We're sunsetting PodQuest on 2025-07-28. Thank you for your support!
Export Podcast Subscriptions
cover of episode Should you be eating poison oak?

Should you be eating poison oak?

2024/9/18
logo of podcast Unexplainable

Unexplainable

AI Deep Dive AI Chapters Transcript
People
J
Jeff Horwitz
M
Mahmoud El-Soli
主持人
专注于电动车和能源领域的播客主持人和内容创作者。
Topics
Jeff Horwitz: 我因为采集松茸蘑菇而反复接触漆树,并因此产生了对漆树过敏的想法。为了采集松茸蘑菇,我不顾漆树的危险,多次进入漆树丛中。我尝试过一些方法来避免接触漆树,但并不总是有效。我在网上论坛看到有人通过食用漆树叶来提高耐受性,这激发了我进行实验的想法。我的计划是通过食用漆树叶来训练免疫系统,从而提高对漆酚的耐受性。我开始食用漆树叶,包括制作茶、煎蛋卷和奶昔等,并逐渐增加食用漆树叶的剂量。漆树叶的味道并不难吃。我逐渐增加食用漆树叶的剂量,最高达到每次10到12片叶子。在皮肤上涂抹漆树叶的汁液后,只出现了轻微的局部红肿,没有出现严重的皮疹。一次性食用大量漆树叶后,出现了全身性皮疹。我承认自己冒险过量食用漆树叶,并因此付出了代价。但我认为自己已经对漆树产生了免疫力,但需要每年春天继续食用漆树叶来维持这种免疫力。 Mahmoud El-Soli: 如果口服漆树提取物,可能会导致肛周皮炎。我认为Jeff 的实验结果不能作为科学结论。他 的方法风险太大,不值得推荐。我开始研究漆树过敏是因为我在密西西比大学注意到这是一个严重且普遍的问题。我认为注射疗法比口服疗法更有效且更安全。我 认为口服漆树提取物疗法失败是因为药企坚持生产口服药片,而不是注射剂。 主持人:对漆树过敏导致的皮疹是美国一个普遍且严重的问题,但目前还没有有效的治疗方法,只有避免接触。本期节目将探讨通过食用漆树叶来建立耐受性的可能性。漆树、漆藤和漆木都含有漆酚,这是一种会引起大多数人过敏反应的化学物质。食用漆树叶存在风险,可能导致口腔、喉咙或胃部出现过敏反应。一些加州的原住民部落过去也使用类似的方法来降低对漆树的过敏反应。早期的医学文献中也有一些关于通过食用漆树叶来治疗漆树过敏的案例。一些早期的科学研究使用了不道德的方法来测试漆树提取物的疗效。一些药物研究表明,通过口服漆树提取物可以有效地降低对漆树的过敏反应,并曾被广泛应用。这些药物后来被FDA审查,但最终没有被批准上市,原因不明。人们对漆酚的反应差异很大,这使得确定安全剂量非常困难。口服漆树提取物可能有效,但其有效性与不良反应之间的平衡需要仔细权衡。Jeff 的成功可能与其个人情况有关,不具有普遍性。Jeff 的实验虽然成功,但这并不是一个可取的方法。Jeff 的实验可能为未来的研究提供启发。Jeff 的实验结果可能为未来的研究提供参考。

Deep Dive

Chapters
Jeff Horwitz, a Wall Street Journal reporter, attempts to develop immunity to poison oak by consuming it. He questions the conventional wisdom of avoiding the plant and explores online forums where people claim success with this unconventional method.
  • Poison ivy, oak, and sumac rashes are a leading cause of disability for firefighters.
  • Conventional advice is to avoid poison oak, but some claim eating it can build immunity.
  • Urushiol, the chemical in poison oak, causes allergic reactions in most people.

Shownotes Transcript

Translations:
中文

Support for this show comes from Amazon Business. We could all use more time. Amazon Business offers smart business buying solutions so you can spend more time growing your business and less time doing the admin. I can see why they call it smart. Learn more about smart business buying at amazonbusiness.com.

