Is Kratom Bad for Your Liver?

Short answer

Yes, kratom can be bad for your liver. Liver injury from kratom is uncommon, but it's real: a 2026 review found 32 published cases, and a few people needed a liver transplant. The FDA lists liver toxicity among the reasons it warns people not to use kratom.

Kratom comes from the leaves of a Southeast Asian tree and is not approved by the FDA for any medical use. For background, see our guide: what is kratom.

What the research shows

Most of what's known comes from case reports, so researchers can't say how often kratom harms the liver.

• US cases: the Drug-Induced Liver Injury Network studies liver damage from drugs and supplements. It attributed 11 cases to kratom, and cases became more common over time. Everyone had symptoms and jaundice. Jaundice started a median of 14 days after they began using kratom, and the median age was 40. Most needed hospital care, and all recovered.

• Published cases worldwide: a 2026 review found 32 cases. Most were cholestatic, meaning bile couldn't flow normally out of the liver, and many people had jaundice. Most improved after stopping kratom, and 4 needed a liver transplant.

Many reports didn't carefully check whether kratom, rather than something else, caused the injury. Products can also differ, and people may take kratom with other substances. That's part of why the risk is hard to pin down.

Warning signs (jaundice, dark urine)

Kratom liver injury often shows up as:

• Jaundice (yellowing of the skin or the whites of the eyes)

• Dark urine

• Belly pain or nausea

• Tiredness that doesn't go away

• Raised liver enzymes on a blood test

These signs aren't specific to kratom. Other liver problems can cause them too, so tell your doctor everything you take.

Who's at higher risk

Researchers don't yet know who is most likely to have liver injury from kratom. In the US cases, most people were men, with a median age of 40, but that's a small group.

It makes sense to be extra careful if you:

• Already have liver disease

• Drink alcohol regularly

• Take other supplements or medicines that can affect the liver

• Use kratom often or in large amounts

If any of these apply, talk to a licensed doctor about your kratom use and whether you need a liver blood test.

When to seek care

If you notice jaundice or dark urine while using kratom, stop using it and get medical care the same day. A doctor can check your liver with a blood test and look for other causes.

Call 911 if someone has trouble breathing, won't wake up or has a seizure. For a possible poisoning, call Poison Control at 1-800-222-1222.

Stopping kratom after regular use can cause withdrawal. If you don't have liver symptoms but have used it heavily or for a long time, make a plan to stop with a licensed doctor. If you do have symptoms, stop and tell the doctor how much you've been using so they can help with withdrawal.

Is it worth a morning off and a clinic bill to ask whether your kratom use puts your liver at risk? Ask Doctronic first. The medical AI chat is free, and a video visit with a licensed doctor is $39. Doctronic doesn't treat addiction, but a licensed doctor on a Doctronic video visit can help with symptoms and refer you to addiction care.

Frequently Asked Questions

Can a blood test show liver damage from kratom?

Yes, it can show liver damage, but not what caused it. Liver tests can pick up raised liver enzymes. Your doctor uses your history, including your kratom use, and sometimes more tests to find the cause.

If my liver tests are normal, is kratom safe for me?

No. Normal tests mean your liver looks fine right now, not that kratom is safe. The FDA says kratom hasn't been shown to be safe for any use, and it also warns about seizures and substance use disorder.

Is kava safer for your liver than kratom?

No. Kava has its own record of severe liver injury, and the FDA warned about it in 2002. Some products combine the two. See how they compare in kava vs kratom.

The Bottom Line

Kratom liver injury is uncommon but can be serious. Watch for jaundice or dark urine, and get care the same day if you see them. If you use kratom and have liver disease or other risks, talk to a licensed doctor about a liver blood test.