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OfflinemotamanM
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Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion
    #25813808 - 02/15/19 06:28 AM (1 month, 7 hours ago)

https://www.sciencedirect.com/science/article/pii/S2211753918301490?fbclid=IwAR30zNJlohoE52yYVYbAf_04buTj_mw-z4Jk18WdSjoo8hjHvhAmvA9Wog0

Medical Mycology Case Reports
Volume 23, March 2019, Pages 55-57

Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion

Author EmilyAustinabConstance A.Mackenziebe

https://doi.org/10.1016/j.mmcr.2018.12.007

Abstract
Psilocybe mushrooms are consumed for their hallucinogenic properties. Fortunately, there are relatively few adverse effects associated with their consumption. This is the first reported case of acute kidney injury (AKI) secondary to confirmed ingestion of Psilocybe cubensis mushroom.

A 15-year-old male developed symptomatic AKI 36 h post-ingestion of Psilocybe cubensis mushrooms. He was admitted to hospital with hypertension, nausea and abdominal pain and a creatinine of 450 mmol/L. A sample of the crop of mushrooms was confirmed by mass spectrometry to contain psilocin. On day 5 post-admission, he was discharged home. Outpatient follow-up confirmed complete resolution of his renal function.

1. Introduction
Psilocybe mushrooms are often consumed for their hallucinogenic properties. Despite the apparent popularity of these mushrooms, relatively few adverse effects are have been reported from their use, with most being benign and self-limited [1]. Here, we report on a patient who developed symptomatic acute kidney injury (AKI) after ingesting Psilocybe cubenesis mushrooms.

2. Case
A 15-year-old male bought a “grow kit” for Psilocybe cubensis mushrooms from an online website. He germinated the spores into mushrooms and ate his “harvest” with three of his friends. All boys experienced hallucinatory effects, which resolved completely over a 6-h period.

36 h after ingestion, the patient developed nausea, abdominal discomfort and low back pain. He did not experience vomiting, diarrhea, or fevers. Initial bloodwork ordered by his primary care provider showed a creatinine of 207 micromoles/L.

After two days, the patient's symptoms persisted. Repeat bloodwork showed worsening of his renal function with a creatinine of 444 micromoles/L (reference range 65–121 micromoles/L) and a urea of 13. 5 mmol/L (reference range 3.0–7.0 mmol/L). He was referred to a pediatric tertiary care hospital, where he was admitted with further evaluation by the nephrology team. On the day of admission (day zero) he was hypertensive with a blood pressure of 144/85. Admission bloodwork included a CBC, LFTs, electrolytes, calcium panel, blood cultures and a CK. All were within the normal ranges, with the exception of an elevated phosphate (1.98 mmol/L, reference range 0.90–1.50 mmol/L). Urine microscopy revealed 5–10 red blood cells per high power field (RBC/HPF), and no protein, leukocytes, or casts. A renal ultrasound showed normal-sized kidneys bilaterally and enhanced cortical echogenicity. Additional investigations included normal complement levels, negative antistreptolysin O titres, negative urine cultures and two sets of negative blood cultures.

Prior to definitive identification of the ingested mushrooms, the initial clinical presentation appeared consistent with possible ingestion of an orellanine-containing mushroom. During his hospital stay, he received supportive care with IV fluids, hydralazine for hypertension, and IV N-acetyl cysteine based on case reports of benefit for orellanine-induced renal injury. On day 5 post-admission, he was discharged home. Serum creatinine and phosphate levels were resolving at 108 micromoles/L and 1.68 mmol/L respectively. Having ruled out infectious and rheumatologic causes, the discharge diagnosis was presumed AKI from mushroom ingestion.

At a 3-month follow up visit, the patient remained asymptomatic, with normal blood pressure and full recovery of his renal function. His creatinine was 80 micromoles/L, with a urea of 4.7 mmol/L, and normal electrolytes. Urinalysis was normal.

