I'm a toxicologist. People have been doing this for hundreds of years. Stop doing it. Don't do it: A TikToker drank a bottle of nutmeg spice in a protein shake. This is what happened to his brain.
GG is a 19-year-old man presenting to the emergency room with dry mouth, flushing, and nausea. He tells the admitting nurse that tiny little Smurfs were dancing around his feet and that some of them had turned into pickles. It was the funniest thing he had ever seen.
GG was an average 19-year-old in 2020 America. Because schools were closed, his classes were online. He skipped them so that he could meme on the Internet. Over the past few days, #nutmegchallenge had become popular. "Nutmeg" is when soccer players kick the ball between their opponents' legs, but that name could be taken literally. In GG's mind, he was going to take it literally. He was going to drink a protein shake flavored with a whole bottle of nutmeg spice and post the video online.
Immediately after drinking a bottle of nutmeg spice in his protein shake, GG felt okay. It didn't taste good. It felt grainy in his throat on the way down. It left a funny aftertaste that he thought should have been minty, but it wasn't. The shake was mixed in cold water and he instantly had a brain freeze. "I'm BadlandsChugs now," he thought. "Time to post the video online and play some video games now," he thought.
As the hours passed, GG's mouth started drying out. He felt like his tongue was becoming sandpaper, grinding the roof of his mouth into sawdust. He drank a gallon of water, but the more he drank, the thirstier he got.
In the bathroom now, GG saw himself running in the mirror, but the faster he ran, the rounder he got. His walls started melting. His heart started pounding, but then little bugs started crawling underneath his skin.
He tried to drink more water and told his mom that he was going to drink the ocean. His face was as red as a beet. He was hot and flushed. He could feel himself crawling out of his own skin. He drank a total of four gallons of water over a few hours as his speech started to slur. He became visibly agitated, and as hard as he tried, he just couldn't urinate any of the water out. His bladder was like a balloon, ready to pop.
In the bathroom again, GG collapses. He starts seizing. In the commotion, his mom finds him on the floor, drifting in and out of consciousness. She calls for 911, as he's brought to the emergency room where we are now.
At examination, GG was agitated, but alert. He was flushed, but had no fever. Breathing was normal. His heart rate was fast, his blood pressure was high, and he had an arrhythmia.
He told doctors that little elves were crawling up his stomach. He warned the doctors that the elves were going to come out soon, bearing gifts of canned carrots. He said that even after drinking the entire ocean, he still hadn't urinated yet that day.
But GG hung his head in silence. He gripped the armrests of his chair, fighting the urge to vomit, as he seizes again for the second time. Doctors had no idea that GG drank a whole bottle of nutmeg. He didn't tell them that. But given this history of present illness, there are several clues as to what's happening.
GG complained of dry mouth. This is why he was so thirsty. But if four gallons of water didn't fix it, then what was going on? It looks like he wasn't producing any saliva. His body was flushed and red, but he didn't have a fever and he wasn't sweating.
This brings us to the idea of "rest and digest." When you take a nap in the middle of the day, you sweat. Your heart rate slows. That's the rest. When you see or smell delicious food, you salivate. That's the digest. Both of these are controlled by your nervous system, but GG isn't sweating despite being flushed. He doesn't have any saliva in his mouth. His heart is pounding. All of this means that he has a blockage of "rest and digest" in his nervous system, but where did that come from?
At this point, GG didn't even know who he was talking to anymore. He unlocked his phone and showed the doctors the video that he made. This tells them everything that they need to know because the nutmeg spice has poisoned his body, causing problems with his brain and his heart.
Nutmeg spice is from the nutmeg tree. Ignore the "spice" part, because if you drink an entire bottle for "Ha ha, funny" TikTok memes, you're not treating it like a spice. Like everything that's herbal and natural, nutmeg has hundreds of chemicals in it. Natural things are all made of chemicals.
