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Although this increase in systemic exposure to the metabolites seems counterintuitive with respect to CYP3A inhibition, the inhibition of their secondary metabolism via UGT2B4/2B7 by kratom is a potential explanation

Stop usage if irritation starts for 1 week and then begin again with a smaller amount or dilute the product
Drug Chem Toxicol 45(3):12951301 Mielke MM (2018) Sex and gender diferences in alzheimers disease dementia
Bone and joint disorders are characterized by perturbations in the bone microenvironment, such as ROS accumulation, hypoxia and osteoimmunology

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Examples of this include pap smears for cervical cancer, HPV or STD screenings or the testing required to determine the results of Fecal Immunochemical Test (FIT) kit for colorectal cancer screening
