Kambo: Let It Go

by Brian Dunning
November 28, 2023

Today we're going to have a look at an alternative wellness therapy, plagiarized from an indigenous Amazonian ritual practice, and today sold profitably to gullible westerners intent on blending the ever-popular ancient wisdom with the modern wellness fad. It's called kambô. Kambô is a paste made from the secretions of poison tree frogs, and when a very small dose is spread into a break in the skin, it causes severe vomiting, diarrhea, and other adverse (and potentially dangerous) reactions. Consequently, it has quickly become a favorite method of virtue signaling — a way to shout "look at how enlightened I am, participating in an indigenous Amazonian ritual" among a very select demographic in the United States and other comfortable western nations. But regardless of the social implications, kambô is still pharmacologically active; and that means that it may indeed provide the benefits its devotees believe it does… and it also might mean that it's deadly.

The process of taking kambô is as follows. A number of different frog species are used, all of the genus Phyllomedusa, most common of which is the brightly colored giant monkey frog. Sticks are jammed into the ground, to which the frog's limbs are tied to stretch it out spread-eagle in the air. This painful stretching stresses the frog and activates its defense mechanism which is to secrete poison from its skin. The secretions are scraped from the frog, collected, and dried into a powder. The frogs are released.

Sessions to administer the kambô are sometimes one-on-one between a practitioner and a participant; usually in the United States where it's sold as a wellness therapy, sessions are with a single practitioner administering to a large group of participants, typically adorned with ceremonial or ritualistic trappings, and with the practitioner often assuming a title such as shaman or priest. They refer to it not as poison, but as "medicine," in keeping with the New Age habit of regarding anything that comes from nature as wholesome and healing. In fact frog poison is no more "medicine" than is rattlesnake venom or box jellyfish neurotoxin.

The powdered secretions are mixed with the practitioner's saliva to create a paste (gross). The participants take off most of their clothes, both to expose their skin to receive the poison, and to avoid soiling their clothes with vomit and diarrhea. The practitioner heats a stick, needle, or blade and burns a series of cuts or punctures in the participant's skin, then smears a bit of the poisonous paste onto each burn.

For some people, the poison takes effect immediately; for others, it can take several minutes, sometimes even up to an hour. The main effects are tachycardia, vomiting, and diarrhea. The face typically swells noticeably. Participants are encouraged to drink a lot of water throughout to increase the vomiting. More severe reactions, which are fortunately rare, include infections at the burn marks, psychosis, renal failure, toxic hepatitis, seizures, and more. A number of people have died, from causes such as cardiac arrhythmia and cerebral edema. But for most people, it's an hour of nonstop vomiting and dry heaves, a severe bout of diarrhea, and a hypertension headache.

So the obvious question to ask is why? Why would anyone willingly subject themselves to this; and moreover, to pay money for it? Prices I found online for the privilege of this lovely experience ranged from about $100 to $400 for a 1-2 hour session. Well, the answer is that in its use among indigenous cultures in the Amazon, nobody pays. It's a cultural thing. It's used to increase fertility, to bring good luck, to expel evil spirits, and to boost strength — there's no evidence that it actually does any of these things, but that's what some believe. But in the United States and other western countries that have appropriated the practice as a for-profit wellness treatment, claims are all over the map. It's one of those things that are claimed to treat everything. The basic claim is a detoxifying cleanse — and, as with all detoxification treatments, the alleged toxins are never identified. It's pretty much the full suite of the usual pseudoscientific claims of New Age: balancing chakras, removing negative energy, increasing spiritual awareness. And just about every wellness claim is made too: kambô will cure depression, addiction, fatigue, and chronic pain; it helps you sleep better and confers strength and energy and mental clarity; it makes you a better manager, a better communicator, better at your job and better at relationships. If anyone wants it, guaranteed there's a kambô practitioner somewhere selling it.

Beginning around 1994, a few Brazilians brought kambô out of the Amazon and into the major cities, where they began offering it as an alternative therapy. From there its growth was slow, but it suddenly went ballistic around 2020 in Silicon Valley, California, when a number of tech execs began using it and loudly proclaiming its virtues, and crediting it for their success. The stereotypical Silicon Valley people have a reputation for being gullible and for buying into every New Age fad that comes along, no matter how ridiculous; but kambô takes it to a whole new level. Watching videos of their group vomiting sessions made me suspect that this had to be a put-on; someone had to have challenged themselves to come up with the most insane, disgusting, painful, and horrible ordeal, and then see if they could sell it to rubes with more money than sense. People writhing, groaning, sobbing with pain; some struggling to carry their vomit buckets as they try to stumble to a bathroom, others lying on their sides so they could squirt from both ends simultaneously; it's really quite a show. In one video I watched, a practitioner described "projectile diarrhea."

