8 risks and rewards of Ayahuasca

An assistant Shaman watching over the Ayahuasca Brew process at Santuario Huistin Ayahuasca Retreat in Pucallpa Peru.
An assistant Shaman watching over the Ayahuasca Brew process at Santuario Huistin Ayahuasca Retreat in Pucallpa Peru.

There are some serious potential downsides to Ayahuasca including feeling sick, psychosis and in some extreme circumstances death, however, on balance, I feel for many people these risks are not present or able to be lowered to be in line with any other travel adventure. With that in mind, the benefits start to stand out. Here are 8 PROs and CONs if you are thinking of doing Ayahuasca.

Risks of Ayahuasca Rewards of Ayahuasca
Remote location: Some retreats are far away from civilisation. What happens if you are not well prepared or have complications in the remote jungle? This is unlikely if you are well prepared however, if you have a particular condition which could be exacerbated by the remote location then find a place that is near a developed city, ie Cusco would be a good bet. Purging: Purging, while it doesn’t sound great fun, is actually very satisfying in my experience and if you follow a good and decent length preparation diet shouldn’t be excessive. It is a natural part of the Ayahuasca process.
Diet combined with MAOI’s: Eating a diet with too much tyramine could lead to complications when combined with Ayahuasca however in my opinion this is quite easily avoided by following the preparation diet for Ayahuasca. Read below for a more on that. Ego dissolution: This is one of the great benefits of Ayahuasca. It’s quite hard to explain to someone who hasn’t experienced it (via psychedelics or other methods) but it is often described as ‘being the observer’ or in other words – being able to observe you mind (aka ego) from a distance and are able to see yourself as separate from it not always within it.
Certain pharmaceuticals combined with Ayahuasca: Pharamaceuticals and Ayahuasca don’t mix well and some are especially dangerous. Read below for more info but some common ones are SSRI’s, certain malaria medication and alititude sickness meds. Learn about yourself and your particular ‘things’: We all fall into various behavioural and thought patterns. Gaining a significant amount of ego dissolution allows you to have a new perspective which can help with various problems in behaviour (addictions for example) and thought patterns you may have. Ayahuasca can also show you solutions or aids to these bahviours or thought patterns in the form of hallucinations which are often very useful as well.
History of certain mental illnesses: Ayahuasca and psychosis doesn’t mix very well. I have read that some Ayahuasca churches have done this for their members but they require a lot more support and monitoring to be safe. If you suffer from psychosis then drinking Ayahuasca should not be a flipant decision and you should make sure those you are drinking with are aware and ready to deal with worst case scenarios. Help physical ailments: I was helped physically by Ayahuasca. I had a long term back injury which was made better after drinking Ayahuasca. I have come to realise that physical pain is often created or exacerbated by mental and emotional stress. Ayahuasca, and other methods like Reiki, can help shift the physical result of emotional issues. See ‘The Mind Body Prescription by Dr John Sarno’.

Risk – Remote location:

Ayahuasca (if done in Peru or other South American countries) is often in a very remote location far from any medical help. What happens if you have some need for a doctor in an emergency? Some Ayahuasca retreats are a hike, boat and car ride from anything you would remotely call a hospital.

How to mitigate this? Don’t go to that place. It’s that simple. There are a lot of retreats that aren’t so remote and some even that have medical staff on hand. Do your research, find a place that suits you and if need be is near a hospital and other resources you need.

If you are determined to go to a remote place then you need to realize and accept that you are taking a risk by doing so. If you have medical issues which may come up then you could take a medical kit with you and buy appropriate travel insurance but ultimately you can only lower risk to a certain level.

Risk – Diet combined with MAOI’s:

There is a risk in combining Ayahuasca, a natural MAOI, with certain types of foods.

Important note: I’m not a doctor, I just read a lot. I took most of the info in the below paragraphs from The MAPS website and this page in particular.

An Ayahuasca brew that one drinks in ceremony contains (note: recipes do vary between Shaman and retreats) The Ayahuasca Vine and the Chacruna Plant. The Charuna has the DMT (hallucinogenic) and the Ayahuasca Vine contains something called an MAOI.

An MAOI (Monoamine Oxidase Inhibitor) is a substance that inhibits the effect of Monoamine Oxidase in the stomach. An MAOI is necessary in order for the DMT within the Ayahuasca brew to actually have an effect when being digested in the stomach.

