Chapter 22: Poisonous and Hallucinogenic Mushrooms

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Imagine this, it's a pretty chilling scenario.

A man, he's doubled over, rushed to the ER, severe vomiting, diarrhea, just agonizing abdominal cramps.

Doctors, they treat what looks like acute gastroenteritis, maybe send him home.

Standard procedure sometimes.

Right.

But then over the next couple of days, the absolute unthinkable happens.

His liver, kidneys, heart, they start to fail, one by one.

Oh, wow.

And despite everything doctors try, he dies.

The tragic truth often missed.

He'd eaten wild mushrooms just 12 hours before the first symptoms even started.

12 hours.

That's the scary part.

So what was happening in those silent hours?

Yeah.

And really, could this have been prevented?

Welcome to The Deep Dive, your shortcut to being well informed.

Today, we're plunging into a world that's, well, it's fascinating, but also profoundly dangerous.

The realm of poisonous and hallucinogenic mushrooms.

Whether you're just curious or maybe more importantly, thinking about safety, understanding these fungi is absolutely crucial.

We'll be using insights from great sources like the fifth kingdom to give you knowledge you won't forget.

It really is a world where people kind of fall into two camps.

You're either a picker, someone who loves foraging, thinks wild mushrooms are amazing finds, or you're a kicker.

A kicker.

Yeah.

Someone who wouldn't dream of touching them.

And it's often cultural.

Anglo -Saxon cultures, often kickers.

Central Eastern Europeans, often enthusiastic pickers.

But sadly, that passion, if you're not properly educated, well, it can lead to just devastating outcomes like that story you just told.

Exactly.

And that danger, fundamentally, it comes down to one massive challenge.

Identification.

There just isn't one simple trick.

No universal rule to tell you if a mushroom's safe or deadly.

Nope.

Those old wives tales, like if it peels, it's safe or bugs eat it, so can you.

They're not just wrong.

They're curious.

It's like playing Russian roulette.

Seriously.

It really is.

The only safe rule, the absolute gold standard, is knowing that mushrooms'

scientific name, with complete 100 % certainty, before you even think about eating it.

Absolutely.

And the stakes.

They're incredibly high.

Globally, we're talking, what, over 10 ,000 species of fleshy fungi?

10 ,000.

Wow.

Yeah.

Most are harmless.

Some are delicious, sure.

But a critical few, deadly.

And many others cause severe, really debilitating illness.

Just to give you an idea, in Europe, there have been times, short periods, with up to 100 fatalities in just two weeks.

A hundred.

That's staggering.

It is.

And what's truly sobering is that one single genus, Amanita, is responsible for, get this, 95 % of all mushroom poisoning fatalities.

95%.

From one group.

Exactly.

Okay.

So our mission today is to explore the 12 recognized types of mushroom poisoning.

We'll dig into their toxins, the scary symptoms, the treatments doctors use, racing against time.

By the end, you'll be much better equipped with, honestly, potentially, life -saving knowledge.

Okay.

Let's unpack this.

We absolutely have to start with the most infamous one.

Amanitan poisoning.

The silent killer.

Dominated by those Amanita species, often called destroying angels or death caps, like we just heard, responsible for almost all fatalities.

And visually, some look so innocent.

Like Amanita verosa, pure white.

It has a ring on the stalk, a little cup at the base called a vulva.

Right, the vulva is key.

Or Amanita falloids, the death cap.

Similar structure, but often a kind of greenish cap.

They don't look particularly threatening.

Not at all.

But that harmless look hides a really insidious weapon.

Amitoxins.

Now, these mushrooms also have phallotoxins, which are nasty if injected.

Okay.

But luckily, our gut usually neutralizes them.

Amitoxins, though, that's the real danger when you eat them.

They are incredibly lethal.

The LD50, that's the dose that kills half a test group.

It's just 0 .1 milligrams per kilogram of body weight.

Tiny.

So small.

A single mushroom cap can easily contain enough to kill a grown adult.

Wow.

And the way they work is just terrifying.

They don't just make you sick to your stomach, they go right for the control center of your cells, the nucleus.

The nucleus itself.

Yeah.

They specifically bind to a critical enzyme, RNA polymerase II.

This enzyme is essential for building proteins, you know, the stuff your cells need to function to live.

When that process gets shut down, the cell just dies.

