Laura Smith
Mushrooms have been consumed by humans since prehistory, but they have also been known to be toxic and implicated in the deaths of several historical figures. Mushroom poisoning occurs after the ingestion of toxic mushrooms, often due to misidentification of a poisonous species as edible. There are about 6000 ingestions annually in the United States, with over half of the cases involving children under six. While most poisonings exhibit symptoms of gastrointestinal upset, severe poisonings can lead to organ failure and even death. The severity of mushroom poisoning depends on factors such as the geographic location, growth conditions, the amount of toxin ingested, and individual susceptibility. To prevent mushroom poisoning, it is crucial to familiarize oneself with both edible and toxic mushroom species and exercise caution when consuming wild mushrooms.
| Characteristics | Values |
|---|---|
| Oxalate Content | Mushrooms contain moderate levels of oxalates. Wild mushrooms contain soluble oxalates, which the body absorbs. |
| Health Risks | Consumption of mushrooms may lead to the deposition of calcium oxalate in the body, which can form crystals that build up in the kidneys and cause kidney stones or damage. |
| Dietary Considerations | People prone to kidney stones may benefit from a low-oxalate diet. Certain cooking methods, such as boiling, can lower oxalate levels in mushrooms. |
| Preparation | Water-prepared mushrooms have lower oxalate levels than more concentrated forms. Fresh mushrooms have varying oxalate levels depending on type. Drying mushrooms does not change oxalate content per gram, but powdered mushrooms have higher oxalate concentrations. |
| Recommended Intake | Healthcare providers generally advise limiting oxalate intake to less than 40-50 mg per day. |
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What You'll Learn
Misidentification of toxic mushrooms as edible
Mushrooms are a versatile component of the human diet, with medicinal and therapeutic properties. However, some species are toxic and can cause serious health issues, including liver failure, seizures, and renal failure. The leading cause of mushroom poisoning is the misidentification of toxic mushrooms as edible ones.
One reason for the misidentification of poisonous mushrooms is their similarity to edible species. For instance, the Shaggy Mane mushroom, which is toxic, has been mistaken for the Amanita species, which is deadly poisonous. The Amanita species, also known as the "Destroying Angel," has a similar appearance to its edible counterpart, the Yellow Morel, or Morchella Americana. The Yellow Morel is easily identifiable by beginners due to its distinct appearance, but its poisonous look-alike, Gyromitra spp., contains a highly toxic and carcinogenic chemical called gyromitrin.
Another example of toxic mushrooms that resemble edible species is the False Morel, which can be mistaken for the True Morel. The False Morel has a wavy and crumpled cap, while the True Morel's cap is pitted. Additionally, the False Morel has a nearly solid stem, whereas the True Morel has a smooth, hollow stem.
To avoid misidentification, it is crucial to learn about the characteristics of both edible and toxic mushrooms. For instance, edible Agarics have pink to brown/black gills, a white cap, and a stout stem with a skirt, while toxic Agarics may cause the mushroom cap to stain bright chrome yellow when bruised. Furthermore, toxic Agarics have an unpleasant chemical smell, resembling Indian ink or iodine.
Cooking methods can also reduce the risk of consuming toxic mushrooms. Boiling mushrooms can lower their oxalate content, and cooking in general can kill harmful microorganisms and bacteria, reducing the risk of foodborne illnesses. However, it is important to note that boiling is more effective for vegetables than mushrooms, and other culinary methods may be more suitable for mushrooms.
In conclusion, the misidentification of toxic mushrooms as edible ones is a significant issue that can lead to serious health consequences. To ensure safe consumption, it is essential to accurately identify mushrooms by learning about their characteristics and, when in doubt, cooking them appropriately to reduce potential toxins.
