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First Aid for Mistletoe Poisoning

Last updated Feb. 27, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Mistletoe Poisoning is the accidental or intentional intake of the leaves of the plant.

What is Mistletoe Poisoning?

  • Mistletoe is a plant that either grows on its own or, as in most cases, grows on a host tree (as a parasite). The leaves and berries of the plant are used in Christmas decorations, and to brew tea, in some regions of the world
  • The plant is known to be mildly toxic in nature. Species of mistletoe are present in both North America and Europe. But, the European mistletoe is more poisonous than its American counterpart
  • Mistletoe Poisoning is the accidental or intentional intake of the leaves of the plant
  • The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Mistletoe Poisoning may be also referred to variously as the following:

  • American Mistletoe Poisoning
  • European Mistletoe Poisoning
  • Mistletoe Toxicity
  • Phoradendron Flavescens Poisoning
  • Viscum Album Poisoning

What are the Causes of Mistletoe Poisoning?

  • Mistletoe Poisoning is caused by eating the berries or leaves of the mistletoe plant. However, consuming any part of the plant is poisonous
  • This intake could be accidental, or in some cases intentional, to bring self-harm
  • In some communities, the extract of mistletoe plant is used to prepare tea. This may be slightly more concentrated and has the potential to cause more severe symptoms
  • The poisonous substance present in the plant is known as phoratoxin (a peptide-based toxin)

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Mistletoe Poisoning?

The signs and symptoms can vary from one individual to another. It may be mild in some and severe in others. Not all individuals who consume the plant parts/products may show symptoms.

The signs and symptoms of Mistletoe Poisoning may include:

  • Nausea and vomiting; diarrhea
  • Abdominal pain; stomach pain
  • Vision abnormalities including blurred vision
  • Lethargy and weakness
  • Feeling drowsy

How is First Aid administered for Mistletoe Poisoning?

First Aid tips for Mistletoe Poisoning:

  • Call 911 or your local emergency help number immediately, for emergency assistance
  • Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
  • Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
  • Confirm that the airways are protected; also, ensure breathing and the presence of pulse
  • Clean the mouth to remove any remaining pieces; wipe mouth with a wet cloth
  • Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
  • Take individual to emergency room (ER) for further treatment
  • Always try to take the plant or plant product to the ER

The emergency medical health professional might perform the following steps towards treating the condition:

  • Monitor vital signs
  • Medically manage symptoms and provide breathing support, if necessary
  • Administer activated charcoal to avoid absorbance of the substance in the body
  • Administer fluids by an intravenous drip line, if necessary

Who should administer First Aid for Mistletoe Poisoning?

First aid for Mistletoe Poisoning is administered by healthcare professionals.

  • The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
  • They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Mistletoe Poisoning?

  • The prognosis of Mistletoe Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient
  • If the individual can recover from the symptoms with appropriate medication and early support, the outcome is generally good. In most cases, the affected individuals get better within 3 days
  • In case of severe symptoms due to severe poisoning, it may prolong the time of recovery. Nevertheless, deaths due to Mistletoe Poisoning is highly unlikely

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Mistletoe Poisoning be Prevented?

Mistletoe Poisoning can be prevented by:

  • Avoiding the usage of natural parts of the mistletoe plant for Christmas decoration purposes, instead using artificial (plastic) mistletoe plants
  • Avoiding eating wild berries and plants, especially if you have no information about them
  • Following working in the garden or fields, hiking, or camping, always wash hands thoroughly, prior to eating anything
  • Always follow instructions for usage of any health or cosmetic products
  • Keeping cosmetics, medications, and other healthcare products out of reach of children in child-proof containers
  • Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

It is important to give your healthcare provider a complete list of prescription and non-prescription medications that are being currently taken. This will help them in assessing the possible drug interactions within various medications and help avoid/prevent accidental or unintentional toxic drug effects.

What are certain Crucial Steps to be followed?

  • Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
  • Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
  • It would be helpful if the following information is readily available:
    • Type, amount and time of consumption of the substance
    • Age and weight of the individual
    • And, the overall health status of the individual

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: July 6, 2017
Last updated: Feb. 27, 2018