Inside the spice is a chemical named myristicin. GG drank it. It went into his stomach, into his intestines, and then absorbed into his liver, where it was broken down and metabolized. This metabolism is so that parts of the chemicals that are reactive get neutralized, so that they can't damage other parts of the body. But how does this myristicin get broken down?
Scientists thought this could happen, which makes it look a lot like this alpha-methylphenethylamine, am-ph-et-amine, something we know as treatment for ADHD, among other things.
In the synapse where the nerves connect, chemicals send signals. When the signal is done, the synapse needs to clear itself so that signals aren't sent nonstop. This means that those chemicals need to be pumped back in or broken down. But if an alpha-methylphenethylamine is present, the synapse doesn't get cleared. It goes into the cell and it forces more chemical out, sending signals nonstop, continuously stimulating the nerve.
This is why we call it a stimulant. This could be the reason for GG's problems at the moment, but something's wrong. Alpha-methylphenethylamine in large amounts pushes out things like adrenaline. What happens during an adrenaline rush? Your heart starts to race. Your body temperature increases. You might even urinate yourself.
The adrenaline rush puts you in "fight or flight" mode. This is the exact opposite of "rest and digest" mode. Both of these are controlled by opposite ends of the same nervous system. Blockage of "rest and digest," which is what GG appears to have, doesn't mean a promotion of "fight or flight" mode.
If the nutmeg that he ate became a large dose of alpha-methylphenethylamine in his body, then he should be in "fight or flight" mode. He wouldn't be holding onto his urine the way he is, and he would have a high body temperature, which would mean fever, but he doesn't have those, meaning that myristicin might not be broken down this way.
This isn't the only chemical that's in nutmeg spice. Elemicin, which is only one change away from myristicin, is also in it. After liver metabolism, elemicin could look like another phenylethylamine, one that comes from a cactus and also causes hallucinations. This could explain GG's tweaked-out state, but the reality is that we're not really sure that these breakdowns actually happen in humans because GG has a blockage of "rest and digest" and not a promotion of "fight or flight."
While nutmeg is a funny spice and "Haha" TikTok memes, it does things in the body. Maybe it does become psychoactive chemicals in the body or the chemicals are already psychoactive in themselves when consumed in large amounts, like a whole bottle in a protein shake. But we still don't know for sure, and this isn't something that you should want to play around with.
The reason that something hasn't been done about this might be because almost no one says that this experience is pleasant. Overwhelmingly, no one ever really wants to do it again and you shouldn't ever do it in the first place.
Usually, herbal products that are common today have Greek and Roman roots, but nutmeg trees don't grow anywhere near Greece or Rome. Western Ancients never wrote about nutmeg. They probably didn't know about it; 1195 AD was the first written account of it in Europe, when an emperor entered Rome and the streets were fumigated with myristica -- that's nutmeg before chemists knew what myristicin was. It was the Arabian traders who imported it in from the islands.
The effects of nutmeg on the brain and heart have been known for hundreds of years now. In the 1300s, a book of remedies written in High Middle German described using nutmeg to get drunk. In 1576, Flemish physician Lobelius described an English woman who became delirious after eating 10 or 12 nutmegs. The English thought it could treat gas, but to no avail.
Nutmeg has been around and well known for centuries, but the effects aren't so funny when they're happening. The Illinois Poison Center looked back and saw that one person had died during nutmeg toxicity, but they weren't sure if it was because of other medicines on top of it.
For GG, the only thing that can be done is to let the spice clear from his body, except something's wrong. While huge amounts of nutmeg can affect the brain, the limited records that we have don't usually say that it causes seizures.
GG said that he drank four gallons of water since he drank the spicy protein shake and he noted that he didn't and couldn't urinate. If he drank all that water and none of it has exited his body from either end, then where could that water be? As this question is raised, GG seizes again in front of the medical team and he doesn't regain consciousness after it's over.
Doctors' suspicions are confirmed to find that GG not only has nutmeg poisoning, but he also has hyponatremia. Hypo- meaning low, natre- referring to sodium, or more formally, natrium, as shown by its symbol on the periodic table of elements, and -emia meaning presence in blood. Low sodium presence in blood.
