From the Guidelines
Apricot seeds should not be consumed due to their high content of amygdalin, which converts to cyanide in the body, posing a significant risk to morbidity, mortality, and quality of life. Even small amounts can be dangerous - consuming just 30 small apricot kernels or 10 large ones can deliver a lethal dose of cyanide for adults, while children face risks from much smaller quantities. Symptoms of cyanide poisoning include headache, dizziness, nausea, vomiting, rapid heart rate, low blood pressure, convulsions, and in severe cases, death. If someone has consumed apricot seeds and shows these symptoms, they should seek immediate medical attention.
Treatment Options
- Treatment may include administration of hydroxocobalamin (Cyanokit) at 5g IV for adults or 70mg/kg for children, which binds cyanide to form non-toxic cyanocobalamin, as recommended by the American Heart Association 1.
- Sodium nitrite can be used as an alternative to hydroxocobalamin, particularly when carbon monoxide poisoning is not a concern, with precise dosing in children and patients with anemia 1.
- Sodium thiosulfate can be administered in addition to hydroxocobalamin or sodium nitrite to enhance cyanide elimination, although its mechanism of action is slower and not suitable for monotherapy in life-threatening poisoning 1.
- Administration of 100% oxygen is also reasonable, even with normal partial pressure of oxygen, as it may provide benefit in the context of cellular poisoning like cyanide 1. Despite claims about apricot seeds having cancer-fighting properties due to containing "vitamin B17" (not actually a vitamin), there is no scientific evidence supporting these benefits, and medical authorities worldwide warn against their consumption, as the risks of cyanide poisoning far outweigh any purported benefits 1.
From the Research
Apricot Seed Ingestion Symptoms and Treatment
- Symptoms of apricot seed ingestion can include weakness, fatigue, vomiting, seizure, headache, dizziness, and palpitations, as well as more severe symptoms such as coma, convulsions, and metabolic acidosis 2, 3, 4, 5.
- The onset of symptoms can occur within 20 minutes to 3 hours after ingestion, with the mean time of onset being 60 minutes 2.
- Treatment for apricot seed ingestion typically involves supportive therapy, gastric emptying, and administration of antidotes such as hydroxocobalamin and sodium thiosulfate 2, 3, 4, 6.
- In severe cases, patients may require mechanical ventilation, antidote treatment, and insulin therapy to manage hyperglycemia and metabolic acidosis 2, 3.
Risk of Cyanide Poisoning
- Apricot seeds contain high levels of cyanogenic glycosides, which can cause life-threatening intoxication if ingested 3, 4, 5.
- Ingesting just a few apricot pits (1-3) can result in severe symptoms, and fatalities have been reported after consuming more than 20 pits 3.
- Children are particularly at risk of cyanide poisoning from apricot seed ingestion, and it is essential to consider this diagnosis in pediatric patients with suspicious findings, sudden loss of consciousness, and increased anion gap acidosis 4.
Treatment Outcomes
- Prompt treatment with antidotes and supportive therapy can lead to full recovery from apricot seed ingestion, with most patients being discharged from the hospital within a few days 2, 3, 4.
- The use of hydroxocobalamin and sodium thiosulfate as antidotes has been shown to be effective in treating cyanide poisoning, although outcomes may vary depending on the severity of the poisoning and the timing of treatment 6.