This Podcast Will Kill You - Ep 166 Amanita poisoning: Death Cap-tivating

Episode Date: February 18, 2025

In forests, in lawns, in city parks across the world lurks a small, pale, unassuming mushroom whose inconspicuous appearance belies its deadly nature. For within this mushroom dwelsl one of the deadliest poisons known to humans: amatoxin. It’s because of this toxin that the aptly-named ‘death cap mushroom’ (Amanita phalloides) is responsible for the vast majority of mushroom-related deaths around the globe each year. What makes this poisonous mushroom so very deadly, and is there anything we can do about it? In this episode, we take a journey through this legendary mushroom’s story, exploring its destructive biology, its murderous history, and its worrying yet hopeful future. Tune in to learn more about these mushrooms that show death can come in small packages. Support this podcast by shopping our latest sponsor deals and promotions at this link: https://bit.ly/3WwtIAuSee omnystudio.com/listener for privacy information.

This is exactly right. There are already enough things charging your card every month. Dinner should not be one of them, which is exactly why Blue Apron is now subscription-free. You heard that right, Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Blue Apron meals are designed by chefs and arrive with pre-portioned ingredients, so there's no meal planning and no extra grocery trip. Order now at Blue Apron.com. Get 50% off your first two orders plus free shipping with code this podcast 50.

Terms and Conditions Apply. Visit blueapron.com slash terms for more information. The greatest to ever play the game. Return to finish what they started. Welcome to Survivor 50. I wanted one more shot. I played the game that I fell in love with 25 years ago. I want to win against the best of the best.

I chickened out at the final tribal. Season 50, it's an honor. Light your torch. I've got some unfinished business. Be part of history. I have more to play for this time. Bigger than ever. Survivor 50.

New milestone season begins CBS tonight at 87 Central. You're listening to a podcast. So you're doing something else too, like maybe scrolling home listings on Redfin, saving places you like without thinking you'll get them. Because that's what house hunting has become. But Redfin isn't built for endless browsing. It's built to help you find and own a home.

Redfin agents close twice as many deals as other agents, which means when you find a place you love, you've got a real shot at getting it. Redfin helps turn saved listings into real addresses. Get started at redfin.com. Own the dream. Just a quick content warning here. The first hand account does include a description of the death of a dog. And so if you would like to skip that, you can fast forward around five or six minutes. Hi, my name's Diana, and I had a beautiful six-month-old Bernie's Mountain Dog puppy named Donato,

which means gift in Italian, and he was that. He was gorgeous. In the summer of, I think it was 2010, I was at a friend's house in August in Carmel Valley, California. It was hot, middle of the summer, not a time that you would think there'd be mushrooms. So we were swimming in the pool, and he was running around having a blast. And he didn't come when I called. I looked for him and I found him in the garden with what looked like was an inverted mushroom growing into the ground.

I couldn't figure out what the heck it was. Little did I know that this cup-like thing in the ground was the vulva of a death cap mushroom. About four hours later, he threw up, but he was still running around inactive, and I didn't think much of it because he was a puppy. But in the middle of the night, he continued throwing up

and had major diarrhea, and he was in obvious pain. So I rushed him to the emergency vet in Carmel Valley at 5 a.m. And in 2010, vets weren't really that aware of mushroom toxicity as they are today. Also, it was a bit of a perfect storm in some ways because my high-level vets that were in the Bay Area were moving their offices, so I had to stay with this small country emergency vet. Though I brought the shards of the mushroom to the vets, they disregarded them, and they gave him some anti-nausea medication and ran a liver test initially, and it was slightly elevated, but they just said, oh, he'll get better. They kept him to watch him, and he was not improving. I could tell he wasn't, and I pushed for another liver test, and they kept putting it off and putting it off.

And finally, late that night, they did it again, and his values were off the charts. We transferred Donato at that point to a larger and high-level vet hospital, and though they tried everything, they couldn't save him. I was devastated. I mean, absolutely devastated. Had I known what I know now, he might have had a chance. Now, yes, I can identify a death cat mushroom in an instant. I would have induced vomiting immediately after seeing that inverted cup in the ground. and today vets, they have a quick and easy way to test for amatoxin poisoning, developed by Candace Beaver. And also, I recognize that, you know, though the summer is not a time that you think of mushrooms, when people water their gardens and create a really nice warm environment underneath their oak trees, you can have death-capped mushrooms in the midst of summer.

So since that horrible day, it's become Donato's legacy and my mission to spread the warning about the danger of mushroom toxicity. I started a blog, Mushrooms 9-1-1. I've handed out over 80,000 mushroom alert cards. And I'm helping, you know, Candace and others to promote the Amatoch test. I hope everybody stays safe out there. And watches their yard. Mushrooms come up quickly.

Yeah. Yeah. That is absolutely heartbreaking. It is. Thank you so much for, taking the time to share your story with us, for having to relive that, and also for all the work that you're doing and trying to raise awareness and advocacy, we really, really appreciate it. Yeah, we truly do. Thank you. Hi, I'm Aaron Welsh. And I'm Aaron Alman Updike. And this is,

this podcast will kill you. And today we're talking about mushrooms, the not just any mushroom. Right. This is our first foray into poisonous mushrooms. It is. And it definitely won't be our last, because if there is anything that I got very interested in, it is how many different toxins there are in so many different mushrooms. Yes. And like, why? Great question. Great question. Yeah, I think this is going to be a really interesting episode. I am really excited to learn about the biology of this toxin. Like what it does. It's scary. It's truly so scary. And it's just bizarre, like to put that along with the ecology and the evolutionary aspects of me? That's the question I have. That's what I want to hear about, Erin, because I was like not reading that. And then I was like, sorry, why does this

toxin exist? What is it, yeah, what is it doing for this mushroom? I know. That's my big question. Well, I do, I know, I guess. Okay, I hope you do, because I want to know. We'll find out. Okay. But before, we can do any of that, it is quarantine time. Aaron, what are we drinking this week? We're drinking. The deadliest dose. I mean, it kind of is. It's like one of the deadliest toxins on the planet, yeah? Yeah.

Yeah. As far as I know. I mean, I guess I didn't look up all deadly toxins, but like as far as mushrooms goes, it's for sure up there. It might be up there. And in the deadliest dose, the quarantini and placebo rita is not deadly. It is delicious. It is.

It has vodka. It has cucumber juice. How fun is that? It has lime juice, simple syrup. and elder flour liqueur. Kind of like a little gimlet, but with elder flour, oh, so good. You'll find the full recipe for that quarantini as well as the non-alcoholic and equally delicious plissie burrito on our website, this podcast, we'll kill you.com, and on our social media.

Are you following us yet on social media? We're on Instagram. We're on TikTok. We are. Yeah, we are all over social media. The internet. Check us out. Do you know what else is on the internet?

our website. Our website. It's there. This podcast will kill you.com. Surprisingly enough, that is the name. That is the URL. And on our website, you can find all sorts of things from transcripts to our show notes. You can find links to bookshop.

org affiliate account, our Goodreads list, music by Bloodmobile. The incredible merch we have, like the shirt that Aaron is wearing. I love this shirt so much. This design is like, it's one of my favorites. The rat queen is, she steals my heart. She's so cute. And other things, Patreon, contact us form, a link to a first-hand account form.

