Mad Honey: How the Sticky Sweetness Hijacks the Body’s Electrical System

When you purchase a jar of honey at the grocery store, it doesn’t usually come with a toxic warning on the label. You’d assume it is about as harmless as food gets, as it's easily stirred into a cup of tea or drizzled over toast. However, a spoonful of one specific type of rare honey can cause dizziness, hallucinations, and a heart rate slow enough to send you to the emergency room.

The culprit behind these symptoms is, in my opinion, appropriately labeled: mad honey.

Mad honey, unlike the typical honey variety, contains grayanotoxin; a naturally occurring neurotoxin found in plants

Native to Nepal and the Black Sea coast of Turkey. When honeybees collect nectar and pollen from these plants

in these regions of the world, grayanotoxins make their way into the resulting honey. 

One thing about mad honey I found especially interesting is not only the fact that it’s poisonous; but how

the poison works on a cellular level. Grayanotoxin interferes with one of the fundamental processes that allows

our nerves, muscles, and heart to function: the movement of sodium ions across cell membranes. Every heartbeat and muscle contraction depends on tightly regulated electrical signals. When our cells need to send a signal, specialized proteins called voltage-gated sodium channels open. Sodium ions rush into the cell and change its electrical charge. This is called depolarization. However, the sodium channel also has to inactivate, allowing the cell to repolarize before the next signal. Almost like an electrical “reset”, similar to restarting your computer.

Grayanotoxins bind to voltage-gated sodium channels and interfere with this inactivation phase, altering their membrane

permeability, repolarization, and can cause prolonged depolarization. Instead of producing a clean electrical signal and resetting,

normal electrical signaling becomes disrupted.Additionally, the autonomic nervous system controls many subconscious functions: heart rate, blood pressure, digestion,

and breathing. The parasympathetic nervous system (PNS) is the body’s “rest and digest” system.

This brings me to the vagus nerve, which plays a vital role in slowing the heart.

The toxin's effects on sodium channels are also correlated with an increase in vagal nerve activity, such as

bradycardia (an abnormally slow heart rate) and hypotension (abnormally low blood pressure). This creates a problematic physiological chain reaction: grayanotoxin causes sodium-channels to function improperly and therefore alter electrical signaling, which increases vagal effects, leading to decreased heart rate and blood pressure.

Before you know it, that innocent-looking spoonful of honey is doing much more than sweetening your tea. Primary symptoms include dizziness, weakness, sweating, nausea, vomiting, blurred vision, fainting, temporary paralysis, and impaired consciousness. That said, the amount actually required to cause this severity of poisoning is difficult to predict because grayanotoxin is usually distributed unevenly throughout the honey.

Now, just for fun, here’s a couple tid-bits of history I found intriguing while deep-diving into this topic:

One of the earliest written descriptions of mad honey comes from the Greek soldier and writer Xenophon,

who described an incident in 401 BC in which soldiers ate local honey and became severely ill.

They experienced vomiting, were unable to stand, and appeared extremely intoxicated. Xenophon described

the scene as resembling a massive defeat, except there was no enemy attacking them

The effects turned out to be temporary and the soldiers recovered within a few days…but that wasn't

the only documented occurrence.

Several centuries later in 65 BCE, the Roman general Pompey sent troops into the same general region

while fighting King Mithridates VI. Ancient accounts describe Mithridates' allies deliberately leaving toxic honey

along the Romans' route. The soldiers ate it, became incapacitated, and then were attacked.

Who would’ve thought honey could be an effective method of biological warfare: why bother with weapons

when you could just leave out some clay pots of toxic honey and wait?

References:

Jansen, Suze A, et al. “Grayanotoxin Poisoning: ‘Mad Honey Disease’ and Beyond.” Cardiovascular Toxicology, U.S. National Library of Medicine, 19 Apr. 2012, pmc.ncbi.nlm.nih.gov/articles/PMC3404272/. 

Ullah, Sana, et al. “Mad Honey: Uses, Intoxicating/Poisoning Effects, Diagnosis, and Treatment.” RSC Advances, The Royal Society of Chemistry, 22 May 2018, pubs.rsc.org/ra/article/8/33/18635/617774/Mad-honey-uses-intoxicating-poisoning-effect. 

Let's Talk About Getting "The Ick"

You have probably experienced it before. The physical recoil when your partner does something absolutely atrocious in front of you. Maybe its their toe shoes or how they say expresso instead of espresso, but whatever it is, you know one thing is for certain: you just got the ick.