They're not writers, but they help their clients shape their businesses' financial stories. They're not an airline, but their network connects global businesses in nearly 180 local markets. They're not detectives, but they work across businesses to uncover new financial opportunities for their clients. They're not just any bank. They are Citi. Learn more at citi.com slash weareciti. That's C-I-T-I dot com slash weareciti.

Every year, tens of millions of Americans get poison ivy, poison oak, or poison sumac rashes. Tens of thousands of them end up in the ER. And these rashes are the number one cause of disability and sick leave for firefighters in the Forest Service. More than fire. So you'd think we'd have some kind of fix by now, right? Like, we don't tell people to just stay out of the sun or totally avoid mosquitoes when they go on a hike.

We've got sunscreen. We've got bug spray. And then for poison ivy, all we've got is just telling people to avoid it, which is what most people try to do. But a couple months ago, I talked to someone who's not exactly a runaway from problems kind of guy. He's more of a swallow the problem whole kind of guy. So he decided to try and make himself immune to poison oak by eating it. Now, I assume your first question is just,

Why would someone do that? I mean, I'm kind of an idiot. Jeff Horwitz loves to forage for these big orange mushrooms called chanterelles. But the thing is that the habitat for chanterelles and the habitat for poison oak are pretty much identical. It's kind of almost rare that you'd find chanterelles in a place where poison oak isn't.

And you still wanted to go get these mushrooms? Yeah, no, I'm like, I'm real dumb. Like, I would see a mushroom in the middle of an obvious thicket of poison oak where I'm just going to be crawling hands and knees through poison oak to get to it. And I'd go in. I'd go in, yeah. Is it just because they taste so good? They're really good. And look, one of my strengths as an investigative reporter is that I'm pretty tenacious. You know, once committed to a thing, I will get there.

Yeah, when he's not crawling through poison oak, Jeff works as an investigative reporter at the Wall Street Journal.

If you've heard of the Facebook files, that was him. You know, I have a hard time, shall we say, not pursuing the target. You know, once committed to a thing, I will get there, barring like some insurmountable impediment. And a future rash does not count as an impediment. So over the years, Jeff kind of just got used to rashes. You'll go home and be like absentmindedly scratching. And that's when it's too late. The oil has soaked into your skin.

And within another 24 hours, redness appears, which then graduates into like a oozy blistering mess that makes you want to scratch your skin off, like down to the bone.

Did you ever try to not get poison oak? Yeah. I mean, I'd try to wear long-sleeve clothing. As soon as I got home, I would basically strip through everything I was wearing into the washing machine. And then I would go shower in cold water with dish soap. So like just a bottle of Dawn. And that usually did it, but like sometimes you'd miss a patch. So it was not a foolproof system.

Eventually, Jeff got so frustrated with getting rash after rash

that he started poking around in some online forums. People were writing things in all caps, like, it worked, I'm immune to poison oak, and then describing how they'd been eating the leaves. But keep in mind, I cover social media and Facebook, so, like, I am very aware of the weaknesses of seeking confirmation, particularly for something that you want to believe. And, like, dermatologist organizations, Backpacker Magazine, NPR,

various, you know, hospital systems answered the question of like, can you become immune to poison oak? And the answer to that was, hell no, you can't. But remember, I'm kind of an idiot. I'm Noam Hassenfeld, and this week on Unexplainable, Jeff puts his body and specifically his butt on the line to answer a seemingly straightforward question. Is it possible to build up a tolerance to poison oak by eating it? And if it is,

Where are all our poison oak pills? So we've been talking about poison ivy, poison oak, poison sumac. They're different plants, but they all have the same chemical called urushiol, which causes an allergic reaction in almost 90% of the population. It's not a toxin. It's just that most people's immune systems kind of go nuts when they touch it.

So just like you can build up a tolerance to other kinds of allergens, Jeff thought he might be able to build up a tolerance to poison oak. The whole idea here is that you're training your immune system to stop freaking out when it encounters urushiol. And so the plan was to like,

get to the point when I could just eat the leaves off of the plant and, you know, have poison oak salads. There is a big issue here, though, right? Like, just touching the thing gives you a rash. And Jeff was planning to eat it. So he was worried it might give him this kind of inside-out poison oak rash, like poison oak on the inside of his throat or his stomach.