You know, there's a lot of good stuff. So check it out. Yeah, do that. All right. Shall we get into this mushroom, Aaron? I think we should. Okay. Let's take a quick break and then begin.

Dinner shows up every night, whether you're prepared for it or not. And with Blue Apron, you won't need to panic order takeout again. Blue Apron meals are designed by chefs and a rise. with pre-portioned ingredients so there's no meal planning and no extra grocery trip. There, assemble and bake meals take about five minutes of hands-on prep. Just spread the pre-chopped ingredients on a sheet pan, put it in the oven, and that's it. And if there's truly no time to cook, dish by Blue Apron meals are fully prepared. Just heat them in the oven or microwave, and dinner is ready.

And here's the exciting news. Blue Apron no longer requires a subscription. You can order meals when you want them and skip when you don't without adding another recurring charge. Order now at blue apron.com. Get 50% off your first two orders plus free shipping with code this podcast 50. Terms and conditions apply. Visit blue apron.com slash terms for more information. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keefe's working hands hand cream is such a relief. It's a concentrated hand cream that is specifically designed to

relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions. Working hands creates a protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades by people who wash their hands constantly or work in

harsh conditions because it actually works. O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth, no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keef's. Just visit O'Keef's Company.com slash this podcast and code this podcast at checkout. A timeless wardrobe starts with pieces that are built well from the beginning. From the fabrics to the fit, everything needs to last beyond one season.

And that's how Quince approaches design. Quince has all the staples covered, from 100% organic cotton sweaters to premium denim made with stretch for all-day comfort and luxe cotton cashmere blends, perfect for the changing seasons. The quality shows in every detail, the stitching, the fit, the fabrics. Every piece is thoughtfully designed to be your new wardrobe essential. And each piece is made with premium materials in ethical, trusted, factories and priced far below what other luxury brands charge. I recently got a pair of Quince's Bella stretch wide-leg jeans, and they are now in constant rotation. They are so comfortable. The

fit is amazing, and they come in a bunch of different washes, so I'm about to go order some more. Refresh your wardrobe with Quince. Go to quince.com slash this podcast to get free shipping on your order and 365-day returns, now available in Canada, too. That's Q-U-I-N-C-E-com slash this podcast to get free shipping and 365-day returns. Quince.com slash this podcast. I know you'll get into this more, Erin, but there are well over 50,000 species of mushroom across the globe. I won't be getting into mushroom diversity. Good, because let me tell you, there are over 50,000 species of mushroom across the globe. Excellent. Many of these are still unclassified, unnamed. At least 350 of them have

been identified as edible mushrooms, and around a thousand are poisonous. Of all of these poisonous mushrooms, there's a really wide variety of different toxins that they produce, each of which has different effects on our bodies. And yet, none of them are quite as deadly as the subject of today's episode, Amanita Faloides. A quick question. Okay. I love it when we start off this way. Okay, when you say that there are a thousand species that are classified as poisonous or have toxins that can be harmful, is that to humans or mammals specifically? Or is that like... That's a great question. I think that is from a human context. But I don't know for sure. Yeah, it was like a review paper. Right. I mean, if it's like edible versus poisonous, yeah, I could see that that being for humans. Anthropocentric, okay?

Yeah. Aminita Faloides or the Death Cap mushroom. I want to paint us a picture here because, I don't know, most people probably aren't that into mushrooms. I think you might be wrong about that, but. Well, okay, I probably am. I'm not that into mushrooms, so I needed to paint myself a picture of what we're talking about here. And as far as mushrooms go, I feel like when I first looked at the pictures of Aminita Faloides, it was pretty innocuous. It was like a mushroom-looking mushroom.

Like, draw a picture of a mushroom, kid. You're going to get something that looks a lot like Aminita. So it has this very kind of gently domed cap with this wide brim. Okay. And it looks a lot like the mushrooms in Fantasia with maybe a less pointy dome. Do you remember those dancing mushrooms in Fantasia? Which music or which act? Like, what else was going on with the mushrooms?

I don't remember. I don't remember, like, the dino one very strongly. I only remember the mushroom one and then the dancing brooms. And I don't know if that was the same skit or not. Okay. No? Okay. Well, then think of the Toad mushroom in Super Mario Brothers?

Toad? Oh, yeah. Okay, Toad, sure. Okay, Toad. Let's do that. So Toad is a red with white dot mushroom. That is also an aminita species, aminida muscaria. Okay.

So Aminida Faloides looks. kind of similar to toad, except that the cap, instead of being red with white dots, is this light, kind of yellowy, green, almost metallic-looking, like very smooth cap. They can be quite large. So we're talking the cap is like between five to 15 centimeters in diameter, which is like two to six inches across, so pretty good size. Wow. And then on the underside, of course, mushrooms have gills. And in the case of Aminida Faloides, they're white. And, pure white gills, and then underneath on their little stalk or stem, which I learned in mycology is called a stipe, just to be fancy. Along this stipe, they have a frilly little,

like, mini skirt that hangs down just below the cap. And their stipe, their stem is pretty beefy looking compared to some other species of amnita. So they're like a little thicker. And they can be pretty long, like three to five inches tall coming out from the ground. It's a white stem, but with some little olivey, kind of scaly bits that you might see on there. And then just below, like buried just beneath the earth where this mushroom is coming out, but often visible, if you were to pull this mushroom all the way out, they have this wider, swollen, like, sock sack-looking situation that hangs down. It's called a vulva. Not a vulva, but a vulva.

V-O-L-V-A. V-O-L-V-A. Okay. It looks almost like, I don't know, like a really fragile eggshell that the mushroom is, like, growing out of. Okay. That is kind of what it is, because when these mushrooms come out of the soil, they first come out in what's called this universal veil, and then the mushroom kind of pokes out of it. All aminita species do this. And so, you know, on the red and white, I'm getting a little too detailed, Aaron, but sorry.

Oh, no, I'm loving it. The red and white mushrooms, the white little dots are remnants of that universal veil. Oh, how fun. Isn't that cute? Yeah. And so other species of aminita have maybe like a big chunk of it kind of left on top of the cap. Okay. Aminita Faloides doesn't have any left on the top.

The frilly skirt that hangs down on the stipe is part of it. And then it has this eggshell sack at the bottom. Okay. Okay. So that's to paint a picture. Google image search also. And I know we'll both probably talk a little bit more about the distribution and range, but to continue to set the stage, this mushroom, what it is, is the reproductive part of a fungus.

