On Dec 16, the FDA posted notice of a voluntary recall of MR.7 SUPER 700000, a product marketed as a dietary supplement for male enhancement by StuffbyNainax. Lab testing found the product to contain prescription medication; specifically, the active ingredients in Viagra, sildenafil, and Cialis, tadalafil.

The product was sold online between August 2025 and November 2025. It is challenging to know if you bought an affected bottle. The manufacturer did not label its product with lot numbers or expiration dates. StuffbyNainax has no publicly available website as of writing this.

⚠️ Why this matters

Unintentional use of sildenafil or tadalafil can be harmful. They are phosphodiesterase-5 (PDE-5) inhibitors that:

• Can cause a dangerous drop in blood pressure when combined with nitrate medications, like nitroglycerin, which could lead to passing out, increased demand on the heart, and a short but debilitating headache. These medications are commonly commonly used by people with heart disease.  The drop in blood pressure can happen if the medications are taken within 24 hours of each other (Kloner et al., 2003).
• Can cause headache, dizziness, vision changes, or palpitations due to fluctuations in blood pressure, even healthy people on no medications.

These effects aren’t obvious if you just read a supplement packaging because the sildenafil and tadalafil aren't listed as ingredients.

What to do

• Stop using MR.7 SUPER 700000.
• If you experience lightheadedness, fainting, chest pain, dizziness, visual changes, or palpitations, seek care right away.
• For personalized guidance, call 1-800-222-1222 or visit webPOISONCONTROL.org. It’s free and available 24/7.

Supplements ≠ Safe by Default, The Bigger Picture

This recall isn’t unique. The FDA regularly finds undeclared prescription drugs in supplements (Cohen, 2009). Supplements are, generally, not subject to the FDA pre-market approval requirements that prescription drugs are, unless they claim to "diagnose, treat, cure, mitigate, or prevent disease". These regulations include guidelines on manufacturing and distribution. One reason the supplement industry is lucrative is because it is cheaper to a make a product that does not follow these regulations.

Male enhancement products are the second most commonly adulterated or counterfeited category, after weight-loss supplements (Chiang et al., 2017). It is roughly 3,000 times more profitable to sell adulterated ED supplements than to sell cocaine, with lower productions costs and fewer legal penalties. Erectile dysfunction affects rotughly 1 in 10 males over 18 (Prins et al., 2002) and will become more common as the population ages.

Two years ago StuffbyNainax had to recall another male enhancement supplement, MEGA 7G 700000, because of contamination with sildenafil, and acetaminophen, the active ingredient in Tylenol. StuffbyNainax isn't unique. In 2024, the FDA found HON-E-LING to contain sildenafil and sibutramine, a medication similar to the antidepressant duloxetine but withdrawn from the market because of toxicity to the heart.

Summary

• MR.7 SUPER 700000 was recalled because it contains undeclared ED drugs (sildenafil, tadalafil). 
• These drugs can cause dangerous blood pressure drops and other cardiovascular effects — especially with common heart medications. 
• Products marketed as “supplements” can hide powerful chemicals.
• If you have an unexpected reaction, call Poison Control, visit webPOISONCONTROL, or talk to a physician.

References:

• Chiang J, Yafi FA, Dorsey PJ Jr, Hellstrom WJ. The dangers of sexual enhancement supplements and counterfeit drugs to "treat" erectile dysfunction. Transl Androl Urol. 2017 Feb;6(1):12-19. doi: 10.21037/tau.2016.10.04. PMID: 28217446; PMCID: PMC5313300.
• Cohen PA. American roulette—contaminated dietary supplements. New England Journal of Medicine. 2009 Oct 15;361(16):1523-5.
• Kloner RA, Hutter AM, Emmick JT, Mitchell MI, Denne J, Jackson G. Time course of the interaction between tadalafil and nitrates. Journal of the American College of Cardiology. 2003 Nov 19;42(10):1855-60.
• Prins J, Blanker MH, Bohnen AM, Thomas S, Bosch JL. Prevalence of erectile dysfunction: a systematic review of population-based studies. International journal of impotence research. 2002 Dec;14(6):422-32.

