Dr. Kathy LeSaint, San Francisco emergency room physician, said that even with modern technology, identifying an edible mushroom is difficult. She remembers all too well a period of weeks in 2016 when the Bay Area had 14 patients poisoned by mushrooms.
Not all of the cases were connected, according to the paper LeSaint wrote for the
US Centers for Disease Control and Prevention, but what they had in common was death cap mushrooms. Death caps and destroying angels, like the ones Hickman ate, belong to the same genus, Amanita.
Among more than 5,000 species of mushrooms, about 50 are poisonous to humans,
research shows. Death caps and related species that have the same toxin are to blame for the majority of mushroom-poisoning deaths.
In the Bay Area cases, all the patients survived eating death caps, LeSaint said, but three needed liver transplants. A child who had a liver transplant also developed permanent neurological problems.
“The cost of severe poisoning and potential death is very real,” LeSaint said.
“The thing about the Amanita species is that they don’t all look the same, which is a problem,” she said. A photo sent to an app would be from just one perspective, when all the angles need to be accounted for. “Even the books may describe a death cap one way, but it can have a spectrum of colors, and not all of them look exactly the same.”
Van de Poll, the New Hampshire instructor, said that even despite the dangers, he highly recommends foraging.
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“Mushrooms have a great deal of fantastic health benefits,” he said.
Research shows that mushrooms are a good source of vitamin D and are low in sodium. They may stimulate a healthy gut, support a healthy immune system, decrease your risk of cancer, promote lower cholesterol and protect brain health.
To stay safe, Van de Poll offers this advice for beginners: “Learn just a handful that you can identify very easily,” and keep consulting experts.
“Always ask somebody you trust, who knows more than you do and you think can provide a reliable and safe answer,” he said.
LeSaint, the ER doctor, said she urges foragers to always exercise extreme caution.
“We don’t want to tell them not to do it, but we always encourage people to go with someone who has some expertise in identification of mushrooms,” she said.
“Mistakes can happen, and the consequences can be death.”
An experimental antidote
Bill Hickman could have used an expert when he picked his toxic mushroom in September 2022. Because his liver and kidneys were at risk of failing, his local hospital transferred him to University Hospital in Cleveland.
Dr. Pierre Gholam, a hepatologist at University Hospital who has treated dozens of people poisoned by mushrooms, helped secure an experimental antidote.
“It’s not FDA-approved, but it seems to be very effective,” he said.
After accidentally eating poisonous mushrooms, William D. Hickman had to be hospitalized in Cleveland. It took six months to feel like himself again.
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The antidote, an extract from a milk thistle plant called
silibinin, needs to be delivered quickly to counter the effects of toxins on the liver.
“The earlier the better, and ideally no later than 72 hours into when you ingest the poison,” Gholam said.
Gholam has found that
silibinin helps about 30% to 50% of patients, and he hopes it will be made more widely available for hospitals to have on hand. As the climate warms and mushroom season expands, and with more people foraging, hospitals may need it.
Gholam has treated 11 people poisoned by mushrooms this year. Cases came earlier than usual, he said, but there were no fatalities.
Hickman got the antidote just in time. Although it doesn’t work for everyone, it saved him.
Video of him in the hospital shows the usually fit Hickman slowly walking down the hall in his hospital gown. He drags his IV pole with him, Tammy by his side, encouraging him.
He says it took at least six months to feel more like himself physically and mentally.
He still gets choked up when he talks about it.
“There are a lot of people involved to make it happen to save me,” he said, his voice catching.
The couple was so grateful that Tammy bought the staff at University Hospital baskets filled with colorful mushroom-shaped cookies.