Dive into the captivating world of poisons with The Poison Lab! Hosted by Clinical Toxicologist Ryan Feldman (@EMPoisonPharmD), who has over a decade of managing poisoning and drug overdose via poison centers and in the emergency department. Also occasional co-hosted by his robo cohost Toxo! (@LabPoison). This show unpacks the fascinating history, cutting-edge science, and life-saving medical management of toxins from around the globe. From stories of those impacted to expert insights from pioneers in poisoning treatment, each episode brings you closer to understanding the poisons that lurk in plain sight. Explore episodes, med videos, games, and more at thepoisonlab.com—every poison has a story to tell!
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A Morel Dilemma: Episode 2 — Investigations and Falsehoods
Saison 2 · Épisode 51
mercredi 3 juin 2026 • Durée 43:55
As reports of severe illness and death come in, the Bozeman outbreak moves from medical mystery to full public health investigation. Local and state investigators race to identify the source, shut down the risk, interview patients, collect food samples, and figure out whether anyone else could still be in danger.
The early signal points toward one unlikely ingredient: morel mushrooms. But for toxicologists, that raises more questions than answers. Morels are supposed to be edible. Rapid vomiting and diarrhea usually suggest foodborne illness, not a deadly mushroom poisoning. So investigators have to ask the question that will drive the rest of the series: is the morel really the culprit, or is something else hiding in the meal?
In Episode 2 of A Morel Dilemma, we meet the public health team on the front lines, hear how the outbreak was contained, and begin testing the first theories behind what made diners so sick.
A Morel Dilemma: Episode 1 — Outbreak in Bozeman
Saison 2 · Épisode 50
mercredi 3 juin 2026 • Durée 33:56
A deadly outbreak begins with a single meal at a sushi restaurant in Bozeman, Montana. Within hours, diners develop severe nausea, vomiting, and diarrhea. Some collapse. Two people die. At first, it looks like food poisoning, but investigators quickly notice one strange ingredient connecting many of the sick patients: morel mushrooms.
In the first episode of A Morel Dilemma, we meet the people caught in the earliest moments of the outbreak and begin following the investigation as it unfolds in real time. What starts as a suspected restaurant-associated illness quickly becomes a much stranger question: how could a prized edible mushroom, eaten for centuries, suddenly be linked to death?
This is not a retrospective summary. It is the beginning of a poisoning mystery, told the way investigators experienced it: with urgency, uncertainty, and more questions than answers.
Poisonous Fungus Amongus is Here— The Rhyming Kid (or Adult) Book For Mushroom Safety
From the mind of a toxicologist who treats real mushroom poisonings alongside doctors and poison centers comes Poisonous Fungus Amongus—a playful, rhyming adventure into the fascinating world of poisonous mushrooms!
Inside, readers will find a colorful introduction to mushroom anatomy and ecology—learning the parts of a mushroom and discovering helpful hints for safe foraging and identifying dangerous look-alikes. Every species featured in these pages is a real poisonous mushroom, brought to life through vivid illustrations and engaging verse.
This beautifully illustrated book goes beyond the basics, exploring how mushrooms grow, reproduce, and take shape in nature—from tiny spores to sprawling mycelium to the fruiting bodies we find in forests and fields.
Through rhymes and clear explanations, readers learn to recognize essential mushroom features—caps, gills, pores, rings, bulbs (volvas), veils, warts, scales, spore prints, and gill types like free, adnate, and decurrent. Each detail helps distinguish the edible from the toxic—and shows how some features can fool us!
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LIVE from Chicago: 2025 NACCT Research Review – Insights from the North American Congress of Clinical Toxicology
Épisode 43
lundi 6 octobre 2025 • Durée 01:41:48
Show Notes
In this special live episode from the 2025 North American Congress of Clinical Toxicology (NACCT), Ryan takes you inside the conference to hear directly from the researchers themselves. Covering 11 abstracts that span high-stakes management decisions, surprising case reports, and challenges to toxicology dogma, this year’s highlights feature everything from amlodipine overdoses to naturopathic misadventures, metformin-associated blindness, and more. The show kicks off with a foreword from Ryan and Dr. Jon Cole (abstract co-chair for AACT) discussing some of their favorite research from the conference.