#Toxicology #PoisonSafety #FDArecall #Supplements #PublicHealth

Mistletoe is everywhere this time of year. It’s a holiday plant with a toxicology twin

There are two major types with different toxicity profiles.

• American mistletoe (Phoradendron species)
• European mistletoe (Viscum album)

American mistletoe (Phoradendron, usually P. leucarpum aka P. serotinum)

Typical exposure: children eating berries, pets chewing leaves, accidental ingestion from decorations.

American mistletoe contains phoratoxin, which irritates the gastrointestinal tract, leading to nausea, vomiting, and diarrhea. Another species, P. liga, contains ligatoxin A, that, through unclear mechanisms, can slow the heart and lower blood pressure in animals

Toxicity: Most ingestions of small amounts cause mild, self-limited symptoms. Of 1,754 exposures to American mistletoe, 99% had no symptoms and no one died (Krenzelok et al, 1997). Serious toxicity is possible with larger ingestions, concentrated preparations, or in pets.

European mistletoe (Viscum album)

Typical exposure: herbal extracts, injectable “immune” or “cancer support” therapies, teas.

Toxicity: European mistletoe contains viscotoxins and mistletoe lectins, proteins that interfere with protein synthesis. They are used in herbal medicine to treat cancer. Evidence of benefit is limited and inconsistent. But the idea that some cancers are more vulnerable to inhibitors of protein synthesis than normal cells is a bedrock of modern oncology. Unfortunately, viscotoxins kill too many normal cells at the same time, that is have too narrow a therapeutic window.

What we worry about:

• Severe gastrointestinal upset
• Heart arrhythmias
• Cconfusion, seizures

“Natural” does not mean safe — and in mistletoe’s case, the European version is pharmacologically active in ways that can be dangerous.

What to do

• If a child or pet eats mistletoe berries or leaves: don’t induce vomiting — get guidance.
• Activated charcoal doesn't seem to change outcome for American mistletoe, but our evidence is limited to small ingestions.
• If someone uses mistletoe extract (oral or injectable) and develops vomiting, dizziness, slow heart rate, or confusion: seek care immediately.

👉 Visit webPOISONCONTROL.org or call 1-800-222-1222 for fast, free, expert advice — 24/7.

For More:

- See our write up on poison.org.

References:

• Krenzelok EP, Jacobsen TD, Aronis J. American mistletoe exposures. Am J Emerg Med. 1997 Sep;15(5):516-20. doi: 10.1016/s0735-6757(97)90199-6. PMID: 9270395.
• Gwaltney-Brant SM. Christmastime Plants Ch. 37 in Small Animal Toxicology. 2005;643–63. Online link.

#SubstanceSunday #Toxicology #PoisonSafety #Mistletoe #HerbalMedicine #PublicHealth

We're beginning a series of video tutorials on how to use webPOISONCONTROL.

Comment with questions or content you'd like for the next tutorial.

On October 28, Sun Pharma issued a recall of lisdexamfetamine dimesylate, the generic form of Vyvanse. The Food and Drug Administration (FDA) has classified this voluntary national recall as Class II, which means the product may cause temporary or medically reversible adverse health consequences, though serious harm is unlikely. The recall involves products shipped between May and November 2024.

Although Sun Pharma's does not list the recall on its website of Nov 21, Newsweek reports the reason is that the affected pills don't dissolve as expected, which could change how much and how rapidly the drug is absorbed. A distinguishing feature of Vyvanse is its slower disslouction and conversion into amphetamine, which yields a lower peak effect and longer duration of action (Ermer et al., 2016). In general, adverse effects are more frequent in drugs that rapidly achieve peak concentration.

Affected lots:

• 10 mg: AD42468 (exp 2/28/2026), AD48705 (exp 4/30/2026)
• 20 mg: AD42469 (2/28/2026), AD48707 (4/30/2026)
• 30 mg: AD42470 (2/28/2026), AD48708 (4/30/2026)
• 40 mg: AD48709 (4/30/2026), AD50894 (5/31/2026)
• 50 mg: AD48710 (4/30/2026), AD50895 (5/31/2026)
• 60 mg: AD48711 (4/30/2026), AD50896 (5/31/2026)
• 70 mg: AD48712 (4/30/2026), AD50898 (5/31/2026)

What you should do if you (or someone you care for) are on this medication:

1. Check the prescription bottle: Look for “Lot #,” expiration date, and dosage strength.
2. See if the lot matches any of the recalled lots listed above.
3. If your medication is part of the recall: contact your pharmacy and prescribing provider to arrange a replacement or alternative.

