Study Finds 85% of Kratom-Derived Products Mislabeled

By Pat Anson

A new study at the University of Florida is likely to increase the growing scrutiny of kratom, 7-OH and other kratom alkaloid products.

Researchers found that the vast majority of kratom-derived tablets, edibles and extracts contain alkaloid and chemical compounds that differ substantially from their product labels, potentially putting consumers at risk.

Some have been altered so significantly during the manufacturing process that researchers concluded “these products are definitively not kratom.”

Kratom comes from the leaves of the Mitragyna speciosa tree in southeast Asia, where it has been used for centuries as a natural pain reliever and stimulant. In recent years, demand for kratom products has risen sharply in the United States, reaching an estimated market size of $2.56 billion in 2025.

As the kratom market has grown, so has the variety of products available, including concentrated formulations of 7-hydroxymitragynine (7-OH) and other kratom alkaloids that have “opioid-like” effects and are far more potent than natural leaf kratom.     

Researchers at the University of Florida College of Pharmacy conducted a laboratory analysis of 44 commercially available kratom-derived products purchased online and in stores in several U.S. states.

The study findings, published in the journal of Drug Testing and Analysis, show that 85% of the kratom products had ingredients and concentrations that did not match their labels. In some cases, products were labeled as having a single alkaloid, but multiple alkaloids were detected. Other products contained compounds that were not disclosed on their labels or were listed but not detected.

“The findings are of strong relevance to public health and underscore regulatory actions needed for proper labeling requirements by manufacturers for consumers to know what they are purchasing,” said co-author Christopher McCurdy, PhD, a Professor and Associate Dean for Faculty Development in the UF College of Pharmacy. 

“Right now, consumers are part of a large experiment in which they are taking products that they believe are properly labeled as to the composition of ingredients, yet they are being deceived intentionally or unintentionally by the manufacturers, putting the public at risk.”

McCurdy and his colleagues have spearheaded much of the U.S. research into kratom, with McCurdy serving as an expert witness in kratom litigation cases on both the plaintiff and defendant sides. 

Their research has grown more complicated in recent years, as the kratom market has been flooded by new semi-synthetic products that are often marketed as “natural kratom.” The DEA is currently planning to classify 7-OH and other concentrated kratom products as illegal Schedule One controlled substances, while keeping natural leaf kratom largely unregulated as a dietary supplement..

“Products containing semisynthetic, kratom-derived compounds should be clearly distinguished from natural kratom products,” says lead author Abhisheak Sharma, PhD, an Assistant Professor of Pharmaceutics in the UF College of Pharmacy. “Stronger manufacturing standards, comprehensive testing and transparent labeling are needed to help people make informed decisions and reduce potential safety risks.”

Kratom Litigation

Advocacy organizations for both natural leaf kratom and 7-OH products support stronger labeling, age restrictions and transparent marketing, but there is little effort to enforce those standards at the federal level. That has left most kratom regulation to individual states and local governments.

In a move reminiscent of the opioid litigation cases that cost the pharmaceutical industry over $50 billion dollars, the city of Baltimore recently filed a complaint against several manufacturers and distributors of kratom products, accusing them of “engaging in unfair, abusive, or deceptive trade practices.” 

Maryland has banned the sale of all synthetic or artificially altered kratom products under the state’s Kratom Consumer Protection Act, which also requires product labels to be accurate.

The Baltimore case focuses on several kratom entrepreneurs behind Optimized Plant Mediated Solutions (OPMS), a kratom brand that sells a potent kratom extract called Black Liquid Kratom that’s been linked to several deaths.

“Defendants have employed a web of shell companies and alter egos, and use multiple business names, assumed names, and trade names to hide the scope of their operation and to avoid liability for their actions… while falsely stating or implying in their labeling, packaging, advertising, and marketing of the Kratom Products that the Kratom Products are safe for consumption or offer therapeutic and health benefits that they do not have,” the complaint alleges.

In 2024, the FDA warned consumers not to use Black Liquid Kratom after it was linked to several adverse events. But the OPMS extracts are still available in smoke shops, vape shops and online, where they are often marketed as “all natural” kratom products.

OPMS is one of the “qualified vendors” registered with the American Kratom Association’s good manufacturing standards program, which requires vendors to have labeling that “provides all the information required for consumers to make an informed purchasing decision.”

In their analysis of Black Liquid Kratom, University of Florida researchers found the OPMS extracts “showed variability in their chemical composition, with measured content different from the values stated on the product labels.”  A laboratory analysis found more alkaloids in Black Liquid Kratom than what was indicated on the product label.

Glucosamine May Contribute to Alzheimer’s Disease

By Pat Anson

An over-the-counter supplement used by millions of people around the world to relieve joint pain has been associated with Alzheimer’s disease and other advanced forms of dementia, according to a new study.

Neuroscientists at the University of Florida say glucosamine raises the risk of someone progressing from mild cognitive impairment to Alzheimer’s disease by about 25 percent.

Glucosamine is an amino sugar found in shellfish that helps build cartilage, ligaments, tendons, and synovial fluid in joints. It is used annually by about 40 million Americans, many of them elderly, to reduce inflammation and symptoms of osteoarthritis.