If you couldn’t make it to NACCT or just want to catch up on some of the most impactful new research in our field, this episode will give you a front-row seat. Check below for links to the published abstracts, the full list of studies discussed, and timestamps for where you can hear each one.
10:43 #7. Is beta blocker toxicity associated with hypoglycemia?
Lead author: Dr. Megan Audette, MD
18:17 #237. V-A ECMO as a treatment for vasoplegic shock in amlodipine poisoning: a comparison
Lead author: Dr. Daniel Tirado, MD
27:59 #247. Blocked but not beaten: ECMO’s role in severe amlodipine toxicity – a poison center case series
Lead author: Dr. Carlos Saldarriaga, MD
28:18 #26. Amlodipine double-dose therapeutic errors reported to Poison Centers
Lead author: Johanne Freeman
30:38 #27. Dosing on the edge: unpacking inadvertent amlodipine ingestions reported to a single poison center
Researcher interviewsBonus ContentSupport the showReach the show
Toxicologist vs The internet (#12) with Dr. Joe Kennedy MD
Épisode 42
mercredi 10 septembre 2025 • Durée 01:34:49
In this episode of The Poison Lab, host Ryan Feldman is joined by Dr. Joe Kennedy, medical toxicologist at the University of Vermont and consultant for the Northern New England Poison Center. Together they work through real poisoning cases to sharpen toxic differentials, sum up practical resuscitation priorities, and connect first-principles pharmacology to bedside decisions. They also answer listener questions on THAM vs bicarbonate, when to dialyze even with “normal” kidneys, and why rattlesnake antivenom costs so much—plus the real-world logistics of sourcing exotic antivenoms in the U.S.
Dr. Kennedy and Ryan discuss the topics below. Looking for timestamps? Join the subscribed feed!
Case set #1: Shock with hyperglycemia, big pupils, and probably NOT what you think it is.
Case set #2: Massive bleeding after gas-station “herbal” products
Case set #3: Refractory wide-complex rhythms in a teen overdose
What started as a nerdy teaching tool made to teach mushroom poisoning by folks who treat mushroom poisoning is now a full-fledged card game—equally great for Friday game night and the classroom.
What’s inside the deck
58 Poisonous Mushroom Cards
Full-color pictures, toxin info, clinical syndromes, key anatomy, U.S. + global distribution, and spore print colors.
88 Play Cards + 30 Bonus Cards
Collect mushrooms, play antidotes and modifiers, stack combos, and score big.
Toxin-Based Scoring
Point systems reflect real-world toxicity—every round plays differently based on your hand and bonus cards.
Endless Replayability
Rule variants at gottapiccem.com keep things fresh.
Ryan is LIVE on the Radio Thursday July 17th 11:45AM-12:30 PM CST WPR Larry Meiller Show!
Épisode 39
mercredi 16 juillet 2025 • Durée 00:54
Listen here (https://www.wpr.org/shows/larry-meiller-show) to hear Ryan Live on AIR for the Larry Meiller show, Thursday July 17th 11:45AM-12:30 PM CST.
Check this "Listen Live" link if your having trouble!
Poisoning Outbreak: Aconite Poisoning at Markham, Ontario Restaurant
The Poison Lab: Outbreak – Markham Aconite Poisoning
On August 29, 2022, twelve diners at a Markham, Ontario restaurant fell critically ill with vomiting, numbness, and life-threatening arrhythmias. The culprit? A deadly plant toxin: aconite.
In this episode—the first of a new Poison Lab Outbreak series—we go inside the Markham mass poisoning case. Join host Ryan Feldman, clinical toxicologist and emergency medicine pharmacist, as he investigates how a rare and lethal toxin ended up in a restaurant spice jar and nearly cost lives.
MURDER for Lunch: Toxicologist vs The internet (#11) with Dr. Amy Zosel MD
Épisode 37
mercredi 30 avril 2025 • Durée 01:29:20
In this episode of The Poison Lab, host Ryan Feldman is joined by Dr. Amy Zosel, a medical toxicologist, emergency physician, and educator. Together, they use real poisoning cases to practice identifying toxins and flexing their toxic differential The conversation dives into intriguing and challenging toxicology cases, with a focus on educating listeners about real-world poisoning scenarios, myth-busting internet misinformation, and providing practical clinical insights.