And this hits hardest in cells that regenerate quickly.

Think intestinal lining, liver, kidneys.

Ah, okay.

So that explains the organ failure.

Exactly.

Widespread organ failure.

And this leads to that terrifying four -stage progression of amitoxin poisoning.

It's so dangerous precisely because of the delay.

First, you've got the latent period.

This is the really sneaky part.

Six to 24 hours, often about 12.

You feel totally fine.

No clue.

Anything's wrong.

Done.

But inside, the damage is already starting.

Silently.

That's why people rarely connect feeling sick later to the mushrooms they ate, maybe even the day before.

Makes sense.

Then stage two hits.

Violently.

Intense vomiting, diarrhea, severe abdominal pain usually lasts about a day.

Rough.

Then stage three.

This is a brief, completely misleading remission.

Yeah.

The symptoms seem to get better.

False hope.

Totally.

You might even feel well enough to leave the hospital.

But then comes stage four.

Catastrophic collapse, kidney, liver function just plummets, coma, and then often death.

It's just awful.

The key thing here, time.

Time is your absolute worst enemy.

That delay means silent damage, making early intervention almost impossible if you don't know what you ate.

And treating it is incredibly challenging because of that delay, because there's no perfect antidote.

By the time you feel sick, a lot of damage might already be done.

So what can doctors do?

They focus on really aggressive strategies.

First, toxin removal.

If you get to the hospital super early, maybe stomach pumping helps.

But more often, they need blood cleansing techniques.

Like dialysis.

Yeah, like hemodialysis or hemoperfusion, filtering the blood over activated charcoal, trying to pull those toxins out.

Second, increasing excretion.

Amitoxins actually show up more in urine than blood, so forced diuresis, lots of IV fluids, diuretics, trying to flush the toxin out.

Third, supportive measures.

Absolutely critical.

Carefully watching electrolytes, fluids, blood sugar, organ function, basically supporting the body as its systems fail.

Right.

And there are some new developments.

An intravenous extract from milk thistle, ligolansil, is often used, and there's something called the bastion treatment, a multi -drug approach, that's reportedly saved lives if given early enough.

Okay, so there are options, but timing is everything.

Everything.

Now, here's where it gets really interesting.

A sort of biological footnote, but it shows just how powerful these toxins are.

Certain types of drosophila, you know, common fruit flies, they can actually eat poisonous amniated mushrooms without any problem.

Seriously, fruit flies?

Yeah.

They're hundreds of times more tolerant to amitoxin than related flies, and this immunity evolved because it gives them a huge advantage.

How so?

Well, other insects, bigger ones like craneflies, can't survive in these toxic mushrooms.

So more food for the drosophila.

Ah, less competition.

Exactly.

Plus, the larvae growing in these toxic fungi, they don't get parasitized by this certain nematode worm that often messes up their relatives' breeding.

So what's deadly for us protects them.

Wow, nature is wild.

Isn't it?

Okay, moving on, let's talk group two.

Modern methylhydrazine poisoning,

often linked to the false morel.

Ah, yes, gerometra.

Right.

True morels, morchella, are super popular with foragers.

But the false morel, gerometra esculenta, looks quite similar and pops up around the same time in spring.

And tragically, this lookalike is responsible for about two, four percent of all fatal mushroom poisonings.

Yeah, it's a significant number.

The toxin in gerometra is called gyrometrin.

And here's a wild fact, when you cook it or digest it, it breaks down into monomethylhydrazine MMH, which is also used as rocket fuel.

No way, rocket fuel.

Seriously, gives you an idea of how toxic it is.

And there's this weird thing, sometimes the cook gets sick, but the people eating it don't.

How does that happen?

Because MMH boils at a relatively low temperature,

so toxic fumes can come off during cooking and be inhaled by the cook.

Another strange thing is the all or nothing response.

Someone might eat gerometra a few times, be fine, and then suddenly one meal is lethal.

They've just hit their body's limit.

So you can't build tolerance, you're just gambling.

Exactly, rolling the dice every time.

So what are the symptoms for this MMH poisoning?

They usually show up two to 12 hours after eating,

typically around six to eight hours.

Starts subtly, maybe a bloated feeling.

Then nausea, violent vomiting, diarrhea, bad abdominal cramps.