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Amatoxin, a deadly mushroom toxin
Mushroom poisoning occurs when toxic mushrooms are ingested, often due to misidentification as edible mushrooms. There are about 6000 ingestions annually in the United States, with children under six years old accounting for more than half of these cases. While most poisonings result in mild gastrointestinal symptoms, severe poisonings can lead to organ failure and even death. Amatoxins are toxins found in certain species of mushrooms and are responsible for the majority of fatal mushroom poisonings worldwide, including over 95% of mushroom-related fatalities in the United States.
Amatoxins are a group of at least nine closely related cyclic peptide toxins synthesized by three genera of deadly poisonous mushrooms: Amanita, Galerina, and Lepiota, as well as one species of the genus Pholiotina. These toxins have a potent effect on the body, with as little as half a mushroom cap capable of causing severe liver injury if ingested. Amatoxins interfere with protein synthesis by inhibiting RNA polymerase II, an essential enzyme in the synthesis of messenger RNA (mRNA). Without mRNA, cell metabolism stops, leading to cell death and potential organ failure. The toxins can also damage other organs, with liver and heart failure resulting in fatalities.
The Amanita species, commonly known as "death caps," are responsible for most mushroom toxicity cases in humans. While some Amanita mushrooms are harmless, others contain both amatoxins and phallotoxins. The concentration of amatoxins varies within the mushroom, with the gills and cap typically containing higher levels than the spores and mycelium. Other mushroom species besides Amanita can also contain amatoxins, such as Galerina and Lepiota, although the specific species within these genera vary.
The severity of amatoxin poisoning depends on various factors, including the amount ingested, age, body weight, health, and time elapsed since ingestion. Treatment options include activated charcoal, which can reduce toxin absorption if administered early, and cyclosporine, an inhibitor of OAT-P transporters. In severe cases of liver injury, a liver transplant may be necessary. The development of monoclonal antibody-based lateral flow immunoassays has provided a sensitive method for detecting amatoxins in urine samples, aiding in the diagnosis and treatment of amatoxin poisoning.
To prevent amatoxin poisoning, it is crucial to properly identify mushroom species before consumption. Familiarizing oneself with both toxic and edible mushrooms, as well as their similar-looking counterparts, can help reduce the risk of accidental ingestion. Additionally, some toxins, like amatoxins, are heat-stable, so cooking or boiling mushrooms may not always eliminate their toxicity.
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Orellanine, a toxin causing kidney failure
Orellanine is a nephrotoxic toxin produced by some mushroom species of the Cortinarius genus, which are typically found in Europe and North America. Orellanine is unique among known mushroom toxins because it is the only one that selectively targets the kidney, causing acute kidney injury (AKI) in humans when ingested. The nephrotoxicity of Cortinarius orellanus was first recognised in the 1950s when the mushroom was identified as the cause of a mass poisoning in Poland.
The onset of symptoms from orellanine poisoning is delayed by 1–2 weeks after ingestion. Some patients suffer mild gastrointestinal discomfort in the latency period before developing signs of renal impairment due to severe interstitial nephritis, acute focal tubular damage, and interstitial fibrosis. The first phase of orellanine poisoning is the prerenal phase, which includes nausea and vomiting, headaches, loin pains, burning thirst, and polyuria. This is followed by the renal phase, which occurs 8 days after ingestion and is characterised by oligoanuria or anuria, which can lead to death in severe cases.
There is no specific antidote to orellanine poisoning. Treatment is symptomatic and relies on standard management of kidney failure, dialysis, and, in the case of incomplete recovery, management of chronic renal insufficiency. Patients with severe but not irreversible damage may begin to recover kidney function 2–4 weeks after the onset of symptoms.
Consuming mushrooms with calcium-rich foods can help reduce the risk of kidney damage. Calcium-rich foods can reduce the risk of deposition of calcium oxalate. When eaten together, the calcium binds with the oxalate in the gut, forming a compound that the body can remove before it reaches the kidneys.
