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The toxic death cap mushroom, known technically as Amanita phalloides, can destroy the livers of people who eat it. A drug being studied in the U.S. derived from milk thistle seeds may help.
When unusually rainy weather near Washington, D.C., produced a bumper crop of mushrooms last fall, it also sparked a scary surge in mushroom poisonings.
Four people in two weeks showed up at area hospitals with life-threatening liver damage after picking and eating tempting fungi that turned out to be toxic.
“We thought it was a good mushroom because it sprung up in our backyard,” one of the victims, Frank Constantinopla, 49, of Springfield, Va., told reporters at the time.
But the treat Constantinopla plucked and stir-fried with noodles was actually the feared death cap toadstool responsible for most mushroom fatalities worldwide. Within days, he was in a local hospital on the brink of liver failure.
Constantinopla’s liver -- and his life -- were saved, however, by an investigational drug derived from an old folk remedy: the seeds of the milk thistle plant, a doctor who treated him told an expert panel on Sunday. As mushroom foraging continues through the spring, fungi fans should take note.
“It’s a treatment and well-described in our hepatology [science of the liver] literature, but it’s not readily available,” said Dr. Jacqueline Laurin, a liver transplant specialist at the Georgetown Transplant Institute, part of MedStar Georgetown University Hospital. “We need to make it easier for people to get it.”
Known as Legalon, the drug is an intravenous form of silibinin, milk-thistle extract, which may turn out to be an antidote to mushroom poisonings that sicken hundreds of people in the U.S. every year, sometimes leading to death.
It’s being tested in a clinical trial led by Dr. Todd Mitchell, a California doctor who developed the "Santa Cruz Protocol" for treating mushroom poisoning. The trial is sponsored by German drugmaker Madaus Inc., which already sells the product approved in Europe.
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Silibinin, a drug derived from the seeds of the milk thistle plant, may help save people with toxic mushroom poisoning.
Nearly 6,000 people reported contact with suspicious mushrooms in 2010, and more than 1,300 people got sick, according to latest figures from the American Association of Poison Control Centers. Some 500 people suffered moderate to major injuries and at least one person died.
Most of the victims were sickened by the Amanita phalloides -- death cap -- varieties that produce amatoxins, which shut down liver function.
Laurin presented the four cases in quick succession that alarmed Georgetown doctors during Digestive Disease Week, a gathering of experts in the field. The study was conducted through the Georgetown University Medical Center.
When Constantinopla was transferred with incipient (or early stage) liver failure, Laurin and her team got in touch with Mitchell, who is a primary care doctor at Dominican Santa Cruz Hospital in California. Mitchell said he advised Laurin about how best to treat the patient. His protocol recommends aggressive hydration and drainage of the bile duct in addition to IV silibinin.
Stores of the drug were found in Pittsburgh and delivered by plane and courier. Within hours, Constantinopla was treated under an exemption of Food and Drug Administration rules that allow a one-patient, one-time use of an unapproved drug.
But when another victim showed up with dire symptoms after eating mushrooms, followed by two more, the hospital was forced to convene an emergency meeting of its institutional review board to grant approval for those patients to be treated, too.
“We knew it wasn’t out of the realm of possibility that another person could show up with mushroom poisoning,” Laurin said.
Mitchell, who has become an expert in amatoxin poisoning, got interested in silibinin in 2007, when he was the emergency room doc who treated six members of a Mexican family who became critically ill after consuming tacos made with toxic mushrooms.
“They had eaten the mushrooms after picking them at a state park outside of Santa Cruz,” he said.
No one in the U.S. had silibinin, so Mitchell had to request that the FDA allow emergency import of enough of the drug to treat the clan. The family’s 82-year-old grandmother died, but others were saved by the milk thistle treatment, including a 25-year-old man who was listed for a liver transplant.
Mitchell was impressed; without good treatment, the mortality rate for amatoxin poisoning can be 50 percent. The toxins basically shut down the protein-making apparatus of cells in the liver, causing the organ to fail.
“The antidote blocks the entry of amatoxin into the liver cell,” he explained.
Despite the fact that Mitchell is not a clinical toxicologist ("I'm just a primary care guy," he said), he decided to try to make sure the drug -- and the protocol that goes with it -- are available in the U.S.
So far, Mitchell's trial includes some 44 patients treated with silibinin and the protocol. Of those, five have died, but Mitchell said the procedure wasn't followed thoroughly in those cases. The others have recovered completely.
“I think we’re actually pretty close to being ready to go to the FDA,” said Mitchell, who noted that he has no financial interest in the drug.
Mushroom experts, known as mycologists, are encouraged by the prospects of silibinin becoming available in the U.S., though they don’t necessarily believe it’s a certain cure -- or that all patients need the treatment.