What many seniors don’t realize is that glucosamine may also be accelerating the formation of protein plaques in their brain, which have been linked to dementia. 

“A lot of these people actively take an over-the-counter supplement that could be making their disease progression worse,” senior author Ramon Sun, PhD, a biochemist and molecular biologist, said in a press release.

It’s important to note that the study findings, published in the journal Nature Metabolism, are preliminary and don’t establish a cause and effect relationship between glucosamine and Alzheimer’s – only an association.

The findings are based on a large retrospective analysis of health records for over 50,000 patients diagnosed with Alzheimer’s disease-related dementias (ADRDs) or mild cognitive impairment (MCI). While most patients with MCI remained stable or even recovered cognitive ability, about 5% progressed to ADRD, representing a clinical worsening of cognitive decline. 

About 8% of the patients studied reported taking glucosamine supplements. When compared to patients who didn’t take glucosamine, researchers saw a 25% higher risk of patients with MCI transitioning to ADRD in the glucosamine user group. In addition, glucosamine use was associated with a 25% increase in mortality risk among ADRD patients.

Researchers believe glucosamine crosses the blood-brain barrier and feeds into pathways that build sugar residue on protein cells. Patients with Alzheimer’s appear to be more vulnerable to this metabolic activity than those with healthy brains.

“The electronic health record data are very provocative,” said co-author Matt Gentry, PhD, chair of UF’s Department of Biochemistry and Molecular Biology. “While it’s an association and not proof of causality, it does raise an important clinical question that now deserves much more attention.”

In tests on genetically modified mice, the UF research team found that glucosamine significantly increased sugar residue on proteins in the brain and reduced the social recognition behavior of mice. When researchers chemically suppressed this process, their “social memory” improved.

Advanced imaging studies on human Alzheimer’s brains also showed significantly increased sugar attachment to proteins compared to healthy brains. 

Taken together, the findings suggest that metabolic dysfunction is not simply a secondary aspect of Alzheimer’s pathology, but a contributing cause. 

“Proteins are the cell’s molecular machines, and many of them need sugar tags added in just the right way to fold correctly, travel to the right place and do their jobs,” Gentry said. “What we found in Alzheimer’s is that this sugar-tagging system appears to be overactive. The Alzheimer’s brain is adding too many of these sugar structures, and this seems to contribute to the disease rather than protect against it.”

The good news about this research is that it could lead to new ways to prevent Alzheimer’s or slow its development.

“Our results suggest that altered metabolism is a significant contributor to Alzheimer’s progression and, in addition, addressing the metabolic defect could be an important complement to approaches focused on Alzheimer’s plaques and tangles,” Sun said.    

Glucosamine is the fourth most widely used supplement in the United States. It is also widely used in China and Europe. Glucosamine is often combined with chondroitin to help build or restore joint cartilage. 

While further studies are needed, the Mayo Clinic says glucosamine “might provide some pain relief” for people with knee osteoarthritis. 

Chronic Pain Causes Brains to Age More Rapidly

By Pat Anson, PNN Editor

Poorly treated or untreated chronic pain can lead to a number of other health problems, from high blood pressure and insomnia to depression and anxiety.

Now there is evidence that chronic pain also causes brains to age more rapidly, raising the risk of developing Alzheimer’s disease and other neurological problems associated with aging.

“Our findings highlight the need to address chronic pain, not just in older individuals but in potentially everyone, as pain may have unintended consequences in the brain that we don’t yet fully understand,” said lead author Yenisel Cruz-Almeida, PhD, a researcher at the University of Florida Institute on Aging.

Over a three-year period, Cruz-Almeida and her colleagues used magnetic resonance imaging (MRI) to measure the volume of gray and white matter in the brains of 47 older adults, ages 60 to 83.  The volunteers were free of neurological disorders and in generally good health, although 33 of them had some type of chronic pain.

Volunteers who did not have chronic pain had brains that appeared four years younger than their actual age.

Chronic pain sufferers had brains that appeared an average of two years older. They were also more likely to have greater pain intensity, have a “less agreeable personality” and be less emotionally stable, according to researchers.

The University of Florida produced this video on the study, which was recently published online in the journal Pain.

“Not everybody ages the same way,” said Cruz-Almeida. “I don’t want people to think, ‘Oh, I have chronic pain. I’m doomed.’ This is not the case. That is not the message we want to get out. There is more nuance than that.”

Interestingly, the volunteers who reported getting pain treatment in the last three months had younger-appearing brains compared to those that did not, suggesting that pain relief slows brain aging. Pain sufferers who had a happier outlook on life and were generally more upbeat also had younger-appearing brains.

“The pain experience is not just in your brain,” said Cruz-Almeida. “There appear to be avenues or things that could be done to change brain age.

“Our findings also suggest that both pain treatments and psychological traits may significantly mitigate the effect of pain on the aging brain and could further decrease the risk of age-related deterioration and death.”

Cruz-Almeida is planning additional research with a larger sample of older adults that will look at ways to alleviate accelerated brain aging.