Ew! Gross! What is causing this reaction?

Some can consider the ick as a modern way of describing a sudden feeling of disgust or loss of attraction. Disgust is associated with changes in the body’s autonomic nervous system. The autonomic nervous system controls many of our automatic bodily functions like breathing and digestion and can respond to many stimuli. Our emotions can produce different patterns of physiological responses within the autonomic nervous system (Levenson, 1992).

When we experience disgust, both the sympathetic and parasympathetic nervous system responds. This can cause a number of responses in the body like nausea and churning, increased salivation, and, surprisingly, decrease heart rate (De Jong et al., 2011). Interestingly, one study found that disgust can be associated with a decrease in heart rate. When participants were exposed to disease-related disgust stimuli, they presented with a decrease heart rate (Rohrmann & Hopp, 2008).

In the case of a severe reaction, the sympathetic nervous system may kick in. The body’s fight or flight response is all thanks to the sympathetic nervous system. One pathway we are familiar with is the SAM pathway, a quick signaling pathway that signals the adrenal medulla to release epinephrine that increases heart rate, breathing, blood flow, and other responses to prepare the body for action. In the case of the ick, the sympathetic nervous system can activate if the feeling of disgust is stressful enough.

What is the purpose of all these uncomfortable reactions? Disgust is thought to function as a protective response that encourages us to get away from things that could potentially be harmful or contaminated. In other words, that sudden feeling of “absolutely not” may be your body’s way of encouraging you to distance yourself from whatever triggered the disgust response. So, the next time your partner does something that makes you suddenly think ew, what the heck is wrong with you, remember that your body is also saying ew too. 

References

De Jong, P. J., van Overveld, M., & Peters, M. L. (2011). Sympathetic and parasympathetic responses to a core disgust video clip as a function of disgust propensity and disgust sensitivity. Biological Psychology, 88(2–3), 174–179. https://doi.org/10.1016/j.biopsycho.2011.07.009

Levenson, R. W. (1992). Autonomic Nervous Systems Differences among Emotions. Psychological Science (0956-7976), 3(1), 23–27. Levenson, R. W. (1992). Autonomic Nervous Systems Differences among Emotions. Psychological Science (0956-7976), 3(1), 23–27. https://doi.org/10.1111/j.1467-9280.1992.tb00251.x

Rohrmann, S., & Hopp, H. (2008). Cardiovascular indicators of disgust. International Journal of Psychophysiology, 68(3), 201–208. https://doi.org/10.1016/j.ijpsycho.2008.01.011

 

Does Salt Water Actually Heal?

Being from a place surrounded by the ocean, whether it's in cultural stories or printed on T-shirts and hats, you hear and see the phrase “salt water heals” very often. And personally, I think it's true. After a long day or if I feel under the weather, a dip in the ocean makes me feel much better, which makes me wonder if there is a measurable physiological basis for it. 

After doing further research on the topic, it seems this is something that scientists have been trying to connect for a while but data is limited in the mechanistic and epidemiological principals. One study I found particularly interesting done by Hooyberg et al (2023) compared beaches to green and urban environments looking at their influence on physiological stress. Researchers showed 164 participants two 16 minute exposures using virtual reality while monitoring their heart rate, heart rate variability, skin conductance, blood pressure, breathing rate, and muscle tone. The study showed that beaches caused lower breathing rates than urban environments and lower sympathetic nervous system activity than green environments. Participants also stated that, under moderate stress, they felt the beach scene decreased negative mood and perceived stress where the green environments did not. 

An additional study that I found complimentary to the last one was done with a random crossover design. 59 healthy adult office workers were randomly assigned to either a blue space, urban space, or control site on 4 days each week for 3 weeks. For 20 minutes a day participants walked along their assigned space. After the walk researchers measured self-reported well-being (also assessed duration of effects at least 4hrs after exposure) and mood, blood pressure, and heart rate variability. They found that participants' well being and mood responses were significantly improved after walking in the blue space compared to the urban space and control site. However there was not a statistically significant difference in cardiovascular response in the blue vs. urban space (Vert et al., 2020). 

The most interesting part about both of these studies is that the feeling of relief is consistent with the blue space/ ocean. The fact that the biomarkers were pretty inconsistent shows that the oceans effect might set off smaller shifts in mood rather than one big stress switch. I would love to see future studies use a more hormonal approach with markers such as cortisol and follow people for longer periods of time. 