The story encourages safe and curious observation: note each feature, dig gently to look for bulbs, observe nearby trees and seasons, and check for bruising or color changes. Along the way, readers also discover fungi’s hidden ecological roles, from tree-nurturing mycorrhizae to the saprotrophs that recycle the forest floor.
With rhythm, rhyme, and a spark of scientific wonder, Poisonous Fungus Amongus blends accuracy with imagination—inviting kids and adults alike to explore and respect the natural world, while learning that curiosity and caution must always grow together when it comes to mushrooms.
Perfect for young readers, nature lovers, teachers, and families who want to explore the mysterious and magical world of fungi!
56:56– #70. Iatrogenic exposure to long-acting buprenorphine injectable in an opioid-naïve patient
Guest: Dr. Conor Young, MD
01:00:11 – #182. Left in the dark: a case of blindness in the setting of metformin toxicity
Guest: Dr. Madison Bombard, MD
01:12:11 – #169. Just because it’s natural doesn’t mean it’s safe: a case of pediatric toxicity from topical and herbal remedies
Guest: Dr. Aria Darling, MD
01:04:31 – #203. Serotonin syndrome after vaping Moocah
Guest: Dr. Connor Murphy, MD
01:07:06 – #307. Intravenous ozone autohemotherapy: a retrospective observational case series
Guest: Nicole McLarty
01:11:25 – #134. Do they really need n-acetylcysteine? Exploratory analysis of outcomes in patients with elevated liver function tests but no detectable acetaminophen
Guest: Dr. Seth Carroll, PharmD
01:15:33 – #130. Outcomes of acute acetaminophen-poisoned patients treated with and without fomepizole: a Toxic registry study
Guest: Dr. Jordan Woollum, PharmD
01:21:23 – #295. Evaluation of onset and resolution of complications after chronic methotrexate poisoning
Guest: Dr. Van Quach, PharmD
01:24:51 – #325. Implications of potassium in salicylate toxicity treated with urinary alkalinization
Guest: Dr. Andrew Yetka, PharmD
Stick around to the very end of the episode for a teaser of Stump the Tox and the brand-new game Tox Wavelength, recorded on the train to NACCT. The full episode is available now for supporting members.
🌍 Global availability (shipping costs + tariffs may apply)
P.S. We’re exploring U.S. manufacturing to lower costs and expand distribution—timeline TBD—so we made the game available now.
If you grab a copy:
📸 Snap a photo of your first round
✉️ Send it to toxtalk1@gmail.com or tag @LabPoison / @tox_talk
Nothing would make Ryan happier than seeing the community play!
You’ll hear firsthand from the experts who responded to the outbreak:
Dr. Jessica Kent, toxicology fellow at the time at the University of Toronto
Dr. Abinhay Sathya, intensivist at Markham Stouffville Hospital
Dr. Margaret Thompson, toxicologist and on-call consultant for the Ontario Poison Centre
Dr. Randy Purves, research scientist at the Canadian Food Inspection Agency (CFIA)
Bryn Shurmer, MS- analytical chemist at the Canadian Food Inspection Agency (CFIA)
Together, they walk us through the outbreak timeline—from the first patients in VT to the public health investigation that uncovered a mislabeled spice bag full of pure aconite root.
Looking for timestamps?
A fully timestamped version of the episode—so you can jump to any topic—is available to our supporting members.
💡 Key topics:
Clinical presentation and toxic effects of aconite
Challenges in mass poisoning recognition and coordination
The crucial role of poison centers in outbreak response
Public health trace-back to contaminated galangal powder
Lessons for emergency departments and toxicologists
💬 Have thoughts or questions? Connect on Instagram @tox_talk, Twitter @LabPoison, or email toxtalk1@gmail.com.
Below this will be key takeaways regarding managing the poisonings discussed, it may ruin your experience if you are guessing the poisons
Key Takeaways:
Amatoxin Mushroom Poisoning: The classic delayed onset of severe GI symptoms, followed by a latent phase, can mask progressive liver damage. Early recognition and treatment with hydration, silibinin, and possible liver transplant are critical.