A sample of the crop of mushrooms yielding the ingested specimens (Fig. 1) was sent to a mycologist who identified the species as Psilocybe cubensis [2]. The identification of the mushroom sample was based on shared characteristics with published descriptions of the Psilocybe cubensis mushroom, including the overall stature of the basidome, the presence of a prominent annulus derived from a partial veil, a blue-staining reaction of tissues, coloring of the pileus and the stipe, the concentric arrangement of the scales, and the lamellae bearing purple-brown basidiospores with germ pores. A sample of the mushroom crop was further analyzed by mass spectrometry (LC-MS/MS). Briefly, 5–10 μL of extracted mushroom (in methanol) was injected and separated using a ToxTyper (Bruker) triple quadrupole liquid chromatography coupled to mass spectrometer (LC-MS/MS). The sample was analyzed in alternating polarity mode using the Toxtyper system equipped with an electrospray ionization source. Full scan MS, MS2 and MS3 spectra were acquired in data dependent MS/MS mode. The Toxtyper system identifies compounds based on retention time, MS, MS2, and if necessary, MS3 information. A peak was identified with a retention time of 2.5 min, corresponding to psilosin. No other peaks were identified, including for orellanine or amatoxin.

The three other boys who ingested the patient's ‘crop’ at the same time also presented to their physicians for evaluation on the advice of the medical team. They all remained asymptomatic and had normal renal function.

3. Discussion
Humans have been consuming hallucinogenic mushrooms for centuries [3]. The Psilocybe cubensis mushroom is one of the more commonly sought species by people using hallucinogenic mushrooms recreationally.

The hallucinogenic compound in Psilocybe mushrooms is the tryptamine molecule, psilocybin. Once ingested, psilocybin is dephosphorylated by the alkaline phosphatase enzyme to the active metabolite, psilocin [4], [5]. Both psilocin and psilocybin resemble the chemical structure of the serotonin molecule, and, not surprisingly, have affinity for several serotonergic receptors, including 5-HT2A, 5HT2C, 5-HT1A, and 5-HT1D [4]. Agonism at the 5-HT2A receptor is believed to account for most of the hallucinatory properties of these molecules [1], [5].

Signs and symptoms of Psilocybe mushroom ingestion include perceptual distortions (including visual hallucinations), euphoria, anxiety, agitation, mydriasis, tachycardia, hypertension and flushing. Symptoms occur within 20–60 min of ingestion and generally resolve within 4–6 h [6], [7].

Ingestion of Psilocybe mushrooms is regarded as having a low potential for harm. The most commonly reported adverse effects are negative sensory experiences, where people present severely agitated, confused and anxious, with impaired concentration and judgment. The rare fatalities associated with Psilocybe ingestion seem related to co-ingestion with another drug (often alcohol) or trauma [8].

Nephrotoxicity has been described following ingestion of a number of mushrooms types, most commonly Cortinarius species, as well as some species of Amanita.

Mushrooms of the Cortinarius genus contain the toxin orellanine [9]. Reported cases of orellanine poisoning describe a delayed onset of renal injury (~3–20 days) after mushroom ingestion. Orellanine toxin has been demonstrated in in vitro studies to cause inhibition of protein, RNA and DNA synthesis, and has also been shown to produce an ortho-semiquinone radical that can lead to oxidative stress, suggesting that the observed renal injury occurs through direct toxicity to the renal tubular epithelium causing tubular necrosis, interstitial nephritis and fibrosis [10]. Case cohorts of exposures are reported, with a high proportion of patients developing irreversible renal failure requiring dialysis and even transplant [11], [12].

An “Amanita nephrotoxic syndrome” is well recognized following exposure to Amanita smithiana and A. proxima [12]. Although the chemical structures of the toxins responsible have not been isolated, a toxin similar to A. smithiana has been identified in other Amanita species including A. boudieri, A. gracilior and A. echinocephala. These patients typically present with nausea and vomiting 2–12 h after mushroom ingestion. Renal injury develops after 2–6 days, associated with mild hepatitis. Renal biopsies in these cases demonstrate acute tubular necrosis and interstitial nephritis with recovery of renal function after supportive care and occasionally hemodialysis [12].