“With good medical care now, 90 percent (of victims) will survive, with or without silibinin," said Michael Beug, chairman of the toxicology committee of the North American Mycological Association.
But Beug said that having the drug could help avoid the rush to extreme treatments, such as transplants.
“To the extent that this slows down the doctor’s reach for a new liver, it’s a good thing,” he said.
The real question is, if Beug accidentally ate a death cap -- he says they’re known to be among the most delicious mushrooms in the world -- would he want the milk thistle drug and protocol?
“You bet,” he said.
Related on Vitals:
- Poisoned lotion? FDA warns of mercury in cosmetics
- Drug poisoning of women may be increasing, study finds
- A second chance for faulty food? FDA calls it 'reconditioning'
In this segment of Curious Medicine, author Nicholas Evans speaks out about accidentally feeding his family wild, poisonous mushrooms and how the experience has affected his outlook on life.
Leave a Comment:
Or just don't eat things you find growing in the wild unless you're an expert in the subject??????
But it wasn't in the wild, it was in his backyard which means it's safe. I mean doesn't everyone wander around their backyard eating what they find? lol
“We thought it was a good mushroom because it sprung up in our backyard,”
Whacky logic and poor grammar. Almost a hat trick.
I guess the rule of natural selection, whereby the herd is thinned of the less intelligent due to their inept actions is proven well here indeed.
It makes you realize that with so many vastly more monumentally stupid actions your not so quick witted neighbors do on a daily basis that DON'T lead to fatal or even grave consequences proves how safe life is for the average person living in the modern world. But it does add rather large numbers of idiots living around us. (Present company excepted, of course. After all, news-vine bloggers are all pretty much intellectual Einsteins. Go ahead, just ask them.)
Like naive children who don't know any better?
Just more proof, if it tastes good it is not good for you.
Nice to see they found a cure for it..but Mushrooms??? Hate them on pizza alone.
Rather see a cure for cancer, aids, and people who vote as republicans...all three top sickness in the nation.
If they are stupid enough to eat the mushroom growing in the backyard then they deserve their fate, pardon me, but you dont eat a fungus unless you know where it came from, i mean really.
I hope our tax dollars didnt pay for their medical problems. Or for thier stupidity.
And who cares about grammar i mean seriously, this isnt your high school exam okay. dont like what you read then dont read it.
The journalist got the jobs and you didnt, if you care so much about the grammar then write to the webmaster and complain, dont bicker us with your proddles.
Really mike you have to complain about republicans on an article about mushrooms? You really need some help.
I really hope u don't feel that way. People should die for making inept decisions ???? Are u a mature adult? I certainly hope u're not in the healthcare profession.
Mushrooms can be tricky to identify, especially before they are full grown.
Just because you see a bunch of people out in a field picking them, you still can't assume they are anything less than deadly.
Seriously? Do we really have to tell people not to eat mushrooms that grow in their backyard?
The poisoned gentleman lives in Springfield, Va.--just outside the Washington DC beltway.
Lack of comon sense must be environmentally pervasive.
Jersey is like that too. With all the world renowned nerd schools they cant drive, or even tie their own shoes. If the guy can afford to live in "The DC beltway" can he not afford to have went & bought some fungus from the store? Book smart but no common sence.
I guess we do have to tell about the ones we can't eat that grow in our yards,because some we can eat.
I pick wild gourmet mushrooms in the fall here in the NW. I go by the credo "when it doubt, throw it out". By the way there is no such thing as a "toadstool", except for excrement from a toad!
As a person who worked at a health food store in the 80's and 90's, I can say that this knowledge was already well known in the world of natural medicine, and Milk Thistle Extract was already being used successfully as a treatment for this toxic mushroom poisoning as well as hepatitis in Europe. There was a recovering drug addict who came into our store often and always bought Milk Thistle Extract so one day I asked her why she took it. She told me that because her mother was so into a health regimen that included supplements and had gotten her into it, she followed a daily supplement regimen that included Milk Thistle Extract. When she finally hit bottom and went into treatment, one of her treating physicians immediately ordered a liver profile upon hearing the details of her drug use, and was convinced that he was going to find extensive damage to her liver. Instead, he was confounded to learn that she had no damage. Maybe there's a lot of quackery in natural medicine, but there's so many substances that have so much potential to do a world of good, and with little to no side effects.
You are correct I take milk thistle myself after years of heavy drinking. It can stave off liver damage from drugs and alcohol. Milk thistle has been a treatment for mushroom poisoning for as long as I can remember.
Thank you! I have a close personal friend who will start taking this soon as I can buy him some.
Milk thistle has been used for years in europe by traditional doctors. It also requires a prescription from a doctor in Germany.
