The history of Kratom: a summary of the use, pharmacology and health effects of a traditional and modern herb

The history of Kratom: a summary of the use, pharmacology and health effects of a traditional and modern herb

Kratom, with a scientific name Mitragyna Speciosa, is a tree that occurs mainly in South Asia, especially in Malaysia, Thailand and Indonesia. This tree reaches a maximum height of 25 centimeters (cm) at ripening and forms a characteristic oval lanceolate leaf shape. The leaves of this tree have a feathered vein that can be white, green or red. Kratom belongs to the family of coffee and has similar dose -dependent stimulating properties such as caffeine, but does not contain theophylline or caffeine.

Kratom has gained importance in the past two decades due to its opiate-like effects and dose-dependent stimulating properties, which are conveyed by the indolal alkaloids contained in the leaves. Historically, Kratom has been used in many Southeast Asian countries for centuries as a remedy and for recreational purposes. Typically, Kratom receives a common name in the region in which it is grown. Only the fresh leaves of the Kratome plant are chewed to achieve stimulating effects and reduce fatigue through hard work among fishermen, farmers or workers. In addition, Kratom was used to treat symptoms of substance use disorders, especially when the opium is withdrawn. The dried leaves are rarely used either to prepare a kettle or for smoking.

The use of Kratom is now prohibited in Malaysia and Indonesia, while Thailand allows the legal growth and consumption of the plant. However, Indonesia exports Kratom as cash crop to the United States and to several other countries. In Europe and the USA, Kratom is sold together with cannabidiol, cannabis and cava products that have all medical and leisure uses. In western countries, Kratom is mainly sold as loose powder, tablet or capsule. These Kratom products usually contain about 2% of MetePynin. In comparison, Kratom products with 7% and 40% MITRATYNIN are sold as a semi-solid resin, rubber or soft capsules. Traditionally, Kratom was used for anti-diarrholical, analgesic, antipyretic, antidiabetic and muscle-relaxing purposes. In the past ten years, Kratom has been used in young adults in Thailand in a homemade mixture called "4 x 100". This plant was also heated with coughing juices that contain diphenhydramine or codeine, and used with soft drinks with caffeine and used for oral intake.

Some of the adverse effects of the Kratom consumption are dehydration, weight loss, hyperpigmentation and constipation. Higher doses of Kratom can lead to lethargy and fatigue, combined with a higher risk of developing dependency and tolerance. In Thailand, rare cases of deaths were also reported by 4 x 100 mixtures.

Previous examinations have shown that Mitragynin and other Kratom-Indol-Alkaloids can serve as patented opioid agonist forerunners and could thus be developed into medication. Several in-vitro and in-vivo studies have also shown that Mobtrynin is a partial agonist of the μ-opio-receptor, together with antagonists of the δ-opio-receptor and κ opio). Some studies have also shown that MITRABYNIN can be converted into 7-hydroxy MITROGYNINE by some cytochrome P450 enzymes, which can explain some of its analgesic effects. Mitragynin has also been proven that it binds receptors with α-adrenergen, with the highest affinity for the α1a receptor and the lowest affinity for the α2B receptor. This connection can also bind to serotonin receptors 5-HT1A and 5-HT2B with low affinity, while two of its enantiomers can bind to these receptors with high affinity.

MITRABYNIN, which makes 66% of Kratom and thus represents a main active ingredient of this plant, can quickly be absorbed by the small intestine and have an impact within minutes. This connection has a terminal half -life of 23 hours and its concentration decreases within about four hours. Mitragynin is usually protein in the serum and is converted into at least seven different phase-i metabolites in the liver. In addition to Mitragynin, 25 other alkaloids were found in lower concentrations in Kratom.

Earlier in-vitro studies on rats showed that Mobendynin is the main alkaloid compound in Kratomex, which can reduce the activity of electroencephalography (EEG) in the parietal and frontal cortex. However, a recently carried out study showed that not only Mitragynin, but also other Kratom alkaloids for the analgesic effects and the pain processing of Kratom are essential. Clinical studies on Kratom are currently limited in many countries, since this means is not classified as medicinal products, Food or nutritional supplements. The US Food and Drug Administration (FDA), for example, has reported that Kratom and its alkaloids are opioid. The FDA banned the import of Kratom and warned the public about consumption.

Several self-reported surveys on Kratom have shown that the users of Kratom are predominantly male, non-Hispanic white Middle Ages, full-time or independent and with a medium-sized incoming. Many of these people use Kratom to treat a mental disorder or chronic pain.

Small doses of Kratom rarely have an impact on health, while larger doses can affect health. Unrest, seizures, vomiting, tachycardia or sedating/opioid -like effects occur during acute overdose. Increasing seizures were reported to a poison center in Thailand in 9% of cases on poison centers in the USA and in 16-18% of cases. The use of Kratom is also related to monomorphic or polymorphic ventricular cardiac arrhythmias. Polymorphic ventricular tachycardia could be due to the effect of Kratom on the QTC interval. In addition, several deaths were reported due to pulmonary congestion as a result of breathing depression after taking high concentrations of MITRABYNIN. Several cases of liver -related injuries by Kratom were also reported. Most patients