Other mushrooms such as A. phalloides, A. virosa, and A. bisporigera containing amatoxin produce a clinical picture that is distinct from other nephrotoxic mushroom ingestions with severe gastrointestinal symptoms (nausea, vomiting, diarrhea) developing 6–24 h post ingestion, followed by fulminant hepatotoxicity associated with AKI. The renal injury is presumed secondary hepatorenal syndrome or direct renal toxicity from amatoxin [13].

There are two case reports in the literature describing possible association of “magic mushroom” ingestion and renal injury. The first was of a 28-year-old man who presented with renal failure and required dialysis [11]. He had mistakenly eaten a Cortinarius mushroom, instead of a hallucinogenic mushroom. On renal biopsy, orellanine toxin was detected, confirming the exposure.

The second case was a 20-year-old woman who presented with symptomatic renal failure 5 days after ingesting what she believed to be “magic mushrooms” [14]. Her symptoms resolved with supportive treatment, and she did not require renal replacement therapies. Of note, she denied experiencing the expected hallucinations or altered sensorium after ingesting the mushrooms. The authors suspected that this patient's renal failure was in fact due to consumption of a Cortinarius mushroom, however the identity of the mushroom she ate was never confirmed, and the patient was lost to follow-up.

Here, we report a case of a patient with evidence of AKI on day 2 post-ingestion of confirmed Psilocybe cubensis mushroom. Based on the temporal association of exposure to the mushrooms in the absence of any other possible cause, we have hypothesized that the AKI was related to Psilocybe cubensis ingestion. Although renal biopsy was not done, other features of his clinical presentation were consistent with acute tubular necrosis (ATN) including the sudden rise in creatinine, microscopic hematuria, and no leukocytes or casts in the urine. While the psilocybin and psilocin molecules are not known to cause ATN, in theory, their affinity for serotonergic receptors may have some vasoconstricting effects that could alter renal hemodynamics, a known risk factor for ATN [1].

We considered the possibility that the spores purchased on the internet were contaminated with another nephrotoxic substance; however, the other people who ingested the mushrooms from the same crop did not become ill, which would be expected if there were a toxic contaminant. Another possibility is that there may have been significant intra-batch variability, and that our patient was exposed to a greater amount of a yet-unidentified toxic contaminant or a greater amount of psilocybin leading to increased serotonergic activity. There may also be unidentified predisposing factors that contribute to the development of ATN following Psilocybe mushroom ingestion. For example, the case of the 20-year-old female who developed AKI after the ingestion of “magic mushrooms” shares similarities to our case. Unfortunately, the identity of that mushroom is not known.

This case identifies that there may be potential for reversible nephrotoxicity following exposure to Psilocybe mushrooms. With supportive care, the AKI in our patient resolved without sequelae.


Acknowledgements
We gratefully acknowledge the contribution of Dr. David Colantonio from the Hospital of Sick Children, who assisted us with the mass spectrometry analysis of the crop specimen.

Conflict of interest
There are none.

