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#1 riseabovethought


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Posted 20 June 2012 - 11:30 AM


The Most Dangerous Mushroom


The death cap is spreading. It looks, smells, and tastes delicious.

140203_MEDEX_shroomline.jpg.CROP.originaThe death cap, Amanita phalloides, from button stage to full-size fruiting body.

Photo courtesy Justin Pierce via

The death cap mushroom likely kills and poisons more people every year than any other mushroom. Now there finally appears to be an effective treatment—but few doctors know about it.


When someone eats Amanita phalloides, she typically won’t experience symptoms for at least six and sometimes as many as 24 hours. Eventually she’ll suffer from abdominal cramps, vomiting, and severely dehydrating diarrhea. This delay means her symptoms might not be associated with mushrooms, and she may be diagnosed with a more benign illness like stomach flu. To make matters worse, if the patient is somewhat hydrated, her symptoms may lessen and she will enter the so-called honeymoon phase.

Meanwhile, the poison stealthily destroys her liver. It binds to and disables an enzyme responsible for making new proteins. Without this enzyme, cells can’t function, and liver failure results. Without proper, prompt treatment, the victim can experience rapid organ failure, coma, and death.

A few mouthfuls of death cap mushroom can kill.

Many people who are poisoned claim the mushroom was the most delicious they’ve ever eaten.

Extremely adventurous mushroom connoisseurs have supposedly removed toxins from slightly poisonous mushrooms such as the fly agaric, Amanita muscaria—the archetypal red and white polka-dotted mushroom beloved by Nintendo video game enthusiasts and nature artists. A complicated boiling process is said to allow the nutty-tasting mushroom to be enjoyed with no harm.

Despite folklore to the contrary, the death cap’s deadliest toxins, called amatoxins, cannot be removed this way. Amatoxins cannot be destroyed by any conventional cooking method, including boiling or baking. Freezing or drying the mushrooms also fails to remove any amount of amatoxin, instead preserving it to wreak havoc later.

The death cap doesn’t taste remotely like death—many people who are poisoned claim the mushroom was the most delicious they’ve ever eaten.

Its appearance doesn’t scream deadly, either: In its early “button” stage, it closely resembles immature edible white species, including the common field mushroomAgaricus campestris. Full-size death cap is reminiscent of other innocuous mushrooms. In California, a number of immigrants have confused it with the edible paddy straw mushroom Volvariella volvacea, which is harvested in Asia.

Upon ingestion of death cap, about 60 percent of the absorbed amatoxins travel directly to the liver. Both poisoned and healthy liver cells spit out amatoxins into bile, which is then concentrated in the gall bladder. After each meal, the gall bladder releases bile into the gut, and the amatoxins travel with salts in the bile. At the end of the small intestine, most the bile gets reabsorbed back into the liver. Amatoxins re-enter the liver via the same receptors as the bile salts, and the poisoning cycle repeats.

The other 40 percent of absorbed amatoxins initially make a beeline to the kidneys, which serve as the blood-waste treatment center of the body. Healthy kidneys can extract amatoxins from the blood and send them to the bladder—an ability that is rare for liver poisons. Until the kidneys kick out every last bit of poison, amatoxins continue damaging the liver. The kidneys can continue to function only if the victim stays sufficiently hydrated. Without aggressive hydration, amatoxins poison the kidneys as well. After the kidneys fail, rapid organ failure is not far behind. But if the patient still has liver and kidney function, and enough fluid to urinate regularly, she can essentially pass the still-intact amatoxins out in urine, like the smallest, deadliest kidney stone.

Every patient who still had intact kidney function and was started on the drug within 96 hours has lived.

To keep the amatoxins from causing damage, a drug would have to protect the liver while the kidneys eliminated the poison. A nationwide clinical trial is testing a new treatment for amatoxin poisoning: silibinin, a drug derived from the plant milk thistle,Silybum marianum. When administered intravenously, the compound sits on and blocks the receptors that bring amatoxin into the liver, thus corralling the amatoxins into the blood stream so the kidneys can expel them faster.

S. Todd Mitchell of Dominican Hospital in Santa Cruz, Calif., and his team have treated more than 60 patients suffering from amatoxin poisonings. Every patient who still had intact kidney function and was started on the drug within 96 hours of eating mushrooms has lived. Only a few patients sought treatment later and did not survive.