So they should just call this drug "Liver Guard" & have that name as a registered trademark. Like nothing at all can damage your liver if you take it. People are soo stupid. That same lady that did drugs could wander out in the street & get hit by a speeder texting. Then their liver & all would be squashed.
Milk thistle is has been well known for decades to be liver-protective but I do not think it was widely known to counteract mushroom poisoning. Now, common sense says...since these toxic mushrooms hurt the liver, anything liver-protective might work. But it's not been widely use as a toxic mushroom antidote. People get so ill when they eat toxic mushrooms that they end up in the hospital...where, of course, few know alternative medicine.
My cousin has Hep C and recently was prescribed milk thistle by his mainstream doc. I found that interesting.
I also worked at a health food store where I learned about Milk Thistle and I like it in tea form. As the name says, it tastes a little bit like milk.
The main thing is that it seems to work. It's one of the few herbs that really does what they claim it does, unlike a lot of the bogus stuff they sell at health food stores.
I have been telling people with hepititis C to take milk thistle for twenty years and it has kept almost all of them from having to take the treatments the hospitals want to give you.Those treatments can make you want to kill yourself.Ask anybody that has taken them and they will tell you this is true.This is what all the doctors in the world should be telling patients instead of giving them no real choice of treatments other than something made from a test tube instead of something natural.
If you must...at least look it up on the internet. He lives, so Darwin only gets half a point.
Ban all mushrooms because it kills. That way we get the illegal shrooms at the same time. It's like killing two birds with one stone. Much easier for us. And please eradicate weed too. Toxic and cancer causing they all have no use on Earth whatsoever!
What about my pepperoni mushroom pizza? No way!
Just how would such a ban be put into effect? The higher fungi are some of the most ancient life forms on the planet, and they will persist long after our kind has joined the dinosaurs in oblivion.
Mushrooms are disgusting! we have no use for them whatsoever!
That's so retarded - I won't even begin to address how much. Non-toxic mushrooms are extremely health promoting. And they can be delicious. You can do what you like - just don't force your ahole logic upon others.
Right on , AB! Furthermore, mushrooms provide happy homes for gnomes. They hide underneath the caps. Just don't mistakenly put gnomes on your pizza and bake them. That is what makes it disgusting and toxic not the actual mushrooms. But to some illogical aholes it's an acquired taste like eating crawfish brains and guts.
Ban all mushrooms? This "final solution" is draconian but to be expected from mushroom Nazis!
John Krisfalusci Why dont you ban sunshine as well it causes cancer, oh and ban trees too because they can give those painful splinters and cause children to break bones, and ban the full moon because it brings out the loonies like yourself.
Oh! But don't bother with cigarettes or alcohol beause we know how safe they are.
If pot had no place on earth it would not be here.God would have had it destroyed.For your information pot head,marijuana is curing cancer.The resines in marijuana are curing cancers of all forms.And it is doing it with no side affects.Only an oncologist would put something like this on this comment topic.
yeah right bruce, because you read it on the internet, so it must be true...
Really?? We are heralding a cure for "mushroom poisoning"? What a sham...
Junk science at its best...
“We thought it was a good mushroom because it sprung up in our backyard” They saved this guy? Darwin is spinning in his grave!
I used to pick and eat about a dozen species of mushrooms in the NE. I was always very careful to ID the shrooms with at least two guide books (by the written descriptions, not just the pictures/illustrations), do a spore print, and even examined the spores with a microscope to confirm that they were as described in the guides.
But my main reason for commenting concerns the drug approval process in this country. The drug mentioned in the article, like many others, is already in use in Europe. When a drug has been approved in Europe, why do we duplicate the effort, and expense, here? Europe is composed of first-world countries that are eminently capable of developing and employing modern technology and medical/scientific processes. Why don't we just take their word for it and save the expense? Somebody must be making money off the testing process.
Ever hear of phocomelia? You can thank that disorder to people using drugs that were approved by Europe but not the U.S. Thalidomide was one of the best antinausea drugs out there. It was being smuggled into the U.S. to treat morning sickness in pregnant women and resulted in phocomelia.
Since you brought it up I thought I'd mention that there is movie by a German filmmaker physically affected by thalidomide about his fellow thalidomide-rs called NoBody's Perfect.
mvinson, you go on as if drugs that were approved in the US and not approved in Europe haven't killed and maimed people too.
Aren't they still doing "bleeding" in Europe!
It won't be approved in the U.S. until one of our pharmaceutical giants finds a way to create the silibinin artificially. The FDA in cahoots with drug companies will not allow any naturally occuring substance to be approved. How could they make money off of something people can grow in their backyard. Like that other natural WEED that is kept illegal.
