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Kratom is unregulated in the US. Products vary widely in strength, and some have been contaminated or adulterated. Here is what regulators, researchers and reporters have documented, with sources.
Documented Risks In The Kratom Market
Salmonella Contamination (2017-2018)
CDC counted 199 people in 41 states infected with outbreak strains of Salmonella linked to kratom. Of 132 people with available information, 50 (38%) were hospitalized. No deaths were reported. CDC posted its final update on May 24, 2018. Source: CDC final update.
Heavy Metals And Salmonella Warnings
FDA states it has warned the public when kratom products were contaminated with Salmonella or concerning levels of heavy metals. Source: FDA and Kratom (content current as of Dec 2, 2025).
Adulterated Products
A 2019 case report in the Journal of Medical Toxicology describes a 54-year-old man who had a large hemorrhagic stroke after using a new kratom product bought online. Investigators found the product was adulterated with phenylethylamine, a stimulant. The authors say the link is possible, not proven. Source: Nacca N, et al. J Med Toxicol. 2020;16(1):71-74. According to PubMed, DOI 10.1007/s13181-019-00741-y (PMID 31713176).
Very High Mitragynine Content
A Tampa Bay Times investigation (Dec. 7, 2023) reported more than 580 Florida deaths over a decade in which kratom was found, 533 with other substances and 46 with kratom alone. The series also reported that some products carry very large doses: Remarkable Herbs leaf powder with more than 2,600 mg of mitragynine, and MIT45 Super K Extra Strong with 367 mg. It linked Remarkable Herbs to at least seven fatal Florida overdoses and O.P.M.S. Silver Maeng Da to at least three. These are the newspaper’s findings, not court findings. Source: Tampa Bay Times, Deadly Dose.
7-OH Products
FDA has issued warning letters to firms marketing products containing 7-hydroxymitragynine (7-OH). See FDA’s announcement. 7-OH is a different, more potent compound than whole-leaf kratom. Check current federal and state rules before buying any 7-OH product.
Red Flags When Choosing A Kratom Vendor
- No third-party lab results. You cannot verify identity, contaminants or alkaloid content.
- Lab reports that are old, generic or not tied to a batch.
- No alkaloid content listed on extracts, shots or concentrates.
- Health or disease claims. FDA has not approved kratom for any use.
- No dosing or warning information on concentrated products.
- No contact details or return policy.
- Gas station and convenience store products with no batch testing.
How To Screen A Vendor
- Ask for a certificate of analysis (COA) for the exact batch. Check that it tests for heavy metals and microbes, not only alkaloids.
- Check whether the vendor is a member of the American Kratom Association GMP program at americankratom.org. Membership is not a guarantee of safety.
- Confirm the vendor will not ship to places where kratom is banned.
- Start with the lowest dose. Do not combine with alcohol, opioids or other sedatives.
The Bottom Line
Kratom carries real risks, including dependence, adulteration and contamination. Most deaths reported in the studies above involved other substances, but that does not make kratom safe. If you use it, buy only from sellers who show batch-specific lab results. For our vendor picks and how we choose them, see who sells the best kratom.
Last reviewed: November 2026. This article is for information only and is not medical advice.