If you read health news or visit vitamin stores, you may have heard about kratom. Kratom is a supplement that is sold as an energy booster, mood lifter, pain reliever and remedy for the symptoms of quitting opioids, called withdrawal. But the truth about kratom is not so simple. And there are safety problems linked to its use.

Kratom is an herbal extract that comes from the leaves of an evergreen tree called Mitragyna speciosa. The tree grows in Southeast Asia. Kratom users can chew the tree's leaves, swallow or brew dry kratom, or add the extract to a liquid.

People who use kratom report that at low doses, kratom acts as an upper, called a stimulant. That means it makes them more alert and gives them more energy. At higher doses, people who use it report that it reduces pain and makes them feel calm and less anxious, also called a sedative.

Some people take kratom to ease the symptoms of quitting opioids, called withdrawal. Kratom may be easier to get than prescription medicines. But it carries its own risk of addiction.

People who use kratom to relax or to be more social most likely think that kratom is natural and safe because it comes from a plant. But the amount of the active part in kratom leaves can vary greatly. So it's hard to know the effects of a given dose.

Some studies have found that some kratom sellers add more of the active ingredient than kratom naturally has. And because kratom products lack clear labels, it's not possible to know how much kratom people who use it take.

Kratom starts to work in minutes. The effects last a few hours. The more kratom you take, the stronger the effects are.

Depending on the amount of active ingredient in the product and the health of the user, taking kratom can be harmful. There are too few studies to be able to rate the claims about the benefits of kratom.

People who take kratom believe that it helps them. But kratom hasn't been shown to be safe or to treat any medical conditions. The U.S. Food and Drug Administration (FDA) has warned people not to use kratom because of possible harm it can cause. The U.S. Drug Enforcement Administration calls kratom a drug of concern.

Poison control centers in the United States received more than 3,400 reports about use of kratom from 2014 through 2019. These included reports of death. Side effects reported included high blood pressure, confusion and seizures.

Kratom has known side effects, including:

• Weight loss.
• Dry mouth.
• Nausea and vomiting.
• Constipation.
• Liver damage.
• Muscle pain.
• High blood pressure.

Kratom also affects the mind and nervous system. It causes:

• Dizziness.
• Drowsiness.
• Smells, tastes, sights, touches or sounds that seem real but aren't, called hallucinations.
• False beliefs, called delusions.
• Depression.
• Trouble breathing.
• Confusion, tremors and seizures.

Kratom products have been linked to a small number of deaths. That's small compared with deaths from other drugs. Nearly all deaths from kratom also involved other drugs or substances that might have been harmful.

Many of the problems linked to pain medicines happen when people take them at high doses or for a long time. Experts don't know what level of kratom can cause those problems. People can overdose with kratom, but it's rare.

Researchers continue to study the effects of kratom. Studies so far have found that kratom has many safety issues.

Kratom has been reported to react with other medicines. This may lead to severe effects, such as liver damage and death. More research is needed.

In a study testing kratom as a treatment for symptoms of quitting opioids, called withdrawal, people who took kratom for more than six months reported withdrawal symptoms like those from opioid use. And people who use kratom may begin craving it. They may need treatments given for opioid addiction, such as buprenorphine (Brixadi, Sublocade, others) and buprenorphine-naloxone (Suboxone, Zubsolv).

Kratom also affects babies during pregnancy. When a pregnant person uses kratom, the baby may be born with symptoms of withdrawal and need treatment.

Kratom products have been found to have heavy metals, such as lead, and harmful germs, such as salmonella, in them. Salmonella poisoning can be fatal. The FDA has linked more than 35 deaths to salmonella-tainted kratom.

Kratom is not regulated in the United States. But federal agencies are taking action to fight false claims about kratom. In the meantime, your safest choice is to work with your healthcare professional to find other treatments.