detected, probably not though. I hadn't known this before, but near-identical occurrences have been fairly well documented in medical literature with regards to hepatic toxicity of kratom. This study in particular bears remarkable similarity to what happened to me - http://link.springer.com/content/pdf...011-0155-5.pdf
 
I was discharged from hospital with a diagnosis of a drug-induced hepatic injury causing severe biliary cholestasis. There’s a strong chance that my liver would have failed (i.e. death) had I taken any more. A month later my jaundice has gone and I’m able to eat. I’m still feeling fatigued, weak, still experiencing abdominal pains and my liver enzymes are still abnormally high. I've lost 10 kilos and I feel like shit.. It's been very painful and it's probably going to take me a while to recover completely.
 
I regret being stupid enough to have thought that recreational use of kratom was safe, I advise anyone considering using it to take extreme caution as it seems that severe hepatic toxicity can occur in minimal recreational use with normal dosage. This crap has done totally disproportionate damage to my body considering the amount I used, not fun at all. If you don't want to take my word for it, take a look at the multiple published medical articles and erowid trip reports which show heavy correlations between liver injury and recreational kratom use. my advice is stay the hell away.
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Offline 2a

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #13 on: May 13, 2013, 07:59:34 am »
I wonder if there's some genetic susceptibility here.  kratom isn't exactly uncommon, and many people use large amounts regularly with no problem.  but then these cases pop up where rather light use over a short period of time wreaks havoc.  the cases weren't isolated either, nor do they appear to be batch-related, so individual differences are about the only thing left.
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Offline Papyrifera

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Re: Kratom and possible Stomach/Intestinal Upset and Liver problems?
« Reply #14 on: May 14, 2013, 08:24:48 am »
I'm thinking the same thing, kratom has a diverse alkaloid profile and we know that everyone metabolizes things differently. A genetic difference leading to a deficient or faulty liver enzyme could make all the difference.
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