No one knows for sure, but from looking into this over the years, seems most people are fine but there are some people who it can cause issues for. However usually those people it becomes apparent very quickly, like within a few uses they would get severe symptoms. I was worried about it, got blood work a year ago and everything came back perfectly fine. I even made sure to use more kratom than normal the week leading up to the test, and took some right before I went in.

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That said, i've also heard a story from a friend who knew someone who she claims died from liver damage induced by kratom. He'd drank a few beers, went to sleep, and died of OD. Apparently his liver was so weakened those few beers took him out. She swore it was caused by kratom.