But he had a plan. Urushiol doesn't work well across certain mucous membranes. So the inside of the mouth, the throat, the stomach, all okay.

The main issues would be his lips. So I got a straw for drinking poison oak smoothies and poison oak tea. And his butt. I definitely learned early on the Latin for, I believe it's a puritis ani, aka itchy butthole. And just to be clear, itchy butthole might sound like it's not so bad, just a little annoying.

But it's a real excruciating pain in the ass. Like, I definitely, that was, like, kind of the thing that, like, I was most afraid of, if I'm being honest, is, like, having to show up to the doctor and be like, yeah, so I ate a whole bunch of poison oak, and I regret that. Like, that seemed like it would be, like, really, really bad, you know, just a little mortifying. So Jeff reached out to a scientist, Mahmoud El-Soli, who has spent a lot of time researching Yerushalayim,

But unlike Jeff, he's been doing that research in a lab, not on Internet forums. And I kept on being like, yeah, but what if I eat it? And so the good doctor was like, I'm not saying it wouldn't work. I'm just saying that you probably don't want to do that. And I was like, yeah, but you're saying it might work. And he's like, yeah, but you're going to regret it. I was like, yeah, but that's a personal choice. Like you're saying this can work.

And he's like, I wanted to tell you, Jeff, if you really take the extract orally, you're going to absolutely get perianal dermatitis. So this is basically your sense is that for it to work, it's going to be very unpleasant. Yes. He's like, you're going to get a really itchy butt.

Still, Jeff is stubborn, kind of a glutton for punishment. That is an identity, and yes, I do identify as such. So he decided on a pretty extreme strategy. He was going to take a full-on shower immediately after he took a crap. Like, every single time, ever.

for months. So any of that poison oak coming through his digestive system wouldn't end up doing what Mahmoud was worried about. The concern was that perhaps using the bathroom and then not taking a shower might make things worse. But Jeff had bigger worries than an itchy butthole, like whether this could kill him. He did find a reference to potential death from smoke inhalation, like burning a bunch of poison oak and poison ivy, breathing it all in, getting it on your lungs.

But Jeff was just planning to eat the stuff. Correct me if I'm wrong on this, but I haven't seen very much in the way of deaths from this. You're not going to get that because you're going to get some kidney or liver issues, but not really lethal. I'll cut back on drinking. But your sense here is that, and correct me if I'm wrong here, I'm probably not taking any massive long-term health risks by doing this, right? I wouldn't think so.

So this past January, Jeff started eating poison oak. I dug up some roots while wearing latex gloves just to keep it off my skin. And then, you know, made some tea. It was like kind of earthy and...

You know, not an unpleasant beverage. I've definitely had much grosser herbal teas. And then a few days later, again, wearing some gloves, I picked some early spring buds, like, you know, half the size of a pea, popped them on me and chewed them up, swallowed, and went back to foraging for mushrooms. Jeff ate poison oak leaves while hiking. He made omelets. He made tea. He made poison oak smoothies. And then every few days, I would...

up dosage with the idea being that if I say hit the point when it was going to start being a problem for me, I would at least like not have gone far past that line. What does poison oak actually taste like? So poison oak, like the leaves themselves, they're like kind of

The Vegli tart have like a kind of that like a little bit of the unripe fruit cottony feel. Slightly sour, but like not bad. Like honestly, like in a salad, if you're eating them, you would not be like, this is bad. They're maybe a little bitter, but like so are endives, right? And radicchio. So like they're perfectly pleasant enough to eat. So if you kept eating more and more poison oak, how...

How big of a dose did you get up to? You know, at first it was like maybe like one or two leaves. But, you know, I was graduating up to like maybe 10 or 12 or so, you know, per smoothie once every couple of days. And then meanwhile, when I was out in the woods, I would continue just to like eat a leaf or two off the plant. And did anything happen? Not for a while. And in fact, I get to a point where I'm like, OK, like, you know, moment of truth. Let's see how this is working. And so I take...

three or four leaves and I crushed them up between my fingers, like roll them around. And then I just smeared this paste on my back. Oh my God. And then I put a bandage on top of it and then went to sleep for the night. To like really smush it in? Yeah, something like that. Yeah. So the idea here was like direct hit. And so two days went by. I thought I was like completely in the clear. Yeah.

