Mushrooms And Liver: What's The Connection?

Mushrooms are a fun ingredient to cook with and delicious to eat, but they can be dangerous to your liver if you're not careful. Mushroom poisoning, or mycetism, can cause severe hepatitis and even acute liver failure, which can be fatal. However, some mushrooms have been found to have hepatoprotective effects against various drug-, toxin-, and alcohol-induced liver diseases. So, does mushroom consumption affect your liver?

Amanita mushroom poisoning can cause acute liver failure

While mushroom poisoning, or mycetism, is a relatively rare occurrence, it can result in acute liver failure. The most common and deadly cause of mushroom poisoning is ingestion of the Amanita phalloides mushroom, also known as the death cap. Amatoxin poisoning may progress into acute liver failure and eventually death if liver transplantation is not performed. The mortality rate after Amanita phalloides poisoning ranges from 10 to 20%.

Amanita phalloides poisoning results in liver damage due to the presence of amanitins, powerful toxins that inhibit RNA polymerase II. This results in deficient protein synthesis and cell necrosis. The clinical picture of Amanita phalloides poisoning is characterised by an asymptomatic lag phase, followed by gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and diarrhoea. This is followed by liver and kidney involvement, which can lead to acute liver failure.

Accurate identification of the specific mushroom species consumed is challenging in over 90% of poisoning incidents, underscoring the necessity for clinical vigilance. Early diagnosis of amatoxin intoxication is crucial, as the latency period between mushroom ingestion and the onset of symptoms can be prolonged. The only specific laboratory test available for diagnosing amatoxin poisoning is the detection of amatoxins in the urine, which must be performed within the first 48 hours after ingestion.

In addition to Amanita phalloides, Amanita verna is another highly toxic wild fungus found in China. Amanita verna poisoning occurs annually, with a high mortality rate of 50%. Cases of Amanita verna poisoning have presented with complex and diverse clinical manifestations, including vomiting, diarrhoea, toxic hepatitis, acute liver failure, toxic encephalopathy, and disseminated intravascular coagulation. Liver transplantation is an effective treatment for acute liver failure caused by Amanita verna poisoning and can improve patient survival rates.

Hepatoprotective effects of mushrooms

Mushrooms can have both positive and negative effects on the liver. While some species of mushrooms can induce catastrophic liver damage, culminating in acute liver failure, others have been found to have hepatoprotective properties.

Amanita phalloides: Inducing Liver Damage

The "death cap mushroom", Amanita phalloides, is known to induce severe liver damage, which is often fatal. Initial symptoms of poisoning include nausea, vomiting, and diarrhea, but by 72 hours, severe liver damage may occur, along with brain swelling, bleeding disorders, and multi-organ failure. Accurate identification of the specific mushroom species consumed is challenging in over 90% of poisoning incidents, making timely medical intervention crucial.

Hepatoprotective Mushrooms:

Several mushroom species have been studied for their potential hepatoprotective effects, offering protection against experimentally induced liver injury. Here are some notable examples:

• Ganoderma lucidum: Also known as Reishi or Lingzhi, this is the most widely studied mushroom species for its hepatoprotective properties. It has been shown to possess antioxidant and hepatoprotective activities, with potential benefits in cancer treatment.
• Antrodia cinnamomea: This mushroom has gained attention for its potential health benefits, especially its hepatoprotective effects against drug-, toxin-, and alcohol-induced liver diseases. Purified anthraquinol, a compound isolated from Antrodia cinnamomea, has been found to inhibit ethanol-induced liver damage in human hepatoma cell lines and mouse models.
• Edible Mushrooms: Various edible mushrooms, such as Volvariella volvacea, Lentinula edodes (Shiitake), Flammulina velutipes, Auricularia auricular, Tremella fuciformis, Grifola frondosa, and Tricholoma lobayense, have been studied for their hepatoprotective activities. These mushrooms were screened using paracetamol-induced liver injury models in rats, and the results indicated potential hepatoprotective effects.
• Herbal Combinations: Certain herbal combinations from China and Japan have been scientifically proven effective for treating liver diseases. For example, silymarin has shown promise against liver cirrhosis, Phyllantus amarus against chronic hepatitis B, and glycyrrhizin for treating chronic viral hepatitis.

