Abstract
Mitragyna speciosa, commonly known as kratom, is a Southeast Asian herb gaining popularity as an alternative to opioids for chronic pain and opioid withdrawal treatment. The U.S. Food and Drug Administration classifies it as a “new dietary ingredient” with the potential to damage the kidneys, liver, and heart. Despite this, kratom is widely available in drug stores and online. We present a case of a patient with long-term daily use of kratom who exhibited altered mental status and focal neurologic deficits with hyponatremia 1 week after abruptly discontinuing kratom use. This case underscores the necessity of obtaining a comprehensive history of all regularly consumed medications and supplements, whether prescribed or otherwise. © 2025 Authors.