And then it started itching. But here's the thing. It was like a little localized redness. And then it kind of like dried up and went away without ever graduating to like blisters. So at this point, I'm like, holy hell, I'm on to something. Like this actually is working for me because like pre-treatment Jeff would have had like one gigantic boil.

But then a couple months ago, Jeff flew too close to the sun. At this point, I was like, I thought I was pretty much to full immunity. And man, I went big. I went, I went. How big? I had like a full poison oak salad. I had a smoothie that must have had like 50 or 60 leaves. Wow. Ground up in there. Okay. It was like a mega dosage. Like I just went huge. And I had a somewhat difficult week.

What happened? Basically, the urushiol went systemic. Systemic, like, all over your body? Yeah, this was blood-borne. I had it popping up behind my ears, like, down my jawline, my neck, my inner thighs. It was starting to, like, run down my arm. So I did manage to get full-body poison oak.

Do you regret going so hard? I mean, I think particularly at this point, because I was writing a story about it, I was like, OK, that's funny. Like a man has fucked around and he has found out, you know, and I enjoy both those processes, both the fucking around and the finding out. Jeff's Icarus moment is a good reminder for anyone else trying to do something like this. The bottom line is that everyone's body and everyone's butt is different.

We've all got vastly different responses to allergens, we've got different pain tolerances, and we've obviously got different tolerances for risk. I wouldn't want to convey to readers that this was something that could be done with zero cost. There's some element of luck here, right? Like, some people respond super well to the treatment, other people get less from it, and there is more of a cost.

But in the end, despite a week of full body poison oak, which again, Jeff absolutely could have avoided. - I probably could have done this in a way that didn't involve a full body rash, but you know, where's the fun in that? - It still seems like mission accomplished.

I think at this point, I am functionally immune. I've been exposed to it and, you know, have sort of dispensed with the old Dawn dish soap routine. So, like, at this point, I'm pretty much all the way there. It's important to eat some leaves every spring, just sort of to maintain that. And plus, I mean, how could I ever possibly give up that party trick? Okay, but if this ended up working for Jeff...

Why is like every single source from NPR to Backpacker magazine so dead set against it? Where's my poison oak pill? That's next. Your business deploys AI pilots everywhere. But are they going anywhere? Or are they stuck in silos, exhausting resources, unable to scale? Maybe you don't need hundreds of AI pilots. You need a holistic strategy.

IBM has 65,000 consultants with Gen AI expertise who can help you design, integrate, and optimize AI solutions. So you're not just deploying AI, you're scaling it across your business. Learn more at ibm.com slash consulting. IBM, let's create. Support for this show comes from Amazon Business.

We could all use more time. Amazon Business offers smart business buying solutions so you can spend more time growing your business and less time doing the admin. I can see why they call it smart. Learn more about smart business buying at amazonbusiness.com. They're not writers, but they help their clients shape their business's financial stories.

They're not an airline, but their network connects global businesses in nearly 180 local markets. They're not detectives, but they work across businesses to uncover new financial opportunities for their clients. They're not just any bank. They are Citi. Learn more at Citi.com slash WeAreCiti. That's C-I-T-I dot com slash WeAreCiti. Poison. Poison Ivy.

So if Jeff was able to DIY a poison oak fix, why isn't everyone talking about this or doing it themselves? Especially because people have been doing things like this for a long time. Some Native American tribes in California used to drink poison oak tea to desensitize themselves

And it worked so well that they could actually weave baskets out of the stuff without getting rashes. Yeah, there are like letters to the AMA back in the 1910s about people effectively treating severe cases of poison ivy. And a lot of these letters came from scientists who were kind of like Jeff, you know, getting real results, but in a kind of rear ends justify the means sort of way.

