Why Mitragynine Is Just as Big an Issue as 7-Hydroxymitragynine (7OH)

When kratom is discussed, most of the attention zeroes in on one alkaloid: 7-hydroxymitragynine (7-OH). Advocates often suggest that the “natural” alkaloid mitragynine is benign, and that 7-OH is the true danger. But this framing is dangerously misleading. In reality, mitragynine itself is just as serious—and often more prevalent—a threat than 7-OH.

1. The Misconception

Kratom promoters frequently claim:

• “Mitragynine is safe.”

• “Only 7-OH causes addiction and danger.”

But studies show both are opioid-active compounds with serious risks of addiction, toxicity, and death—mitragynine included.

2. Mitragynine Is the Dominant Alkaloid

• Mitragynine makes up approximately 60–70% of the alkaloid content in kratom leaves—a majority share.   

https://proteopedia.org/wiki/index.php/Kratom?utm_source=chatgpt.com

https://www.nature.com/articles/s41598-020-76119-w?utm_source=chatgpt.com

• With such high prevalence, most kratom users consume far more mitragynine than 7-OH.

3. Mitragynine Converts Into 7-OH and More

• Mitragynine is metabolized in the liver by CYP3A enzymes into 7-hydroxymitragynine (7-OH)—a substantially more potent opioid.    

https://pmc.ncbi.nlm.nih.gov/articles/PMC6598159/?utm_source=chatgpt.com

https://www.sciencedirect.com/science/article/abs/pii/S0022356524004464?utm_source=chatgpt.com

https://www.mdpi.com/1420-3049/29/5/984?utm_source=chatgpt.com

• It can also be converted into mitragynine pseudoindoxyl, an even more potent opioid agonist.   

https://pmc.ncbi.nlm.nih.gov/articles/PMC7737207/?utm_source=chatgpt.com

https://en.wikipedia.org/wiki/Mitragynine_pseudoindoxyl?utm_source=chatgpt.com

This means: even if users “avoid” 7-OH in product form, their bodies may produce it—and even stronger opioids—after consuming mitragynine.

4. Toxicity Is Not the Same as Overdose

• Mitragynine has been linked to independent cases of fatal toxicity, including reports in Canada where high mitragynine levels were viewed as independently lethal.   

https://pmc.ncbi.nlm.nih.gov/articles/PMC6490129/?utm_source=chatgpt.com

https://www.sciencedirect.com/science/article/abs/pii/S246817091930102X?utm_source=chatgpt.com

• A 2024 study found dozens of deaths attributed solely to mitragynine exposure, with no other opioids present.

https://journals.lww.com/journaladdictionmedicine/fulltext/2025/05000/the_associations_of_kratom__mitragynine_%2C_opioids%2C.12.aspx?utm_source=chatgpt.com

These findings demonstrate that mitragynine alone can be fatal—without any involvement of 7-OH.

5. Addiction and Dependence

• Mitragynine is strongly tied to dependence and withdrawal symptoms, including cravings and opioid-like withdrawal—even when 7-OH levels are low.   

https://en.wikipedia.org/wiki/Mitragyna_speciosa?utm_source=chatgpt.com

https://www.theguardian.com/us-news/2023/jul/30/florida-woman-kratom-damages-judgment?utm_source=chatgpt.com

Users frequently report continued use driven by addiction to mitragynine itself.

6. Legal Fallout and Real-World Impact

• In 2023, the family of a woman in Florida was awarded over $11 million in damages after her death from acute mitragynine intoxication—underscoring its lethal potential. 

https://www.theguardian.com/us-news/2023/jul/30/florida-woman-kratom-damages-judgment?utm_source=chatgpt.com

• Meanwhile, 7-OH is now being classified as an emerging public health threat, with regulatory efforts—including federal scheduling and Florida’s emergency ban—highlighting its potency and risk.  

https://www.verywellhealth.com/7-oh-kratom-byproducts-11788990?utm_source=chatgpt.com

https://en.wikipedia.org/wiki/7-Hydroxymitragynine?utm_source=chatgpt.com

But while 7-OH draws headlines for its high potency, the fact that mitragynine is far more common—and converts into these potent metabolites—makes it equally critical to address.

Conclusion: Mitragynine Should Not Be Overlooked

The bottom line is clear:

1. Mitragynine is the most abundant kratom alkaloid.

2. It converts into stronger opioids inside the body.

3. It has caused deaths on its own.

4. It fuels addiction independently of 7-OH.

Any policy or public health response must treat mitragynine on par with 7-OH. Regulators, lawmakers, and families must stop assuming that “natural equals safe”—and recognize that mitragynine itself is a public health threat deserving urgent attention.

References (for internal use)

• Conversion of mitragynine to 7-OH in human and mouse liver:    https://pmc.ncbi.nlm.nih.gov/articles/PMC6598159/?utm_source=chatgpt.com

https://www.sciencedirect.com/science/article/abs/pii/S0022356524004464?utm_source=chatgpt.com

https://www.mdpi.com/1420-3049/29/5/984?utm_source=chatgpt.com

• Mitragynine pseudoindoxyl formation and potency:   https://pmc.ncbi.nlm.nih.gov/articles/PMC7737207/?utm_source=chatgpt.com

https://en.wikipedia.org/wiki/Mitragynine_pseudoindoxyl?utm_source=chatgpt.com

• Fatal mitragynine cases and toxicity:   https://pmc.ncbi.nlm.nih.gov/articles/PMC6490129/?utm_source=chatgpt.com

https://www.sciencedirect.com/science/article/abs/pii/S246817091930102X?utm_source=chatgpt.com

• Dozens of mitragynine-only death cases:  https://journals.lww.com/journaladdictionmedicine/fulltext/2025/05000/the_associations_of_kratom__mitragynine_%2C_opioids%2C.12.aspx?utm_source=chatgpt.com

• Prevalence of mitragynine in kratom:   https://proteopedia.org/wiki/index.php/Kratom?utm_source=chatgpt.com

https://www.nature.com/articles/s41598-020-76119-w?utm_source=chatgpt.com

• Adverse effects and dependency from mitragynine:  https://en.wikipedia.org/wiki/Mitragyna_speciosa?utm_source=chatgpt.com

• Legal case from Florida:  https://www.theguardian.com/us-news/2023/jul/30/florida-woman-kratom-damages-judgment?utm_source=chatgpt.com

• 7-OH regulatory pressures and public health classification:   https://www.verywellhealth.com/7-oh-kratom-byproducts-11788990?utm_source=chatgpt.com

https://en.wikipedia.org/wiki/7-Hydroxymitragynine?utm_source=chatgpt.com

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The Hidden Dangers of Kratom’s Alkaloids: 7-Hydroxymitragynine & Mitragynine