Kratom: What to know about the loosely regulated herbal drug
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What you need to know
- Kratom is a tropical plant that some people use to ease pain, anxiety, or symptoms of opioid withdrawal.ย
- Many people describe it as a natural and safe remedy. But kratom is not FDA-approved, and its claimed health benefits havenโt been proven in clinical trials.
- One of kratomโs active ingredients, 7-OH, has been linked to serious health risksโespecially when itโs highly concentrated or produced syntheticallyโprompting federal and state officials to consider regulations or bans.
In July, the Food and Drug Administration took the unusual step of recommending a nationwide ban on certain products made from kratom, a plant with opioid-like effects native to Southeast Asia. In the U.S., many people say it helps them manage pain, anxiety, or the difficult symptoms of opioid withdrawal. But researchers and regulators say kratomโs effects are still not well understood and that its risks may outweigh potential benefits. Hereโs what you need to know.
What is kratom?
Kratom leaves can be chewed, smoked, or made into tea to extract their medicinal and intoxicating effects. The plant contains two main compounds, mitragynine and 7-OH, that bind to the same receptors in the brain that respond to opioids like morphine, oxycodone, and fentanyl.
In natural leaf form, 7-OH appears only in tiny amounts. But when itโs made synthetically, it can be highly concentrated and much more potent. Some research suggests that concentrated 7-OH is more than 13 times stronger than morphine.
Many people assume kratom is safe because it is plant-based. But experts warn that โnaturalโ does not equal safe or healthy.
โPeople are really drawn to like these natural ways of overcoming everyday illness and problems because it feels like itโs a healthy option,โ said Suzette Glasner, a clinical psychologist and professor of psychiatry at UCLA, on her podcast.
But she cautioned that โkratom in and of itself, unless you really know what youโre getting, is not inherently safe.โ
Why do people use kratom?
Kratomโs popularity has surged over the last decade because it is far more accessible than similar drugs. In many states, anyone over the age of 18 can buy kratom products at gas stations, at smoke shops, or onlineโno prescription required.
A 2024 analysis of social media conversations found that people most often mentioned using kratom to help treat opioid withdrawal, anxiety, depression, and chronic pain.
Unlike opioids, kratom can also have stimulating effects, such as increased energy and focus.
But while these stories make kratom sound like a miracle drug, none of its alleged health benefits have been proven in clinical trials. Kratom is not approved by the FDA to treat any medical condition. As a supplement, it is not regulated or held to the same safety standards as prescription and over-the-counter medications.
What are the risks of kratom?
In August, Americaโs Poison Centers issued a health advisory after receiving reports of serious illnesses linked to 7-OH, including nausea, vomiting, rapid heartbeat, trouble breathing, loss of consciousness, and seizures. These concerns echo 2019 research suggesting kratom use is โassociated with significant toxicitiesโ and โposes a public health threat due to its availability as an herbal supplement.โ
Reports of kratom overdoses, including overdose deaths, have also made headlines in recent years. A Tampa Bay Times investigation identified nearly 600 kratom-related deaths in Florida between 2013 and 2022. In Los Angeles County, health officials reported multiple fatal overdoses linked to kratom earlier this year.
Most of these deaths involved more than one substance. A 2019 study in the U.K. found that 87 percent of kratom-associated deaths involved other substances. Mixing substances can increase the risk of dangerous side effects, even if each substance is seemingly safe on its own.
How is kratom regulated?
Kratom products are not currently regulated at the federal level, though that could soon change. The FDA has recommended classifying 7-OH as a controlled substanceโwhich would effectively ban its sale or use nationwide. FDA Commissioner Marty Makary emphasized that the ban would only apply to 7-OH, not kratom leaf products.
A patchwork of state laws already exists. Six statesโAlabama, Arkansas, Indiana, Louisiana, Vermont, and Wisconsinโand Washington, D.C., ban the sale and possession of kratom. At least 22 others have rules that include age minimums, labeling standards, and restrictions on 7-OH. Rhode Island recently became the first state to overturn an existing ban on kratom products.
