Research · 2026-01-16
Hematological and Clinical-Chemistry Parameters of Kratom Users: A Comparative Study of Users and Non-Users in Southern Thailand
Source: Scientific Reports (Nature)
Why it matters
Large cross-sectional study of 581 traditional kratom users in Southern Thailand finds no clinically significant hepatic or hematological toxicity after adjustment for confounding factors, contrasting with case reports from Western users. Findings suggest formulation, dosing pattern, and individual susceptibility may determine adverse outcome risk.
The big picture
Long-term traditional kratom use in endemic Southeast Asian communities shows different safety profile than concentrated Western products. While unadjusted analyses showed minor blood parameter differences, these disappeared after controlling for lifestyle factors (smoking, alcohol, BMI). Renal function markers were altered but attributed to body composition differences rather than direct nephrotoxicity.
Key findings
- No significant differences in liver function markers (AST, ALT, alkaline phosphatase, bilirubin) between 285 kratom users and 296 non-users after adjustment for confounders
- Kratom users showed lower serum creatinine (0.89 vs 0.99 mg/dL) and higher eGFR, likely reflecting lower BMI and muscle mass rather than improved kidney function
- Unadjusted hematological differences (WBC, RBC, platelets) became non-significant after controlling for age, sex, BMI, smoking, and alcohol use
- Long-term users (≥5 years) had lower glucose and HbA1c; higher consumption associated with lower creatinine and BUN
- All hematological and biochemical parameters remained within normal clinical reference ranges in both groups
What they say
""In this large-scale, cross-sectional study conducted among a traditional kratom-using community in Southern Thailand, we found no evidence of clinically significant hematological or hepatic abnormalities associated with chronic kratom use after robust adjustment for confounding variables."" — La-up et al., Mahidol University
Bottom line
**Traditional kratom use in endemic Southeast Asian communities shows no hepatotoxicity or hematological harm after adjustment for lifestyle factors; Western adverse events may reflect high-potency products, polysubstance use, or vulnerable populations.**