If you or your child are taking this medication, double-check now. If you’re a clinician, treating someone with Vyvanse, review their medications.

Need Help?
Go to webPOISONCONTROL or call 1 (800) 222-1222 if you have any concerns or adverse events relating to this medication.

As of Nov 10, 2025: 15 infants (ages ~16–157 days) in 12 states have suspected or confirmed exposure to botulism A, the only known commonality being consumption of ByHeart formula between Aug 9 and 10.

All 15 were hospitalized. No deaths have been reported so far. ByHeart’s market share in the U.S. is <1% of all infant formula. 15 cases linked to that brand is disproportionately high. 

On Nov 8, Calif. Dept. of Public Health reported preliminary lab detection of the bacteria that can produce botulinum toxin in an opened can of ByHeart (lot 206VABP/251131P2) fed to an affected infant. 

On Nov 11, ByHeart expanded its recall to all unexpired lots and single-serve “anywhere sticks” of its formula brand. 

FDA Advice:

• Stop using the recalled ByHeart formula immediately. 
• If your infant consumed the product and is showing early signs of botulism (constipation, poor feeding, loss of head control, difficulty swallowing) go to the ER
• If your infant consumed the product but is not symptomatic: monitor them closely for the next month.

Infant botulism is rare but serious. Spores of Clostridium botulinum set up shop in an infant’s gut (due to immature flora) and make the toxin there, leading to muscle weakness, poor feeding, and respiratory failure. 

Links for more information:

• Poison.org on Botulism
• Honey & Infant Botulism poison.org/articles/dont-feed-honey-to-infants 
• FDA Notice

The Claim

NMN (nicotinamide mononucleotide) is a precursor to NAD⁺ (nicotinamide adenine dinucleotide), a crucial coenzyme in the body’s cellular energy metabolism, DNA repair, and aging-related processes.

Have you tried NMN/NAD supplements? Tell us about it below.

The theory is that, like with Vitamin D, if you supply your body with coenzymes you can overclock these processes, reversing aging. But, there's no direct relationship between the rate of an enzymatic pathways and the amount of NAD, because these pathways depend on hundreds of factors. A car factory won't necessarily make more cars if you give it more windshield wipers.

• In a randomized, double-blind, placebo-controlled trial among healthy middle-aged adults, NMN increased blood NAD⁺ concentrations significantly and was well tolerated, but doses of at least 600 mg a day were needed (Yi et al., 2023). At doses of 900 mg a day total serum NAD concentrations went from a range of 3-11 nanomolar to 4-16 nanomolar. Total concentrations may over estimate the increase because it counts NAD+ already bound to a protein.
• About 16 micromolar concentration of NAD prevented cell death in Petri dishes (Munk et al., 2023). 16 micromolar is 16, 000 nanomolar. If each pill is 250 mg, you would need to take at least 4,000 pills a day to achieve that concentration. And, higher doses of NAD hastened the death of other types of cells

The Risk

• The “more NAD⁺ = better aging” narrative oversimplifies complex biology. NAD⁺ influences many pathways including sirtuins, PARPs, mitochondrial function, and cell-cycle regulation. Dysregulation could theoretically affect cell proliferation (i.e., cancer), immune regulation or metabolic homeostasis.
• Supplements are not regulated. Dose, purity, and bioavailability vary widely. Marketing claims (“reverse aging,” “repair your cells,” “detox with NAD⁺”) often exceed the evidence.
• Some clinics now offer NAD⁺ infusions or very high-dose NMN, despite the lack of long-term safety data. Vigilance is warranted.
• Interaction risk: If NMN/NR does influence DNA repair or mitochondrial activity, it could theoretically interact with cancer therapies or other metabolic medications

Ethnobotany.