So it's also called the fruiting body. And it's just the part of this fungus that's visible above ground. But beneath every mushroom, there's a lot more to the fungal organism than meets our little eye. And in the case of the death cap, this mushroom is one part of what's called an ectomachylosal fungus, which is a fancy way of saying that this fungus makes its home via a symbiotic relationship with the roots of a bunch of different tree species. So in order to grow, it has to have certain tree species around it that it makes its home with. So while it's native to Europe, this mushroom has spread to essentially the entire. entire globe with the exception of Antarctica. It's in Australia, South America, Africa, Asia,

North America, everywhere. Yeah. And it is the most deadly mushroom to humans that we know of. There are three main toxins, or like classes of toxins that are present in aminida phaloides. There are amatoxins, phallotoxins, and virotoxins. But today, we're, only going to focus on one of these, and that is the amatoxins. The reason is that the phallotoxins and the virotoxins, while they exist and they are toxic to cells in vitro to various degrees, they're mostly not absorbed by our guts, and so they don't really contribute to the toxicity of these mushrooms, at least in humans. Okay. So we're just talking today about amatoxins. This is a group of toxins. They're called, like in terms of what their chemical structure,

is they're like a little ball of a protein. They're called cyclic octopeptides because they're eight amino acids and they form two little rings. And because of the shape of these toxins, they're pretty heat stable. So they're not degraded very substantially in the process of, say, cooking or drying them. And there's a wide variety of amatoxins. It's not just one, but the primary one that is especially deadly in death cap mushrooms at really high concentrations is called alpha a manitin. I think that's how you say it. And let me tell you how deadly this particular toxin is.

The lethal dose for humans can be as low as 0.1 milligram per kilogram of body weight. It's wild. It is wild. So that means six to eight milligrams of this toxin, which is like that's how much, I don't know, a teaspoon of salt weighs like between five and ten milligrams, depending on the brand. So we're talking about like a teaspoon, can kill a grown adult human that weighs between 60 and 80 kilograms, which is 130 to 180 pounds. And how much is in a mushroom? I knew you were going to ask how much is in a mushroom. It can vary, of course.

And just like with other plants that we've talked about, it's going to depend if we're talking about the cap, the gills, the stock. etc. But on the low end, the average estimate is about 0.2 milligrams per gram of mushroom tissue, and a whole mushroom of this species might weigh like 100 grams. So that's like 20 milligrams in an entire mushroom. 20 milligrams. That's more than double what it would take to kill a human being. Yeah, so a half a mushroom is sufficient. Wow. I know. It's terrifying. Now, aminida falloids is by no means the only mushroom that makes this toxin or any of the other amatoxins, because there are others that are very deadly as well. There are lots of other species in this genus that do,

and some of them have equally terrifying names, like the destroying angel or the springtime destroying angel. And there are also a couple of other genera, too, Galarina and Lepioda. I might be pronouncing those wrong. And all of these can sometimes look very similar to and be confused for edible mushrooms or psychogenic mushrooms. So it's very easy to confuse both the death cap mushroom and other similarly toxic mushrooms for things that you might want to ingest. So then the question is, what is this toxin actually doing to our bodies? Like, why is it so deadly?

this protein, it turns out, blocks transcription. That's not a good thing. It's not a good thing. And for anyone who's like, I'm sorry, that's too technical of a biology term. Let me tell you what that means. It means that it blocks the process by which our cells are making proteins. So our cells, like their job, our job of our cells is to make proteins to be able to do, I don't know, life. And so this toxin blocks a fundamental step in the process that all of our cells have to be able to do.

And when that happens, our cells stop being able to metabolize. And that then sends out signals that induce apoptosis or programmed cell death. So this toxin doesn't, it is called a cytotoxic toxin, like that's the classification of it. But it's not super directly killing our cells. It kills our cells by making them non-functional and then our body kills off those non-functional cells. Wow. Yeah, and it does this irreversibly. So it irreversibly binds to a protein that blocks transcription and makes it non-functional.

Can I ask what that protein is? It's RNA polymerase 2, if you really want details. I actually do, yeah. Yeah, RNA polymerase 2. So it, yeah. So it's like, that's pretty bad. Yeah, it's like not only does it just shut it down, it shuts it down and then marks it for destruction. Exactly, exactly. And because this is a really small protein toxin, it can and does travel via our bloodstream after it's absorbed in our GI tract to pretty much anywhere in our body. And we do not have any enzymes, any machinery to inactivate this toxin. We do not metabolize it. We don't break it down into something less harmful.

all that our bodies can do is try and get rid of it. And we do that via our kidneys. So our kidneys filter it out and they do bless our glomeruli, a phenomenal job of it, but they sustain some pretty significant damage in the process. And they can't filter all of it out. So when we ingest this toxin, it gets absorbed really rapidly through our gut wall into our bloodstream, like within a of hours. It's at peak concentration. And within a few days, about 75, 85% of it is filtered out through our kidneys. But the rest of it goes to our liver. And our hepatocytes or our liver cells are some of the main sites of damage. And part of this is because what happens is that this toxin can be sequestered into our gallbladder. Ooh. So a quick,

I know you probably have questions, but a quick anatomy lesson before that. Your gallbladder is this separate organ that's like a storage bag that sits in almost like a little pocket nook in your liver. And it holds bile, which is a juice that your liver makes and your liver has to secrete into your intestines to help it digest fat. But it's stored in your gallbladder. So your liver makes it, poaches it into your gallbladder. your gall better holds it and then squeezes to release that bile into your intestine when you need it. So as this toxin makes its way into our liver, it hitches a ride kind of on our bile and then hangs out in our gallbladder. And then every time a person eats a meal or just like exists because your gallbladder is still secreting,

this toxin can be squirted out into your intestine, be reabsorbed, find its way back into the liver, and cause more damage, be re-sequestered into the gallbladder, be resecreted, etc, etc, etc., in a process that's called enterohepatic recirculation. Oh, my God. So it just hangs out. It can just keep doing its thing over and over again. And little do you know you feel really bad. you barf, you poop, whatever, and then you're like, oh, I'm starting to feel better. I'm going to eat some more, and it's there hiding in your gallbladder. Exactly.

That is, I hate to anthropomorphize sinister. But yeah, it is. But I will. Yeah. Anyone who works long hours knows the routine. Wash, sanitize, repeat. By the end of the day, your hands feel like they've been through something. That's why O'Keefe's working hands hand cream is such a relief.

It's a concentrated hand cream that is specifically designed to relieve extremely dry, cracked hands caused by constant hand washing and harsh conditions. Working hands creates a protective layer on the skin that locks in moisture. It's non-greasy, unscented, and absorbs quickly. A little goes a long way. Moisturization that lasts up to 48 hours. It's made for people whose hands take a beating at work, from health care and food service to salon, lab, and caregiving environments. It's been relied on for decades. by people who wash their hands constantly or work in harsh conditions because it actually works.

O'Keefs is my hand cream of choice in these dry Colorado winters when it feels like my skin is always on the verge of cracking. It keeps them soft and smooth no matter how harsh it is outside. We're offering our listeners 15% off their first order of O'Keef's. Just visit o'Keef's company.com slash this podcast and code this podcast at checkout. Let's talk about modern home shopping. It's sort of become a fun side hobby, right? Scrolling listings at night, dreaming about kitchens you've never seen, or backyards you haven't even stepped foot in, all from the comforts of pretty much anywhere.