You might feel faint, lose muscle control, get a fever.

In severe cases, it gets worse.

Jaundice, convulsions, coma, and death within two to seven days.

That sounds horrific.

What's it doing at the cellular level?

It's really damaging.

Hemolytic breaks down red blood cells.

It's neurotoxic, causes severe gut irritation.

And it really hits the liver hard.

You'll see signs like methamoglobin in the blood, rising bilirubin, liver enzymes go up, blood sugar drops.

Is there an antidote?

Thankfully, yes.

There's a specific one.

Pyridoxine, hydrochloride, vitamin B6, basically.

Yeah, vitamin B6.

Yeah.

That plus supportive CARE -IV glucose managing kidney issues, that's crucial for survival here.

Okay, good to know there's something specific.

Now, group three,

orlanine poisoning.

The long delay.

This sounds maybe the most terrifying because of that delay.

It is uniquely sinister,

yeah.

Species like Cortinarius or Alanis.

The symptoms have an extremely delayed onset, often three or four days after eating.

Days?

Sometimes up to 10 or even 17 days later.

Seventeen days.

How would you even connect it back?

Exactly.

Diagnosis is incredibly difficult.

The patient might not even remember eating mushrooms weeks ago.

So what does this toxin or alanine do?

That's a potent nephrotoxin, meaning it specifically targets and destroys your kidneys.

Kidneys, okay.

Initial symptoms days or weeks later can be intense thirst, a burning dry mouth, then headache, chills, pain in your lower back or abdomen.

Nausea, vomiting might follow.

Urination might even increase at first, weirdly, but then it slows down and can stop completely.

Waste products build up in the blood.

And the end result?

Total irreversible kidney failure.

Often, the only option is a kidney transplant.

That long delay is just the ultimate deadly trap.

Unbelievable.

Okay, let's shift gears a bit.

Group four.

Coprine poisoning.

The antibes -like or alcohol trap.

Ah, the inky cap coprenopsis atramentaria.

Right.

What's weird here is the mushroom itself isn't toxic, is it?

Only if you drink alcohol.

That's absolutely right.

Symptoms only appear 30 to 60 minutes after you drink alcohol.

And here's the really strange part.

This reaction can happen up to five days after you ate the mushroom.

Five days later.

Yeah.

Yeah, the toxin copren blocks your body from breaking down alcohol properly, specifically at the acetaldehyde stage.

So you get this rapid buildup of acetaldehyde, basically acetaldehyde poisoning.

What does that feel like?

It's intensely unpleasant.

Hot flushes, especially in the face and neck.

Metallic taste, tingling, numbness, heart palpitations, a throbbing headache, nausea, vomiting.

Ugh, sounds awful.

It is.

The crucial takeaway here.

If you've eaten any wild mushroom, even one you think is safe, just avoid alcohol for several days afterwards.

Play it safe.

Good advice.

Is it fatal, though?

Typically no, thankfully.

Just really unpleasant.

Symptoms last as long as there's alcohol in your system.

Maybe two to four hours, then you recover.

It's so bad, apparently it often makes people swear off booze for a while.

I can imagine.

And you mentioned antabuse.

Right.

It's fascinating.

Copren works almost exactly like the drug antabuse or disulfiram, which is used to treat alcoholism by making drinking incredibly unpleasant.

Same mechanism.

Nature's own antabuse.

Group V muscarine poisoning.

The PSL syndrome.

You mentioned being careful with little mushrooms in the grass.

Yes, exactly.

Little white or brown mushrooms may be growing in your lawn.

Be careful.

Some species in general, like cleoside and inoside, contain significant amounts of muscarine.

And muscarine acts fast.

Very fast.

Symptoms within 30 minutes to two hours.

It basically overstimulates your body's exocrine glands, the ones that secrete fluids.

This leads to the classic PSL syndrome.

P for perspiration, S for salivation, L for lacrimation.

So sweating,

drooling, crying.

Lots of it.

Plus constricted pupils, blurred vision, muscle spasms, diarrhea, a slow heartbeat, and a drop in blood pressure.

Is it dangerous?

The main danger, though it's rare, is for people with pre -existing heart conditions.

Enough muscarine could potentially cause the heart to stop.

Oh, wow.

Is there a treatment?

Yes, thankfully.

There's a specific and effective antidote, atropine.