The research hasn’t been published yet—60 patients aren’t enough to confirm that silibinin really is the liver savior it seems to be—but the researchers are confident. “When we present to FDA, it will be a slam dunk for approval,” Mitchell says. “The drug has virtually no side effects, it’s very well tolerated, and if used correctly it’s awesomely effective.”

After ingesting amatoxins, “patients go into early renal failure for two reasons,” Mitchell explains. “One, they just present so late that their kidneys have already shut down. Or two, more commonly, they’re just not aggressively hydrated enough by the treating physicians.”

Medical treatment often goes awry in the early stages of amatoxin poisoning. Poison control centers generally recommend three main treatments, none of which is effective.

First, activated charcoal is recommended to prevent poisons from being absorbed by the gastrointestinal tract and causing liver damage. This works well for most poisonings, but by the time a patient usually seeks medical assistance for amatoxins, the poison has traveled well past the GI tract. Similarly, centers often recommend pumping the patient’s stomach, which is hard on the body and does nothing to remove the amatoxins damaging the liver. Third, acetylcysteine is often prescribed. It is very effective at preventing liver damage in acetaminophen poisoning. But in amatoxin poisonings, it is completely ineffective, thins the blood unnecessarily, and gives misleading liver-function test results.

These recommendations make the patient sicker while diverting attention from the most effective weapon against amatoxins: aggressive hydration.

Part of the challenge of recognizing the symptoms of amatoxin poisoning and properly treating it is that mushroom poisonings are relatively rare. The first time a physician treats a patient for amatoxin poisoning, Mitchell explains, is likely to be her last. Doctors may be encountering more cases in the near future, however.

140203_MEDEX_whitecouple.jpg.CROP.promovThis pure white variety of death cap,Amanita phalloides var. alba, resembles many edible species, especially when young.

Photo courtesy Ron Pastorino via*

The death cap mushroom is an invasive species from Europe, now present on every continent except Antarctica. It became such a world traveler because humans spread the mushroom’s spores around like glitter at a kids’ glitter party.

Fungi such as the death cap are ectomycorrhizal, meaning that they live symbiotically on the roots of trees. The fungus extends from the roots to form a network in the soil, called a mycelium, which is much finer than tree roots. The mycelium can more easily reach nutrients like nitrogen and phosphorous than the tree can, and it trades these nutrients with the tree in exchange for sugars, which the tree makes using photosynthesis.

A mushroom is the lovechild of two sexually compatible mycelia. Mushrooms in turn make tiny spores that easily disperse and can grow into new mycelia.

A shift from partnering with a deciduous oak to a coniferous pine tree is a very large step for a fungus.

In the 19th century, people tried introducing their favorite trees to new continents. Seeds were planted but quickly died. Nothing seemed to help until someone had the bright idea to bring seedlings in pots with their native soil. The soil worked like a charm. The trees grew smashingly, but people didn’t know they had spread fungal spores and other soil microbes along with the trees.

A few researchers in the mid-20th century did notice that some mushrooms seemed to have appeared in new areas, but because they lacked a historical baseline for fungal diversity, nothing could be proved. Most scientists simply assumed the death cap was native to both Europe and the United States.

Anne Pringle became interested in the death cap as a postdoctoral fellow studying fungi at the University of California–Berkeley. (Disclosure: She later became my graduate adviser.) She was learning the local mushrooms by collecting them in the small canyon behind her house. She brought one sample to an adviser, Tom Bruns, who identified it as Amanita phalloides. He then hinted about an enticing rumor among the amateur mycological community that the death cap wasn’t actually native to California.

Pringle admitted the idea was interesting but didn’t think too much about it until Bruns dropped some not-so-subtle hints that she should investigate, such as leaving drawings of a skull and crossbones on her desk.

Pringle quickly learned that scientists in the early 20th century had been using descriptions to identify death cap that were so broad they encompassed several other species. By sequencing the DNA of old, dried specimens in collections across the country, she found that all specimens labeled before 1938 were actually different species of Amanita. While other North American mushrooms had long records in herbaria, the death cap made a sudden appearance in 1938 and became increasingly common after that year.

Pringle also sequenced the DNA of wild A. phalloides mushrooms picked in the United States and Europe. She found much less genetic variation in U.S. mushrooms. That indicated that the species had started in Europe and that the U.S. mushrooms had undergone a “population bottleneck” in which a mere handful of individuals had colonized the continent.

140203_MEDEX_earthinhand.jpg.CROP.promovA young death cap specimen.