Redfin knows a lot of people like you want to own, but are stuck in this browsing mode loop. That's where Redfin flips the script. With listings that update within minutes and tours you can book right from the Redfin app, you can see your dream home the moment it appears. Now, liking a listing is easy, but actually landing it, that's where Redfin comes in.

Redfin has over 2,200 agents with local expertise. And Redfin agents close twice as many deals as other agents. That means they want to help you win, not just window shop. Redfin is built to help you go from just looking to wait. This could actually be home. So become the newest neighbor on the block. Visit Redfin.com to start finding and start owning. That's redfin.com.

If data management is slowing down your business, you need the Intuit ERP. If one entity is here and one here and one here and one here, you need the Intuit ERP. If scaling your business feels like start starting over, you need the Intuit ERP. Intuit Enterprise Suite is the AI-Native ERP solution that consolidates, migrates, and automates, all in one place. Learn more at Intuit.com slash ERP. And so that, Aaron, you kind of bring up the good point of then what does this actually look like in terms of the symptoms? What do we see then this toxin we know is causing this damage? What does it look like?

Yeah. It's really, really awful. The symptoms of death cap poisoning, of amatoxin poisoning, follow a three-phase course, four phases, really, because the first phase is usually called this latent period. And the latent period is that a lot of times we think of if something is going to be toxic when you ingest it, you're going to feel those effects right away, right? You eat bad potato salad, you start barfing from that staff orias toxin right away. But not the case with amatoxins. The latent phase is anywhere from six to 24 or more hours before phase two or the symptomatic phase starts. So after, a period of several hours, people will start having first a gastrointestinal phase. And this is really intense vomiting, abdominal pain, diarrhea. And this diarrhea can be so severe that it's often described as cholera-like, which is a throwback all the way to season one. So if you don't remember, cholera causes such frequent and like purely liquid. It's described as ricewater

stool, such severe diarrhea that people die of dehydration very rapidly. And that is a possibility here. So people can have such severe diarrhea that they go into hypovolemic shock from how much liquid they're losing. Their blood sugar can dip really low because it's not just doing this to your GI tract. It's, again, affecting your liver. And so it affects your glycogen stores, which can then cause you to have really low blood sugar. And this GI phase can last. for usually like a couple of days, so one to two days. But it's very easy at this point to entirely miss the fact that this came from a mushroom poisoning, right? Because there was a delay between when you ate that mushroom, if you even knew what you were eating, and when you had symptoms.

And this is nonspecific. It could look like so many other acute gastrointestinal illnesses. Okay, I have a quick question about sort of like the timing of symptoms showing up. up. Yeah. It's not like a dose response thing. Correct. Okay. So then does it, is there any relationship between the structure of the toxin, whether it's like protein or something else, and how quickly those symptoms emerge, or is it primarily about sort of the target of those toxins? It's a really good question. I really, really tried to understand and find an answer to the question of like, why exactly is there such a delay in the symptoms? And I don't, I still don't really understand.

Because this toxin, it's a small protein toxin. Most toxins are proteins. It's absorbed very rapidly from our GI tract. So you can detect it in the blood within a number of hours. And then, like I said, pretty quickly our kidneys start excreting it, right? They're working really hard and they're excreting a lot of it within that first couple of days. From everything that I've read, it seems like this toxin, it's damaging cells in our liver, in our kidney, and in our GI tract. But because of the fact that it is pausing transcription, blocking ourselves from doing their job, and then causing damage where those cells are essentially dying and killing themselves from apoptosis.

It's not like an immediate effect, if that makes sense. So like it takes some time. And then on top of that, as we'll see, as this continues to progress, the whole enterohepatic recirculation starts to happen that really ends up kicking the crap out of the liver. It still doesn't, in my view, at least, like, very satisfactorily answer that question of, like, why exactly is it such a long delay? Because it can sometimes be like 24 hours, 48 hours. Some of that probably does have to do with the dose, right? The more that you're exposed to, probably the earlier on that you'll have symptoms.

But it's still going to be at least six hours delayed, usually. Hmm, okay. So it's just, I guess, how long it takes for you to start seeing the damage. to yourselves. Yeah. And then after that, you enter this phase that is very scary because it's a false recovery phase. And that is where these abdominal symptoms start to subside, but the damage is really only

just beginning because that toxin is continuing to attack the liver. And this then manifests as really highly elevated liver enzymes. So your liver cells are literally just bursting open and leaching out their contents. And within three to five days of first ingesting these mushrooms, you'll enter phase four, which is fulminate liver failure. So enzymes that are supposed to be contained in your liver are now circulating throughout your bloodstream. Your liver essentially just isn't working. And as we've talked about before on this podcast, your liver is a very important organ.

And when it stops working, it means that you can't make clotting factors, so you can't clot your blood. So you'll start bleeding internally. As this continues to recirculate, you start to see additional damage to your kidneys. You'll see severe metabolic derangements, which means your electrolytes aren't normal. Your liver is just non-functional. And without treatment, and in a lot of cases when it progresses to this point, the only treatment is liver transplant, then death is almost certain, which can sometimes be anywhere from six to ten days. after that mushroom was initially consumed. Wow.

Yeah. For dogs, as we heard in our firsthand account, and dogs, we don't have great numbers in like how much more commonly they're affected, but certainly they're much more likely to be eating mushrooms in a forest than a human. The process is very similar, but it tends to happen on a much more rapid time scale. So we're talking about all of this happening within a period of a couple of days rather than a week or more. But the symptoms still take six hours to show up?

Not necessarily six, but they still are delayed by a number of hours usually. Okay. Okay. So, yeah, that's the kind of full-on course of this. It's awful. It really is. And it's, I can't underscore just how severe it is. Like, if this progresses to the point of liver, fulminate liver failure, there isn't anything

you can do except liver transplant. Yeah. Because of just, it's, it has irreversibly killed so many of your liver cells at that point. there are things that can be done before it gets to that point. And so early identification is incredibly important, like knowing that this is amatoxin poisoning is super important. And while we don't have all that much in the way of highly specific treatments, like we don't have an antidote, there is a lot that we can do in terms of supportive care.

And so that includes like really aggressive IV hydration because that is trying to help your kidneys flush out as much of this toxin as it can while also protecting the kidneys from damage from the toxin. And then there's some really interesting medicines that we use, some of which don't have a lot of data but are still used because they're easier medicines to get, and some of which have more data, but at least in the U.S. are not approved by the FDA for use, so they're hard to come by. But the idea behind all these medicines is to help protect the liver and block the toxin from entering liver cells. Got it.

So one of the big medicines that's used is actually comes from milk thistle, the milk thistle plant. Yeah. It's called syllabinin, I think, is the compound. Okay. And it basically, it binds to something on our liver cells that then blocks the toxin from entering. So if too much of that toxin has already entered and damaged your cells, then it might not be that helpful.

