Re: kratom

#16
Ein Bekannter von mir, in früheren Jahren exzessiver Kratom Gebraucher, entwickelte in seiner aktiven Zeit eine Leberinsuffizienz mit Erhöhung der Transaminasen, also der klassischen Leberwerte mit unklarer Genese. In der folgenden Zeit der Abstinenz normalisierten sich seine Leberwerte wieder. Heute bin ich über den folgenden Bericht über mögliche Leberschädigungen gestolpert.

Liver Experts Sound Alarm on Kratom

Boston—The Drug-Induced Liver Injury Network (DILIN) is raising concerns about patients presenting with severe liver disease after consuming kratom, a botanical product with opioid-like effects that has become increasingly popular in the wake of the opioid epidemic.

Derived from the Mitragyna speciosa, an evergreen indigenous to Southeast Asia, kratom triggers opioid receptors, acting as a stimulant in low doses but a sedative/hypnotic agent in higher doses. In 2018, researchers identified at least five people in the DILIN database who had experienced liver injury after consuming kratom. That was up from one in 2016, they reported.

“I think that all providers and consumers should be aware that this product is out there and is quite accessible,” said Victor J. Navarro, MD, the chief of hepatology at the Einstein Healthcare Network in Philadelphia, who presented the findings at the 2019 Liver Meeting of the American Association for the Study of Liver Diseases (abstract 212). “From the perspective of the DILIN, we feel this is a bellwether that not only are we seeing increased use of kratom, but that liver injury might be one characteristic of its use.”

To help describe kratom-associated hepatotoxicity, Dr. Navarro and his colleagues examined 404 cases of herbal and dietary supplement–associated liver injury in the DILIN between 2004 and 2018. Of these, eight were associated with products containing kratom: two in 2008, one in 2016 and five in 2018.

A causal association with kratom was established in seven of the eight cases (median age, 46 years; range, 25-70 years). Six cases occurred in men.

In five of the eight cases, patients reported having used kratom for its psychotropic effects; one said they took it for joint pain. The products were used for a median of 22 days (range, 15-49 days) before the onset of liver injury. Five patients had jaundice, six itching, five abdominal pain and three fever; none had rash.

Median laboratory values among the eight patients were as follows:

alanine aminotransferase at onset: 326 U/L (range, 52-588 U/L);
aspartate aminotransferase: 154 U/L (range, 29-367 U/L);
alkaline phosphatase: 292 U/L (range, 181-365 U/L); and
total bilirubin: 9.5 mg/dL (range, 5.2-36.2 mg/dL).

The corresponding peak values of these results were 362 U/L, 154 U/L, 294 U/L and 20.1 mg/dL. The median R value at onset was 3.0 (range, 0.9-3.2), which the researchers said indicates mixed hepatocellular and cholestatic injury.

Two of the patients underwent biopsy, which demonstrated cholestasis. Although six patients were hospitalized, all recovered without a transplant. Three products underwent chemical analysis; all three had kratom compounds and no other toxins.

“I think the importance of disseminating this is very timely with the opioid epidemic,” said Meena B. Bansal, MD, a professor of medicine at Mount Sinai Medical Center, in New York City. “Physicians may be seeing an increased incidence of this and really need to be watchful.”

—Michael Vlessides

https://www.gastroendonews.com/FDA-Upda ... zfNwU0W31E

Re: kratom

#17
Nomad hat geschrieben:
2. März 2020, 21:01
Nach meinen Erfahrungen sind die mir bekannten Phytoopioide im großen und ganzen ziemlich sicher im Umgang.
Gibt es da noch wesentlich mehr als Kratom? Von einem oder zwei habe ich schonmal gehört, allerdings fallen mir die gerade auch nicht mehr ein.
„Sapere aude" ---laut der Übersetzung von Immanuel Kant; „Habe Mut, Dich Deines eigenen Verstandes zu bedienen!“

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