References:

Everaert, G., Aerts, R., Bourgois, J. G., Buysse, A., Covaci, A., De Rijcke, M., Diopere, E., Hooyberg, A., Lachat, C., Lahousse, L., Mees, J., Michels, N., Plusquin, M., Raes, F., Rappé, K., Roose, H., Severin, M., Van Campenhout, K., Vanhaecke, L., … Asselman, J. (2025). Ocean for Health: A Transdisciplinary Framework to Accelerate Research on Ocean–Human Health Connections. Environmental Science & Technology, 59(27), 13585–13593. https://doi.org/10.1021/acs.est.5c05463

Hooyberg, A., Michels, N., Roose, H., Everaert, G., Mokas, I., Malina, R., Vanderhasselt, M.-A., & De Henauw, S. (2023). The psychophysiological reactivity to beaches vs. to green and urban environments: insights from a virtual reality experiment. Journal of Environmental Psychology, 91, 102103. https://doi.org/10.1016/j.jenvp.2023.102103

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Vert, C., Gascon, M., Ranzani, O., Márquez, S., Triguero-Mas, M., Carrasco-Turigas, G., Arjona, L., Koch, S., Llopis, M., Donaire-Gonzalez, D., Elliott, L. R., & Nieuwenhuijsen, M. (2020). Physical and mental health effects of repeated short walks in a blue space environment: A randomised crossover study. Environmental Research, 188, 109812. https://doi.org/10.1016/j.envres.2020.109812

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Protein Intake Risks and Optimization

 

Increasing one’s protein intake has recently risen as a popular trend in the health and wellness industry. On social media, there is an emphasis on reaching “daily protein intake goals”. Even on grocery store shelves, we are seeing an increase in protein as many previously low-protein items now have a higher protein option. Protein is also often a main selling point, being marketed on the front of items in large fonts. All this to say, the increase in protein intake has become very popular. Thus, I wanted to explore risks, as well as optimal protein consumption. 

The main risk thought to be associated with protein intake would be kidney disease. It was thought that increased protein intake would increase the pressure in the kidneys and cause hyperfiltration, contributing to kidney disease (Campbell et al. 2007). However, this has been shown to be incorrect. In fact, it was demonstrated that even in populations already at risk for kidney disease, increasing protein intake did not contribute nor cause the disease (Antonio et al. 2024). Overall, increasing protein intake has not shown to cause any significant renal issues. 

There is a common misconception that consuming protein within about an hour after exercise produces the greatest benefit, however that doesn’t seem to be the case (Antonio et al. 2024) Another study shows that consuming protein even 24-27 hours after exercise can have the same effects (Antonio et al. 2024). So, optimal protein intake doesn't necessarily mean consuming it as soon as possible post-workout, as the same muscle growth results can be seen when a high protein meal is had within about a day of the workout. The amount of protein consumed is much more significant in the timing it is consumed at in order to see growth results. 

Another aspect of protein consumption commonly talked about is protein quality. It was shown that animal protein sources typically help achieve more optimal growth compared to plant based proteins (Cintineo et al. 2018). However, there are many aspects of protein quality, leading to the conclusion that several kinds of protein would be best. Protein quality is evaluated on amino acid content, as well as what micronutrients, calories, and fats are included in the product (Campbell et al. 2007). In order to hit all the protein and nutrient necessities, a mix of several kinds of protein is best (Campbell et al. 2007). 

References

Antonio, J., Evans, C., Ferrando, A. A., Stout, J. R., Antonio, B., Cintineo, H. P., Harty, P., Arent, S. M., Candow, D. G., Forbes, S. C., Kerksick, C. M., Pereira, F., Gonzalez, D., & Kreider, R. B. (2024). Common questions and misconceptions about protein supplementation: what does the scientific evidence really show? Journal of the International Society of Sports Nutrition, 21(1). https://doi.org/10.1080/15502783.2024.2341903

Campbell, B., Kreider, R. B., Ziegenfuss, T., La Bounty, P., Roberts, M., Burke, D., Landis, J., Lopez, H., & Antonio, J. (2007). International Society of Sports Nutrition position stand: protein and exercise. Journal of the International Society of Sports Nutrition, 4(1), 8. https://doi.org/10.1186/1550-2783-4-8

Cintineo, H. P., Arent, M. A., Antonio, J., & Arent, S. M. (2018). Effects of Protein Supplementation on Performance and Recovery in Resistance and Endurance Training. Frontiers in Nutrition, 5(83). https://doi.org/10.3389/fnut.2018.00083

A Clue in the Family Tree

While shadowing a pediatric procedure at Children's Hospital, an anesthesiologist told me something that I didn't expect. A perfectly healthy child can go into a routine surgery and wake up with brain damage, and the only warning sign might be hidden in their mother’s family line. Nothing on the chart will show it. 