But because we know that that recirculation process means that more and more toxin is being introduced to your liver cells, like over and over and over again, this can basically stop it from ever getting into the cells. In the U.S., this medicine is not licensed for use, but there was a big clinical trial of it. And so, like, through that clinical trial, a lot of people did get access to it. And it seems like, I don't know, maybe it will be approved sometime soon. but it is used really widely throughout Europe. Okay. And then there's a few other medicines like penicillin or n-acetyl cysteine or knack that are used for a similar, like with a similar theoretical effect, but the data just isn't as strong that they're

actually that helpful. Penicillin. I know. Penicillin G, IV penicillin, yeah. It's like thought that it maybe helps. Again, the data is not great on that, but it's like, let's do something. Yeah. Yeah, sure.

And I imagine, too, that there's not, like you said, it's hard to come by clinical data because there are fortunately relatively few cases of this. Exactly. This is fortunately still rare, which means that it's hard to do large clinical trials, which is a good thing. Right, right. But yeah, and then other than that, then treatment also focuses on stopping that gallbladder from contracting and dumping out more of that toxin. So sometimes even people will put a tube into the gallbladder to drain the bile or use a medicine that helps just like stop contraction overall and like not let people eat for a number of days to really just kind of slow that whole process down. Question. Answer.

A lot of people have had their gallbladder removed. Do we know anything about amatoxin poisoning in people with their gallbladder shoes? I do not, but what an interesting question. No, I didn't see anything. about that, probably because the numbers, again, are like, what, how you, it would be an epidemiological, like, retrospective study. Yeah, that's a really interesting thing to try and look at, like, the clinical course of people who are post-gall bladder removal and then, unfortunately, exposed versus not what an interesting. I did not see that anywhere. I mean, I would love to do an

episode on the gallbladder, which- I know. We said that very recently, Erin. I know, but when, when did we say it. I was just thinking this sounds familiar to me. I don't know. I don't remember, but yes. I think it was when I asked you to describe all the parts of the digestive system. Well, that was neurovirus. Oh, maybe not then. I don't know. Maybe it was, I don't know. Someone listening is going to be like, you guys, it was so obvious. We've recorded a lot recently, okay. It's hard to keep them all straight. I know, I know. The gallbladder is really interesting. But yeah, that's a great question whether, I mean, theoretically, yeah, it should be, it should be, you would get less of that enterohepatic recirculation. So theoretically, that should be protective.

Does it mean that you're not going to get sick? No, but should it be protective against liver failure potentially? Hmm. Theoretically. Interesting. Yeah. But that is the terrifying amatoxins present in amineta phaloides or the death cap mushroom. Aaron? Terrifying is right. Why? Why? Why on earth? Does a little mushroom growing on tree roots in the forest need to have a toxin that can kill us so easily at such high concentrations in its tissue? I mean, you know what we always say? That's a great question. Do I know? Let's find out after this break. Can't wait.

Erin, I swear that one of these days, my search history for this podcast is going to put me on some kind of watch list. if I'm not already on one. To illustrate, I'm going to read you a really long quote that I came across when doing research for this episode. Can't wait. Ready? Quote, for murderers, there is only... I'm telling you, this was published in an academic journal. Let me just say that.

Okay, keep going. I'm sorry for interrupting. For murderers, there is only one. kind of mushroom worth considering. Oh my God. Aminida Faloides. From the murderer's point of view, the deadly aminita suffers from one shortcoming. An occasional victim, after days or weeks or even months of shattering illness, slowly recovers and returns to circulation.

Oh my God. True. He is only a frail replica of his former self, but he is alive and has foiled the murderer's coup. What journal, Erin? Oh, there's more. Can I? Okay. Sorry.

I need to keep. You don't know this. On the other hand, if the murderer also hates his victim and if success attends his undertaking, his worst instincts and hopes will have been more than satisfied by the slow progress and horrible suffering that attend the victim's downward course into the grave. Oh, my God. The symptoms of poisoning by the. deadly aminitas are distinctive, dramatic, and terrifying. And there's more. I just, I'm going to keep

going. Keep going. Nothing arouses suspicion as the greedy diner consumes his fateful dish, nor does he suspect anything for many hours thereafter. The victim goes about his affairs, blissfully unaware that the fingers of death are entwining him. Perhaps he speaks with relish of the mushrooms he has eaten, and may ask for another helping of the same kind at the next meal. If they have been served to him intentionally, his murderer, standing by, eyes him with wicked and dissembled solicitude, alert for the inevitable moment. Of a sudden, the victim is gripped by appalling abdominal distress, followed by vomiting and diarrhea. Neither emetics nor purgatives can help him now, for his system has absorbed the venom during the long period of silent invasion.

end quote. What I need to know. Okay. So, like I said, it's from an academic publication, not a murder mystery novel, not a handbook on how to murder someone with mushrooms, although it kind of reads like that. Right. It's from a 19... How to get away with murder. Yeah. Sorry. That's not... Best worst show. Yeah. It's from a 1972 article in Harvard's Botanical Museum Leaflets titled The Death of Claudius or Mushrooms for Murderers by R. Gordon Watson. Harvard. Okay. Okay, 70s, though.

30s, sure. Yeah. I also just want to say, sorry, I'm just interrupting here, this, researching this episode has made me, I will now never not ask someone with diarrhea, have you eaten mushrooms. Yeah. Well, in California, I mean, I guess Southern California. Southern California less, but I, like, I've never asked someone that I ask always, like, have you eaten anything new or different?

Have you traveled anywhere? Like, I ask about food exposures, obviously, but never have I specifically asked mushrooms. I ask picnics. I don't ask mushrooms. And now I will always be asking about mushrooms. Well, especially because I feel like if you have eaten mushrooms before and you may not think that you're eating something new or different when in, fact it is a new and different species.

Right. Or like, deadly. I, I just, I have, I have fear. Yeah. I empathize. I feel similarly. Okay.

But keep going. Yeah. Okay. So, so this article by Wasson is not meant to offer a murderer's perspective on Dudley mushrooms. Okay. Maybe. But rather seemingly to go through one of the most famous instances of mushroom murders in

history. that of the Roman Emperor Claudius I. What? Yep. Which is one of the many historical poisonings that contributes to the lore and notoriety surrounding this fungus. So what I want to do today is first take us through that lore, like what historical deaths have been attributed to this mushroom, and then go into the very real threat that they pose today as they continue their spread before trying to get at the center of the question why? Why? Why do these mushrooms, as you asked, possess this extremely deadly quality? Does it serve an evolutionary purpose?

Does it? For now, back to Claudius. Claudius was an unlikely emperor. Even though he was born in 10 BCE into the ruling family of the Roman Empire, he was not close in line of succession. And the circumstances of his birth, he was born at 32 weeks. in 10 BCE, right? Wow. Okay.

I mean, how accurate was dating back then, though? I don't know. I do feel like for some reason, I don't know why I got this idea, but I feel like his life is pretty well documented. Yeah. It's just fascinating that like 32, that's very specific. Right. How do they date the first?