Still, Jeff was doing this on his own butt. Like, most of these scientists were not that brave. Like this one scientist in Texas in the 30s who ran experiments on his eight-year-old neighbor. This kid was referred to in the medical literature as $2 Richard, who, for the price of $2, would allow said scientist to basically intentionally expose him. That same scientist also experimented on his kid's nurse,

And it's honestly kind of horrifying. Limbs swilled up to double their size, entire body turned fiery red. But it did work. She did, after a couple of months of just this, like, shock and awe, poison ivy treatment, end up resistant. These methods weren't great, to say the least. But they got results. And more reputable scientists started to see the potential here.

They started developing drugs and running real double-blind studies. Like this one study on a drug named Aqua Ivy, which looked at a group of over 100 Coast Guard cadets. They were assigned to, like, clear brush along the Mississippi River. So it just, like, poison ivy infested people.

Half of them received poison ivy extract pills. The other half received placebos. And this stuff worked overwhelmingly. Like, all but one or two of them were, like, fully immune. And then the remaining two had only, like, very moderate reactions. Like, very clearly, this was doable.

Pretty soon, these drugs started taking off. They were being made by big companies like the predecessors of Merck and Pfizer. They were given to people on military bases. They were handed out to all kinds of outdoor workers. There were literally ads in Time magazine. You know, you'd have a picture of this kid with a straw hat fishing. And the tagline would be like, he's up to his hips in poison ivy, but all he's going to catch is trout.

So the big question then is just what happened? We had these double blind tests. We had publicly available drugs. We had magazine ads. Where'd all that go? Yeah. So in the 60s, the FDA started reviewing what were called grandfathered drugs. So these are drugs that like existed before the FDA did and were widely used.

And it turns out that some of them were bullshit, right? There were a lot of drugs that just simply didn't work. You know, they'd been around for decades, but like there just wasn't evidence for them. And so the FDA formed these various commissions to sort of review which of these medicines are real, which of them need more testing, and which of them should just be thrown in the bin. Mm-hmm.

And the advisory panel on plant-based allergies, they were like the urushiol-based treatments, fully effective, fully safe. We just need to see some of the drug companies put together a study or two demonstrating the appropriate standardized dosage. And this never happened. They like never gave the data to the FDA? The drug companies didn't turn it in. The FDA extended the deadline a couple of times. And then the stuff never got turned in.

Do we know why? So we basically lost track of some of these records. And I checked in with Merck and Pfizer about this. They don't have records either because this is like, you know, five drug company mergers ago. Now, it's hard to say exactly what happened here, but there are a few possibilities. One is that they retested the drugs and couldn't conclusively show they worked. You know, back then you didn't have to report failed results.

It's also possible that there just wasn't enough money in it for the drug companies, especially when people could just make this stuff at home. Or, and this is the explanation that I find most compelling, it might have just been too hard to give the FDA what they asked for, this safe, standardized dosage. Because people have all kinds of different reactions to urushiol. Yeah, so my brother gets it really bad. Like, seriously, it looks like monster movie survivor makeup.

I get it a moderate amount. And then on the other end, my wife just isn't allergic. Most people don't get a reaction the first time they're exposed, but they only do once they've come in contact with it a few times. It's what's called sensitization. So companies might have pushed this dose too high at first, you know, just to make sure it actually produced an effect, which has some pretty obvious backsides. I mean, downsides.

Like, there was a point in the 70s where there was a recall on a urushiol drug. There were absolutely instances where people received extremely bad butt rashes slash some level of systemic skin-based outbreak. On the other hand, drug companies might have pushed the dosages too far the other way, trying to play it safe. Because again, like, massive anal rash is not a side effect that I think many people are, like, cool with, even if it works.

The issue here really is, it's not like it doesn't work or it works. The issue is the level of how much it works relative to the problems that you get as a result of ingesting those megadoses of poison ivy extract. That's what scientist Mahmoud Alsoli told Jeff when they talked at the beginning of this process. Mahmoud has been doing research on potential treatments for poison ivy and poison oak for decades.