Photo courtesy Franck Richard

Why were most scientists wrong about the death cap? Prior to Pringle’s discovery, known invasive fungi fell exclusively into the category of plant or animal diseases, such as the one that wiped out the American chestnut. These fungi were ones we can usually see on the host, and they cause obvious symptoms.

The death cap can’t live without its tree host. In order to become invasive, A. phalloides underwent something incredibly rare: a host shift. The fungus somehow switched from being able to grow only on European oak roots to growing on a completely different oak species, the California live oak. Not only was it able to colonize a new species of oak, but in the United States it has also been found to grow on native pines.

A shift from partnering with a deciduous oak to canoodling with a coniferous pine tree is a very large step for a fungus. Pringle’s discovery shook up scientists’ ideas of what it means to be a symbiont.

The death cap story intrigued me, and it is one of the reasons I joined the Pringle lab. I am currently conducting a literature review of research on Amanita phalloides and hope to eventually uncover the cellular mechanism by which the death cap was able to switch hosts.

The death cap is now widely distributed in the United States. Based on the weather patterns within its native range, it appears to have spread as far as tolerable conditions allow on the East Coast. But there are still areas in the Pacific Northwest and Canada that it should be able to live in but where it hasn’t yet been recorded. The mushroom is spreading in Ohio, and marching south into Mexico.

With this long history of confusion about whether or not the death cap is native, combined with the fact that it’s still spreading, it’s not surprising that people accidentally harvest and eat it. Similarly, it’s no wonder that people intentionally eat it: It’s large and meaty, it’s often plentiful, and it smells delicious.

Top Comment

One thing that makes this mushroom especially dangerous is that it commonly grows among Agaricus campestris, the meadow mushroom, which it closely resembles to the untrained eye.  More...

-Jon Webb

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Even very experienced mushroom hunters aware of both the historical confusion and the death cap’s resemblance to edible fungi have been poisoned by Amanita phalloides. Because the mushroom is so deadly and can grow side by side with edible species, one wrong mushroom picked in the failing light can invite disaster.

If you ever suspect you may be suffering from mushroom poisoning, ask your doctor to call Mitchell in Santa Cruz and request to be enrolled in the milk thistle treatment study. He will ship silibinin to anyone, anywhere in the world.

And remember to stay hydrated if you want to live.

*Correction, Feb. 11, 2014: This article misspelled photographer Ron Pastorino's last name. (Return.)


Cat Adams is a graduate student at Harvard University studying plant-fungal interactions. Follow her at ScienceIsMetal and on Twitter.


Edited by riseabovethought, 29 April 2015 - 01:57 PM.

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#2 hyphaenation


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Posted 20 June 2012 - 11:38 AM

Thanks for this thread.

Good for people to know what it looks like to avoid it.

Interestingly enough , despite the apt name Death Cap , new research points to the fact that medicines can be made from this deadly mushroom that can cure pancreatic cancer. Never to be tried at home of course , else you could easily kill yourself.


Nature is very wild ...
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#3 iatebadshrooms


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Posted 20 June 2012 - 01:06 PM

Those grow abundantly here is southern Georgia amongst the pine's and pine straw littered forest floor. They are a unique looking mushroom the variety down here tend to have that yellow color to the cap and green tint to gills sometimes pink. They are every where, I worry about people's dog's because they tend to also grow in pinestraw where the landscapers have installed bushes in peoples yards.........

#4 riseabovethought


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Posted 20 June 2012 - 01:41 PM

Check out a great movie from netflix called Know Your Mushrooms if you get the chance. Great flick the Topiate will enjoy!
The Amanita Phalloides is responsible for most mushroom -related deaths worldwide. It appears most people assume that most mushrooms are toxic and dangerous and they avoid em all because of poor education. Fungi- knowledge is becomming more and more valuable.

I want everyone to know about this one mushroom, especially! If you know how to recognize this one, the likeliness of danger is decreased substantially. And after seeing that thread about 'do you know someone permanently injured by shrooms?' - I felt like we should put this into perspective.

Edited by riseabovethought, 20 June 2012 - 02:00 PM.

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#5 Alder Logs

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Posted 20 June 2012 - 01:53 PM

I knew about the deadly amanitas when I was young and stupid. I say "stupid" because I didn't know about the galerinas.
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#6 Man of Knowledge

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Posted 20 June 2012 - 04:13 PM

I knew about the deadly amanitas when I was young and stupid. I say "stupid" because I didn't know about the galerinas.