Sure. Yeah, yeah, yeah. Yeah, yeah. Anyways. But he also had poor health during childhood, which included a limp, a movement disorder, and quote unquote, disfigure. whatever that meant. And these things led most people, including Claudius himself, to believe that he would spend most of his life behind the scenes, which is what he did, becoming a historian and a

politician, until a series of chaotic, despotic events and assassinations made him emperor in 41 CE at the age of 51. Okay. Skipping over his time as emperor, you can read more about that in books and Wikipedia, and jumping instead to his death at the age of 64 in 54 CE, as told in the form of a modern medical case report. This is great. Okay. Quote, case presentation. In October, a 64-year-old man developed post-prandial abdominal pain and vomiting. He had been feeling well until passing out during a banquet at which he had consumed a large quantity of wine and food. One dish, that was composed of mushrooms was a longtime favorite. On regaining consciousness shortly thereafter,

he complained of severe abdominal pain. He vomited and felt somewhat better. A physician induced additional vomiting by placing a feather in the back of the patient's throat. Interesting. Yeah, not true. Sounds absolutely horrible. Shortly thereafter, the patient's condition deteriorated.

He became confused and exhibited signs of unremitting abdominal pain and fecal incontinence. He died 12 hours after the onset of his, illness." End quote. Many writers, both modern and ancient, have attributed Claudius' death to Aminida Faloides, the death cap mushroom, allegedly sneaked onto his plate by his fourth wife, Agrippina, who wanted to make sure that her son, Nero, Claudius's stepson, would succeed as emperor

rather than Claudius's other son, Britannicus, from a previous marriage. Oh, my gosh. I know. It's so dramatic. Now, was it actually a murder? could be. There's motive, there's opportunity, there's knowledge of the deadly power of death cat mushrooms, which I find fascinating. The symptoms match for the most part, kind of. The account written closest to his death describes it as murder, open and shut. But there are some holes in this theory.

Most of the accusations of murder came out years after Claudius died and are kind of just repeating rumors, you know, like where does the source actually come from? Depending on the source, the timeline doesn't really fit. Like, did he get sick at the banquet right after eating mushrooms and then die shortly after? Or was it a while after he ate them that he started having these symptoms? Right. And like death in 12 hours. It's like pretty. It's pretty fast. Yeah. And finally, I'll just say that one common way to discredit powerful women back in the day was to call them a poisoner. Today it's train wreck and ancient Rome. It was poisoner. In any case, we probably aren't going to ever fully resolved whether Claudius was assassinated

via mushrooms or died of cardiovascular disease, which is another hypothesis. Okay. Yeah. We're just like something else. Yeah. Like some other, I'm not convinced it was Aminita by the description that was in that case report. I mean, 12 hours. The other thing, though, is that there's another account of Agrippina's son Nero saying,

oh yeah, my mom killed him, you know, like all these sorts of things. So it's like, you know. I don't know. We weren't there. You know, who was? Who was? But the influence that Claudius's death has had on death cap mushroom lore is indisputable. Wow.

I love that. I know. He's any, any paper that's like the history of death cat mushrooms, it's like Claudius. Okay. And he's not the only one. As the author of that murder article puts it, this is what I'm calling it, quote, mycologists are prone to exaggerate the importance of mushroom poisonings in history. In their writings, we repeatedly find a list of eminent persons who have died allegedly from eating poisonous mushrooms,

a list that they copy from each other without verification. Oh my gosh, such shade. I know. So rather than making the same mistake, I'm just going to go through a few more famous cases that seem to be more or less, like, they have more support, I guess I'll say that. Okay, love that. Starting with another Roman emperor, the Holy Roman Emperor, Charles the 6th. Okay.

Quote, on the 10th of October 1740, at night, his complaint was increased by indigestion, occasioned by a dish of mushrooms stewed in oil, of which he ate voraciously. end quote. Ten days later, he died. And his death as the last male Hapsburg, a royal Austrian dynasty, set off a continent-wide war, the war of the Austrian succession. When Charles's daughter, Maria Teresa, said she had the right to succeed her father, but some countries wouldn't accept her as a woman. Right. Yeah. Wow. No, it's interesting to me that no one suggests that he was murdered, but more just that he ate a bad batch. The wrong, the wrong washrooms. Staken mushroom identity. Yeah. And I'm no war of the Austrian succession historian. I was kind of planning on reading a book about it. And then I was like, what are you doing? Like you have, you don't have the time for this. But it seems like a big deal from what I gathered. Yeah. Yeah. As Voltaire put it, quote, a pot of mushrooms changed the history of Europe. Wow. End quote. Yeah. Okay. Big deal.

Big deal. The next murder by mushroom story I'm going to tell comes to us from France in the early 20th century. A man named Girard, together with his wife and mistress. Love it. They dreamt up a really quite sinister insurance fraud scheme. So he would befriend wealthy individuals or couples and then take out insurance policies in their names with either himself or his wife or mistress posing as the future victim on the policy.

Oh, wow. So then he would invite them over to dinner and serve them death cap mushrooms. He also apparently tried with anthrax and typhoid, but aminida Faloides was his favorite. Fave. This is preferred method. When his victims died, he would collect on the policy. So he would show up. I mean, this was like the early 1900.

So he would just like show up. You could just do that, I guess. Yeah. Yeah. I don't know insurance history. Things didn't always go as planned. Okay. He didn't collect the mushrooms himself, but instead hired a local guy.

named Theo. Okay. Theo wasn't the greatest mycologist and sometimes collected non-toxic lookalikes. So Girard's victims just went away well-fed instead of poisoned.

But eventually Gerard's greed proved to be his downfall. He took out four insurance policies on one woman. He collected on three of them successfully, but the fourth launched an investigation and the whole grizzly story came out. Oh, my God.

Girard, his wife, and his mistress were all arrested, but Gerard himself died of tuberculosis before confessing, and he maintained his innocence until his last breath. Wow. Mm-hmm. Okay, dark. Dark. Okay, and one more last dark one, but I'm going to mention briefly because so many of you out there would not forgive me for skipping this one, and I think at least a handful of you have reached out and mentioned this. Okay. And this is the 2023 death cap poisonings in Australia. This is a very very, very, very quick version of this story, because I'm sure there are true crime podcasts that have covered it. In July 23, a woman named Aaron Patterson invited her ex-in-laws over for lunch. So this is her

ex-husband's parents, Gail and Don, and his mom's sister and her husband, Heather and Ian, and she fed them Beef Wellington. The next day, all four guests, but not, Aaron, went to the hospital with GI distress. And over the following week, Three of the four, Gail, Don, and Heather died. Oh, my God. Ian recovered, but only after weeks. And tests revealed death cap mushrooms as the cause of their death. And a few months later, Aaron Patterson was charged with three counts of murder and five counts of attempted murder,

which included times over the previous years when her ex-husband got really sick of suspected food poisonings. So he was actually supposed to be at that lunch, but he canceled last minute. Wow. As of the time of this recording, the last update is that Aaron pled not guilty, I think in May 24, and the case is going to the Supreme Court of Victoria. And there's lots more out there on this case, if you'd like to read more, the food dehydrator that she threw away after the lunch. Her kids also eating the Beef Wellington with the mushrooms scraped aside. There's, yeah, but we're not a true crime podcast, so that's, that's where.

