Poisonous and Psychotropic Mushrooms

Amanita, fly agaric, brain mushroom, false morels, death cap, parasol; mushroom, destroying angel, Bolete, Satan's Bolete, Tricholomas, deadly corts, Cortinarious, Entolomas, Gyropilus, laughing mushrooms, poison pie, Russula, Omphalotus, Jack-o'-lantern, Paxillus, Lacterius, milk cap, liberty cap, Psilocybe, crown cup, Clitocybe, Inocybes, inky cap, Coprinus, ergot, Claviceps, earthballs, sulfer tuft, philiotina, Hypholoma

How to avoid being poisoned by mushrooms.

1. Never eat any mushroom that has a cup at the base of the stem. It may be a deadly Amanita.

2. Never eat any mushroom that has a veil that is fine and threadlike. It is a Cortinarius and the veil is called a cortina. There are some edible Cortinarius but you should know the mushrooms very well before you eat them.

3. Never eat more than one species of mushroom for the first time in any one day.

4. Never eat more than a taste of a mushroom the first time you eat it. Wait for at least six hours before eating that mushroom or any other mushroom again.

5. Never assume that just because a friend says that he eats the mushroom that it is safe for you. You may be allergic to that species.

6. Never eat a mushroom that smells bad or is starting to spoil.

7. Never eat any small brown mushroom that you can not identify as to genera and species. It might be a deadly galerina.

8. Never trust any so called test for a poisonous mushroom such as putting a quarter in the pan you are cooking it in and if it turns black the mushroom is poisonous. That just isn't so.

9. Never overeat any species of mushroom as most mushrooms are rather indigestible and can make you sick even if they are not poisonous.

10. Never eat any mushroom you are not absolutely sure is an edible species.

11. Get a book that tells you how to identify the mushroom species and study it before trying any new mushrooms.

12. Join the New Mexico Mycological Society or some other society in your area and attend the meetings to learn more about mushrooms.

13. Eat the mushrooms that you know are safe and you have previously tried as soon as possible after picking them. Coprinus will turn to black ink within a day and become inedible.

14. If you have more edible mushrooms than you can eat at once then dry them or freeze them as soon as possible to preserve them for another time.

Mushroom Poisoning Syndromes

There are many different types of mycotoxins . It's not surprising then, that there are different degrees and types of mushroom poisoning. Since most mushroom species are rarely eaten, many toxins are poorly documented. NAMA maintains a case registry where you may report instances of mushroom poisoning.

The following list is not exhaustive. It is presented here for imformational purposes, and should not be considered an aid to diagnosis. If you suspect that you have consumed a poisonous mushroom, contact a physician, or your local poison control center.

Contents

Gastrointestinal Irritants

The most frequent form of mushroom poisoning is caused by a wide variety of gastrointestinal irritants. The symptoms usually appear within 20 minutes to 4 hours of ingesting the mushrooms, and include nausea, vomiting, cramps, and diarrhea, which normally pass after the irritant had been expelled. Severe cases may require hospitalization. Treatment is largely supportive - helping the patient's body to eliminate what it's not equipped to handle. Recovery is complete, though a bout with severe gastro-intestinal distress may put one off ever eating mushrooms again!

Muscarine

Mushrooms : Inocybe species, Clitocybe dealbata , and several relatives, Omphalatus species, and certain red-pored Boletus .

The symptoms usually occur within 15-30 minutes of ingestion, and are focused on the involuntary nervous system. They include excessive salivation, sweating, tears, lactation (in pregnant women), plus severe vomiting and diarrhea. These symptoms may be accompanied by visual disturbances, irregular pulse, decreased blood pressure, and difficulty breathing. Victims normally recover within 24 hours, but severe cases may result in death due to respiratory failure. Atropine is a specific antidote, but must be administered by a physician.

Isoxazole Derivatives (Muscimol, Ibotenic Acid, and relatives)

Mushrooms : Amanita muscaria , A. pantherina , A. gemmata , A. cothurnata , A. frostiana , A. crenulata , A. strobiliformus , Tricholoma muscarium .

There is a great deal of confusion concerning these toxins, and much misinformation about their treatment. Atropine is NOT indicated in cases of poisoning by ibotenic acid or muscimol but is frequently cited as a treatment for A. muscaria poisonings in the medical literature, where the toxin is erroneously listed as muscarine! Atropine's effects are close to those of ibotenic acid, and may even exacerbate the symptoms.

Symptoms appear within 30 minute to 2 hours after ingestion, and last for several hours. Nausea and vomiting are quite common, but the principle effects are on the central nervous system: confusion, visual distortion, a feeling of greater strength, delusions and convulsions. Drowsiness is a common symptoms, and many who ingest these mushrooms fall asleep and can not be roused. This facet of the syndrome can be particularly frightening for the attending physician, as most cases involve patients w ho arrive in this apparently comatose state. The resulting panicked reaction and overtreatment, generally produces no benefit to the patient.

Treatment is largely supportive -- reassuring the patient that the effects are only temporary. Recovery is normally spontaneous. To reiterate: Muscarine plays no documented clinical role in poisonings by or A. patherina . Atropine is not indicated.

Amanitin (Amatoxins)

Mushrooms : Amanita phallodies, A. ocreata, A. verna, A. bisporigera, Conocybe filaris, Galerina autumnalis, G. marginata, G. venenata, Lepiotia castanea, L. helveola, L. josserandii & close relatives.

Extremely Serious . The fatality rate for Amanitin poisoning is about 50%. It is doubly dangerous due to the fact that the symptoms are delayed for 6 to 24 hours after ingestion, by which time the toxins have been completely absorbed by the body.