In summary, while certain mushrooms can cause severe liver damage, there is ongoing research into the hepatoprotective effects of various mushroom species. These studies suggest that specific mushrooms and their extracts may offer protective benefits against experimentally induced liver injuries and certain liver diseases. However, further research is needed to fully understand the mechanisms and potential applications of these hepatoprotective mushrooms.

Mushroom poisoning in animals

Mushroom poisoning, or mycetism, in animals is a serious concern for pet owners, especially those with dogs and cats. While most mushroom ingestions are benign, certain species, such as Amanita phalloides, or ""death cap" mushrooms, can induce fatal liver damage. The toxins in these mushrooms can cause severe and often irreversible liver failure, leading to death within about 10 days.

Signs of mushroom poisoning vary depending on the species and amount ingested. Gastrointestinal (GI) distress is a common symptom, with vomiting and diarrhea being the most prevalent. Pets may also experience a slow heart rate (bradycardia) and respiratory issues. In some cases, the initial GI symptoms subside, but the underlying liver failure progresses, leading to jaundice, weakness, lethargy, and even coma.

To prevent mushroom poisoning, pet owners should be vigilant about their pets' surroundings and keep them away from wild mushrooms. If mushroom ingestion is suspected, prompt veterinary treatment is critical. Veterinarians may induce vomiting to remove the mushrooms from the stomach and administer activated charcoal to bind with the toxins and prevent absorption.

Identifying the specific mushroom species ingested is crucial but challenging in most poisoning cases. Preserving the mushroom by wrapping it in a damp paper towel or taking detailed photographs can aid in identification by a mycologist or a local college's laboratory. While most mushroom poisonings in animals are not fatal, it is important to seek veterinary care as soon as possible to minimize the risk of severe and irreversible organ damage.

Wild mushroom-induced acute liver injury

While the majority of mushroom ingestions are harmless, certain wild mushrooms, such as Amanita phalloides (commonly known as the "death cap mushroom"), can cause severe liver damage and even acute liver failure. This is known as wild mushroom-induced acute liver injury or acute liver failure (ALF).

The initial symptoms of death cap mushroom poisoning include nausea, vomiting, and diarrhea, which may lead people to believe they are recovering. However, within 72 hours, severe liver damage becomes apparent and can be fatal. Other complications include brain swelling, bleeding disorders, and multi-organ failure.

The prognosis and need for emergency liver transplantation in patients with wild mushroom-induced acute liver injury can be predicted using various criteria, including King's College, Clichy, Ganzert's, and Escudié’s criteria. These criteria take into account factors such as prothrombin index, serum Cr levels, INR values, and the presence of hepatic encephalopathy. Monitoring total bilirubin and activated partial thromboplastin time (aPTT) levels is also crucial in predicting clinical outcomes and determining the need for advanced interventions.

The specific treatment for wild mushroom-induced acute liver injury is limited, and accurate identification of the ingested mushroom species is challenging in most poisoning cases. Therefore, clinical vigilance and early recognition of the potential for severe outcomes are essential for timely and effective intervention.

Mushroom poisoning symptoms

Mushroom poisoning, or mycetism, is a pressing health concern worldwide. While the majority of mushroom ingestions are harmless, certain species can cause severe liver damage and even death. The most toxic mushroom is the Amanita phalloides, commonly known as the death cap mushroom, which causes 95% of mushroom poisoning deaths. This mushroom is found in Europe, Asia, and North America, and has been a particular problem in Canada and the United States.

Symptoms of death cap mushroom poisoning typically occur 6 to 24 hours after ingestion and include nausea, vomiting, abdominal pain, and diarrhoea. While these initial symptoms may improve after a few days, severe liver damage becomes apparent after 72 hours and can be fatal. Other possible symptoms include brain swelling, bleeding disorders, and multi-organ failure.

Other mushrooms that can cause similar symptoms to the death cap include some species of Galerina, Lepiota, and Conocybe. These mushrooms typically grow in clusters on the ground and have a cap that ranges in colour from pale yellow to green to olive brown. The gills are white, and the base of the stem has a membranous cup.

If you suspect that you or someone you know has eaten a poisonous mushroom, do not wait for symptoms to occur before seeking medical attention. Contact your local poison control centre or emergency services immediately. It may be helpful to have a sample or photo of the mushroom for identification purposes.

While mushroom poisoning can be life-threatening, timely and effective intervention can save lives. Treatment for mushroom poisoning is typically guided by symptoms and may include supportive care, fluid and electrolyte replacement, and, in cases of liver failure, liver transplantation.

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