I'm going to leave things. Oh my gosh. Awful, though. Awful. Awful. And these famous or infamous mushroom poisonings may make up most of the headlines for death caps, but they represent only a small proportion of all of the deaths or illnesses caused by these mushrooms. For Agrippina to use this as her murder weapon, she had to have known that their consumption was deadly, which means, of course, that people had eaten them and gotten sick or worse for centuries. As a. As a. As Gerard's mushroom picker Theo was collecting the wrong kind of mushroom, i.e. the non-toxic kind. Right.

The opposite of what you would normally call the wrong kind. Other people were making the opposite mistake and bringing home death caps for their evening meal. In fact, the same year that Girard was arrested, 31 school children in Poland died after eating a meal containing amnita falloides that had been served at school. At school. Isn't that absolutely devastating? Awful.

So sad. Accidental ingestion of amnata phaloides has always been a hazard for mushroom foragers in the areas where this mushroom grows naturally. And it turns out that area is growing. The death cap mushroom's natural range is in Europe, as you mentioned. But in the early decades of the 20th century, around the 1920s or 1930s, it was introduced to California. Not intentionally, but it likely hitchhiked in soil or ornamental trees or shrubs brought over from Europe, which were then planted. The oldest amnata phaloides specimens are from 1938 and 1945 and come from Monterey County and Berkeley. Since their accidental introduction, the mushrooms have actually seemed to really take to the California habitat and have successfully established populations in natural environments, gradually expanding their range,

with a corresponding increase in accidental poisoning cases. And California isn't the only place we've seen Aminida Faloides find its footing. As this deadly mushroom expands its distribution, there has been a pressing need to get better at treating people and animals who have ingested them. And we've really made strides as far as that goes. I mean, it's not perfect, but we really have made strides. Yeah, major. Major. In the early 20th century,

mortality rates from amatoxin poisonings were upwards of 60 to 70%. With the introduction of fluid replacement therapy and better supportive care, that dropped to 30% and it's even lower today. It is. We'll talk about it. And while we don't have a cure for amatoxin poisoning, we do have a rapid diagnostic test. Shout out to Candice Beaver and team, which can really help healthcare professionals identify the cause of poisonings

much more rapidly than before and start people on the supportive care that they need so much sooner. Right. Death cap mushrooms are responsible for the majority, 90% of mushroom-related deaths around the world. Their toxicity is extreme. Like, like we said, half a mushroom can kill a person. It almost puts ricin to shame. Why are these guys so very, very deadly?

What purpose, if any, do their toxins serve? That is a fantastic question. The short answer is that it's likely for defense against things that eat fungi. Insects, nematodes, gastropods like slugs, and possibly other animals. Okay. This is a common reason that fungi, plants, and animals evolve the ability to produce similar toxins. The long answer to this question of why is that we don't fully know. Of course.

We don't know. Of course not. We don't know precisely which organisms are the target of this toxin. Is it mammals? maybe. But the toxin takes a long time to act, which could make it more difficult to associate the mushroom with symptoms. So it's like not a great learning tool, right? Right. Yeah. That's what's so confusing about it. And it's like, the other thing is like just how potent it is. Uh-huh. Right. And there doesn't seem to be any evolved resistance to the toxin in the mammal species that have been studied,

which is not very many species. But still. But still. Yeah. So in a lot of these papers, especially the older ones, there will be repeated this common knowledge that squirrels are immune. But in this book that I read about this, the author was like, I tried to track down the original study or source and I can't find anything. Okay. Yeah. So, I mean, it's possible that mammal sensitivity could vary across species, but we don't have good data, mostly just anecdotes. And it might just be that mammals are collateral damage. Interesting. So is it insects?

This seems more likely. Insects are more numerous across a landscape and thus may be a stronger driver for this toxin's production. And plus, studies of different Drosophila species, so Drosophila that is genus of flies, show that resistance to amatoxin varies across species. Some Drosophila species, which feed on fungi, are more resistant to the toxin than those that don't. And this resistance might offer an advantage to these flies beyond just surviving a meal. One study showed that these toxin-producing mushrooms might prevent these flies from getting parasitized by nematodes. What?

Yeah. Because the toxin is there in their body, and so then it kills the nematodes or something? Something like that, I think, yeah. What? Yeah. The study of these toxins is fascinating, especially because they bear similarities to other toxins produced across the animal kingdom, like venoms in cone snails, snakes, and spiders. And they could be affecting how this mushroom expands its geographic range and deals with

environmental change. And so with that, Erin. You're going to... I'm leaving you with that. Leaving you with that to tell us where we are with this mushroom today. I have so many different questions. So do I. Does that mean there's changes in like RNA polymerase? in those flies. Like, what is the mechanism of resistance? I have so many questions. I'll link to the paper. Okay, okay. I'll read more. But we'll wrap up soon right after this break. We've said it a few times now, but it bears repeating that this mushroom is now everywhere.

It's on every continent except Antarctica. It is absolutely spreading, especially in places like California, through parts of Canada, the Pacific Northwest, anywhere where suitable trees exist. And there's a wide variety of tree species, by the way, that this mushroom grows in association with. And like you mentioned, Aaron, death cap mushrooms specifically, aminita falloides, in all of the papers, in all of the research, are by far and away the most common cause of mushroom-related death responsible for over 90 in some papers 95% of deaths related to mushroom ingestion. How many deaths a year does this mean? I still don't really know. A lot of papers cite somewhere

between 50 and 100 deaths annually across Europe. But in some years, up to 100 deaths have been reported in China alone. So how many? And in place, and in place, places like the U.S. and Canada, it really can vary year to year because some years there are kind of big, whether it's because of rainfall, where there's a lot more of this mushroom growing, and then people find it unintentionally. So it really can vary year to year. And then the other big question that can also vary is like, how likely is it that a poisoning will be deadly? And this depends on so many different factors. Not only how much mushroom did a person consume, were they able to get access to health care?

Did that health care facility quickly figure out that it was death cap toxicity? Did they treat it correctly? What part of the mushroom did they eat? How high was that particular mushroom in amatoxin? Like, it really, really can vary. Looking at all the case studies over the last several decades, it really can vary what the case fatality rates tend to be. And it's anywhere from five to 30 percent of cases.

that end in death in recent years. And it varies country to country how mycophobic or mycophilic countries are. Those are new words I learned, so I wanted to throw those in here. I learned that too. And I was like, yeah, it cracked me up because I had never really thought that much about it. Me neither. But there are like countries like the U.S., for example, are mycophobic countries. We don't tend to forage a lot for mushrooms, whereas some places in Europe are considered

mycophilic countries where foraging for mushrooms is like a big part of cultural traditions in those areas. So in those areas, you're going to see more accidental exposure to mushrooms. Yeah. But also in combination with more knowledge about mushrooms overall. So it kind of, it all just depends, honestly. to year. Yeah. Well, and this is where I feel like awareness and raising awareness is so important. It's so, so, so important because, Erin, so there was a kind of outbreak that happened in

2016 in Northern California. There were 14 total cases that were reported. Nobody died, but three people ended up needing liver transplants, including one 18-month-old baby, who ended up with really severe neurologic impairment because of how sick she got from liver. failure. Oh my God. So what was very notable to me in reading the case reports about this outbreak is that people were ingesting mushrooms that other people handed them without any idea, in some cases, who those people were, who were like strangers who were giving them mushrooms that they foraged, and without any knowledge necessarily that that mushrooms could be this deadly or that this deadly of a mushroom existed in this region.

