KAMBO & HYPONATREMIA: FACTS VS. MODERN MYTHS
Most Kambo practitioners recommend drinking some water prior to the Kambo session, with the reason that it will help you purge easier and overall reduce some of the discomfort that can be experienced during the session. And yes, this is true for the vast majority of people, but it can also be done without any water, and some people may actually prefer it.
Traditionally both methods were used, usually related to personal preference. For the most part, a couple of cups of chapo (sweet plantain brew) or masato (cassava/yuca beverage) were consumed during the application; no specific quantity recommendation, it was more about the feeling of fullness than a strict amount.
Over the last years the discussion on this topic has become very prominent in the Kambo community as multiple people have lost their lives because of misinformation and inexperience that led to hyponatremia, which is directly related to the quantity of water that was consumed during a Kambo session.
Hyponatremia Explained
Hyponatremia is a condition where blood sodium concentration falls below normal—typically <135 mmol/L (normal range: 135–145 mmol/L). Severe cases (<120–125 mmol/L) can be life-threatening.
Importantly, hyponatremia is not primarily a lack of sodium in the body; in healthy people it is almost always the consequence of too much water relative to the sodium present, although exceptions exist in certain health conditions where sodium loss and abnormal fluid retention play a larger role. Our kidneys normally handle excess water efficiently by filtering and excreting it as dilute urine, with a maximum capacity of about 0.8–1 liter per hour in healthy adults. When we consume a large amount of plain water rapidly, the excess water enters the bloodstream and distributes throughout the body before the kidneys can fully remove it. This added volume dilutes the concentration of sodium already present in the extracellular fluid.
Sodium is the main osmotic regulator in extracellular fluid (ECF: blood plasma and interstitial spaces), accounting for ~90% of its osmotic force. When sodium concentration drops, water moves via osmosis (through aquaporin channels) from the dilute ECF into cells (intracellular fluid), causing them to swell.
Most cells tolerate mild swelling, but brain cells are at high risk. The rigid skull cannot expand, so swelling increases intracranial pressure, compressing brain tissue and potentially causing:
- Headache, nausea, confusion
- Seizures
- Coma
- Brain herniation or death
Modern Adaptations and Dangers
During the last decade Kambo use has been increasing rapidly outside the tribal communities of the Amazon. With that, new forms and methods have also developed by non-natives, of which some have been very beneficial, while some others not so much. It was during 2016 that I first heard about practitioners suggesting that drinking large amounts of water (4+L) was beneficial as it would help “cleansing” the body better. That same year a practitioner in Poland who was taught that practice by a respected Kambo organization at the time had a client who had to be hospitalized and later died because of it. Unfortunately, those teachers didn’t change their practice straight away and it was promoted by many for some years after that incident, consequently leading to more harm to individuals around the globe.
It is important to understand that water intoxication (hyponatremia) during Kambo isn’t really as much related to the Kambo itself. Reports of individuals that have been harmed because of drinking large amounts of water exist independently. Every reported case of hyponatremia related to Kambo included the individuals drinking 3–6 L of water, an amount that when drank without using Kambo equally can be fatal as some reports show
The Curent Situation
Today it is a standardized practice for any well-trained practitioner to keep the water intake during the session between 1.5 and 2 L. Some practitioners are going even a step further promoting a method known as “Dry Kambo” no water intake at all to avoid any possible water-related harm. This has the consequence for some users that they may end up feeling extremely sick while not able to vomit, or if they vomit it is often very difficult and includes dry heaving and discomfort.
Considering that large water intake dilutes sodium in the body, some practitioners are strongly promoting the intake of electrolytes prior to the session or warning about receiving Kambo if someone has low sodium levels. This is also related to some Kambo peptides that may trigger the ADH (antidiuretic hormone, also called vasopressin) release, signaling the kidneys to hold onto water.
Salt Intake and Low-Sodium Diets: Tradition vs. Modern Concerns
The Matses tribe didn’t use salt in their diet till their contact with outsiders in the 70s while their Kambo use predates that event probably for centuries. They also used to practice dietas for becoming better hunters.
During that time, they would be isolated from others, following a very simple diet with no salt and applying Kambo to themselves twice a day for multiple days in a row before they would go out to hunt. Similarly, dietas without salt and Kambo use exist among some tribes in Brazil as well. They also have the practice of using Kambo after ayahuasca ceremonies, which some western practitioners have called dangerous, among other things also because of the low sodium diet that some individuals may follow prior to the ceremony.
But data shows no danger in practice.
Traditionally among all the tribes there are zero cases of Kambo-related harm.
Kambo ceremonies after ayahuasca have also been conducted for many years and thousands of people without any reported harm, except for 2 cases where the individuals drank about 6 L of water or another case where an individual had an esophagus rupture due to a preexisting condition, while those cases did happen during a Kambo session that followed an ayahuasca ceremony the harm experienced wasn’t because of low sodium intake and surly not because of the Ayahuasca the night before as there are documented cases of individuals experiencing exactly the same reactions during a Kambo session without drinking Ayahuasca previously.
My personal observation and practice leading hundreds of people through the Kambo dieta and witnessing over 1000 Kambo sessions that were done by individuals on a low sodium diet, I never have seen any danger because of it nor did someone have an adverse reaction.
Another observational study in which 147 people had 241 sessions drinking 1–2 L water showed no severe electrolyte problems.
Some individuals also may say that traditionally the natives didn’t need to consume salt prior to a Kambo session because the chapo or masato have all the electrolytes in it. Unfortunately, this isn’t fully correct, while it does contain some potassium and sugar the sodium content in those drinks is so low that it is insignificant. Considering the quantity consumed and rapid purging following the consumption it is questionable if any are absorbed at all.
Conclusion: Balance Is Key
Kambo can be intense but also beneficial when done responsibly. Hyponatremia and brain swelling are real risks, but they are mainly tied to excessive water (3–6 L), not low salt or ADH effects alone. No reported cases exist at 1–2 L, even on low sodium.
Standard practice today is 1.5–2 L water is consider safe. Electrolytes before a sessions can be taken but not necessary, as most people consume to much salt and sugar anyway. Normal sodium levels are ideal, but lower levels alone don’t cause harm in controlled settings, as data suggest.
We must distinguish proven risks (excessive water) from theoretical ones (low salt). Our learning should include tradition, experience, and data – observant practice with presence is the key. There is no need to fear water intake during Kambo or when the sodium levels are lower, but it is also important to know where the safe limits are. A balanced responsible practice with presence and observation is the key.