HJere are some images of deadly Amanita phalloides from on the campus of the University of Washington, less that twenty feet from a large crop of Psilocybe cyanescens. Of course, Galerina autumnalis resembles P. cyanescens and P. stuntzii more than Amanita phalloides does, but you do not want to eat this shroom at all.

Some photos of Amanita phalloides from Seattle.



I have many more but this should suffice for now. cool post, but only good if seeking edibles. Not good for seeking magic. But those who seek magic have a less chance of posioning oneself if only looking for one or two magic species oout of 5,000 shrooms while those seeking edibles have several hundred to choose from so their chances of being poisoned are easier for those who want dinner and not a high. Did that make sense to those who just read these words?

man of knowledge
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#7 EstimatedProphet


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Posted 21 June 2012 - 09:19 PM

I am not trying to thread jack, but this is a really good site for all things Amanita.

http://www.amanitace...nita phalloides

#8 ethnobotanist420


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Posted 21 June 2012 - 09:22 PM

They don't look safe to me in any sense of the word lol they just look malicious.
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#9 rasbilly



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Posted 21 June 2012 - 09:54 PM

Wow, blast from the past, I did a book report on those way way back in elementary school. I wish I had the giant illustrations I made for it! Thanks for posting this!

#10 warriorsoul


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Posted 22 June 2012 - 06:40 AM

In the east we have its sister "the eastern destroying angel", also just as deadly.


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#11 riseabovethought


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Posted 05 April 2013 - 01:43 PM

bump reminder

#12 MycoDani


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Posted 05 April 2013 - 03:44 PM

They grow where I am too but for some reason I always stayed away. My Grama had a book on mushrooms so I learned early because fungus just interested the heck out of me.

Good thread Rise especially for people with children. Yet everyone should be aware of this amanita!

#13 Rebelutionsssss



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Posted 05 April 2013 - 07:39 PM

When the seasons right I see tons of these. They're actually Really beautiful mushrooms. They get quite large as well. Another one you should put up is the jack-o-lantern mushroom. Some very novice hunters in my area some how mistook them for chantrells and got violently ill

#14 wildedibles



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Posted 06 April 2013 - 05:35 AM

Here are some pictures of Amanita brunnescens. another poisonous one deadly

Posted Image
by warriorsoul

Edited by wildedibles, 06 April 2013 - 06:18 AM.

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#15 riseabovethought


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Posted 28 April 2015 - 04:19 PM

Take another look.  Remember this one.  Remember it well.

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#16 Sidestreet


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Posted 28 April 2015 - 04:56 PM

Archive material
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#17 Coopdog



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Posted 28 April 2015 - 05:28 PM

Man Rise, I only got a couple of pics in all that material. Hopefully they will open up with another browser. I have pretty much quit using IE for everything but topia, because for some reason nothing will open (messages and likes and such) with Firefox. I was really hoping the server migration would sort that issue out, because I can't use IE for a few other sites because nothing will work on them with IE. Computers are a pain in the ass sometimes!


At any rate, I had a brother in law who would eat any mushrooms he found and I once barely saved him as he was slicing up one of these to put into a big pan of mushrooms he was frying in butter. Just to be safe I threw the whole pan out in the trash. They used to grow out front under the trees out there but I kept kicking them over and thought they were gone, but a few years ago my North American Timberwolf came up poisoned and I truly don't think anyone did it. I think some of these came back up and he ate them maybe. Broke our heart regardless of how it happened.


Man of Knowledge, I have also noticed Gallerinas and Phalloids growing near cyans. Dissuaded me from picking any there at all. Picking mushrooms by the handful here is dangerous to the point of being deadly. Funny how they tend to grow together. Scary that is.

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#18 invisibilitysyndrome



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Posted 29 April 2015 - 07:47 AM

I believe this is one...death cap?

#19 warriorsoul


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Posted 29 April 2015 - 12:57 PM

Amanita section Lepidella. Some are toxic in this section, some are non-toxic.


http://www.amanitace...ction Lepidella

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#20 happy4nic8r


    cyans rule!!

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Posted 29 April 2015 - 01:00 PM

I printed the one that I use for an avatar, they have a most interesting print. 


they have white spores, but a dirty brown exude surrounds the print making it look two tone, 


I'm trying to include a photo here, let me see, too bad i did it on cardboard.


InvisibilityS, I don't think they have warts, looks like amanita though. see warriorsoul above. (edit)


apr29 (10).JPG

Edited by happy4nic8r, 29 April 2015 - 01:01 PM.

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