Given carefully intravenously.

Okay.

Good to know.

Now for something maybe more familiar from pictures.

Group 6.

Ibotenic acid mucimole poisoning.

The fairy tale mushroom.

Ah, Amanita muscaria.

The classic red cap with white spots.

Exactly.

Seen everywhere in storybooks.

Right.

And unlike its deadly Amanita cousins we talked about first, this one's effects are primarily psychoactive, not usually organ damaging.

So what happens if someone eats it?

Well, you might get some muscle spasms, dizziness, maybe vomiting if you eat too much, but then it's often followed by this deep sleep filled with really vivid fantastic dreams.

Waking up, people often report a good trip, feeling elated, hyperactive, maybe a bit uncoordinated, talking nonstop, and seeing reality differently.

Sometimes though, it can be a downer.

It has such a rich history, doesn't it?

Absolutely fascinating.

Some scholars think the ancient Somahims from India, 3 ,000 years old, are actually about Amanita muscaria.

Wow.

And Siberian tribes used it for centuries.

Religious ceremonies, recreation,

and there's that wild story about recycling the intoxicant.

The reindeer urine thing?

Yeah.

Apparently the active compounds pass through the body unchanged into the urine.

Siberians noticed reindeer liked eating snow where someone had urinated after eating the mushroom, so they figured out you could drink the urine of someone who'd eaten the mushroom to get the effects, especially when mushrooms were scarce.

That is truly extreme recycling.

Definitely.

Chemically, the fresh mushroom has ibotenic acid, but drying it converts that into muscimol, which is way more psychoactive, like five to ten times more.

So drying makes it much stronger.

Significantly.

Treatment -wise, usually nothing specific is needed.

Recovery is typically spontaneous within 24 hours, but critically, do not give atropine.

It can actually make the symptoms worse.

Good to know.

Okay, let's dive into group seven.

Psilocybin, psilocin poisoning, known as the flesh of the gods.

Tinnanocattle, the secret mushrooms of the Aztecs.

Used for thousands of years, right?

And rediscovered famously by R.

Gordon Wasson.

His descriptions were incredible.

Weren't they?

Kaleidoscopic visions, euphoria, peace.

Feeling like a disembodied eye flying through other dimensions.

Pretty profound stuff.

What mushrooms cause this?

They come from several genera, mostly psilocybe, but also pineolus, conocid, gymnopolis.

The active compounds are psilocybin and psilocin.

They're indole alkaloids, chemically related to serotonin, a key neurotransmitter in our brain.

How much does it take?

A typical effective dose is pretty small.

Around four to eight milligrams of psilocybin.

That's roughly what you'd find in about two grams of dried mushrooms.

Are they dangerous physically?

Generally considered pretty safe physiologically, unless you take absolutely huge amounts.

The main risk is psychological a bad trip.

Right.

Anxiety, paranoia.

Exactly.

Usually managed with reassurance, maybe tranquilizers in rare cases.

One note.

In children, it can sometimes cause high fever or convulsions.

Importantly, don't give aspirin.

Tep baths are better.

But what's really fascinating now is the medical potential.

Ah, the clinical trials.

Yes.

Since around 2013, places like Johns Hopkins, NYU, they've been studying psilocybin for anxiety and depression, especially in cancer patients.

And the results?

Really promising.

A single dose of synthetic psilocybin showed significant long lasting reductions in symptoms for many patients, like 80 % feeling better for months with minimal side effects.

Wow.

So huge potential there.

Definitely.

It's a really active area of research.

Okay.

Next up, group eight, gastrointestinal irritants.

Nicaraguan.

Yeah, this is a real mixed bag.

Lots of different fungi from various generacas, belates, russula, many others.

And their common link is?

They just make you sick to your stomach.

Within 30 to 90 minutes of eating them, you get varying degrees of vomiting, diarrhea, abdominal cramps.

Unpleasant.

But not deadly like a man in.

Generally no, thankfully.

The symptoms, while rough, usually clear up on their own in three, four hours.

Full recovery takes maybe a day.

The toxins involved?

Mostly unknown because it's such a diverse group.

But the key is the rapid onset, you know, pretty quickly what caused it.

And it usually passes relatively fast.

Treatment is just managing symptoms then?

Pretty much.

Emptying the stomach if possible and definitely watching for dehydrogen, especially in older or more vulnerable people.

