Episode 92: Mad Honey - Grayanotoxins and Cardiovascular Effects

This week on The Tox Lab, we're diving into the world of mad honey and grayanotoxin poisoning.

We examine where mad honey comes from and its cultural uses before turning to the compounds responsible for its toxic effects: grayanotoxins. We discuss how these compounds affect voltage-gated sodium channels and how this can lead to severe bradycardia, hypotension, cardiac conduction abnormalities, dizziness, neurological symptoms and, in some cases, hallucinations.

The episode also examines reported cases of mad honey poisoning, including a severe case in Nepal and a case from the UK involving imported raw honey. We consider why the concentration of grayanotoxins can make the effects of mad honey difficult to predict and explore the clinical features of grayanotoxin poisoning.

Join us as we explore the chemistry, pharmacology, history and toxicology of mad honey, and discover how something as familiar as honey can cause significant cardiovascular and neurological toxicity.

Hope you enjoy!

Links to the papers we discussed:

https://pmc.ncbi.nlm.nih.gov/articles/PMC9978999/pdf/EFS2-21-e07866.pdf

https://www.mdpi.com/1420-3049/30/19/3925

https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/10.1002/jat.4855

https://pmc.ncbi.nlm.nih.gov/articles/PMC6293183/pdf/CCR3-6-2355.pdf

https://www.cureus.com/articles/488288-mad-honey-poisoning-caused-by-grayanotoxin-toxicity-in-a-75-year-old-male-patient-presenting-with-hypotension-and-bradycardia-in-the-united-kingdom-a-case-report#!/

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