References
[1]
F. Tyls, T. Palenicek, J. Horacek
Psilocybin--Summary of knowledge and new perspectives
Eur. Neuropsychopharmacol., 24 (3) (2014), pp. 342-356
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[2]
M. Noordeloos
The family Strophariaceae
C. Bas, T.W. Kuyper, M.E. Noordeloos, E.C. Vellinga (Eds.) (1st ed), Flora Agaricina Neerlandica, 4, A. A. Balkema, Rotterdam, Netherlands and Brookfield, VT, USA (1999), pp. 27-106
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F.J. Carod-Artal
Hallucinogenic drugs in pre-Columbian Mesoamerican cultures
Neurologia, 30 (1) (2015), pp. 42-49
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The pharmacology of psilocybin
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Hallucinogens
Pharmacol. Ther., 101 (2) (2004), pp. 131-181
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F. Hasler, U. Grimberg, M.A. Benz, T. Huber, F.X. Vollenweider
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Mushrooms Med., 40 (3) (2012), pp. 135-138
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Harm potential of magic mushroom use: a review
Regul. Toxicol. Pharmacol., 59 (3) (2011), pp. 423-429
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[9]
V.C. Danel, P.F. Saviuc, D. Garon
Main features of Cortinarius spp. poisoning: a literature review
Toxicon, 39 (7) (2001), pp. 1053-1060
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[10]
R.J. Dinis-Oliveira, M. Soares, C. Rocha-Pereira, F. Carvalho
Human and experimental toxicology of orellanine
Hum. Exp. Toxicol., 35 (9) (2016), pp. 1016-1029
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[11]
M. Franz, H. Regele, M. Kirchmair, J. Kletzmayr, G. Sunder-Plassmann, W.H. Horl, et al.
Magic mushrooms: hope for a 'cheap high' resulting in end-stage renal failure
Nephrol. Dial. Transplant., 11 (11) (1996), pp. 2324-2327
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[12]
M. Kirchmair, P. Carrilho, R. Pfab, B. Haberl, J. Felgueiras, F. Carvalho, et al.
Amanita poisonings resulting in acute, reversible renal failure: new cases, new toxic Amanita mushrooms
Nephrol. Dial. Transplant., 27 (4) (2012), pp. 1380-1386
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[13]
K.J. Berger, D.A. Guss
Mycotoxins revisited: part I
J. Emerg. Med., 28 (1) (2005), pp. 53-62
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[14]
E. Raff, P.F. Halloran, C.M. Kjellstrand
Renal failure after eating "magic" mushrooms
CMAJ, 147 (9) (1992), pp. 1339-1341
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© 2019 The Authors. Published by Elsevier B.V. on behalf of International Society for Human and Animal Mycology

Pttps://www.sciencedirect.com/science/article/pii/S2211753918301490/pdfft?md5=6a9244e4b120460b5e7ec25cbebb2c4c&pid=1-s2.0-S2211753918301490-main.pdf



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OfflineMorel Guy
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: motaman]
    #25813828 - 02/15/19 06:59 AM (1 month, 7 hours ago)

Nothing about a drug combo reaction?

I read on wikipedia haldol is bad for a shroom trip.  I've had other reactions on meds as well.  Risperidal was not such a bad combo.

Curious about the creatinine levels.


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Offlinetacodude
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Morel Guy]
    #25814134 - 02/15/19 11:00 AM (1 month, 3 hours ago)

Did they REALLY have to do all that testing to figure out it is a cubensis? I call bullshit... I'm sure there is more to the story.


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OfflineZyiadem
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: tacodude]
    #25814190 - 02/15/19 11:27 AM (1 month, 2 hours ago)

Probably my dude, making sure no strain of cubes has other toxins is important for people to make informed decisions for what they consume.

Likely the guy had something else in his blood that caused a reaction that he didn't want to disclose.


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Offlinetacodude
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Zyiadem]
    #25814210 - 02/15/19 11:43 AM (1 month, 2 hours ago)

I get properly identifying is important, but besides looking at the spores under a microscope at most all that other stuff was beyond excessive. I understand why it was done with the claims made, but they could've made the same effort looking into other possibilities rather than confirm well known facts about a very common psychedelic mushroom.


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OfflineQuirkmeister92
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Zyiadem]
    #25814225 - 02/15/19 11:53 AM (1 month, 2 hours ago)

He's 15 so I bet this is gonna be a lifelong condition he will learn to live with. Do note they have NOT biopsied his kidneys. This reminds me of people who don't know they are prone to mental instability, who take a psychedelic and then break. The drugs only exacerbate underlying conditions.


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OfflineFractal420
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Quirkmeister92]
    #25814244 - 02/15/19 12:10 PM (1 month, 2 hours ago)

This is weird. Definitely some weird timing as certain states are trying to legalize mushrooms. But i mean, ive experienced strong stomach pain from raw cubes. I wonder if the growkit was healthy mycelium. Then again ive always heard that if the mushroom looks healthy it is.

I mean, all the pics ive seen of outdoor exotics and the billions of contams on the substate


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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Fractal420] * 1
    #25814270 - 02/15/19 12:26 PM (1 month, 1 hour ago)

Mushrooms are known for taking in heavy metals, provided there is some in the substrate, and i cant imagine that being good for your kidney. Could be another possible explanation


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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Mad Season] * 1
    #25814452 - 02/15/19 02:08 PM (1 month, 10 minutes ago)

NARC alert! Total bullshit just follow the links for yourself.

