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Earl Grey tea intoxication (2022)
- stephenitis 3y agosounds like a allergy to oil of bergamot.
- A_D_E_P_T 3y agoCould be chronic fluoride toxicity. Coincidentally, I had occasion to post this in another thread just a couple of days ago: https://journals.sagepub.com/doi/full/10.1177/1403494821990284 https://journals.sagepub.com/doi/full/10.1177/14034948219902... Black tea contains a lot of fluorine, so if you're drinking a gallon a day, you're deep into hyperfluorosis territory.
- ginko 3y agoHe had no issues with pure black tea (and switched back to it in fact), so it must have been something to do with the bergamot.
- A_D_E_P_T 3y agoAh, right, so on to the next possibility. Bergamot contains a chemical, a sort of terpene, aptly named "bergamottin." https://en.wikipedia.org/wiki/Bergamottin https://en.wikipedia.org/wiki/Bergamottin Bergamottin famously inhibits a major liver enzyme inelegantly named CYP3A4. CYP3A4 is responsible for metabolizing a huge number of drugs and other substances. (e.g., endogenous steroid hormones.) This is what's responsible for the "grapefruit juice effect." https://en.wikipedia.org/wiki/Grapefruit%E2%80%93drug_interactions https://en.wikipedia.org/wiki/Grapefruit%E2%80%93drug_intera... Bergamottin also inhibits CYP1A1, which metabolizes theophylline, and CYP1A2, which metabolizes caffeine. The most likely possibility is that consuming that much bergamottin, together with caffeine, disrupted the metabolism of the latter, leading to caffeine-induced toxicity in skeletal/cardiac muscle. (Cramps, fasciculations, etc.) But it could also be that the inhibition of CYP3A4 messed with the metabolism of something else the man was ingesting.
- stephenitis 3y agowow this is interesting to me. I'm so curious how this effects dental health in people where daily tea drinking is common. tea stains your teeth a bit but does it also strengthen enamel with the flouride?
- BadHumans 3y agoNever knew this. Thanks for the reading material.
- throwup238 3y agoEarl gray with real bergamot oil is really expensive and hard to find nowadays. Most brands use “natural flavors”
- kamilner 3y agoHuh, that's somewhat surprising given bergamot fruit is not all that expensive. We may be spoiled in the UK but you can buy Earl Grey with real bergamot oil for a reasonable price here https://www.waitrose.com/ecom/products/brew-tea-co-earl-grey-loose-leaf/632765-381238-381239 https://www.waitrose.com/ecom/products/brew-tea-co-earl-grey...
- ginko 3y agoThis was Twinings earl grey. Sure it's not high end stuff, but it's still no dollar bin tea. Royal warrant and all that. This case is also from 20 years ago so I do think that it was real bergamot.
- vmilner 3y agoYeah - my mother has this (symptoms similar to the article) - annoyingly more teas seem to be including small amounts of bergamot in - currently Twinings English Breakfast in the uk is fine though - so we stock up when on special offer.
- stephenitis 3y agoI only drink green and oolong teas, but another commenterr pointed out to a study that it might've be flouride content of the tea
- Tainnor 3y agoNot sure that there is anything interesting to be drawn from a singular anecdote that includes no conclusive medical analysis, but regardless of the type or brand of tea, drinking 4 liters of black tea per day doesn't exactly strike me as the healthiest lifestyle to begin with.
- LeoPanthera 3y agoI'm far from a medical expert, but I would imagine that large quantities of tea are less unhealthy than even small quantities of alcohol, or soda.
- Tainnor 3y agoBlack tea contains caffeine and large amounts of caffeine are probably not very healthy. I assume he must have built up quite a tolerance but I would be on edge all day after such an amount.
- LeoPanthera 3y agoCaffeine is one of the most studied substances that we consume and every time a new study happens they always find some new way that it is good for you. Obviously huge quantities of anything are bad, but caffeine has virtually no downsides.
