Silibinin or Silly Putty for Mushroom Poisoning?
October 2, 2011, 3:08 pm
Silibinin, an extract from the seed of the milk thistle plant (Silybum marianum), is often discussed as a possible treatment for poisoning from certain mushrooms such as Amanita phylloides, but has never been adequately studied (although there is an on-going drug-company-sponsored trial). It is commonly available over-the-counter as an oral preparation in health food stores, and sold under the name Legalon in Europe. Silibinin may act to inhibit sites on the hepatocyte membrane that facilitate uptake of amatoxin into the cell. It is also an antioxidant.
The Shots blog post reports that with all the heavy rain on the east coast this summer, an abundance of Amanita mushrooms has sprouted. Georgetown University Hospital has admitted four patients from Virginia and Maryland over the last month with toxic mushroom poisoning. These patients were treated with intravenous silibinin on an experimental basis. According to the post, two patients recovered and two are in fair condition.
However, the report states that the first two patients developed severe nausea, vomiting, and diarrhea within hours of eating the mushrooms. These early-onset gastrointestinal effects are not consistent with Amanita ingestion. It is always possible, of course, that a mixture of mushrooms was consumed, with some non-Amanita species causing the rapid GI effects. But how did the Georgetown physicians know specifically that Amanita was also ingested?
It may be that the ongoing multicenter trial will demonstrate a benefit of silibinin in this setting. At the present, however, there is as much scientific evidence for using silibinin to treat Amanita toxicity as there is for using Silly Putty.