As political pressure to restrict kratom mounts, some advocates argue that banning kratom entirely could push people who rely on it to manage withdrawal symptoms toward more dangerous street drugs. Others say thoughtful regulationโsuch as product testing and clear labelingโwould offer consumers better protection without criminalizing use.
For now, the FDA does not consider kratom โappropriate for use as a dietary supplementโ and warns against using it as a medical treatment.
This article first appeared on Public Good News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
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Maca Root’s Benefits For The Mood And The Ability
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Maca Root: What It Does And Doesnโt Do
Maca root, or Lepidium meyenii, gets thought of as a root vegetable, though itโs in fact a cruciferous vegetable and more closely related to cabbageโnotwithstanding that it also gets called โPeruvian ginsengโ.
- Nutritionally, itโs full of all manner of nutrients (vitamins, minerals, fiber, and a wide array of phytochemicals)
- Medicinally, itโs long enjoyed traditional use against a wide variety of illnesses, including respiratory infections and inflammatory diseases.
Itโs also traditionally an aphrodisiac.
Is it really anti-inflammatory?
Probably notโฆ Unless fermented. This hasnโt been studied deeply, but a 2023 study found that non-fermented and fermented maca root extracts had opposite effects in this regard:
However, this was an in vitro study, so we canโt say for sure that the results will carry over to humans.
Is it really an aphrodisiac?
Actually yes, it seems so. Hereโs a study in which 45 women with antidepressant-induced sexual dysfunction found it significantly improved both libido and sexual function:
โIn summary, maca root may alleviate antidepressant-induced sexual dysfunction as women age, particularly in the domain of orgasmโ
~ Dr. Christina Dording et al.
Read in full: A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women
As for men, well these mice (not technically men) found it beneficial too:
Effects of combined extracts of Lepidium meyenii and Allium tuberosum Rottl. on [e-word] dysfunction
(pardon the censorship; weโre trying to avoid peopleโs spam filters)
It did also improve fertility (and, actually in real men this time):
Does Lepidium meyenii (Maca) improve seminal quality?
Oh, to be in the mood
Hereโs an interesting study in which 3g/day yielded significant mood improvement in these 175 (human) subjects:
And yes, it was found to be โwell-toleratedโ which is scientist-speak for โthis appears to be completely safe, but we donโt want to commit ourselves to an absolutist statement and we canโt prove a negativeโ.
Oh, to have the energy
As it turns out, maca root does also offer benefits in this regard too:
(thatโs not an added ingredient; itโs just a relevant chemical that the root naturally contains)
Want to try some?
We donโt sell it, but here for your convenience is an example product on Amazon ๐
Enjoy!
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Cucumber vs Eggplant โ Which is Healthier?
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Our Verdict
When comparing cucumber to eggplant, we picked the eggplant.
Why?
In terms of macros, eggplant has 6x the fiber, as well as slightly more carbs and protein, making it the clear winner in this category.
In the category of vitamins, cucumber has more of vitamins A, C, and K, while eggplant has more of vitamins B1, B2, B3, B5, B6, B7, B9, E, and choline; an easy win for eggplant here.
When it comes to minerals, cucumber has more calcium, iron, and zinc, while eggplant has more copper, magnesium, manganese, and potassium; a marginal win for eggplant this time.
Looking at phytochemicals, the two vegetables are about equal here, with nothing especially noteworthy in their polyphenol profiles to set one ahead of the other. So, a tie.
Adding up the sections makes for a clear overall win for eggplant, but by all means enjoy either or both, as diversity is good!
Want to learn more?
You might like:
Some Surprising Truths About Hunger And Satiety โ our main feature in which we examine the science of volumetrics, including a study that shows how water incorporated into a food (but not served with a food) decreases caloric intake. So, cucumbers are great for this.
Enjoy!
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What Really Works For Anti-Aging? Science-Backed Skincare Ingredients
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Dr. Andrea Suarez, dermatologist, goes beyond her pet hate skincare myths (e.g. sunscreen causes cancer, tanning is healthy), and talks about how actually one of her biggest frustrations is people wasting money on ineffective skincare products.
She also details what works, according to the evidence:
Science vs hype
Dr. Suarez explains that the root causes of skin aging are sun exposure, lifestyle habits, and menopause-related hormone decline (as applicable). However, skin aging is not the same for everyone, as for example paler skin tends to show more wrinkling and yellowing while richly melanated skin resists wrinkling but develops more pigmentation and texture issues.