It's still done here in the US as treatments for certain conditions, such as hereditary hemochromatosis. Of course it's done with the same procedure as donating blood - but, it is, nonetheless, bleeding the patient.
who'da thunk it? a mushroom growing in the backyard was poisonous... how can that be.. everyone knows only safe, healthy, shrooms grow in one's backyard.. He sounds like a fungi...
Collecting and eating wild mushrooms can be done safely I've done it for thirty odd years. It is a great deal more important to learn to recognize poison than it is food. One should be familiar with the species being sought and all potential poisonous varieties that might occur in the same environment. Picking in grass is a whole different world from picking in a forest.
I wholeheartedly agree with the maxim, "when in doubt throw it out" and would add another pearl of mycophile wisdom.
There are bold mushroom pickers, and there are old mushroom pickers, but there are no old bold pickers. I personally am of the old variety.
Who gives a rats' ass about this? One hundred, that's one hundred percent of the people who ingest poisonous mushrooms do it because they have done what is stupidity at best. Buy them in the damned store or get an advanced degree in mycology you fools. Of course, most top mycologists would never eat mushrooms.
What the heck were these people thinking? Eating wild mushrooms w/o knowing how to identify them?????
I love it :) If it isn't people eating at Mickey D's 5 days a week and wondering why they are gaining weight - it's other stupid people eating mushrooms. Mcrooms maybe:)
If they are growing on the top of cow patties...then beware unless you want to take an unwanted trip in lala land.
Those are the best kind!
The fungus amoung us......
"Thought it was good mushroom BECAUSE IT SPROUTED IN OUR BACK YARD..." What a fricking IDIOT! If you do not KNOW how to classify EVERY mushroom, DON'T EAT ANY of them! You can get seriously DEAD!
they gonna try and fix stupid? you dont mess with natural selection!
What do you know, another natural substance which is more effective than anything they could design in a lab. Don't worry though, I'm sure the government will ban it once someone designs an expensive synthetic that isn't as effective but costs a lot more.
oh, they won't "ban" it , they will just issue a patent for said natural substance and give the pharmaceutical company sole rights to use what was found naturally so they can charge the big bucks
Pharmaceutical companies can't make money on natural cures. Subsequently, govermental regulatory agencies don't have justification for bigger budgets and more control. Finally, politicians don't get donations and payoffs when pharmaceutical companies don't make money. More laws and regulations can fix that problem.
I wonder if you could eat those if you mixed'em 50/50 with milk thistles? They are great in stir-fries, but awful on the digestion.
Poisoning from Mushrooms can be treated with Chromium Bicarbonate mixed with water. Simple and effective!
Milk Thistle has long been used a a natural cure for liver illnesses - except of course more recently in the USA due to the heavy hand of the medical industry. Frustrating that they treat it as bad until they "discover it". Milk Thistle helps the liver with glutathione, and I suspect that glutathione would probably be beneficial as well for mushroom poisoning, as it is benefical for most other liver related illnesses and toxicity issues. For example glutathione is the treatment of choice for Tylenol poisoning, and relieves the toxic overload of alcohol. (hangover!). The best source of glutathione is from natural precursors, since we can't absorb glutathione directly.
I been studying Natural Health and herbology since I was 14, I am avid harvester of natural herbs, I have harvested mushrooms but I am very careful. (I haven't even done that for years). I have treated people with milk thistle for years. Great Liver builder, Also I would recommend using Wheatgrass Juice to detox, also . I have not seen a main stream doctor for 20 years.
Oh yay... we have things like flesh-eating bacteria, MRSA, C-Diff, diabetes, on and on, but someone is concentrating on the huge problem of mushroom poisoning. I am sooo comforted.
"WE THOUGHT IT WAS A GOOD MUSHROOM BECAUSE IT SPRUG UP IN OUR BACKYARD" Do yourself a favor, and stick to what comes into your local grocery store!!!!! If you have no other frame of reference when it comes to wild mushrooms or any wild edible plant other than "It is growing in your backyard" then you have NO business picking, and eating it!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!DUMB, DUMB, DUMB, DUMB!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Back in the seventies in Santa Cruz, a fungus expert and his wife, Tim and Dorothy Orr, died consuming this same deadly mushroom, which in its button stage resembles an Italian mushroom called 'cocorra', or hard-boiled egg, and their two children barely made it. But even as an amateur, the thing is, to me it's an ugly mushroom, radiating its toxicity with its greenish tinge and frilly skirt and odorless white gills, and the first sign you must look for is the lack of bird pecks or bugs, which know better than to eat it. But their death proves even a good guide is useless if you don't obey its rules. Even with a trusted species, a small taste and waiting period is advised.
difference is, they made an error after carefully looking into it
Mr. C, the patient above, did not research the mushroom at all.
he thought it was fine because, he said, it grew up in his backyard.
so so different!