What a joke this so called science site is just full of anti drug crap.

https://www.sciencedirect.com/science/article/pii/S0306987718312106

Quote:

Cannabis use during pregnancy: Are we at the verge of defining a “fetal cannabis spectrum disorder”?




https://doi.org/10.1016/j.mehy.2019.02.017 and if you follow their link to prove their facts it just redirects you back to the same web page.

I feel sorry for anyone stupid enough to believe anything that site produces.


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OfflineFractal420
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: rider420]
    #25814545 - 02/15/19 02:56 PM (30 days, 23 hours ago)

Thanks for clearing that up. Quite a smear piece in that case. Cause i got genuinely concerned.

I dont think commercial or DIY substrates would have heavy metals unless the water came from Flint.

I mean, possible bacteria or mold but generally if the fruit looks okay then it is. Thats what ive always heard on the shroomery at least

I saw a cube grow that was done outside in the summer and it def had contams and a couple fruit didnt look healthy so they didnt get picked. Most looked nice tho and should be fine. And potent as fuck. That tub pushed out like 5 flushes and strangely the tub only looked contammed in the beginning (some yellow liquid). By the end was all healthy fruit and couldnt even see any contams. And it didnt turn green either.

Just some bacteria i guess

I dont get to fuck with premade mycelium since im in the states and i prolly would rather DIY my own genetics and grains anyway


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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Fractal420]
    #25814620 - 02/15/19 03:24 PM (30 days, 22 hours ago)

it was published in Medical Mycology Case Reports, science direct just hosts

the cannabis/pregnancy one was published in Medical Hypotheses, which is a non peer reviewed journal


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OfflineHolybullshit
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Fractal420] * 1
    #25814626 - 02/15/19 03:26 PM (30 days, 22 hours ago)

Definitively blaming this primarily on cubensis is a large leap of logic. Kid probably had some underlying issues, possibly a genetic predisposition either affecting his kidneys or his serotonin system,  ingested other drugs, poor diet, dehydration, any number of things also going on at the same time.

Or could have been caused by contamination of the substrate or fruit bodies that may not have been equally distributed among the mushrooms or the doses could have been very different, I'm sure the kid growing the shrooms probably over did it compared to his friends.

And a 15 year old growing his own magic mushrooms, I think it would be a solid bet he is a poly-substance abuser.

This is more likely just a coincidence, or amalgamation of factors, possibly triggered by the stress on the body of tripping, but not any compound found within cubensis mushrooms, at least not one that would affect the gross population. If it were then we here would have definitely seen evidence of it before now.

It's more akin the someone having a food allergy and shouldn't be used to scare others about the dangers of cubensis mushrooms. This was clearly written up by people with an agenda; or else the title would read "after consumption" and not "cause by".

Just look at all the other information about toxic mushrooms that have NOTHING to do with Cubensis mushrooms and has no relevance to this case. It's just thrown in to make those ignorant of fungi think mushrooms as a group are dangerous and scary. Or confuse them, linking toxic species and their dangers to Cubensis mushrooms in their minds. The authors keep going back to the case of the 20 year old woman who did NOT experience any hallucinations or mood alterations, strong evidence that she did not consume Cubensis mushrooms yet they repeatedly say the mushrooms were never identified even though anyone impartial would have to assume they were not Cubensis mushrooms, as the original author did.

And while I'm on the topic, why do those papers even blame magic mushrooms in their title? Cubensis mushrooms were NOT consumed.

Look at the author's own words. "other people who ingested the mushrooms from the same crop did not become ill, which would be expected if there were a toxic contaminant" that's basically admitting that the cause lies with the patient.