So it really does come down to knowledge of what mushrooms you're eating, how to know which ones are poisonous and which ones are not, because they can sometimes look really similar, especially depending on the stage of mushrooms. Like early, like young aminata phaloides can look really similar to a lot of other edible mushrooms, whereas they look more distinctive as they're matured. So it just, it really can depend on where you find them and in what association. Like, yeah. So one other big need, in addition to awareness among people who are foraging and consuming mushrooms is also awareness among health care providers and the ability to confirm that suspicion once you've thought of it. And especially a type of detection method that is cheap, that is easy to use, and that is

fast, because every moment counts. Every moment counts. And like you mentioned, Erin, people have been working on a lot. exactly this. Shout out to Candice Beaver. Thank you for contacting us and providing so many sources, by the way. Super helpful. There now exists a test like this. It works a lot like a COVID test or a pregnancy test where you put urine or mushroom tissue that you extract onto a little test that looks like a COVID test. And two lines means negative for amatoxin and one line means positive for amatoxin. And this has been used both now in theory and also in practice. So,

So it's new, but it exists, and it's cheap. It's like $10 a test. And like, I don't forage for mushrooms, but if I did, I would definitely buy some of these tests. So, yeah, so those kinds of diagnostic tools need to be able to be in the hands of people not only who forage, but also veterinarians and health care providers, like people who are going to be seeing amatoxin poisoning on the front line. And then also newer treatment methods is the other thing. And it goes without saying that this is a huge area in need for research because we don't have anything that specifically treats or targets amatoxin poisoning. There was a paper that came out in nature in 2022 that got a lot of press because it was

very exciting. And it was using a medicine, it's not really medicine. It was using a substance called endosyanine green, which is actually a dye that is used in medical diagnostics. So we use it not uncommonly in diagnostics for looking at things like liver output or cardiac output. And in this study that they published, it was effective at stopping amatoxin from entering liver cells in mice and in culture. So not in human peoples, but it's still a really big deal because this is something like milk thistle that is already available in the U.S. Because it's already used in diagnostics.

Right, yeah. So while we don't have anything like immediate, like brand new treatment, we do have people doing that research and things on the horizon, which is really important. Mm-hmm. And that, Erin, is death cap mushrooms. I, before we do sources, I want to plug poison control hotline. Poison Control Hotline. And pet poison control or animal poison control hotlines. Both of these things are crucial.

Yep. And people are amazing in how they can help you. Like, they're the ones who are going to think of mushroom poisoning. Yes. Like, if I forgot to ask that question, they're not going to forget to ask that question. Right. And also, like, mushroom ID is another really important thing that experts can do. So it's just, yeah, don't forget, poison control.

Poison Control. 1-800-222-1-2-2. If you don't have it saved on your phone, you can save it. You can save it. And there's an animal. And there's an animal. I have the animal one. It is 888-426-4435. Does that work across the whole U.S.? I'm not sure. It has worked for me in Colorado. I had to call up for my little puppy. He was fine. Good.

Not for mushrooms. Not for mushrooms. I forget what it was for. Oh, cherry pits. Oh, I remember that. Yeah, that was a really lovely evening of cleaning up vomit. He was fine. He was fine. He was fine. Everything's fine. Well, if you want to read more, we have so much more. I also have a great paper, it's not my turn yet, but about more generally all the other toxins that are present in mushrooms and all the other syndromes that you can get from other mushroom toxicity. So we really need to do more episodes on mushroom toxins. Love it. I mean, I would love to do that. Yeah. Do you want to go first? I mean, I guess that was a cool paper. Other sources, there was two papers that I read by Vetter, one from 2023 and an older one from 1998. So the 2023 one was published in molecules, and it was called Amanitins, the most poisonous molecules of the fungal world. And a few other really interesting papers on Aminida, on Aminidaphrodes, on the Amatoxins in general,

some really depressing ones, like when people got it wrong, in how they treated an amnata poisoning before someone got to the hospital and the consequences of that. And then also the MMWR report about that outbreak in 2016 in Northern California. Erin, you should go because then I usually do the wrap-ups. I don't know how to end my sources section. Hilarious. I don't know how to, I don't know how to end this. So I have a number of articles and maybe a book or two in there. The book where I got a lot of sort of the history part of that amnata phaloides is from mushrooms, poisons, and panaceas, a handbook for naturalists, mycologists, and physicians by Dennis Benjamin. And if you want to read more about the

evolutionary significance of these toxins, there is a chapter in a book, and the chapter is titled Ecology and Evolution of the Aminita Cyclic Peptide Toxins. And that is by Walton from 2018. I also think I might have misspoke and said that the paper that was using Indocyanine Green came out in 2022. It was actually 2023 in Nature Communications. But we'll post all of the sources from this episode and all of our episodes on our website. This podcast will kill you.com under the episodes tab. We will. A big thank you again to the provider of our first hand account.

We really cannot thank you enough for being willing to share your story and for all the awareness work that you do. Yeah, thank you. Thank you also to Bloodmobile, who provides the music for this episode and all of our episodes. Thank you to Tom Brifogel and Leanna Skolachi for the amazing audio mixing. Thank you to everyone at Exactly Right Network. And thank you to you, listeners. We hope that you learned something about mushrooms. How do you feel about mushrooms? Do you eat mushrooms? Do you forage mushrooms? Do you forage mushrooms? I'm really want to know. Are you macophobic or mycophilic? I'm mycophobic. Or somewhere in between.

Micaneutrile. Oh, myco neutral. I like that. And as always, a special thank you to our patrons. Thank you so much for your support. It really means the world to us. It does. It does. Well, until next time, wash your hands. You filthy animals. Success starts with your drive. An American Public University is here to fuel it. With affordable tuition and over 200 flexible online programs, APU helps you gain the skills and confidence to move forward. changing careers, starting fresh, or pursuing a lifelong passion. Our programs are designed for people who never stop. You bring the fire, APU will fuel the journey. Learn more at APU.APUS.edu.

Go on. Get a little out there. Into the big heart of Nevada, where you can go off road and off the map, on two lakes or on horseback. Dip into hot springs and dive into deserts. Climb a mountain or make your best effort. See thousands of stars in some of the darkest skies. Stake out haunted hotels. Can you make it to sunrise?

There's always something new to see because we've got plenty of space to just be. Plan your trip at travel Nevada.com. You know that feeling when a story just grabs you and won't let go? That's the kind of drama that's waiting for you on Disney Plus Hulu. Mysterious post-apocalyptic thrillers like the acclaimed Hulu original, Paradise. Action Adventure Drama, like Daredevil Born Again,

and iconic medical dramas like Gray's Anatomy, or maybe you want your drama with a side of comic relief, with shows like high potential. Find a drama you want on Disney Plus and Hulu with a bundle subscription. Terms apply.