GG wasn't able to urinate. Urinary retention is a blockage of "rest and digest." As his bladder stretched and distended, it signaled to the body to hold onto water by releasing something called antidiuretic hormone, also known as vasopressin. If a diuretic causes someone to urinate, then an antidiuretic prevents someone from urinating.
If the bladder is stretched, the body doesn't want to produce any more urine because it's going to stretch the bladder more, so it lets out the hormone to tell everything to stop and to hold onto water.
GG was also nauseous. Vomiting is a way that someone's going to lose water, so nausea is a powerful stimulus for the release of antidiuretic hormone.
All of this meaning that those four gallons of water that he drank are now sitting inside of him, unable to get out. But if nothing has left his body, then how is it possible that there's low sodium? Nothing's left his body, so there shouldn't be less sodium present, right? Yes, but the water in your body is made of 0.9% sodium chloride. For every one liter of water, there are nine grams of salt.
Most of the water in your body is inside of your cells and in general exists with 0.9% sodium chloride. In the medical world, we call this "normal saline" or "isotonic." The interesting thing about sodium is that wherever it is, water will flow towards it.
In this small science experiment, I dissolve salt in this water and place it into a tube. I submerge the tube in a pool of distilled water, and you'll see that water flows towards the salt. That water flows towards the sodium.
If water flows towards where there's salt, and GG's blood has a low sodium presence, then it means his body water is flowing into the cells. This would mean that his organs are swelling with water. This would mean that it's going into his stomach and his intestines.
That should be okay because your abdomen is soft, but the water would also be going into his liver. It would be flowing into his heart and his muscles, but those aren't enclosed in a hard space either, so it wouldn't be too big a problem if they swelled up inside. But how about the brain?
The brain is enclosed in a hard space, the skull. The brain only has space to expand 8% in volume until it starts to crush up against the sides of the skull and ooze out of the sutures. As water keeps flowing into the sodium-rich cells of GG's body, his brain is starting to crush up against the sides of his skull, smashing blood vessels as it expands, preventing blood flow and causing hypoxia, or the deprivation of oxygen.
This damage, upon brain expansion, is called herniation and means permanent brain damage in GG's case. The psychosis. The hallucinations. The final seizure without regaining of consciousness. Since GG is still breathing, it may not yet be too late. He may not have herniated his brain just yet.
The easiest way to treat this problem of his at this point is to use the same science that diagnosed his hyponatremia. If water follows sodium and water is flowing into his organs, then the fix is to draw that water out of his organs with even saltier water.
If 0.9% sodium chloride is the standard in his body and the water that he drank is flowing towards that gradient, then infusing 3% hypertonic water into his veins will reverse the flow of that water back into his bloodstream and out of his brain. Doctors use a catheter to pull urine out of his bladder. There's not much that they can do to reverse the nutmeg other than to wait it out.
All of these are reasons as to why it's not clear what nutmeg really does to the body. If nutmeg does become an alpha-methylphenethylamine, excess of those do cause the body to release a lot of antidiuretic hormone, causing someone to hold onto water. But did that actually happen or was it because nutmeg caused a blockage of "rest and digest," causing urinary retention?
Holding onto urine and stretching the bladder causes secretion of antidiuretic hormone. Nausea stimulates it too, so which one was it? The psychoactive events following nutmeg could obscure the neurologic signs of confusion, agitation, and delirium that's also caused by physical changes to the brain during hyponatremia, when the water starts to swell into the brain and the brain starts to expand against the skull.
Luckily, for GG, no herniation occurred in his brain and the 3% sodium infusion was enough to solve the hyponatremia and draw the water out of his brain. Upon regaining consciousness, he realized that no amount of views on TikTok made that terrible experience worth it.
Thank you so much for watching. Take care of yourself and be well.
Chubbyemu is a PharmD who works in the pharmaceutical industry. See more of his videos on his .