At the same time as it is doing this, an MAOI is also blocking the absorption of Norepinephrine. Norepinephrine is created in the stomach by foods which contain Tyramine and if you have too much Norepinephrine in your body then you are at risk from Hypertension and you can suffer from nausea, occipital headache, and even intracranial hemorrhage (aka a Stroke).

So in essence, when you eat food with Tyramine you create Norepinephrine in your body which can’t be dealt with appropriately because the MAOI in Ayahuasca is blocking its absorption. If levels of Norepinephrine get too high you are in danger of the effects of Hypertension. In order to reduce these effects, you can reduce foods containing Tyramine. This is what’s known as the ‘Ayahuasca Diet’. Not to be confused with the ‘Ayahuasca Dieta’ – read on for a description of this.

Finding recipes and understanding what Foods to avoid on an Ayahuasca Diet?

Some have suggested that the Ayahuasca Diet is quite similar to an Alkaline Diet and so, I suggest that you use this as a way to find recipes for your diet but, alter them when you see fit. You can read a list of Alkaline Diet Recipes here including preparation instructions.

I would pick a meal from an Alkaline Diet and then check the recipe against the below list of things to avoid and promote out of or into your diet. You can see the list on the Gaia Sagrada site.

So, what is a ‘Dieta’ then?

A Dieta is more than just what you eat and goes as far as cutting out

  • sex,
  • harsh or intense music, books, and thoughts and
  • in some cases contact with people.

This is the way Amazonian Shaman have traditionally worked with plant medicine and I have been told by doing this you can deepen your experience with the plant medicine as well as reduce the purging effect.

The Dieta does have a food component though. It involves,

  • eating very simple food like rice, plantains, and potatoes with no flavoring
  • while ‘Dieting’, as it is called, on certain plants to receive their teachings.
  • Tobacco is another plant people diet on for example but, there are many others. Ayahuasca is not the only plant medicine.
  • By default, owing to its simplicity, a Dieta is also low in Tyramine which I mentioned previously in this article.

The food you consume on a Dieta is more restrictive than the Diet described above. You can see an example of these foods here on Gaia Sagrada but think plantains and rice and maybe a few eggs as a start.

How long do I Diet or Dieta for?

If you are undertaking the Dieta then this is something that you would usually be doing under the advice of a Shaman and hence, they would be advising you on how long to undertake this for. Depending on how long your stay is this could be anywhere from weeks to months. As I mentioned a Dieta usually involves dieting on other plant medicines and as such isn’t something you would normally do in preparation for going to a retreat but something you did once you were at the retreat.

If you are preparing for arriving at your retreat then you could start between 2-4 weeks before your ceremony. The more the better really. From my research, the cleaner your system the better your ceremonies will go with respect to purging but, also the depth of the plants’ effects.

If 2-4 weeks is too much for you then my recommendation would be at the very least to do 3-5 days before the first ceremony.

Is Diet or Dieta right for me?

That probably depends on you. I would say at the very least start with the less restrictive Diet. You can actually make some pretty tasty meals from using Alkaline Meals as a base and refining a little bit. If you start a few weeks out you can always make it more strict if you feel the need.

Risk – Certain pharmaceuticals combined with Ayahuasca:

Above I explained how increased norepinephrine while under the influence of Ayahuasca can be dangerous. In the same way that Tyramine can cause increased norepinephrine there are certain pharmaceutical drugs which do the same and as such are not safe while preparing for or while you are taking Ayahuasca. As such, you will read and hear that in preparation for your Ayahuasca experience you should not take certain pharmaceuticals like those for depression and psychosis.

Like I said above, I’m not a doctor. If you are on any medication then check if you can take it. Here is a good place to start, see Table 2. This is not an exhaustive list so if you are unsure or you are taking something that isn’t on this list then talk to your doctor to confirm.

Using the information in this article you should be able to have a conversation with a doctor about what drugs you need to avoid – ie ones which lead to increased norepinephrine.

Risk – history of certain mental illnesses:

While Ayahuasca is quite well known to be able to help depression (try and look for the documentary The Last Shaman on Netflix) there are cases where it can cause psychosis in those that take it. As a general rule, this isn’t the case, but if you have a history of psychosis in the family then it is possible that Ayahuasca can increase or trigger this. I am not an expert in mental health but, in my time researching this blog I have come across this several times so I think it is worth mentioning.