Edited by Holybullshit (02/15/19 03:57 PM)


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Offlinetacodude
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Holybullshit]
    #25814743 - 02/15/19 04:19 PM (30 days, 22 hours ago)

Exactly! If they all got sick that would mean something, but when something as simple as insufficient blood flow can trigger the same issue. I just think they are jumping to conclusion using fancy analytics as an attempt to prove its real science.... It's not


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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: tacodude]
    #25814987 - 02/15/19 06:03 PM (30 days, 20 hours ago)

Totally agree,  15yo growing mushrooms has likely tried all kinds of substances that certainly could impact a youth that had preexisting conditions.

Why does the study even bring up other mushrooms,  like amanita? I see more mushroom phobia,  coincidently right around the time,  2 states actively seeking legal/ decrim of psilocybin...

Seems possible tobacco scientists have found a new employer to feed fear and stupidity!

Love the poly substance abuser term!  Can't wait to see my wife's face when i admit to her i'm officially poly!


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OfflineFractal420
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: sycodelix]
    #25817472 - 02/16/19 08:53 PM (29 days, 17 hours ago)

I dunno, when i was a teen one of my friends attempted PF tek or something like that, got like an 8th out of it lol

He didnt really know what he was doing too well, but did end up with mushrooms. Def not older than 16 yo. But didnt stick with it. We ended up finding it easier to just get 2ci back then. Or locally MDA (sometimes MDMA), and around 17 i found some real good WoW for the first time, this hippie dude that was always hanging out the same area in central park


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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Fractal420]
    #25817479 - 02/16/19 08:59 PM (29 days, 17 hours ago)

Sounds legit

:ancientaliens:


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OfflinePsilosopherr
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Morel Guy]
    #25817717 - 02/16/19 11:10 PM (29 days, 15 hours ago)

..but mushrooms is jesus, and jesus wouldn't hurt nobody

always love all the wanna-be doctors who know drugs can do no harm no matter what. foaming at the mouth over what they immediately assume to be propaganda.

Lets just admit we have no freaking idea what we're talking about here.

You're right though fractal this is peculiar timing with the petitions recent success.


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OfflineMorel Guy
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Psilosopherr]
    #25818120 - 02/17/19 07:43 AM (29 days, 6 hours ago)

I think it sounds like a bad drug combo.  Something set this off.  If its' valid.


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OfflineHolybullshit
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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Psilosopherr]
    #25818677 - 02/17/19 01:35 PM (29 days, 44 minutes ago)

Quote:

Psilosopherr said:
always love all the wanna-be doctors who know drugs can do no harm no matter what. foaming at the mouth over what they immediately assume to be propaganda.




Don't you think we would have seen this at least a few times before if it affected the gross population with no compounding factors involved?? It's not like kidney failure is something that can just fly under the radar, especially if it can be caused after a single use at normal dosage levels. It's the fact that the authors try to place the blame squarely on Cubensis mushrooms while bringing up all kinds of extraneous information about other mushroom species that were not at all involved which should make it obvious to anyone who can think critically that this was written with an agenda, no medical degree necessary.

The language used is important as well, even in those old papers which included the label "magic mushrooms" in the title even though no Cubensis mushrooms were involved they used the term "after" and not caused by, because you can't know that with any certainty after 1 incident.

It's not about anyone's personal feelings about drug use, it's not like I am on here trying to convince people ketamine is safe for your bladder, I would just like our scientists and their supporting institutions to do their due diligence objectively and not use their status and influence to carry out smear campaigns. If the idea of that doesn't upset you, then you are the one with a problem, not me.

edit: And honestly, given your offensive characterization of the posters in this thread, I would say you are lashing out more than anyone here. I definitely didn't see anyone "foaming at the mouth". It's not like anyone was talking in all caps, or resorting to name-calling(except for you).

If you disagree with any analysis offered, or harbor opposing opinions, feel free to express them. But you aren't doing yourself any favors when you resort to ad hominem attacks instead of actually discussing the topic at hand.


Edited by Holybullshit (02/17/19 01:52 PM)


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Re: Acute renal injury cause by confirmed Psilocybe cubensis mushroom ingestion [Re: Holybullshit]
    #25819545 - 02/17/19 08:44 PM (28 days, 17 hours ago)

He wasn't talking about anyone here, but the doctors stupid enough to fall for this article.


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