This safety study (n=22) investigated alterations to the liver of those who consumed ayahuasca at least twice a month, for at least a year and found none. They concluded that ayahuasca doesn’t affect liver (hepatic) function.
Abstract
“Ayahuasca is a beverage obtained from decoctions of the liana Banisteriopsis caapi plus the shrub Psychotria viridis. This beverage contains a combination of monoamine oxidase inhibitors (harmine, harmaline, and tetrahydroharmine) and N,N-dimethyltryptamine, the main substance responsible for its visionary effect. The ritualistic use of ayahuasca is becoming a global phenomenon. Most members of ayahuasca churches consume this beverage throughout their life, and many reports have discussed the therapeutic potential of this beverage. Ayahuasca is consumed orally, and the liver, as the major organ for the metabolism and detoxification of xenobiotics absorbed from the alimentary tract, may be susceptible to injury by compounds present in the ayahuasca decoction. In this study, we evaluated biochemical parameters related to hepatic damage in the serum of 22 volunteers who consumed ayahuasca twice a month or more for at least one year. There was no significant alteration in the following parameters: alanine aminotransferase, aspartate aminotransferase, bilirubin, creatinine, urea, lactate dehydrogenase, alkaline phosphatase, and gamma glutamyl transferase. These findings indicate that chronic ayahuasca consumption in a religious context apparently does not affect hepatic function.“
Authors: Sueli M. Mello, Paula C. Soubhia, Gabriela Silveira, Nelson F. Corrêa-Neto, Rafael Lanaro, José L. Costa & Alessandra Linardi
Summary
Ayahuasca is a beverage obtained from decoctions of the liana Banisteriopsis caapi plus the shrub Psychotria viridis. The liver is susceptible to injury by compounds present in the ayahuasca decoction, but chronic consumption in a religious context does not affect hepatic function.
Introduction
Ayahuasca is a decoction made from the leaves of the shrub Psychotria viridis and the liana Banisteriopsis caapi. It induces profound changes to perception, particularly in the visual, auditory, and somatosensory systems, leading to a state of significant introspection.
DMT and its derivatives are endogenous substances in mammals, including humans. The liver is the major organ for the metabolism and detoxification of drugs and xenobiotics absorbed from the alimentary tract, and may therefore be susceptible to injury by these compounds at any time.
In-vitro studies have shown that -carbolines can cause cell damage. Harmine decreases intracellular levels of ATP and the mitochondrial membrane potential, and increases levels of glutathione disulfide and reactive oxygen species, indicating oxidative stress.
Ayahuasca is used by Indigenous groups and has been used in religious syncretic movements to facilitate self-knowledge and introspection. Ayahuasca use is recognized as a legal practice in Brazil in three churches. 22 volunteers from the Center of Integral Development Luz do Vegetal consumed ayahuasca twice a month or more for at least one year.
Participants
Volunteers were selected based on age, sex, no renal or hepatic comorbidities, and ayahuasca consumption of twice a month for at least one year. They drank 1.5 mL of ayahuasca/kg body weight.
A descriptive cross-sectional study was conducted on volunteers who provided demographic information and details of ayahuasca use.
Ayahuasca
Ayahuasca is prepared by pounding the liana B. caapi and rinsing the leaves of P. viridis with water. The mixture is boiled and concentrated to produce 100 L of beverage.
Biological samples
Blood samples were collected from healthy individuals after consuming ayahuasca. The serum was separated, stored, and frozen at -20°C.
Determination of biochemical parameters
The biochemical parameters were determined using a Roche/Hitachi modular analyzer. The kits were COBAS® brand and the manufacturer’s guidelines were followed.
Statistical analysis
The sample size for one-way ANOVA for repeated measures was calculated using 85% power and 27% effect size.
We performed a General Linear Model (GLM) for each biochemical parameter studied and used sex, age, and time as co-variables. A one-way ANOVA for repeated measures was used to analyze the data.
Results
The biochemical parameters evaluated in serum before and after ayahuasca ingestion were within the maximum and minimum reference values in men and women, and there was no difference among the time intervals studied before and after ayahuasca ingestion.
The average values among men were significantly higher compared to women for all of the parameters analyzed. There were no differences over time in the parameters investigated in this study.
Discussion
The religious use of ayahuasca in Brazil is recognized as a legal practice. However, the toxicological safety of ayahuasca was extensively questioned, and only in 1987 was the use of ayahuasca officially legalized in Brazil.
In a systematic review of human studies based on 28 articles, the authors found that ayahuasca has positive effects on mental health, including antidepressive and antiaddictive effects, as well as increased positive mood and cognition, increased spirituality, and reduced impulsivity. Ayahuasca may have therapeutic potential, and it has been shown to decrease consumption of alcohol, cocaine, and other drugs of abuse in regular ayahuasca users. It also has antidepressant and anxiolytic effects, and a single dose may have an effect on resistant depression.
Ayahuasca compounds have been reported to exert a neuroprotective effect, and harmine has been shown to have a neuroprotective effect in rats submitted to cerebral ischemia and in patients with Parkinson’s disease.
Several studies have examined the possible cytotoxicity of ayahuasca and -carbolines, with harmine being the most toxic. These studies suggest that the liver is a potential target organ.
We examined the liver function of volunteers who consumed ayahuasca for at least one year. The serum levels of AST and ALT were below the maximum reference value, and there was no difference among the time intervals in men and women.
Alkaline phosphatase is an enzyme found in many tissues, including the liver, and may be increased by extrahepatic diseases. GGT may also be increased by alcohol consumption or the use of drugs such as barbiturates and phenytoin.
Lactate dehydrogenase is present in several tissues and can be detected in serum. It is used in the diagnosis of liver diseases such as acute viral hepatitis, liver metastatic cirrhosis, and carcinoma, as well as cardiopathies and kidney and lung tumors.
Total bilirubin is composed of indirect (unconjugated) and direct (conjugated) bilirubin, and may be used to assess hepatobiliary damage or obstruction, as well as non-hepatic causes such as hemolysis or muscle damage.
Since hepatic dysfunction may cause a decrease in renal function, we evaluated the serum creatinine and urea levels in the volunteers. The levels remained within the maximum and minimum reference values for both sexes and there were no changes over time after ayahuasca consumption.
In conclusion, this study shows that long-term consumption of ayahuasca within a religious context does not affect liver function in volunteers. However, additional studies with larger samples are needed to assess its safety.