If you would like some more information then I suggest these two articles are a good place to start. This article has an interview and is a good place to get quick answers in laymen terms, for example

What should the average person take away from your review?
It seems that people with a family or personal history of psychotic symptoms and disorders are more vulnerable to experience psychotic episodes after ayahuasca (or other psychedelic/hallucinogen such as LSD and psilocybin) intake. These people should avoid using these substances, and the people offering them should avoid giving them to people with these characteristics.

Rafael G. dos Santos of the University of São Paul as quoted from psypost.com.

This scientific article also has some good insights and references to further studies for those who really want the nitty gritty,

“…although psychiatric complications such as anxiety and psychotic reactions associated with ritual ayahuasca are rare, they may occur, especially among vulnerable individuals. In the ritual contexts of ayahuasca use, individuals with a personal or family history of psychotic illness or that are currently with psychotic symptoms are generally not allowed to use ayahuasca or are advised that they should avoid it.”

As written in Archives of Clinical Psychology research paper.

Purging – some say risk, I say reward:

Throwing up in a bucket and potentially shitting yourself don’t sound glamorous or even remotely desirable. When the benefits became known to me of what Ayahuasca could do for me then throwing up and potentially shitting myself became ‘not a big deal’. In my ceremonies to date, I’ve only thrown up a few times and I haven’t shit myself (yet!).

In my experience, you’re not going to permanently damage yourself from doing either of these. I think this is more of an ‘attitude’ than anything else. Funnily enough, purging actually feels very satisfying. After all, the reason your purging is because you have ‘things’ that aren’t required or desirable in your body.

These could be physical things but, also un-needed emotions from things in your life. You’re simply getting rid of the physical things that are holding you back or you don’t need anymore.

Reward – Ego dissolution:

Ego is a powerful aspect of human beings. I think it’s fair to say that it’s sometimes too powerful in the eyes of Ayahuasca. Not that ego isn’t desirable or necessary in certain situations but, in my opinion, it’s not ‘checked’ enough.

Ayahuasca, and other psychedelics are able to dissolve your ego such that you are able to achieve the status of ‘observer’ or ‘witness’. Once you can do this you tend to have feelings of empathy and ‘we are all one’ as the structures which make you think you are separate from everything else (that being the ego) are dissolved temporarily but, with lasting effect.

I think this is a reward because there are many benefits to being able to be the observer. In my experience, after some ego dissolution, you are able to more easily observe how your ego has thought patterns and makes you say and do things. Given you are arms length form it now, you can choose to have those thoughts and do or say those things.

This topic is fraught with difficulty trying to explain and is even harder if you haven’t experienced ego dissolution yet. I think this TED Talk describes it as well as anyone. The speaker in this video is not talking about ego dissolution from a psychedelic practice but from a meditation practice. There is more than one way to become the observer after all.

Reward – Learn about yourself and your particular ‘things’:

We all have ‘particular things’ which have shaped us or influenced us in positive and negative ways. I had a tumultuous relationship with my Dad which isn’t uncommon for young males but, it did lead to some things which I had been holding onto for too long and that weren’t helpful.

Ayahuasca helped me to see the reason behind our troublesome relationship and made me feel more empathy and understanding for his situation. While I don’t think that this gave him justification for some of his actions it made me not worry about them so much. I was able to let go of it. It wasn’t an obstacle to me in my life anymore and I consider that a great thing.

Reward – help physical ailments:

I had a back injury (and resultant surgery) which I had been rehabbing from for about 2 years at the time of my first Ayahuasca ceremony. It was difficult for me to sit for longer than 20-30 minutes without discomfort bordering on pain. After my second ever ceremony one of my intentions was to see if Ayahuasca could do anything about the injury.

The next day I still had nerve damage and I still had a ‘bad back’ but a lot of the tension I had held in my back had gone making sitting for long periods of time easier and having a lot less discomfort. This is still the case 6 months after as I write this. It was a permanent reduction in the discomfort I had in my low back.


All in all, I think Ayahuasca is much like anything else. It can be dangerous if you don’t figure out the pitfalls and avoid them but, these things are quite avoidable I think. Given this, I think the risks are no larger than traveling in general. I was traveling through South America when I did Ayahuasca and hence why I compare it to travel in this way. Once you can mitigate the risk, the potential upsides become even more attractive.

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3 years ago

Has anyone died from taking Ayahuasca?