The scars created by the contaminated burns sometimes fade, sometimes don't. Among some users, proudly displaying those scars — lots of little dots in neat rows — is a status symbol, much like athletes who use cupping and are sure to show off their dark round hickies.

The poison has to be purchased and shipped from the Amazon, and you might wonder why not just bring some of the frogs up here and have your own unlimited supply. The reason is that wouldn't work. The toxicity of the poison secreted by the frogs comes from certain things they eat in their native Amazonian habitat. If you transplanted the frogs here and fed them regular frog diets, their poison would lose its toxicity. So for now, the powder has to be purchased from Brazil — where, paradoxically, it's illegal to sell it. Kambô is totally unrestricted in the United States and most other countries, with the notable exception of Australia where several deaths prompted the Therapeutic Goods Administration to ban it. So, somehow, creative sellers are getting it out of Brazil, and now it's easy enough to find and buy online — though of course, as an unregulated substance, there are no standards at all for purity or potency. California shamans, beware.

But participants need to beware even more. These kambô practitioners are completely unregulated. Some of them have created their own training and certification programs, but they have no legitimacy outside their own little club. There is no such thing as board certification or accreditation outside of what they make up themselves, a practice intended only to deceive gullible participants into a risky for-profit ritual.

How risky? Some of the risks are fairly obvious, and all of them have resulted in at least some deaths or hospitalizations. Drug interactions are one; as kambô is pharmacologically active, it's possible for it to interact harmfully with any drug, not just pharmaceutical drugs, but recreational and herbal drugs as well. There is insufficient data to even make specific warnings. Hyponatremia, aka water intoxication, is another. Participants are told to drink a lot of water before and during the ritual, and this throws your electrolytes out of balance causing your cells to hold too much water, potentially causing fatal swelling of the brain. All sorts of cardiac problems can be triggered by the tachycardia that kambô induces; it's absolutely a terrible idea for anyone with any cardiovascular condition including hypertension. This has sent more kambô participants to the morgue than anything else.

Searching for articles on kambô in medical journals is sobering. From Toxicology Reports (2022): "Kambô: Natural drug or potential toxic agent? A literature review of acute poisoning cases." From Integrative Cancer Therapies (2021) (yes, some people do try to treat cancer with it): "Kambô-Induced Systemic Inflammatory Response: A Case Report of Acute Disease Progression of Cholangiocarcinoma." From The Cureus Journal of Medical Science (2020): "Kambô Frog Poison as a Cause of Esophageal Rupture" - this was the most common cause for hospitalizations that I came across in my research. From Clinical Toxicology (2018): "Prolonged toxicity from Kambô cleansing ritual." And so on, and so on, and so on.

As far as any journal articles finding positive effects? None, zip, zero. Much of the reason for this, I expect, is that there has never been a medical claim made that is specific and consistent enough to be testable. Each practitioner you hear talk about it gives a different list of things they say it will treat, and/or wellness effects it will bring. And when you hear interviews with participants, they all give totally different and random reasons why they're doing it. Some of these beliefs for what benefits kambô provides may be more common than others, but none of them are agreed upon, and certainly none of them are supported by evidence.

Should this change tomorrow, and the results of some clinical trial are published finding that kambô does indeed have some medical benefit that exceeds placebo, that still won't be any reason to get excited. It's almost certain that whatever that hypothetical benefit is, it can be obtained much more safely and effectively through some other treatment already on the market — and, moreover, without the severe vomiting, diarrhea, tachycardia, pain, disgusting mess, and high price tag.

Kambô is the classic case of risks exceeding benefits. There are numerous known risks, and zero known benefits. Logically there is no reason to take kambô at all. It certainly can't be argued that it's fun (unless you have a very strange notion of fun) and to endure it to receive some benefit, you have to be deep into cognitive dissonance. Keep your lunch in your tummy, keep your money in your pocket, and keep kambô off your skin.

By Brian Dunning
Follow @BrianDunning