He wasn't exaggerating. In 2026, doctors in several countries reported healthy children and adults who went into routine surgery and came out with severe brain injury, or didn't survive(Al Masher et al., 2026). In Chile, one of those children was only there for dental work(Yanez Hinojosa et al., 2026). Genetic testing showed they shared the same tiny change in a mitochondrial gene called MT-ND4, passed down through their mothers’ families and traced back to one region in South America. 

So, what exactly happens in the body? Every cell has mitochondria (the powerhouse) tiny power plants that make ATP, the energy our cells run on. They do this through the electron transport chain which works like an assembly line, and the first station is called complex I. The MT-ND4 gene helps build that station. We inherit mitochondria exclusively from our mothers, so this mutation travels quietly down the mother's line. 

Most days, an individual with this mutation experiences no side effects. The problem is Sevoflurane, a common anesthesia gas used to put kids to sleep for surgical procedures. Research suggests Sevoflurane also shows complex I (Effects of a Mitochondrial Genetic Variant, 2026). A healthy persons mitochondria can still make enough ATP, even when Sevoflurance slows complex I. In someone with the mutation, complex I is already weakened, so the adding of Sevoflurance causes ATP production to fall, and the brain is affected first because it has one of the highest energy demands in the body and almost no energy reserves. 

Without ATP, the pumps that keep ions balanced stop working. The cell’s voltage depolarizes, ion channels open, sodium and calcium rush in, and the brain cells swell and die. This is detrimental because once enough brain cells are lost, a child or adult with this mutation can suffer permanent brain damage or even death. 

The good news: it's preventable. If doctors understand the risks, they can choose different anesthesia medicines (Tobias et al., 2026). This is where the biomedical value of non-maleficence comes in. We usually picture harm as a mistake; the wrong dose or working on the wrong tooth. In this case, the danger is in the patient’s DNA and no one is at fault. Doing no harm means searching for risks no one can see before they have the chance to appear.   

References: 

 1. Yanez Hinojosa, C. I., Anríquez Jiménez, S., Lara Román, C. F., Fuentes Contreras, J. E., & Pacheco Jara, J. F. (2026). Potential Mitochondrial Pharmacogenetic Susceptibility to Severe Neurologic Events after General Anesthesia: Report from the Chilean Ministry of Health. Anesthesiology, 144(6), 1489–1491. https://doi.org/10.1097/ALN.0000000000005935

 2. Tobias, M., Dairo, K., Slenkovich, N., Cambier, G., & Tobias, J. D. (2026). Total Intravenous Anesthesia With Remimazolam and Remifentanil for Intraoperative Care of a Child with Venezuelan Heritage, at Risk for a Mitochondrial Disorder. Journal of medical cases, 17(8), 428–431. https://doi.org/10.14740/jmc5358

3. Al Mandhari, M., Ibarra, C., Bruguera Torres, C., Mc Donnell, C., Fuda, G., & on behalf of the Canadian Anesthesiologists’ Society. (2026). Canadian Anesthesiologists’ Society advisory statement on emerging reports of severe neurologic complications following general anesthesia in patients with maternal Venezuelan ancestry. Canadian Journal of Anesthesia/Journal Canadien d’anesthésie. https://doi.org/10.1007/s12630-026-03130-6 

Why does pregame adrenaline rush make you want to run through a wall?

One of the main things I miss about being an athlete is those pregame feelings. That excitement and rush before a game is something that was for sure taken advantage of, so why not write about it while I am washed up now?

While you're standing on the sideline waiting for a big game to start, your heart is pounding, your hands are shaky, and suddenly you feel like you could sprint through a wall. Not necessarily saying you became this unstoppable athlete, but your body is getting some help from adrenaline. What exactly is happening inside your body that makes the pregame adrenaline rush feel so powerful?