- dbspin 3y agoResponses to caffeine vary wildly, but personally I experience acute anxiety a couple of hours after even one cup. It took me many years as a regular coke / tea / coffee drinker to figure out that was causing daily anxiety. I do wonder what proportion of people never make the link, although it seems prevalence of high sensitivity to caffeine is rare in the general population [1] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242593/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242593/
- Lazonedo 3y ago
- AdmiralAsshat 3y agoSo to be clear, the dude was drinking the equivalent of one of these every day: https://d2d8wwwkmhfcva.cloudfront.net/800x/d2lnr5mha7bycj.cloudfront.net/product-image/file/large_6615d4ef-6f9b-47e8-aa37-69c1be4b2666.jpeg https://d2d8wwwkmhfcva.cloudfront.net/800x/d2lnr5mha7bycj.cl... I'm not sure the average person could drink a gallon of water a day without any ill effects, much less tea.
- Geeek 3y agoI drink aprox 1.5 gallons per day. I am fine.
- Krasnol 3y agoI drank that much for 30 years. This guy seems to be special. My side effects were "only" the sugar related teeth problems (coloring and decay).
- dylan604 3y agoIt was tough, but I've reduced the sugar in my iced tea. I grew up in the South where sweet tea is just part of the culture. It took a while, but I'm now acclimated to unsweet tea. I realized that if I could acclimate to the taste of beer, I could handle tea too
- Krasnol 3y agoI'm on a quite nice white tea mix now. I always had the issue of not being able to handle the bitterness of most of the teas. Especially after they got cold. This one goes quite well without any sugar.
- kevinmchugh 3y agoTea will discolor teeth even without sugar.
- Krasnol 3y agoTrue, but the mix of black tea with lemon and sugar was overkill. It cost me a lot.
- Krasnol 3y agoScarry. I grew up on Black Tea sorts. I drank a similar amount to the patient above, with far too much sugar and lemon juice. Stopped because I wanted to reduce my sugar consumption and to have white teeth again.
- dang 3y agoRelated: Earl Grey tea intoxication [pdf] - https://news.ycombinator.com/item?id=8155176 https://news.ycombinator.com/item?id=8155176 - Aug 2014 (39 comments)
- ComputerGuru 3y agoYour comment was downvoted, possibly because the URL submitted at that HN discussion is down. Here's an archived copy of that PDF, which is the same case: https://web.archive.org/web/20140912083558/http://www.docente.unicas.it/useruploads/000811/files/earl_grey_tea_intoxication.pdf https://web.archive.org/web/20140912083558/http://www.docent...
- dang 3y agoWho can say! But those 'related' links are mostly intended for looking at past HN comments in any case. Sometimes I add an archive link to old threads whose URLs have rotted. I'll do that there. Thanks for the link!
- dylan604 3y ago"He was still drinking 2L...(his entire fluid intake)" Isn't that low? I drink at least a gallon a day, and more during summer. I learned the hard way via kidney stone that low fluid intake is bad. After further analysis of the stone's makeup, my doctor's prescription for avoiding future stones was stay hydrated. I have followed that advice ever since.
- jadyoyster 3y agoThe idea that you need to drink liters of water a day is a modern invention due to misreading of research. It completely depends on the weather, exertion, and how much water is in the food you eat. https://www.mcgill.ca/oss/article/health-nutrition/water-myth https://www.mcgill.ca/oss/article/health-nutrition/water-myt...
- deleted 3y ago[deleted]
- dylan604 3y agoYou deciding that need is a misreading is you assuming what other's lifestyles are. If you have one of your listed caveats, you need that amount. Your suggesting that it's not needed It also has to do with the person's metabolism and other factors.
- jadyoyster 3y agoYou're right, I should have added genetics and disease as well! The gist is if your urine is of a light color and you have no issues there is no need to worry or try to force yourself to drink.
- 0xffff2 3y agoOn an average day working my office desk job, my hydration goal is 2L and it's plenty. I often have to force myself over the finish line. (And I was a trained healthcare professional in a former life; I know how to judge hydration and I'm plenty well hydrated.) I cannot even remotely imagine drinking 4L of water in a day unless I was doing manual labor in warm weather for most of the day.
- sandworm101 3y agoWhat strength of earl grey tea? My grandmother never drank water, insisting only tea. But she drank seriously week tea, more like tea-flavored water. I've seen other people (brits) drink tea so dark it looks like coffee.
