For some, a “bad trip” from mushrooms means a metaphorical journey to a dark corner of the mind, conjuring chilling images and intense distress. But for many, a bad trip is profoundly real—a journey to an emergency room as deadly toxins circulate in the body, killing liver tissue and threatening life.
That is the terrifying experience of those who decide to forage for wild mushrooms in the US without expertise in mycology. They likely do not realize that there are several lethal varieties of mushrooms in the country, which are surprisingly common, look almost indistinguishable from safe, edible mushrooms, and, in some cases, taste good. The deadly toxins don’t kick in until hours later.
These fatal fungi are found throughout the US but are in peak bloom in Ohio right now, where doctors are warning against mushroom foraging after a rash of poisonings. Late last month, Cincinnati Children’s Hospital put out a warning that they had received several patients who were poisoned by eating wild mushrooms foraged in the southwest area of the state. “You should never eat wild mushrooms,” the hospital wrote in a tweet. It went on to advise anyone with symptoms after eating a wild mushroom to immediately contact the area poison control center.
Meanwhile, doctors to the north in Cleveland also reported an uptick in mushroom poisonings and sent their own warnings against eating any foraged fungi. “The bottom line is it’s a very, very dangerous proposition for anyone—especially between the dates of Sept. 15 and Oct. 15 in Northeast Ohio. That’s when these things tend to grow,” Pierre Gholam, a liver specialist at University Hospitals and professor at Case Western Reserve University, told Cleveland.com this week. “It’s really playing Russian roulette with your health.”
Gholam told the outlet that he had expected this year’s mushroom bloom would be bad, given the area’s humid, rainy summer. “I could tell just by looking at my own yard that this was not going to be a good season,” he said.
Trippy toxins
The mushrooms Gholam and other health officials worry about are lethal Amanita mushrooms. There are many Amanita species, many of which are not harmful, but all the lethal ones are classified in the section Phalloideae. The section includes Amanita phalloides, which is commonly known as the “death cap.” It also includes a cluster of closely related all-white species commonly called “destroying angels” or sometimes “death angels,” which include A. bisporigera and A. ocreata found in the eastern and western US, respectively, among others, such as A. virosa, mainly found in Europe.
This lethal lineup of mushrooms contains amatoxins, which include alpha, beta, and gamma amanitin. Amatoxin poisoning accounts for more than 90 percent of all deaths resulting from mushroom poisoning worldwide. Part of what makes them so deadly is that they can easily be confused with other, completely edible mushrooms. Death caps, for instance, can look much like straw and Gypsy mushrooms. The various destroying angels can be mistaken for button, meadow, and horse mushrooms. In Cleveland, Gholham recently treated a patient who had eaten a deadly Amanita mushroom he found in his yard after a plant identification app on his phone identified the mushroom as an edible variety. It almost killed him.
The mushrooms’ amatoxins are easily absorbed through the gastrointestinal tracts once they’ve been eaten. From there, the toxins head to the kidneys and, in particular, the liver, which is one of the most important organs in the body for making proteins. Amatoxins work by blocking a key enzyme involved in making new proteins, called RNA polymerase type II. In the liver, blocking this enzyme causes a cascade of trouble that results in cell death and tissue necrosis. While some of the toxin ultimately gets flushed in urine, some gets transported out of the liver with bile acids, where they end up back in the intestines for the process to begin again—in what’s called an enterohepatic cycle.
If you’re wondering, there is no way to avoid these toxins once you’ve inadvertently picked a lethal mushroom. They are extremely stable. No cooking, freezing, or drying breaks them down.