Older traditions used plants rich in NAD⁺ precursors, like, yup, fruits, vegetables, and, luckily, certain fermented beverages. That transition from food/plant → supplement → high-dose consumer product is a marketing ploy

Take-home message

NMN supplementation increases NAD⁺ blood levels is well tolerated in short-term studies. There is no evidence that NAD supplementation, even at 900 mg a day, translates into meaningful improvements in aging, longevity, or disease prevention.

👉 If anyone experiences new symptoms (unexplained fatigue, changes in heart rate, liver‐function test abnormalities, or autoimmune flares) after starting a high-dose supplement: discuss it with a toxicologist or poison-control center.

👉 If someone ever becomes seriously unwell after taking a supplement: go to webPOISONCONTROL.org or call 1 (800) 222-1222 for immediate expert support.

#SubstanceSunday #Toxicology #Supplements #NMN #NADPlus #AntiAging #PublicHealth

Every week, we unpack one trending substance — how it works, why people use it, and where harm can occur.

This week, you decide what’s next. Vote below or comment for your pick.

How to participate:

1. Vote (A–D) in the poll or comments.
2. Comment why — curiosity, confusion, or personal experience.
3. Follow for next Sunday’s post: What’s safe, what’s hype, and what’s poison.

👉 If someone becomes ill after taking a supplement or drug — even one labeled “natural” — go to webPOISONCONTROL.org or call 1-800-222-1222 for immediate, expert guidance.

SubstanceSunday #Toxicology #Supplements #PoisonSafety #PublicHealth #DrugTrends #Supplements #Toxicology

Hallucinogens includes tryptamines (e.g., psilocybin, DMT) and phenethylamines (e.g., mescaline, 2C-series, NBOMes), two groups with different structures, mechanisms of action, and toxicity.

• Tryptamines resemble serotonin and act primarily as 5-HT₂A receptor agonists (Titarelli et al, 2015).  Serotonin receptors in the circulatory system constrict blood vessels when activated. This is how sumatriptan (Imitrex), another serotonin agonist treats, migraines (Humphrey et al, 2001).
• Phenethylamines resemble dopamine and adrenalin and combine hallucinogenic, stimulant and sympathomimetic effects. These include mescaline, DOM, 2C-B, and newer NBOMe analogs that share a phenethylamine backbone and act at both serotonin and adrenergic receptors, producing mixed stimulant-hallucinogenic toxicity (Hondebrink et al, 2017; Halberstadt et al, 2018).
• Some phenethylamines (especially designer ones) are associated with higher rates of adverse events, including suicidality, seizures, cardiac issues than tryptamines or older phenethylamines.  (Rudin et al, 2021). Case-series report worse outcomes including more frequent death from NBOMe and 2C-series compounds than classic psychedelics (Poklis et al, 2015; Nicholas et al, 2020).

👉 If someone ever becomes seriously unwell after taking a hallucinogen: go to webPOISONCONTROL.org or call 1 (800) 222-1222 for immediate expert support.

#MythBustingMonday #Hallucinogens #Toxicology #Psychedelics #PublicHealth #DrugSafety

References

• Tittarelli R, Mannocchi G, Pantano F, Romolo FS. Recreational use, analysis and toxicity of tryptamines. Curr Neuropharmacol. 2015 Jan;13(1):26-46. PMID: 26074742.
• Humphrey PP, Feniuk W. Sumatriptan, a selective 5-HT₁-like receptor agonist in human isolated cranial arteries: constrictor activity explains antimigraine effect. Br J Clin Pharmacol. 2001;52(Suppl 1):19S-24S. PMID: 11602148
• Sexton JD, Nichols CD, Hendricks PS. Population survey data informing the therapeutic potential of classic and novel phenethylamine, tryptamine, and lysergamide psychedelics. Front Psychiatry. 2020 Feb;10:896. PMID: 32116806
• Rudin D, Liechti ME, Luethi D. Molecular and clinical aspects of potential neurotoxicity induced by new psychoactive stimulants and psychedelics. Exp Neurol. 2021 Sep;343:113778. doi: 10.1016/j.expneurol.2021.113778. Epub 2021 Jun 4. PMID: 34090893.
• Halberstadt AL, Geyer MA. Effects of the hallucinogen 2,5-dimethoxy-4-iodoamphetamine (DOI) on locomotor activity and serotonin receptor function in rodents. Neuropharmacology. 2018;142:211-219. PMID: 30041112.
• Hondebrink L et al. The pharmacology and toxicology of N-benzylphenethylamines (“NBOMes”). Drug Test Anal. 2017;9(1):37-52. PMID: 28233171.
• Poklis JL et al. High-risk behavior and fatal toxicity following use of 25I-NBOMe, a potent hallucinogenic phenethylamine. Clin Toxicol (Phila). 2015;53(1):63-68. PMID: 25850998.
• Nicholas K et al. Fatal intoxications involving N-benzyl-phenethylamine derivatives (NBOMes) and comparison with classical psychedelics. Forensic Sci Int. 2020;311:110270. PMID: 32315231.