- biomcgary 3y agoBrits drinking tea is one of the clearest examples of food consumption by one group being toxic for another group (see https://en.wikipedia.org/wiki/First_Opium_War https://en.wikipedia.org/wiki/First_Opium_War).
- Cass 3y agoThe most House (the TV show)-like case that ever happened in my medical career was the case of the patient with liver failure due to green tea intoxication. A young man presented in our hospital with acute liver failure. He'd just spent a month traveling through the rain forests of Brazil, Colombia and Peru. During his trip, he'd consumed unknown drugs in a Peruvian shaman ceremony and had unprotected sex with a Peruvian sex worker. We tested him for everything obvious. He didn't test positive for any known drugs or any obvious drug-related toxins. He didn't have HIV. He didn't have hepatitis A, B, or C. He didn't have EBV, he didn't have CMV, he didn't have Dengue Fever, he didn't have Yellow Fever, he didn't have Malaria. He didn't have any sign of autoimmune conditions. We called the institute for tropical diseases. We tested him for tropical diseases we'd never even heard of. He didn't have those. He didn't have Syphilis. He didn't have Gonorrhea. He didn't have liver cancer, or any other discernible cancers. We called the institute for tropical diseases again. They started researching. We tested him for diseases the experts for tropical diseases hadn't even heard of. He had none of those, either. His liver, which had started failing for no discernible reason, now stopped failing, for equally indiscernible reason. We started planning his discharge. We had a nice final discussion. He really appreciated how hard we'd tried, he said, and he really appreciated how kind everyone had been, and sorry again about the unprotected sex with sex workers thing, that was effing stupid in retrospect. He said he was looking forward to getting home and detoxing from all this. He said he didn't think the green tea we had on the ward (cheap, shit, comes in bags, unlikely to have ever encountered a tea plant in real life) did anything much, detox-wise, and anyway he'd feel bad emptying our hot water carafe all the time. Um. How much green tea do you drink, I asked him. 4 to 5 liters per day, he said. I googled "green tea liver failure," with some vague memory that sometimes tea gets contaminated during the drying process and maybe he'd caught a bad batch? Turns out, green tea just... causes liver failures, occasionally, in higher doses. Probably due to the anti-oxidants. You live and you learn. The patient went home and limited his green tea consumption to no more than a cup per day. He checked in with me a year later, because I'd asked him for an update, and his liver was doing perfectly fine and had never failed him again.
- monkeynotes 3y ago4-5 liters! Two liters of green tea typically contains over 400mg of caffeine which is the upper limit recommended for adults. This guy was consuming around 1g of caffeine a day.
- riffic 3y agoWill tea, Earl Grey, hot, send me spiraling into a profound, dreamlike state, where I live out an entire lifetime, learning the flute and undergoing life-changing experiences, all within the span of a few real-world minutes?
- luke-stanley 3y agoIt may depend on what safety settings your replicator is set to.
- Magi604 3y agoYou know the saying, "anything in excess is bad". Also I've never been fond of the Twinings brand of teas. They always had a super strong flavor.
- zwieback 3y agoAt work we just cost-optimized away the better teas like Tazo and Stash but one station, interestingly in the blue-collar facilities area, started stocking Twinings. I do go down there for Earl Grey but was reminded that that particular one always seemed too bergamotty to me. We ran a bakery for a while and sold a chocolate shortbread with bergamot oil, now I wonder if anyone ever had a reaction from our cookies. Probably not, I'm guessing you'd have to eat about $50 worth...
- karolist 3y agoReminds me of chifir, which is still popular in Russian and easter-euro prisons "Ultimately, making chifir involves brewing a great deal of black tea and for a long time. It may be left to brew overnight and drunk either hot or cold." They use it as some sort of substate for alcohol but I'm not sure of exact effect. I know it causes extremely bad teeth rot after multi year consumption. https://en.wikipedia.org/wiki/Chifir https://en.wikipedia.org/wiki/Chifir
- deleted 3y ago[deleted]
- mynameisnoone 3y agoI would investigate dehydration from caffeine, caffeine intoxication, or antinutrients or adulterants from the bergamot.