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Hallucinogenic mushroom poisoning
Hallucinogenic mushrooms, commonly known as "magic mushrooms" or "shrooms", are fungi that contain ibotenic acid, muscimol, psilocybin, or psilocin. They have been used in indigenous New World cultures for millennia and continue to be fashionable among drug users, especially young people, due to their perceived harmlessness compared to other hallucinogens. However, hallucinogenic mushroom poisoning can cause neurotoxic effects like hallucinations, agitation, and anxiety.
The circumstances that lead to the ingestion of hallucinogenic mushrooms include intentional consumption by adults and adolescents seeking a state of intoxication and incorrect mushroom identification by naïve foragers. In a study of 174 adolescents with a history of substance abuse, 26% reported having used hallucinogenic mushrooms, often in combination with other substances. While hallucinogenic mushroom poisoning is typically non-fatal, severe outcomes have been reported, including myocardial infarction, severe rhabdomyolysis, acute renal failure, posterior encephalopathy, protracted paranoid psychosis, and suicide.
The care of patients with hallucinogenic mushroom poisoning is primarily supportive and symptomatic, and most patients can be treated without medications. However, seizures are uncommon, except in young children. The vast majority of poisoned individuals recover without serious permanent morbidity. Nevertheless, it is recommended to seek immediate medical attention if symptoms such as muscle spasms, confusion, and delirium occur after consuming mushrooms.
The clinical presentation of hallucinogenic mushroom poisoning differs depending on the specific toxin ingested. Psilocybin-containing mushrooms, including Psilocybe, Conocybe, Gymnopilus, and Panaeolus, cause altered sensorium and euphoria within 30 minutes to 2 hours of ingestion, lasting typically between 4 and 12 hours. On the other hand, muscarine-containing mushrooms like Clitocybe and Inocybe can lead to cholinergic effects such as abdominal cramping, diaphoresis, salivation, lacrimation, bronchospasm, bronchorrhea, and bradycardia, usually occurring within 30 minutes.
To prevent hallucinogenic mushroom poisoning, it is important to correctly identify mushrooms before consumption and be aware of similar-looking toxic species. Additionally, boiling, cooking, freezing, or processing may not alter the toxicity of some mushrooms, so proper preparation methods are crucial.
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Cholinergic toxicity
The management of cholinergic toxicity can be difficult, and the fatality rate is generally more than 15%. Due to severe bronchospasm and bronchorrhea, the respiratory system may fail and require assisted ventilation. Respiratory failure may also occur from profound muscle weakness affecting the diaphragm. Cholinergic toxicity may be treated with anticholinergic agents such as glycopyrrolate or atropine.
It is important to note that boiling, cooking, freezing, or processing may not alter the toxicity of some mushrooms. Therefore, to prevent mushroom poisoning, it is crucial for mushroom gatherers to familiarize themselves with the mushrooms they intend to collect, as well as with any similar-looking toxic species.
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Frequently asked questions
Symptoms can vary from slight gastrointestinal discomfort to organ failure and death. The most common symptom is gastrointestinal upset, including nausea, vomiting, abdominal cramping, and diarrhoea. Other symptoms include hallucinations, blurred vision, palpitations, and respiratory failure. Serious symptoms do not always occur immediately and may take days or weeks to develop.
Mushroom poisoning occurs when toxic mushrooms are ingested, often due to misidentification as edible mushrooms. There are approximately 100 species of mushrooms that cause the majority of poisoning cases when eaten by humans, and only 15-20 species are potentially lethal. Poisonous mushrooms contain a variety of toxins, including amatoxins, gyromitrins, orellanine, muscarine, psilocybin, muscimol, ibotenic acid, and coprine.
To prevent mushroom poisoning, it is important to properly identify mushrooms before consumption. Mushroom gatherers should familiarize themselves with both edible and toxic mushroom species, especially toxic look-alikes. It is recommended to only forage for mushrooms with someone highly experienced in identifying edible and poisonous mushrooms.
