Physical health review is not a barrier to participation, it is how we match you to the right retreat type and preparation protocol. Most physical health conditions are manageable with appropriate review. A small number are absolute contraindications. Understanding the difference early means no surprises later.
Medical systems we review
Cardiovascular
Concerns
Uncontrolled hypertension (>160/100), recent myocardial infarction (<6 months), severe arrhythmia, unstable valvular disease. Both psilocybin and ayahuasca transiently elevate heart rate and blood pressure.
Clearance pathway
Stable cardiovascular disease with cardiologist clearance may be eligible. Recent cardiac events or uncontrolled hypertension are absolute contraindications.
Hepatic (liver)
Concerns
Active cirrhosis, acute liver failure, active hepatitis B or C infection. Psilocybin and ayahuasca are hepatically metabolized, compromised liver function alters drug clearance and increases toxicity risk.
Clearance pathway
Mild or compensated liver disease may be eligible with labs (LFTs, bilirubin). Active liver failure or cirrhosis is an absolute contraindication.
Lab work (CBC, CMP, liver enzymes) may be requested. Timeline: 2–4 weeks from request.
Neurological
Concerns
Uncontrolled seizure disorder, recent seizure (<6 months). Psychedelics lower seizure threshold in some individuals. History of seizures requires careful review.
Clearance pathway
Controlled seizure disorder (2+ years seizure-free on stable medication) may be eligible with neurologist clearance. Uncontrolled or recent seizure activity is an absolute contraindication.
Endocrine / Metabolic
Concerns
Diabetes (type 1 or 2) requires blood glucose management during ceremony. Thyroid disorders on medication are generally manageable. Adrenal insufficiency requires specific protocol.
Clearance pathway
Individual assessment based on medication interactions and glucose management capacity during a ceremony window.
Respiratory
Concerns
Severe COPD or active respiratory compromise. Ayahuasca ceremonies can involve purging; respiratory reserve matters. Moderate asthma on controlled medication is generally not a barrier.
Clearance pathway
Individual assessment based on severity, current control, and retreat type.
Reproductive
Concerns
Pregnancy is an absolute contraindication at any stage. Breastfeeding is also a contraindication. Teratogenic risk of psychedelics is unknown, the ethical barrier is absolute regardless.
Clearance pathway
No clearance pathway exists for pregnancy. Participation is not possible.
Medications and supplements
Concerns
Physical health medications (cardiovascular, endocrine, neurological) interact with psychedelics in ways that must be reviewed case by case.
Clearance pathway
Pharmacist review of all medications is part of standard screening. See medication interactions for detail.
Lab work and medical clearance
For some conditions, we request recent labs (CBC, CMP, liver enzymes) or a medical clearance letter from a specialist before finalizing placement. Lab costs are typically the applicant's responsibility. The timeline from request to clearance is usually 2–4 weeks.
See the full contraindications matrix for both Tier 1 absolute and Tier 2 relative conditions.