Kratom, and other “natural” substances like it, are being promoted heavily online as treatments for diabetes and conditions including opioid addiction despite a lack of scientific evidence and their known addictive qualities.
The February 6 warning by the U.S. Food and Drug Administration about the use of kratom for treating diabetes, and particularly type-diabetes, may have caught many people by surprise. Its warning was blunt and blanket: that kratom is neither effective or safe for the treatment of any condition.
Kratom is the common name for a species of tropical evergreen tree in the coffee family, Mitragyna speciosa. It is indigenous to the western region of Southeast Asia, from Burma to Thailand, Malaysia, and Indonesia and as far into the south Pacific as Papua New Guinea. It has been used for medicinal and other purposes in those regions since at least the 19th century.
Its active ingredient is in the leaves and has been extracted and processed in various forms. The reason the FDA even expressed an opinion about it is that it has been and still is being sold in other countries, particularly in the West, as a food supplement, usually in capsule form and most often combined with other ingredients.
Perhaps the most important thing to know about it is that very little is known about it. Research about its therapeutic qualities has been meager and of generally poor quality.
Readers of the English-language press in Southeast Asia are aware of it primarily for the frequent headlines about its illegality and the arrests of people selling it commercially. In Thailand it is a Category V drug, the category for a class of narcotics that also includes marijuana.
Its casual use in the rural regions of Southeast Asia mirrors that of the betel leaf, with which it is sometimes confused. There is a wide range of plants that qualify as betel, which is typically chewed and recognizable to foreigners by the rusty-blood-colored spittle its users expectorate everywhere, their mouths and teeth stained the same color.
In India, there are species of the betel leaf that are so nontoxic and medically benign that they are served as a dessert wrapping for other sweet and savory ingredients. Other species yield a highly addictive drug whose effects are strong and more along the lines of an opioid, bringing, alternatively, the effects of a sedating narcotic or of a powerful, amphetamine-like stimulant.
Kratom in its natural form is similarly considered to have sedative, pain-killing, and stimulant qualities and is used both in traditional medicine and home entertaining. It is considered by some to be a preventative for diabetes, and in other cases a treatment for insulin resistancee. And it is garnering new attention in the West as a treatment for withdrawal from opioid addiction.
Kratom and the treatment of diabetes
The FDA advisory does not specifically address the use of kratom in regulating insulin sensitivity. Lyndsay Mayer, an FDA spokeswoman is on record as saying:
“Because this product has not been reviewed for safety or efficacy, we have no information on what people with diabetes specifically should know about using this product. Our general warning stands: The FDA is urging all consumers not to use kratom products.”
The reason for the warning is clear. Kartom and its derivatives, usually in combination with other substances, remain available in Western markets as a “natural” alternative to insulin or in other ways a regulator of blood-glucose levels. Kratom increasingly appears on diabetes "user" blogs and websites, indicating that people are experimenting with it.
The FDA claims that people who have turned to it typically have done so with “disastrous” results.
Further, it can’t be said strongly enough that any attempts to bring the leaves or their derivatives back from Southeast Asia in their “pure” form could have disastrous legal consequences. Authorities are familiar with products and on the lookout for them. Possession is likely to result in imprisonment and, at a minimum, deportation with a re-entry ban for life.
Claims about kratom’s efficacy in treating diabetes
Claims for the efficacy of kratom in the treatment of diabetes appear almost exclusively on discussion boards and on websites in which the word kratom appears. Examples are ilovekratom.com and buykratombulkusa.com. Personal testimonials notwithstanding, there is no scientific basis for the claims.
The main claim for kratom’s efficacy in the treatment of diabetes is that it can promote weight loss, due to its stimulant, and amphetamine-like effects. Because weight reduction and control are acknowledged—and medically advised—aspects of the management of diabetes, kratom’s alleged capacity to lower weight is deceptively seen as unambiguously beneficial.
A typical claim cites U.S. Drug Enforcement Agency “research that shows that Kratom can help with weight loss,” while beginning the following sentence with “Although they [the DEA] criticize its weight loss effects.” Another site notes that kratom is better known for its stimulant and analgesic properties, which could also be useful for diabetics suffering from peripheral neuropathy.”
There is an unmistakable "conspiracy theory" element in the language of almost all of the online endorsements of kratom—and in the treatment of diabetes in particular. The thinking advances the idea that "Big Phrama" doesn’t want a treatment or cure for diabetes, which would cut into its profits selling patented drugs to treat it, and to keep diabetes a chronic condition, assuring ongoing sales. By the same token, it is alleged that Big Pharm doesn’t want people to know about the plants it uses to make or synthesize its pharmaceuticals.
What is overlooked, when it is mentioned at all, is one of the reasons drugs to treat insulin resistance are calibrated for long-term use is that they are not, per se, addictive. It is precisely the “feel-good” qualities of kratom that not only makes it addictive for most users but also causes various degrees of kratom poisoning, sometimes fatal.
Take no dietary supplements that your doctor—or a qualified one—does not know you are taking. The real concerns go beyond the known addictive qualities of kratom.
Because of its illegality, it is, besides being dangerous in itself, krtaom is sure to be readily available only in combination with other substances, about which even less is usually known. “Pure” kratom is remarkably bitter and therefore, even in “native cultures,” usually ingested with some form of an offsetting sweetener. The hazard for people with diabetes could hardly be clearer.
The responsible websites about kratom, and those promoting its use for medicinal reasons, acknowledge the other non-medical treatment for conditions such as diabetes, namely, appropriate diet scrupulously adhered to and an a regime of regular physician-approved exercise regularly and routinely practiced.
Given the ongoing and, by all appearances, escalating crisis of opioid addictions in developed countries, internet “news” about kratom’s “powers” to replace opioids or help with withdrawal from them is sure to keep pace. To put it bluntly, what is usually left out of the promotion of substances like kratom is that, in their source countries, they are the “poor people’s cures.”
Given the alternatives, including the non-medical, lifestyle-oriented ones, outside these “folk medicine cultures,” they are beset regarded as poor medicine. It’s unlikely that the resurgence of underground promotion of these substances is unrelated to the bans, advisories, and laws of developed countries.
Claims about the effectiveness of kratom in treating diabetes