So I called him up and I asked him how he first got the itch to work on poison ivy. I personally, where I come from, I come from Egypt. We have no woods. We have no poison ivy. We have no nothing. So I didn't even know what the heck poison ivy is. But then I got to the University of Mississippi in 1975. And when I got through working with the people in the institute, I got to realize this is really a major problem.

This is a condition that's really serious, affects a lot of people, but there's no answer to it on the market. I figured there's got to be a way to take care of that. Mahmoud knew that when you swallow Yerushalayim, most of it ends up getting processed by your gut, by your kidneys. So you need a lot of it to have any real effect. That's why he wanted his drug to be an injection. With an injection, he'd be able to take a derivative of Yerushalayim and precisely target specific cells.

But the drug companies he was working with, they kept pushing for a pill. We told them that it's not going to work orally. But they said, well, we have to try that because eventually we want to have that as a over-the-counter thing. And you couldn't have an injectable over-the-counter. So that's why they wanted to go with the oral. Those over-the-counter oral pills ended up failing. The last one was taken off the market in the 90s.

Which is why Mahmoud thinks the injectable is still the best way forward. The best way to get a useful effect without leading to massive rashes. And he is making progress. His company, Hapton Sciences, is heading into phase two trials on an injectable right now. And when he looks at what Jeff did with his smoothies and salads plan, even though it was successful, Mahmoud isn't convinced it's a legitimate alternative option here. It's a one-subject experiment.

Is that something that would stand scientific scrutiny? No. So we can't really make conclusions based on that. Could oral ingestion of poison ivy extract lead, no matter what the cost is, to some degree of desensitization or tolerance? Maybe, but I don't believe that it is worth the risk.

And then how many people would be willing to go through what he went through to do this? Remember, Jeff isn't a normal person. I mean, I'm kind of an idiot.

And that might be the thing that made it work for him. Most people aren't going to go take a full-on shower every time they go to the bathroom for months. My personal view and the whole story is this is someone who was curious enough to take the risk of doing something that is out of the norm to see where is this going to take me.

I mean, I admire him for doing this, but if it tells me anything, it tells me that's not the way. That's for sure. But who knows? Sometimes it takes an idiot to move science forward.

Maybe Jeff will end up being someone else's $2 Richard. The kind of reckless one-subject experiment that inspires someone else to take the baton and come up with a new, testable solution. Maybe many years from now, science museums are going to have giant busts of Jeff's rash-free butt. Even if Jeff isn't exactly having a lot of luck getting people to try out his plan. You know, I respect that. Makes a lot of sense. Probably the wiser choice.

This episode was reported and produced by me, Noam Hassenfeld. We had editing from Jorge Just, with help from Meredith Hodnot, who runs our team. Mixing and sound design from Christian Ayala. Music from me, and fact-checking from Melissa Hirsch. Manding Nguyen is looking through the lost and found, and Bird Pinkerton made her pitch to the tortoises. She told them about the octopuses, about the platypuses, about the birds. The head tortoise slowly moved his head up, and slowly...

slowly moved his head down. The tortoises were in. Or at least that's what Bird assumed. They were nodding really, really slowly. Thanks to Raymond Fague for his help this week. And if you have thoughts about the show, send us an email. We're at unexplainable at vox.com. And you can also leave us a review or a rating wherever you listen. It really helps us find new listeners.

You can also support this show and all of Vox's journalism by joining our membership program today. You can go to vox.com slash members to sign up. And if you signed up because of our show, send us a note. We'd love to hear from you. Unexplainable is part of the Vox Media Podcast Network, and we'll be back next week. Support for this show comes from Amazon Business.

We could all use more time. Amazon Business offers smart business buying solutions so you can spend more time growing your business and less time doing the admin. I can see why they call it smart. Learn more about smart business buying at amazonbusiness.com.

They're not writers, but they help their clients shape their businesses' financial stories. They're not an airline, but their network connects global businesses in nearly 180 local markets. They're not detectives, but they work across businesses to uncover new financial opportunities for their clients. They're not just any bank. They are Citi. Learn more at citi.com slash weareciti. That's C-I-T-I dot com slash weareciti.