Kratom & 7-OH

Kratom alkaloids:
how they connect

Kratom contains many active compounds. Two — mitragynine and 7-hydroxymitragynine (7-OH) — are the most clinically relevant. Lab-synthesized analogs of 7-OH, such as MGM-15 and MGM-16, are not found naturally in the plant. Here is a plain-English explainer of where each one comes from and how they compare in potency.

Medically reviewed by S. Elias, MD·Last reviewed May 2026
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The short version

Plant, body, lab — three places these compounds come from.

Kratom leaves contain naturally occurring alkaloids. Once kratom is ingested, the body can form additional active compounds from those alkaloids. Separately, researchers have synthesized stronger 7-OH analogs in the lab; those analogs are not known to occur naturally in kratom leaf.

Natural — plant

What is naturally in the leaf

Kratom leaves contain many alkaloids. Two are most relevant here:

Mitragynine

The main kratom alkaloid. In some varieties, it may account for up to ~66% of the alkaloid fraction. It affects the brain in complex ways and is not the same as a classic opioid.

7-OH

7-hydroxymitragynine. Occurs naturally in kratom leaf in trace amounts. It has stronger opioid-receptor activity than mitragynine in lab and animal studies.

Formed — body

What your body can form

After kratom use, liver enzymes can convert some mitragynine into 7-OH:

More 7-OH

This can add to 7-OH exposure beyond the trace amount present in the leaf alone. The 7-OH formed in the body is the same chemical as the trace 7-OH found naturally in kratom leaf.

Mitragynine pseudoindoxyl

Another opioid-active metabolite formed through 7-OH pathways. It can have stronger opioid-receptor activity than mitragynine.

Synthesized — lab

What can be synthesized

Researchers have synthesized 7-OH analogs with stronger opioid-receptor activity. These analogs are not known to occur naturally in kratom leaf.

MGM-15

Semi-synthetic analog of 7-OH. Also called dihydro-7-hydroxymitragynine, DH-7OH-MIT, or DHM. Early data suggest stronger opioid-receptor activity than 7-OH.

MGM-16

A 9-fluoro analog of MGM-15. In one mouse pain model, MGM-16 was reported to be ~240× as potent as morphine. This is not a human dose conversion.

What studies suggest about relative potency

from receptor, metabolism, and animal studies — not human dose conversions

Mitragynine

Reference point (1×)

7-OH

~5–9× mitragynine in selected assays

MGM-15

Early data: stronger opioid-receptor activity than 7-OH

MGM-16

~240× morphine in one mouse pain model

General pattern in cited studies — not to scale

Quick reference

Compound table.

CompoundWhere it comes fromWhat it isStudy-based potency signal
Mitragynine Natural in kratom leaf (up to ~66% of leaf alkaloids) Main kratom alkaloid; complex pharmacology reference point
7-OH= 7-hydroxymitragynine Trace amounts in leaf + body can form more from mitragynine Natural minor alkaloid/metabolite with stronger opioid-receptor activity than mitragynine ~5–9×mitragynine in selected assays
Dihydro-7-OH= MGM-15 = DH-7OH-MIT Semi-synthetic analog of 7-OH A semi-synthetic 7-OH analog; early data suggest higher opioid-receptor activity Early data suggest> 7-OH; limited human data
MGM-16 Synthetic 9-fluoro analog of MGM-15 Experimental analog studied in animals ~240×morphine in one mouse pain model

Treatment context

Why buprenorphine/naloxone, often called Suboxone, can help with kratom and 7-OH dependence.

Buprenorphine is the part of buprenorphine/naloxone, often known by the brand name Suboxone, that acts at opioid receptors. It binds tightly to mu-opioid receptors. Opioid-active kratom compounds, including mitragynine and especially 7-hydroxymitragynine, also act on this receptor system.

When buprenorphine is started at the right time and dose, it can occupy those receptors in a steadier way and may help reduce opioid-like withdrawal symptoms and cravings in selected patients. Timing matters because buprenorphine binds tightly. If a larger dose is started too soon, before kratom or 7-OH effects have worn down enough, symptoms can suddenly worsen. This is called precipitated withdrawal.

Buprenorphine is a partial opioid agonist. In plain English, it turns the opioid receptor on only partway. That can be enough to help with withdrawal and cravings for some patients, but it does not activate the receptor in the same way as a full opioid agonist. Some effects level off at higher doses, which is often called the ceiling effect.

This partial-agonist effect is one reason many patients, once on a stable dose, feel steady rather than high or in withdrawal. Suboxone can still cause sleepiness, slowed breathing, or impairment, especially when starting treatment, after dose changes, or when combined with alcohol, benzodiazepines, gabapentin, pregabalin, or other sedating substances.

Using buprenorphine/naloxone for kratom or 7-OH dependence is off-label. The evidence is still limited, especially for concentrated 7-OH products, and comes mainly from case reports, case series, clinical experience, and opioid-receptor pharmacology. The decision should be individualized.

Important: The potency numbers above come from cell-receptor, metabolism, forensic, and animal studies. They are not human dose conversions. Human effects vary by product, dose, route, prior opioid exposure, medical conditions, and other substances. Strong opioid-receptor agonists can carry serious risks, including sedation, tolerance, physical dependence, withdrawal, respiratory depression, and overdose, especially when combined with alcohol, benzodiazepines, opioids, gabapentin, pregabalin, or other sedatives.

Related

References

Peer-reviewed and regulatory sources

  1. Obeng S, Wilkerson JL, León F, et al. Pharmacological comparison of mitragynine and 7-hydroxymitragynine: in vitro affinity and efficacy for μ-opioid receptor and opioid-like behavioral effects in rats. J Pharmacol Exp Ther. 2021. jpet.aspetjournals.org
  2. Kruegel AC, et al. 7-Hydroxymitragynine is an active metabolite of mitragynine and a key mediator of its analgesic effects. ACS Cent Sci. 2019. PMC6598159
  3. Matsumoto K, et al. Orally active opioid μ/δ dual agonist MGM-16, a derivative of the indole alkaloid mitragynine, exhibits potent antiallodynic effect on neuropathic pain in mice. J Pharmacol Exp Ther. 2014. jpet (Matsumoto 2014)
  4. Krotulski AJ, Denn MT, Walton SE, Logan BK. Dihydro-7-Hydroxy Mitragynine (MGM-15) — New Drug Monograph. Center for Forensic Science Research & Education, NPS Discovery, 2026. cfsre.org
  5. Alsbrook S, et al. From kratom to 7-hydroxymitragynine: evolution of a natural remedy into a public-health threat. Pharm Biol. 2025. PubMed 41275505
  6. U.S. Food & Drug Administration. Products Containing 7-OH Can Cause Serious Harm. Consumer Update, 2025. fda.gov
  7. U.S. Food & Drug Administration. FDA Takes Steps to Restrict 7-OH Opioid Products. Press Announcement, 2025. fda.gov
  8. DailyMed (NIH). Suboxone Prescribing Information. dailymed.nlm.nih.gov
  9. UIC Drug Information Group. Buprenorphine and buprenorphine-naloxone for kratom withdrawal. dig.pharmacy.uic.edu
  10. University of Florida College of Pharmacy. Kratom resources & alkaloid composition. csp.pharmacy.ufl.edu

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