Okay.

Group IX.

Rhabdomyolysis.

Muscle destruction.

That sounds serious.

It is very serious.

Primarily linked to two species.

Tricoloma equestria, which believe it or not, used to be considered edible.

Wow.

And Ressola subnigricans.

And rubbed myeloma as meat.

Breakdown of skeletal muscle.

Your muscles literally start breaking down.

This releases a protein called myoglobin into your blood.

That myoglobin can then damage your kidneys, leading to dark urine and potential kidney failure.

When do symptoms start?

It can be delayed, usually 24 to 72 hours after the last meal.

Symptoms include fatigue, weakness, and severe muscle pain myalgia.

Needs immediate medical help.

Definitely serious.

Group X pleurocibella porogens, or angel wings,

causes acute brain damage.

Yes.

This is a delicate, pretty mushroom.

But back in 2004 in Japan, it caused several death from acute brain damage, mostly in people who already had kidney problems.

Do we know the toxin?

Still unidentified.

Which just shows how much we still don't know about some of these fungi, even common -looking ones, and that underlying health can be a factor.

Right.

Gruvexii, Paxilis invulitis, the poison Pax, hemolytic anemia.

Yeah, destruction of red blood cells.

This one isn't eaten much in North America, but it causes issues in Eastern Europe.

What's the tricky part here?

The anemia often only develops after someone has eaten the mushroom repeatedly over time.

Ah, so it's cumulative.

Seems to be.

Which makes diagnosis hard, right?

Because the first few times might seem fine.

Another reminder that toxins work in different ways.

Definitely.

Okay, last one.

Group 12, Amanita smithiana,

the matsutake mimic.

Found in the Pacific Northwest, often mistaken for the highly prized matsutake mushroom, a dangerous look -alike.

And its effects.

Similar to oral anean kidney and liver failure, but the onset is much faster, usually 4 to 11 hours, not days or weeks.

Do we know the toxin?

We know it's not an amytoxin, but the specific compound is still unknown, just another example of the diverse chemical arsenal fungi have, and why look -alikes are so dangerous.

Okay, so after running through all 12 of those,

pretty alarming groups, but crucial info.

Yeah.

What's the bigger picture?

Can we group these patterns?

Yeah, I think we can see about four basic patterns emerging from what we've discussed.

Okay, pattern one.

First, you've got toxins causing delayed, widespread cell destruction.

Think Amanitan, oral anean, MMH, the silent killers attacking organs.

Right, delayed and devastating.

Pattern two.

Second, toxins acting on the autonomic nervous system.

Symptoms appear quickly, or like with cuprine, when alcohol is present.

Muscarine, cuprine fit here.

Okay, nervous system effects, often fast.

Third.

Third, toxins acting directly on the central nervous system.

Again, rapid onset.

Mussomol from Amanita muscaria, psilocybin, changing perception, mood.

Psychoactive effects.

Yeah.

And the last pattern.

And finally, that sort of catch -all group, Undetermined toxins acting mostly on the gut.

Causing immediate, unpleasant GI distress, but usually not fatal.

Our group eight.

Got it.

Cell destroyers, nerve agents, CNS agents, and gut irritants.

That helps simplify it a bit.

So the huge takeaway.

When it comes to wild mushrooms, caution isn't just a good idea.

It's, well, it's absolutely essential.

Life or death essential.

Yeah.

Identifying species needs real, expert knowledge, reliable tools.

Not folklore, not guessing.

That really is the core message.

Unless you are a genuine mushroom expert, and I mean someone with serious training experience,

multiple reliable field guides.

Right.

The safest bet is just don't eat wild mushrooms.

Period.

Or if you absolutely insist,

stick to maybe one or two species you have learned inside and out and verified with absolute certainty.

No pretty sure.

No pretty sure allowed.

Nope.

And amazing, even with modern science, so many mushroom toxins are still unknown or lack specific antidotes.

It's this field with incredible potential like the psilocybin research, but also these profound, sometimes deadly mysteries makes you wonder what other secrets are fungi hiding?

How many more will we uncover?

It's a constantly evolving field.

Well, thank you for joining us on this really crucial deep dive into the world of poisonous and hallucinogenic mushrooms.

We genuinely hope you feel much better informed now and definitely safer.