Tetramine Toxicity: Known for causing refractory seizures, tetramine is a rare but serious poisoning often requiring aggressive supportive care and anticonvulsants.
Love what you're hearing? Help us reach more toxicology enthusiasts by leaving a review on Apple Podcasts, Spotify, or wherever you listen. Don’t forget to share this episode with your colleagues and friends!
These mushrooms have delayed symptoms (>6 hours) and are associated with significant toxicity:
G – Gyromitrin (Gyromitra esculenta) – False morels; inhibits GABA, leading to seizures.
O – Orellanine (Cortinarius spp.) – Causes renal failure; famously poisoned The Horse Whisperer author.
T – Tricholoma equestre (Man on Horseback) – Leads to rhabdomyolysis.
A – Amatoxin (Amanita phalloides, Galerina spp.) – Causes liver failure; the most lethal mushroom toxicity.
Early Onset Nausea, Late Toxicity Mushrooms
²
²
A² – Allenic norleucine (Amanita smithiana) – Found in the Pacific Northwest; early GI symptoms followed by renal failure.
These may present early but still cause significant toxicity.
P² – Paxillus spp. – Can cause hemolytic anemia and multi-organ injury.
Early-Onset Nausea Mushrooms
P– Psilocybin (Psilocybe spp.) – Hallucinogenic, similar to LSD, typically low toxicity but may cause hyperthermia or seizures.
Symptoms appear within 6 hours and are usually self-limited.
I – Ibotenic Acid & Muscimol (Amanita muscaria, Amanita pantherina) – Acts like a “mushroom speedball”, causing both stimulant and sedative effects.
C – Coprine (Coprinus spp., Inky Caps) – Induces disulfiram-like reaction with alcohol.
E – Emetic Mushrooms (LBMs: Little Brown Mushrooms) – Various species that cause self-limited vomiting and diarrhea.
M – Muscarine (Clitocybe, Inocybe spp.) – Cholinergic crisis (SLUDGE symptoms), similar to nerve agents.
Ryan's Modified Mnemonic GOTTAAA PICCEM
The GOTTA3 P2ICCEM Mnemonic (Ryan's Modification)
Late-Onset (Severe) Toxic Mushrooms
These mushrooms have delayed symptoms (>6 hours) and are associated with significant toxicity:
G – Gyromitrin (Gyromitra esculenta) – False morels; inhibits GABA, leading to seizures. While this is classically taught, newer data suggests its extremely rare, GI effects, with or without hepatoxicity or minor neurologic symptoms predominate
O – Orellanine (Cortinarius spp.) – Causes renal failure; famously poisoned The Horse Whisperer author.
T – Tricholoma equestre (Man on Horseback) – Leads to rhabdomyolysis.
A² – Allenic norleucine (Amanita smithiana) – Found in the Pacific Northwest; early GI symptoms followed by renal failure.
These may present early but still cause significant toxicity.
P² – Paxillus spp. – Can cause hemolytic anemia and multi-organ injury.
Early-Onset Nausea Mushrooms
P– Psilocybin (Psilocybe spp.) – Hallucinogenic, similar to LSD, typically low toxicity but may cause hyperthermia or seizures.
Symptoms appear within 6 hours and are usually self-limited.
I – Ibotenic Acid & Muscimol (Amanita muscaria, Amanita pantherina) – Acts like a “mushroom speedball”, causing both stimulant and sedative effects.
C – Coprine (Coprinus spp., Inky Caps) – Induces disulfiram-like reaction with alcohol. Thee are actually many species that have been implciated here incuding Verpa bohemica (early morel) and Boletus luridus (luride bolete).
C- Cholinergics (muscarine containing, Clitocybe, Inocybe spp.) Cholinergic crisis (SLUDGE symptoms), similar to nerve agents.
E – Emetic Mushrooms (LBMs: Little Brown Mushrooms) – Various species that cause self-limited vomiting and diarrhea.
M – Morchella (morels) while an edible delicacy, they must be thoroughly cooked, recently multiple deaths have been links to eating morels, and the exact mechanism of toxicity is unclear but they result in incredibly fast GI effects.
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