The pregame feeling starts with the sympathetic nervous system, or the “fight-or-flight” response. Your body does not need to wait for the game to start to prep for what is about to happen. Research has shown that trained individuals can experience an anticipatory rise in epinephrine and norepinephrine before exercise begins (Egan & Sharples, 2023). These hormones help prepare the body for action by increasing cardiovascular activity and making more energy available to working muscles.

Where does that sudden burst of energy come from? Epinephrine binds to adrenergic receptors throughout the body, producing different responses depending on the tissue. In the heart, activation of β1-adrenergic receptors increases heart rate and the force of contraction, increasing cardiac output and helping deliver more blood to working tissues. In skeletal muscle, β2-adrenergic signaling can influence membrane excitability and excitation-contraction coupling. β2-receptor activation stimulates cAMP-dependent protein kinase signaling, which can increase Ca²⁺ release from the sarcoplasmic reticulum (Cairns & Borrani, 2015). The released Ca²⁺ binds to troponin, causing tropomyosin to move and allowing actin and myosin to interact and generate force. Epinephrine also increases the availability of fuels such as glucose and fatty acids that can be used to produce ATP during exercise (Zouhal et al., 2008). Basically, your body is making sure your muscles have the blood, fuel, and physiological preparation they need before you even step onto the field.

That pregame rush isn't only responsible for making you feel ready to run through a wall. The same sympathetic response also contributes to that racing heart, shaky hands, and butterflies before a game. Your body is essentially preparing you to face whatever is waiting on the other side of the field. So, if a little adrenaline can help prepare an athlete to perform, what happens when pregame nerves cause too much of it?

References: 

Cairns, S. P., & Borrani, F. (2015). β-Adrenergic modulation of skeletal muscle contraction: Key role of excitation–contraction coupling. The Journal of Physiology, 593(21), 4713–4727. https://doi.org/10.1113/JP270909

Egan, B., & Sharples, A. P. (2023). Molecular responses to acute exercise and their relevance for adaptations in skeletal muscle to exercise training. Physiological Reviews, 103(3), 2057–2170. https://doi.org/10.1152/physrev.00054.2021

Zouhal, H., Jacob, C., Delamarche, P., & Gratas-Delamarche, A. (2008). Catecholamines and the effects of exercise, training and gender. Sports Medicine, 38(5), 401–423. https://doi.org/10.2165/00007256-200838050-00004

Can They Stop Blowing that Puff of Air in My Eyes?

When we go to the eye doctor, many of us, including myself, are scared of the machine that blows air in our eyes. Why is the puff of air so intimidating? I know the puff of air is coming, it’s a scary/anxious feeling, I have to make sure my eyes stay open or it’s going to be embarrassing, but somehow I still blinked. The nerves in the cornea give a signal to the brainstem in order to protect the eye, therefore the phenomenon of corneal reflex occurs. It’s where the eyelids close before you can even stop it. Then you question why am I here, do I even need my eyes checked, what is this stupid test? This stupid test is actually very important. It’s called tonometry and it measures intraocular pressure. Aqueous humor is the clear fluid that the front of the eye is filled with and is constantly making. The purpose of the aqueous humor is to drain out and if the drainage doesn’t happen then the pressure builds up. Results of this include damaging the optic nerve or more importantly the peripheral vision first. This is the leading cause of irreversible blindness worldwide known as glaucoma. People with diabetes may be at a higher risk and some medications, especially individuals who take steroids therefore, it’s essential for physicians to check eye pressures during an annual exam. 

A quick burst of air comes from the air puff tonometry to briefly flatten the cornea and the sensor within measures how much force it took. Typical normal ranges are between 10-21 mmHg, but can vary from person to person. The interesting part is that nothing actually touches your eyes. Luckily, the clinic I used to work at didn’t have this device and chose a friendlier one. The iCare tonometry utilizes a very small plastic ball to the cornea and back. It’s very similar to the traditional tonometry, however the iCare tonometry measures how quickly it rebounds. Now, I understand it sounds a little intimidating with something touching the eye, but it’s super fast and painless, and many of my previous patients had mentioned how it tickles their eyelashes (if that’s even possible). So next time, be brave because a few seconds of discomfort protects vision you can’t get back.

References: 

Cleveland Clinic. (2022, May 25). Tonometry: What Is It, Test Procedure, Ranges & Results. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/22859-tonometry

Icons8. (n.d.). tonometry. Icons8. Retrieved September 27, 2026, from https://icons8.com/icon/rrpp0hc9hrAx/tonometry

World Health Organization. (2023, August 10). Blindness and vision impairment. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment