Evaluation of the Mitragynine Content, Levels of Toxic Metals and the Presence of Microbes in Kratom Products Purchased in the Western Suburbs of Chicago

Abstract

Kratom (Mitragyna speciosa, Korth) is a tree-like plant that is indigenous to Southeast Asia. Kratom leaf products have been used in traditional folk medicine for their unique combination of stimulant and opioid-like effects. Kratom is being increasingly used in the West for its reputed benefits in the treatment of pain, depression and opioid use disorder. Recently, the United States Food and Drug Administration and Centers for Disease Control have raised concerns regarding the contamination of some kratom products with toxic metals (Pb and Ni) and microbes such as Salmonella. To further explore this issue, eight different kratom products were legally purchased from various “head”/”smoke” shops in the Western Suburbs of Chicago and then tested for microbial burden, a panel of metals (Ni, Pb, Cr, As, Hg, Cd), and levels of the main psychoactive alkaloid mitragynine. All of the samples contained significant, but variable, levels of mitragynine (3.9–62.1 mg/g), indicating that the products were, in fact, derived from kratom. All but two of the samples tested positive for the presence of various microbes including bacteria and fungi. However, none of the samples tested positive for Salmonella. Seven products showed significant levels of Ni (0.73–7.4 µg/g), Pb (0.16–1.6 µg/g) and Cr (0.21–5.7 µg/g) while the other product was negative for metals. These data indicate that many kratom products contain variable levels of mitragynine and can contain significant levels of toxic metals and microbes. These findings highlight the need for more stringent standards for the production and sale of kratom products.

Multiorgan Dysfunction Related to Kratom Ingestion

“…has been recognized in the literature, but thorough testing for Salmonella in our patient was negative. 10 The syndrome of drug-induced colitis has well described; histopathological findings of drug-induced colitis are nonspecific and can be similar to ischemic colitis, which may present a diagnostic dilemma. 11 To the best of our knowledge, this is only the second reported patient to require orthotopic liver transplantation for acute liver failure as a consequence of kratom ingestion.…”

Kratom Use Within the Context of the Evolving Opioid Crisis and the COVID-19 Pandemic in the United States

“…This discrepancy suggests that the problem might not be related to the toxicity of kratom per se, but rather the poor quality of some kratom products being sold in the West, including the United States. Various studies indicate that many kratom products may be adulterated with other drugs or be contaminated with toxic metals and infectious microbes (Prozialeck et al, 2019;Prozialeck et al, 2020). In addition to the potential for acute toxicity, kratom can produce a state of physical dependence for which the term "kratom use disorder" has been coined.…”

Can Kratom (Mitragyna speciosa) Alleviate COVID-19 Pain? A Case Study

“…An established quantitative liquid chromatography mass spectrometry method was conducted (62) and found that the sample obtained from the patient is kratom due to the presence of mitragynine (102 mg/g kratom powder) and 7-hydroxymitragynine (0.8 mg/g kratom powder). The extracted kratom sample was analyzed for the presence of 13 opioids and 8 benzodiazepines by comparing the chromatograms to those of the reference mixtures Pain Management Multicomponent Opiate Mixture-13 solution and Benzodiazepine Multi-component Mixture-8 solution.…”