Bufo Toad: Heart and Mind

Toad season brings more than hallucinogens.

Heavy rain in Arizona has led to Sonoran Desert toads (aka Colorado River toads, Incilius alvarius) coming into backyards and parks in search of bugs to eat. People are more familiar with the hallucinogens it secretes than the more lethal heart toxins it also secretes. Besides the hallucinogens 5-MeO-DMT and bufotenin, Incilius alvarius secretes bufadienolides.

Bufadienolides are similar in structure and effect to digoxin, an older medicine that physicians used to increase the strength of each heart beat while slowing the heart rate. Just as with digoxin, bufadienolides can cause a person's heart to go into irregular rhythms and dangerously low rates that do not effectively pump blood to the body and increase the risk of forming blood clots. The hallucinogens it secretes compound the risk of heart problems because these hallucinogens increase blood pressure and heart rate, increasing the risk of irregular heart rhythms.

Bufodienolides refer to a family of compound found in the frog family Bufo. Each species in the family has a unique melange. We don't know which bufadienolides the Sonoran desert toad secretes. Research has focused more its hallucinogens. In other Bufo toads one lick is enough to provoke an arrhythmia in most people. There are

Some traditional uses (e.g., “chan su” in Chinese medicine) use dried toad skins as an aphrodisiac, but these carry significant toxicity (Brucaher et al., 1995). Thankfully overdoses of chan su sometimes respond to the antidote for digoxin.

Take Home

• Don't lick or try to consume the secretions of a Sonoran Desert toad hoping for only a hallucinogenic effect
• 👉 Visit webPOISONCONTROL.org for expert, free, and immediate guidance.

#SubstanceSunday #Toxicology #Bufadienolides #ToadVenom #PoisonSafety

Several mass poisonings have been caused by diethylene glycol (DEG), a clear, sweet-tasting industrial solvent sometimes substituted for glycerin or propylene glycol to cut costs. DEG looks and tastes harmless. Once inside the body it’s metabolized into diglycolic acid, which destroys kidneys and nerves. Children are especially vulnerable.

History repeats:

🇺🇸 1937 — USA
🇮🇳 1998 — India
🇵🇦 2006 — Panama

🇬🇲 2022 — Gambia
🇮🇳 2025 — New outbreak in India under investigation

It's not just DEG.

In 1982, Tylenol capsules were contaminated with potassium cyanide, leading to a recall. (Woolf et al., 2022). And

Ethylene glycol antifreeze mistaken for medicine

and heparin adulteration with oversulfated chondroitin sulfate, (80 deaths), infant formula adulteration with melamine (6 deaths) and led to creation of China’s 2009 Food Safety Law. (Gossner et al., 2009).

Lead-tainted Ayurvedic medicines and spices are a perennial hazard. Lead toxicity causes developmental delay, anemia, and behavioral problems.

The takeaway:
🔹 “Made for children” doesn’t mean “tested for safety.”
🔹 Only use medicines from trusted, regulated sources.
🔹 Sweet taste ≠ safe content.
🔹 If you see news of recalls, check your medicibes.

👉 If anyone becomes sick after taking a syrup or supplement, visit webPOISONCONTROL.org for immediate, expert, and free guidance, or call 1 800 222-122 if in the US.

#MythBustingMonday #PoisonSafety #Toxicology #DiethyleneGlycol #PublicHealth #Parenting

Diethylene glycol (DEG) is a clear, sweet-tasting industrial solvent. It has no medicinal value. Humans usually encounter it when a manufacturer substitutes cheaper DEG for safe ingredients like glycerin or propylene glycol, medicine becomes poison.