With this in mind, here are the products that she ranks as…
Best:
- Sunscreen is the most effective anti-aging product with strong evidence for reversing and preventing damage in all skin tones.
- Topical retinoids like tretinoin and adapalene improve collagen, reduce wrinkles, and even skin tone.
- Alpha hydroxy acids such as glycolic acid and ammonium lactate exfoliate and hydrate, improving texture and skin thickness.
- Niacinamide is a marvelously multitasking antioxidant that improves moisture, dark spots, redness, and sallowness.
- Vitamin C works best in the form of stable ascorbic acid combined with vitamin E and ferulic acid.
Questionable:
- Topical peptides may hydrate and reduce water loss but lack strong evidence for significant anti-aging effects.
- Topical estrogen may boost collagen in menopausal skin but may also cause pigmentation and vascular changes.
Worthless:
- Growth factors are unlikely to be effective at all and probably act only as moisturisers
- Exosomes and PDRN lack clinical evidence and are mostly marketing hype
In short: an effective anti-aging skincare routine includes cleansing, moisturising, daily sunscreen, and possibly a retinoid. Also important are lifestyle factors like healthy diet, stress reduction, and avoiding smoking and alcohol. Thus, she bids us skip trendy products and stick with simple, proven ingredients used consistently.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesnโt Load Automatically!
Want to learn more?
You might also enjoy:
The Evidence-Based Skincare That Beats Product-Specific Hype โ in case you’d like a second opinion from another dermatologist
Take care!
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Green Coffee Bean Extract: Coffee Benefits Without The Coffee?
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Coffee is, on balance, very good for the health in moderation. We wrote about it here:
The Bitter Truth About Coffee (or is it?)
Some quick facts before moving on:
- Coffee is the worldโs biggest source of antioxidants
- 65% reduced risk of Alzheimerโs for coffee-drinkers
- 67% reduced risk of type 2 diabetes for coffee-drinkers
- 43% reduced risk of liver cancer for coffee-drinkers
- 53% reduced suicide risk for coffee-drinkers
Those are some compelling statistics!
But what about the caffeine content?
Assuming one doesn’t have a caffeine sensitivity, caffeine is also healthy in moderationโbut it is easy to accidentally become dependent on it, so it can be good to take a “tolerance break” once in a while, and then reintroduce it with more modest moderation:
Caffeine: Cognitive Enhancer Or Brain-Wrecker?
We also, for that matter, have discussed its impact on the gut:
Coffee & Your Gut โ surprise, it’s a positive impact
What if I don’t like coffee?
We suspect that, having seen the title of this article, you know what the answer’s going to be here:
Green coffee bean extract is the extract from green (i.e. unroasted) coffee beans. It has one or two advantages over drinking coffee:
- For those who do not like drinking coffee, this supplement sidesteps that neatly
- Roasting coffee beans destroys a lot (sometimes almost all; it depends on the temperature and duration) of their chlorogenic acid, a highly beneficial polyphenol; using unroasted (i.e. green) coffee beans avoids that
See: Role of roasting conditions in the level of chlorogenic acid content in coffee beans
All about GCE and CGA
That’s “green coffee extract” and “chlorogenic acid”, respectively, bearing in mind that the latter is found generously in the former.
As to what it does:
โCGA is an important and biologically active dietary polyphenol, playing several important and therapeutic roles such as antioxidant activity, antibacterial, hepatoprotective, cardioprotective, anti-inflammatory, antipyretic, neuroprotective, anti-obesity, antiviral, anti-microbial, anti-hypertension, free radicals scavenger and a central nervous system (CNS) stimulator. Furthermore, CGA causes hepatoprotective effects.โ
๐ Those are the things we know for sure that it does. And it may do even more things:
โIn addition, it has been found that CGA could modulate lipid metabolism and glucose in both genetically and healthy metabolic related disorders. It is speculated that CGA can perform crucial roles in lipid and glucose metabolism regulation and thus help to treat many disorders such as hepatic steatosis, cardiovascular disease, diabetes, and obesity as well.โ
Read in full: Chlorogenic acid (CGA): A pharmacological review and call for further research
About lipid metabolism…
- Green coffee extract supplementation significantly reduces serum total cholesterol levels.
