From the Guidelines
Psilocybin mushrooms do not typically cause liver failure in healthy individuals when used occasionally. The primary concern with mushroom consumption is not liver toxicity from psilocybin itself, but rather the risk of misidentifying a toxic mushroom species that can cause severe liver damage or death [ 1 ]. Psilocybin is metabolized in the liver, but it does not produce toxic metabolites that would cause liver injury in most people. However, individuals with pre-existing liver conditions should exercise caution, as any substance processed by the liver could potentially exacerbate existing problems.
The main risks associated with psilocybin mushrooms are psychological effects, including anxiety, panic, and temporary psychosis in vulnerable individuals, rather than liver toxicity. It is crucial to differentiate between psilocybin mushrooms and other species, as some mushrooms can cause acute liver failure (ALF), necessitating considerations for liver transplantation as a lifesaving option [ 1 ]. If someone experiences symptoms like jaundice, abdominal pain, or unusual fatigue after consuming mushrooms, they should seek immediate medical attention, as these could indicate liver problems.
Key considerations for liver health in the context of mushroom consumption include:
- The risk of liver failure is more closely associated with the ingestion of toxic mushroom species rather than psilocybin mushrooms themselves.
- Pre-existing liver conditions may increase the risk of liver problems when consuming any substance metabolized by the liver.
- Immediate medical attention is necessary if symptoms of liver injury occur after mushroom consumption.
- The management of acute liver failure, including considerations for transplantation, is critical in cases of mushroom poisoning [ 1 ].
From the Research
Liver Failure and Psilocybin Mushrooms
- There is no direct evidence in the provided studies that psilocybin mushrooms cause liver failure.
- However, studies 2, 3 discuss liver failure caused by ingestion of toxic mushrooms, specifically Amanita phalloides and Amanita ocreata, which are different from psilocybin mushrooms.
- The study 2 reports on 27 patients who developed severe liver injury after ingesting wild mushrooms, with 24 patients ingesting Amanita phalloides and 3 patients ingesting Amanita ocreata.
- Another study 3 reports on 18 patients with amatoxin-induced acute liver failure (ALF) or acute liver injury (ALI), with 13 patients having ALF and 5 patients having ALI.
Drug-Induced Liver Injury
- A study 4 discusses drug-induced liver injury, which can be caused by various substances, including drugs and toxins.
- The study 4 mentions that drug-induced liver injury can be hepatocellular or cholestatic, and that the diagnosis requires the exclusion of other plausible causes and the search for a clinical drug signature.
- Another study 5 discusses the evaluation of abnormal liver function tests and mentions that many liver tests are not specific for the liver and can be affected by various factors.
Liver Injury and Mushrooms
- A study 3 reports that patients with mushroom poisoning with ALI have favorable survival, while around half of those presenting with ALF may eventually require liver transplantation.
- The study 3 also mentions that N-acetylcysteine was used in nearly all patients, while silibinin, penicillin, and nasobiliary drainage were used less frequently.
- It is essential to note that the studies provided do not specifically discuss psilocybin mushrooms, and the information available is related to other types of mushrooms, such as Amanita phalloides and Amanita ocreata.
Antipsychotic Safety in Liver Disease
- A study 6 discusses antipsychotic safety in liver disease and mentions that antipsychotic-induced liver dysfunction is uncommon to rare.
- The study 6 grades antipsychotics as low, low to moderate, moderate, moderate to high, or high risk for causing or worsening liver disease, but does not mention psilocybin mushrooms.