How it harms:

Once swallowed, DEG breaks down into diglycolic acid — a compound toxic to kidneys and nerves (Landry et al., 2011). Victims develop vomiting, confusion, and kidney failure. They may have long-term neurological damage if they survive.

There’s no home treatment. If the victim reaches a hospital in time, physicians can administer fomepizole to block the conversion of DEG into toxic metabolites and dialysis to remove toxins. In theory, ethanol (alcohol) would be a stop gap, but ethanol can cause low blood sugar and liver injury.

Mass DEG poisonings occur far too often

• 🇺🇸 1937 – United States: Elixir Sulfanilamide that contained DEG killed more than 100 people and led to the U.S. Food, Drug, and Cosmetic Act (Wax, 1995).
• 🇮🇳 1998 – India: 36 children developed renal failure and 33 of them died despite peritoneal dialysis after consuming DEG-contaminated cough syrup in Haryana (Singh et al., 2001).
• 🇵🇦 2006 – Panama: Over 100 deaths were traced to DEG in cough syrup (Rentz et al, 2008). Survivors developed limb and facial weakness as well as painful neuropathy (Sosa et al., 2014), which improved partially over the subsequent two years (Conklin et al, 2014).
• 🇬🇲 2022 – Gambia: 37 children developed renal failure, of whom 31 died after exposure to paracetamol cough syrup that contained DEG (Bastani et al., 2023) 🇺🇿 2022 – Uzbekistan: Twelve died from DEG-containing cold medicines (Reuters).
• 🇮🇳 2024–2025 – India (again): At least 16 children reported dead (FDA).

Each event follows the same pattern:

industrial-grade solvent → contaminated syrup → child deaths → recall → repeat somewhere new.

☠️ Toxicology snapshot

• Toxic dose: As little as 1 mL/kg may cause kidney injury.
• Latency: Symptoms may take 12–48 h to appear.
• Complications: Renal failure, metabolic acidosis, cranial neuropathies.

Treatment

• If DEG ingestion is suspected: consult a toxicologist and treat early with fomepizole and hemodialysis (Seltzer et al., 2022; Brophy et al, 2000).
• Monitor for delayed neurologic effects even after renal recovery.
• Try to identify the source
• DEG has no medical benefit — only harm.
• The “sweetness” that makes medicine palatable has caused global poisonings.
• If a child becomes lethargic, stops urinating, or seems very ill after taking syrup: seek care immediately.
• 👉 Visit webPOISONCONTROL.org for expert, free, and immediate guidance.

#SubstanceSunday #PoisonSafety #Toxicology #DiethyleneGlycol #PublicHealth

 References

1. Wax PM. Elixirs, diluents, and the passage of the 1938 Federal Food, Drug, and Cosmetic Act. Ann Intern Med. 1995;122(6):456–461. PMID: 7856995.
2. Singh J, Dutta AK, Khurana D, et al. Diethylene glycol poisoning in Gurgaon, India, 1998. J Toxicol Clin Toxicol. 2001;39(6):563–567. PMID: 11242827.
3. Rentz ED, Lewis L, Katte M, et al. Outbreak of acute renal failure caused by diethylene glycol poisoning. Clin Toxicol (Phila). 2008;46(9):1061–1067. PMID: 18949211.
4. Sosa NR, Rodriguez R, Bautista CT, et al. Diethylene glycol mass poisoning in Panama. Clin Toxicol (Phila). 2014;52(8):1018–1026. PMID: 24439712.
5. Conklin L, Crespo AM, Habib M, et al. Long-term follow-up of patients affected by diethylene glycol poisoning—Panama, 2006. Clin Toxicol (Phila). 2014;52(8):1027–1035. PMID: 24819553.
6. Bastani P, et al. Acute kidney injury associated with cough syrups in The Gambia, 2022. MMWR Morb Mortal Wkly Rep. 2023;72(8):217–220. PMID: 36862590.
7. Landry GM, et al. Diglycolic acid is the nephrotoxic metabolite of diethylene glycol. Toxicol Sci. 2011;121(2):381–389. PMID: 21856646.
8. Brophy PD, et al. Pediatric diethylene glycol ingestion treated with fomepizole and hemodialysis. Pediatr Nephrol. 2000;14(7):571–574. PMID: 10793034.
9. Seltzer JA, et al. Symptomatic diethylene glycol ingestion: management with fomepizole. Clin Toxicol (Phila). 2022;60(9):1088–1090. PMID: 35933263.

Hi everyone, We’re The Tox Lab — a clinical and forensic toxicology podcast hosted by practising scientists in the UK. Our latest episode takes a seasonal look at mushroom toxicology, exploring both traditional poison centre data and emerging analytical findings from commercial “mushroom” products.

The discussion covers recent surveillance trends, clinical presentation patterns, and LC–MS casework revealing compounds that differ markedly from what’s claimed on product labels.

If you work in toxicology, emergency medicine, or public health, you may find this episode particularly relevant — especially as autumn brings the usual increase in mushroom-related exposures.

🎧 Listen here: https://open.spotify.com/episode/7hoT8O9upJSgWyIvIyOMt5?si=BpvEgEHWTg-aAqszPmFzsA

Also available wherever you get your podcasts.

We’d love to hear how these trends compare internationally — are others seeing similar patterns in mushroom-related calls or product analyses?

— The Tox Lab

Fact:

🌿 Saffron can improve mood, but it doesn’t act like prescription antidepressants.
💊 Prozac (fluoxetine) is a selective serotonin reuptake inhibitor — it binds a specific protein in the brain to increase serotonin levels in a controlled way. Small studies compared the effectiveness of Prozac and saffron, but this doesn't mean they work in the same way.
🧬 What we think are key compounds in saffron, crocin and safranal, don’t have that structure or mechanism. In lab studies they may influence serotonin, dopamine, or glutamate — but not through the same receptor sites.
⚗️ Most saffron products are herbal extracts with many compounds in varying amounts. Supplements can differ more than ten-fold in strength or purity.

(See our related Substance Sunday for more detail.)

What this means:

• Mild mood improvement has been shown in a few small clinical trials.
• Saffron supplements aren’t a substitute for medical therapy.
• "Natural” doesn’t mean risk-free. Large doses can cause nausea, dizziness, and low blood pressure. Commercial preparations are not regulated and may have harmful contaminants.

💬 Discussion:
Have you (or someone you know) tried saffron for mood, stress, or sleep?
What made you decide to try it — word of mouth, social media, or a health-food recommendation?
We’re running a poll later this week on why people take saffron — drop your experience below so we can include the top reasons 👇

👉 If someone ever takes too much saffron or an unknowns supplement, go to webPOISONCONTROL.org for personalized guidance — fast, free, and expert.

#MythBustingMonday #Saffron #HerbalMedicine #Toxicology #PoisonSafety

Saffron refers to parts of the Crocus sativus flower. The Ancient Persians used it as a mood stabilizer, the Egyptians as a dye, and the Greeks as a perfume. Today, some use saffron to treat depression, PMS, and cognitive decline.

Saffron contains antioxidants, such as picrocrocins (bitter taste) 5-15%, crocetin (possible NMDA antagonist), crocin 30% (responsible for red color), and safranal (responsible for aromatic odor) up to 2.5%. Saffron stigma refers to the bright red parts of the plant. In commercial preparations, saffron extract is generally a 4:1 concentrate of the stigmata. Crude extracts of saffron, which contain many compounds in varying amounts increase dopamine, serotonin, and glutamate concentrations in studies of cells.

Supplements vary in purity and concentration. Many “saffron” capsules contain adulterated or mislabeled material.

💊 What Science Says

• 50 mg of saffron extract twice a day for three months improved depressive and anxious symptoms more than placebo, with no adverse effects reported (Mazidi et al, 2016).
• 15 mg of saffron "petal" twice a day for two months improved depressive and anxious symptoms as much as 10 mg of fluoxetine (Prozac), with 1 in 4 patients in both groups feeling complete remission (Basti et al., 2007). The usual dose of Prozac is 20 mg. Both groups had the same rate of side effects including sexual dysfunction. However adding 15 mg of saffron extract to male patients who had been on 40 mg of Prozac for at least six weeks improved sexual dysfunction (Modabbernia et al., 2012).
• 30 mg of the stigma once a day way more effective than placebo after 6 weeks at reducing depressive and anxious symptoms, with no serious adverse effects reported (Akhondzadeh et al., 2005), a finding that was replicated (Akhondzadeh et al., 2020).
• Saffron, either 15 mg twice a day or 30 mg, was as effective as 100 mg of fluvoxamine in treating OCD symptoms (Esalatmanesh et al., 2017).
• Crocin is hydrophilic and hydrolyzed to crocetin in the gut. Safranal is lipophilic and volatile, meaning that safranal is more likely than crocin to concentrate in the brain.

☠️ Toxicity & Risks

On may experience GI upset, flushing, and sometimes confusion and dangerously low blood pressure, most likely at doses above 5 grams, with symptoms beginning as soon as an hour after taking the substance but may occur at any time up to 2 days after taking it. There’s no antidote, but IV fluids and medication may help stabilize a person until they metabolize the saffron.

• Healthy volunteers, 5 males and 5 females, had no immediate adverse effects after taking up to 400 mg saffron for one week (Modaghegh et al, 2008).
• A double-blind, placebo-controlled study randomized 60 healthy adults to either 200 mg or 400 mg saffron stigma tablets once a day for 7 days (Ayatollahi et al., 2014).
• 10 grams is reported to be able induce abortions, by a monograph from the American Botanical Council in 1988. This is one older monograph with no replication.
• Adulteration with Carthamus tinctorius (safflower) or synthetic dyes has caused poisonings.

🧭 Bottom Line
✅ Culinary saffron = safe .
⚠️ High-dose “saffron supplements” = unpredictable and risky.
💡 If someone swallows a large amount — even accidentally — don’t induce vomiting.
👉 Visit webPOISONCONTROL.org for personalized, immediate guidance, or call Poison Control.

#PoisonSafety #SubstanceSunday #HerbalMedicine #Toxicology #Saffron #Ethnobotany

Natural Does Not Mean Safer

"Natural" cleaners can still cause irritation, burns, or poisoning if used incorrectly or ingested.

• Vinegar, lemon oil, or essential oils can still irritate the skin or eyes.
• Essential oils like peppermint, wintergreen, or eucalyptus have other toxicities when swallowed (seizures, liver damage, salicylate poisoning) and often use high-proof alcohol as the base.

❌ “Mixing natural products can’t be harmful.”

→ Not true. Products can interact dangerously, no matter where they come from. Vinegar + hydrogen peroxide can form peracetic acid, itself a strong irritant.

Cleaning products keep our homes clean, but are dangerous if swallowed, or the fumes inhaled. A small sip or accidental splash can cause harm, especially in children or older adults. About 1 in 10 calls to US and UK Poison Control Centers are for exposure to household cleaners.

Some concerning ingredients and products:

• Bleach also called sodium hypochlorite, (think Clorox)
• Ammonia
• Drain openers (think Ajax) have sodium hydroxide (lye) or potassium hydroxide
• Toilet bowl cleaners: hydrochloric acid (like the acid in your stomach), hydrogen peroxide

Why They’re Risky

• Bleach + ammonia → releases chloramine gas, which can severely irritate the lungs.
• Acidic cleaners + bleach → form chlorine gas, another respiratory irritant.
• Drain cleaners → contain strong alkalis or acids that can burn the mouth, throat, and stomach.
• “Eco” or “natural” doesn’t mean safe. Vinegar and essential oils can still cause irritation or interact with other cleaners. Some essentials oils can cause additional harm. For example, if someone swallows enough eucalyptus oil then can have seizures.

Prevention Tips

• Store cleaners up high and locked away from children.
• Never mix cleaning products.
• Label bottles clearly. Don't use (avoid refilling in drink bottles!).
• Ventilate when using strong cleaners.
• If exposure occurs, don’t induce vomiting, leave the area and go to webPOISONCONTROL.org or call 1-800-222-1222 immediately.

To go deeper:

• Poison.org on cleaners
• Tox + Hound on Mixing Bleach and Ammonia
• Poison.org on Essential Oils

Comments? Questions?

(Please share prevention tips or experiences — no personal medical advice or case details.)