- Green coffee extract supplementation significantly reduces serum LDL (“bad” cholesterol) levels.
- Increases in HDL (“good” cholesterol) after green coffee bean extract consumption are significant in green coffee bean extract dosages โฅ400mg/day.
About blood glucose and insulin…
- Green coffee extract supplementation significantly improved fasting blood sugar levels
- Green coffee extract supplementation at โฅ400ย mg/day significantly lowered postprandial insulin levels (that’s good)
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon ๐
Enjoy!
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Cannabis Myths vs Reality
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Cannabis Myths vs Reality
We asked you for your (health-related) opinion on cannabis useโspecifically, the kind with psychoactive THC, not just CBD. We got the above-pictured, below-described, spread of responses:
- A little over a third of you voted for โItโs a great way to relax, without most of the dangers of alcoholโ.
- A little under a third of you voted for โIt may have some medical uses, but recreational use is best avoidedโ.
- About a quarter of you voted for โThe negative health effects outweigh the possible benefitsโ
- Three of you voted for โIt is the gateway to a life of drug-induced stupor and potentially worseโ
So, what does the science say?
A quick legal note first: weโre a health science publication, and are writing from that perspective. We do not know your location, much less your local laws and regulations, and so cannot comment on such. Please check your own local laws and regulations in that regard.
Cannabis use can cause serious health problems: True or False?
True. Whether the risks outweigh the benefits is a personal and subjective matter (for example, a person using it to mitigate the pain of late stage cancer is probably unconcerned with many other potential risks), but whatโs objectively true is that it can cause serious health problems.
One subscriber who voted for โThe negative health effects outweigh the possible benefitsโ wrote:
โAt a bare minimum, you are ingesting SMOKE into your lungs!! Everyone SEEMS TO BE against smoking cigarettes, but cannabis smoking is OK?? Lung cancer comes in many forms.โ
Of course, that is assuming smoking cannabis, and not consuming it as an edible. But, what does the science say on smoking it, and lung cancer?
Thereโs a lot less research about this when it comes to cannabis, compared to tobacco. But, there is some:
โResults from our pooled analyses provide little evidence for an increased risk of lung cancer among habitual or long-term cannabis smokers, although the possibility of potential adverse effect for heavy consumption cannot be excluded.โ
Read: Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium
Another study agreed there appears to be no association with lung cancer, but that there are other lung diseases to consider, such as bronchitis and COPD:
โSmoking cannabis is associated with symptoms of chronic bronchitis, and there may be a modest association with the development of chronic obstructive pulmonary disease. Current evidence does not suggest an association with lung cancer.โ
Read: Cannabis Use, Lung Cancer, and Related Issues
Cannabis edibles are much safer than smoking cannabis: True or False?
Broadly True, with an important caveat.
One subscriber who selected โIt may have some medical uses, but recreational use is best avoidedโ, wrote:
โI’ve been taking cannabis gummies for fibromyalgia. I don’t know if they’re helping but they’re not doing any harm. You cannot overdose you don’t become addicted.โ
Firstly, of course consuming edibles (rather than inhaling cannabis) eliminates the smoke-related risk factors we discussed above. However, other risks remain, including the much greater ease of accidentally overdosing.
โVisits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.โ
Note: that โmore frequentโ for inhaled cannabis, is because more people inhale it than eat it. If we adjust the numbers to control for how much less often people eat it, suddenly we see that the numbers of hospital admissions are disproportionately high for edibles, compared to inhaled cannabis.
Or, as the study author put it:
โThere are more adverse drug events associated on a milligram per milligram basis of THC when it comes in form of edibles versus an inhaled cannabis. If 1,000 people smoked pot and 1,000 people at the same dose in an edible, then more people would have more adverse drug events from edible cannabis.โ
See the numbers: Acute Illness Associated With Cannabis Use, by Route of Exposure
Why does this happen?
- Itโs often because edibles take longer to take effect, so someone thinks โthis isnโt very strongโ and has more.
