Menthol Toxicity: An Unusual Cause of Coma

Baibars, Motaz; Eng, S S; Shaheen, Khaldoon; Alraiyes, Abdul Hamid; Alraies, M. Chadi

doi:10.1155/2012/187039

Cited by 26 publications

(14 citation statements)

References 8 publications

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“…Chronic ingestion of menthol (non-specifically described as consuming "two bags" of menthol rich cough droplets; [10 mg] per droplet) has also been reported. This caused coma and ataxia alongside skin lesions, and gastrointestinal and neurological symptoms in an older individual [1]. Symptoms of this nature have been reported in isolation across experimental models [51,56], though the most common side effects of menthol are related to allergic contact cheilitis, e.g., dermal reactions to the use of menthol containing lip balms [70].…”

Section: Health Effectsmentioning

confidence: 99%

Menthol as an Ergogenic Aid for the Tokyo 2021 Olympic Games: An Expert-Led Consensus Statement Using the Modified Delphi Method

et al. 2020

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Introduction Menthol topical application and mouth rinsing are ergogenic in hot environments, improving performance and perception, with differing effects on body temperature regulation. Consequently, athletes and federations are beginning to explore the possible benefits to elite sport performance for the Tokyo 2021 Olympics, which will take place in hot (~ 31 °C), humid (70% RH) conditions. There is no clear consensus on safe and effective menthol use for athletes, practitioners, or researchers. The present study addressed this shortfall by producing expert-led consensus recommendations. Method Fourteen contributors were recruited following ethical approval. A three-step modified Delphi method was used for voting on 96 statements generated following literature consultation; 192 statements total (96/96 topical application/mouth rinsing). Round 1 contributors voted to “agree” or “disagree” with statements; 80% agreement was required to accept statements. In round 2, contributors voted to “support” or “change” their round 1 unaccepted statements, with knowledge of the extant voting from round 1. Round 3 contributors met to discuss voting against key remaining statements. Results Forty-seven statements reached consensus in round 1 (30/17 topical application/rinsing); 14 proved redundant. Six statements reached consensus in round 2 (2/4 topical application/rinsing); 116 statements proved redundant. Nine further statements were agreed in round 3 (6/3 topical application/rinsing) with caveats. Discussion Consensus was reached on 62 statements in total (38/24 topical application/rinsing), enabling the development of guidance on safe menthol administration, with a view to enhancing performance and perception in the heat without impairing body temperature regulation.

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Section: Health Effectsmentioning

confidence: 99%

Menthol as an Ergogenic Aid for the Tokyo 2021 Olympic Games: An Expert-Led Consensus Statement Using the Modified Delphi Method

et al. 2020

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“…Chronic exposure to menthol ingestion has been reported in the USA and is associated with cutaneous, gastrointestinal, and neurological manifestations. [ 3 ] A high dose of peppermint oil ingestion was also reported where the patient presented in transient shock, hematuria, renal, and respiratory failure. [ 4 ] Renal dysfunction is common probably because of interstitial nephritis.…”

Section: Discussionmentioning

confidence: 99%

A fatal case of menthol poisoning

Kumar

Baitha

Aggarwal

et al. 2016

Int J App Basic Med Res

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Menthol is a monocyclic terpene alcohol, which is present naturally in peppermint and can be synthesized artificially as well. Generally, it is considered as very safe and has wide usage in medicine and food. There are case reports of toxicity due to excessive consumption of menthol, but a fatal intoxication has never been reported in the medical literature. We present a case of fatal menthol intoxication in a worker, who accidently got exposed when he was working in a peppermint factory. Emergency physicians must keep in mind this extremely rare manifestation of menthol poisoning. All necessary precaution should be taken to reduce its intake or exposure, as it has no specific antidote. Early recognition and supportive treatment of this poisoning is the key for a successful outcome.

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“…Though this act fixed the maximum level of menthol in pan masala at 0.1% (1.0mg/g), it was noticed that as many as 75% of samples of branded pan masala contained 1.1-6.5mg of menthol per gram of the product and in non branded pan masala up to 92% of the samples contained 1.1-6.5mg of menthol per gram of the product [66] . There were reports to show that chronic intake of menthol was injurious to human health [67] . Most of the pan masala and pan flavorings found in Indian market were reported to contain artificial sweetener, saccharin, a known urinary bladder carcinogen, in several folds higher than the maximum levels permitted by the Prevention of Food Adulteration (PFA) Act of India [68] .…”

Section: Adulteration In Pan Masalamentioning

confidence: 99%