Amanitins are a group of complex cyclic polypeptides which damage tissues by inhibiting RNA synthesis within each individual cell. Onset of symptoms manifests itself in four stages:

If you have any reason to suspect that someone has ingested an amanitin-containing mushroom, Don't wait for Symptoms to appear! There is no antidote for amanitin poisoning, and the best hope is to rush the person to the hospital where the toxins can be removed before being fully absorbed into the body. Treatment is largely supportive and symptomatic. Penicillin, kutkin, and silibinin/silymarin show promise as treatments, along with oral activated charcoal and electrolytes.

Gyromitrin

Mushrooms : Several Gyromitra spp., also many related Ascomycetes, such as some species of Helvella , Verpa , & Cudonia spp.

Gyromitrin's product of hydrolisis is monomethylhydrazine (MMH), a colorless, volatile, highly toxic, carcinogenic compound, first discovered and used for it's hypergolic properties in combination with nitrogen tetroxide. MMH is used by NASA as rocket fuel, which should give some idea of what is meant by "volatile".

"Volatile" also means that gyromitrin has a low boiling point, and thus mushrooms containing it can have a puzzling non-effect on some, whereas others are severely poisoned. The dividing line between a "safe" and "lethal" dose is very slim.

Symptoms appear within 2 to 24 hours and include headaches, abdominal distress, severe diarrhea, and vomiting. In severe cases, liver, kidney, and red blood cell damage may occur, possibly resulting in death. Treatment is largely supportive, and a physician should be consulted.

Gyromitrin is also a known carcinogen, so consuming a less than toxic dose may also cause trouble down the line.

Orellanine

Mushrooms : Cortinarius orellanus , C. orellanoides , C. speciosissimus , C. rainerensis , C. splendens , C. atrovirens , C. venenosus , C. gentilis and many other Cortinarius spp.

Extremely Serious . Onset of symptoms from orelanine poisoning can be very greatly delayed (as much as three weeks), the toxin isn't very well understood, and specific treatments are not available.

Symptoms occur within 36 hours to 3 weeks of ingestion (average is about 8 days), and include nausea, vomiting, lethargy, anorexia, frequent urination, burning thirst, headache, sensations of coldness and shivering (fever generally absent), evidence or progressive kidney failure.

Beyond the standard management of kidney failure, there is little but supportive treatment of use in cases of orellanine poisoning. Patients with severe, but not irreversible damage may begin to recover kidney function between two and four weeks after the onset of symptoms.

Psilocybin, Psilocin, and other Indole Derivatives

Mushrooms : Psilocybe cyanescens , P. stuntzii , P. cubensis , P. semilanceata , Panaeolous cyanescens .

These indoles are well-known as hallucinogens, and these mushrooms have played important roles in religion and medicine in some parts of the world, notably in South America. Their properties were "rediscovered" by mycologists in Oaxaca in the 1930s, and studied by mycoethnographers Gordon and Valentina Wasson in the 1950s; their chemistry was documented by Albert Hoffmann.

Both psilocybin and psilocin -- a dephosphorylated version which is some ten times as potent -- are found naturally in mushrooms, though their ecological purpose is unknown. In the human body, they affect the serotonergic systems in the brain, and show some cross-tolerance with substances such as LSD.

Onset of symptoms usually occurs within an hour of ingestion, and effects typically last up to four to six hours. Effects are primarily psychological and perceptual, including heightened color perception, emotional effects such as religious ecstasy or anxiety, and sometimes hallucinations or delusions. As with any other psychologically-active substance, mindset and situation can greatly influence psilocybin's subjective effects. Care should be taken not to frighten or upset a person under its influence, and if a victim does become anxious, to reassure them that the effects are temporary. Little research has been done on antitoxins, but tryptophan may have a mitigating effect.

Nausea and vomiting are sometimes associated, but generally occur earlier than the psychological effects, and may be associated with other toxins present in some psilocybin-bearing species, rather than with the indoles themselves. A very few severe reactions, including fevers and deaths, have been reported in contexts of psilocybin poisoning of small children; "grazing" accidents by toddlers should be treated in a hospital.

Perhaps the greatest danger posed by psilocybin as a mycotoxin is that the mycologically ignorant may, in hunting for "magic mushrooms", find themselves consuming something different and far more dangerous. Galerina autumnalis and other amanitoxin-bearing "little brown mushrooms" may be mistaken for hallucinogenic species, and there has even been a report of children inhaling the spores of Lycoperdon puffballs in the hopes of "getting high", only to wreak havoc on their lungs.

Miscellaneous and Unknown Toxins

Amanita smithiana

Amanita smithiana has caused numerous poisonings in the Pacific Northwest, where it is possibly being mistaken for the popular Matsutake, or "Pine Mushroom" Tricholoma magnavelare , to which it bears a superficial resemblance. Many physicians have been quick to attribute these poisonings to orellanine, and indeed there are some obvious similarities in the symptoms. However, onset of symptoms is more rapid in cases of A.smithiana poisoning (between 4 and 11 hours, compared to orellanine with a 36 hour to 3 week onset period). A.smithiana causes both renal and hepatic failure.

Paxillus involutus

Although rarely reported in North America, poisonings by Paxillus involutus do occur, and the mushroom is common enough to warrant inclusion here. It is the third most common cause of gastrointestinal symptoms in Eastern Europe, where is has a long and unfortunate culinary history. However, the main toxic component in P. involutus causes acute immune-mediated hemolytic anemia.

Hemolytic anemia occurs mainly in individuals who have eaten P.involutus for many years without ill effect. Because the syndrome is related to repeat, long-term exposure to the toxin, poisonings may likely go unrecognized, with the more likely diagnosis being idiopathic immune hemolytic anemia.

It is perhaps warranted to suggest that in cases of idiopathic anemia, especially in patients of Eastern European extraction, that the question of P.involutus consumption be raised.