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It may be a side effect of taking huge amounts of extract, but is not possible when consuming the leaves, as far as I know. I’ve known people who claim to take an ounce (28g) of leave per day without issue. (I take btw 2-8 grams in a day myself so I can’t speak to higher doses)

In general taking excessive amounts triggers vomiting, similar to when you eat too many psilocybin mushrooms (well, some say it’s ideal to vomit shroom-wise, but I’m not a fan). So mitragyna speciosa is incredibly safe.

Unfortunately Wikipedia’s treatment of the topic could be improved, but there is very little existing literature out there. I read one review study I was pretty happy with but I’m not on a laptop so i can’t go dig up the link unfortunately