A Comprehensive Review on Therapeutic Potential of Mitragyna speciosa (Kratom)
The study, "A Comprehensive Review on Therapeutic Potential of Mitragyna speciosa (Kratom) in Age-related Disorders," was co-led by corresponding authors Dr. Theebaa Anasamy of the Department of Pharmacy, Faculty of Medicine and Health Sciences, MAHSA University, Bandar Saujana Putra, Selangor, Malaysia, and Dr. Nur Irlia Sofea Mohammad Zamani and Dr. Faidruz Azura Jam of the Department of Pharmacology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia in The Open Medicinal Chemistry Journal.
An Ageing World and the Search for Better Treatments
Global life expectancy has risen from 51 to 73 years over the past six decades, and the number of people aged 80 and above is projected to triple by 2050, reaching 426 million. With this demographic shift comes a growing burden of age-related chronic diseases, including Alzheimer's disease, Parkinson's disease, type 2 diabetes mellitus, osteoarthritis, and cardiovascular disease. These conditions collectively affect hundreds of millions of people, impose enormous demands on healthcare systems, and are often managed with complex medication regimens that carry significant side effects, drug interactions, and limited long-term efficacy. Against this backdrop, there is understandable interest in plant-derived compounds that may act through multiple biological pathways simultaneously and offer a different therapeutic profile. Kratom, a tropical tree whose leaves have been chewed or brewed as tea for generations in Thailand, Malaysia, Indonesia, and Myanmar for pain relief and general wellness, has attracted scientific attention primarily because of its two main active alkaloids, mitragynine and 7-hydroxymitragynine, which interact with opioid receptors to produce analgesic, mood-modulating, and potentially neuroprotective effects.
What the Science Shows Across Five Disease Areas
The review, which drew on literature from PubMed, Scopus, and Google Scholar spanning 2000 to 2026, examined preclinical and clinical evidence across five age-related conditions. For type 2 diabetes, mitragynine and phenolic compounds in Kratom have been shown in laboratory studies to inhibit two digestive enzymes, alpha-glucosidase and alpha-amylase, that break down carbohydrates into glucose, potentially slowing the rate of glucose absorption after meals. A small human crossover study of ten participants also reported a reduction in postprandial blood glucose following acute Kratom tea consumption, though the authors note this is far from sufficient to support a clinical claim. For Alzheimer's disease, preclinical studies suggest Kratom alkaloids may suppress neuro inflammation, reduce oxidative damage to neurons, and inhibit acetylcholinesterase, an enzyme whose overactivity is directly linked to the memory and cognitive deficits that characterise the disease. For Parkinson's disease, a zebrafish study found that alkaloid-rich Kratom extract preserved dopaminergic neurons against chemical-induced damage and improved locomotor function, though the review is careful to note that this reflects an acute toxin model rather than the slow, progressive neurodegeneration that occurs in human Parkinson's disease. For osteoarthritis, the primary evidence relates to Kratom's analgesic and anti-inflammatory properties, including inhibition of COX-2 and suppression of inflammatory mediators such as TNF-alpha and IL-6, which may translate to pain relief and reduced joint inflammation, though direct evidence from disease-specific studies is limited. For cardiovascular disease, the picture is genuinely mixed: observational data from Kratom-using populations in Southeast Asia suggest modestly improved lipid profiles, including higher HDL and lower triglycerides, but preclinical studies have also identified a concerning risk of cardiac arrhythmia through inhibition of the hERG potassium channel, which regulates electrical repolarisation of the heart muscle. The authors conclude that the potential lipid-related cardiovascular benefits are outweighed by the clinically significant and potentially fatal risk of arrhythmias, particularly in elderly individuals who already have reduced cardiac reserve.
Serious Risks and a Long Road Before Clinical Use
The review does not shy away from the substantial safety concerns associated with Kratom. Its primary alkaloids have opioid-like properties that carry real risks of dependence, tolerance, and withdrawal, including muscle pain, irritability, diarrhoea, and insomnia upon cessation. Hepatotoxicity has been documented in case reports, with a typical onset of around three weeks and clinical features including jaundice, dark urine, and elevated liver enzymes. At the pharmacokinetic level, Kratom alkaloids are potent inhibitors of the CYP3A4 and CYP2D6 enzymes that metabolise a large proportion of commonly prescribed drugs, including statins, Alzheimer's medications such as donepezil, and antipsychotics, meaning that elderly patients on multiple medications face a particularly high risk of clinically significant drug interactions. Quality control of commercially available Kratom products is also a serious problem: contamination with heavy metals, synthetic opioids, and microbial agents has been documented, and without standardised manufacturing and third-party testing, the exposure any individual receives cannot be reliably quantified. The authors call for well-controlled clinical trials with clearly characterised and standardised products, dose-response studies in older adult populations specifically, and a regulatory framework that enables research while protecting consumers.
Article title: A Comprehensive Review on Therapeutic Potential of Mitragyna speciosa (Kratom) in Age-related Disorders
DOI: 10.2174/0118741045472078260819050435
Read the published article here: https://bit.ly/4dmiI0r
The Open Medicinal Chemistry Journal
10.2174/0118741045472078260819050435
Systematic review
A Comprehensive Review on Therapeutic Potential of Mitragyna speciosa (Kratom) in Age-related Disorders