- Itโs also sometimes because someone errantly eats someone elseโs edibles, not realising what they are.
- Itโs sometimes a combination of the above problems: a person who is now high, may simply forget and/or make a bad decision when it comes to eating more.
On the other hand, that doesnโt mean inhaling it is necessarily safer. As well as the pulmonary issues we discussed previously, inhaling cannabis has a higher risk of cannabinoid hyperemesis syndrome (and the resultant cyclic vomiting thatโs difficult to treat).
You can read about this fascinating condition thatโs sometimes informally called โscromitingโ, a portmanteau of screaming and vomiting:
Cannabinoid Hyperemesis Syndrome
You canโt get addicted to cannabis: True or False?
False. However, it is fair to say that the likelihood of developing a substance abuse disorder is lower than for alcohol, and much lower than for nicotine.
See: Prevalence of Marijuana Use Disorders in the United States Between 2001โ2002 and 2012โ2013
If you prefer just the stats without the science, hereโs the CDCโs rendering of that:
Addiction (Marijuana or Cannabis Use Disorder)
However, there is an interesting complicating factor, which is age. One is 4โ7 times more likely to develop a substance abuse disorder, if one starts use as an adolescent, rather than later as an adult:
Cannabis is the gateway to use of more dangerous drugs: True or False?
False, generally speaking. Of course, for any population there will be some outliers, but there appears to be no meaningful causal relation between cannabis use and other substance use:
Interestingly, the strongest association (where any existed at all) was between cannabis use and opioid use. However, rather than this being a matter of cannabis use being a gateway to opioid use, it seems more likely that this is a matter of people looking to both for the same purpose: pain relief.
As a result, growing accessibility of cannabis may actually reduce opioid problems:
- Cannabis as a Gateway Drug for Opioid Use Disorder
- Association between medical cannabis laws and opioid overdose mortality has reversed over time
Some final wordsโฆ
Cannabis is a complex drug with complex mechanisms and complex health considerations, and research is mostly quite young, due to its historic illegality seriously cramping science by reducing sample sizes to negligible. Simply put, thereโs a lot we still donโt know.
Also, we covered some important topics today, but there were others we didnโt have time to cover, such as the other potential psychological benefitsโand risks. Likely weโll revisit those another day.
Lastly, while weโve covered a bunch of risks today, those of you who said it has fewer and lesser risks than alcohol are quite rightโthe only reason we couldnโt focus on that more, is because to talk about all the risks of alcohol would make this feature many times longer!
Meanwhile, whether you partake or not, stay safe and stay well.
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The Truth About Chocolate & Skin Health
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Itโs Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where weโve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future tooโthereโs always more to say!
As ever: if the question/request can be answered briefly, weโll do it here in our Q&A Thursday edition. If not, weโll make a main feature of it shortly afterwards!
So, no question/request too big or small
โWhat’s the science on chocolate and acne? Asking for a family memberโ
The science is: these two things are broadly unrelated to each other.
There was a very illustrative study done specifically for this, though!
โ65 subjects with moderate acne ate either a bar containing ten times the amount of chocolate in a typical bar, or an identical-appearing bar which contained no chocolate. Counting of all the lesions on one side of the face before and after each ingestion period indicated no difference between the bars.
Five normal subjects ingested two enriched chocolate bars daily for one month; this represented a daily addition of the diet of 1,200 calories, of which about half was vegetable fat. This excessive intake of chocolate and fat did not alter the composition or output of sebum.
A review of studies purporting to show that diets high in carbohydrate or fat stimulate sebaceous secretion and adversely affect acne vulgaris indicates that these claims are unproved.โ
Source: Effect of Chocolate on Acne Vulgaris
As for what might help against acne more than needlessly abstaining from chocolate:
Why Do We Have Pores, And Could We Not?
โฆas well as:
Of Brains & Breakouts: The Neuroscience Of Your Skin
And here are some other articles that might interest you about chocolate:
- Chocolate & Health: Fact or Fiction?
- The โLove Drugโ: Get PEA-Brained!
- Enjoy Bitter Foods For Your Heart & Brain
Enjoy! And while we have your attentionโฆ Would you like this section to be bigger? If so, send us more questions!
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