Grayanotoxin poisoning is associated with which exposure?

• A. Consumption of honey produced from the pollen and nectar of rhododendrons
• B. Eating sub-tropical Bar Jack fish
• C. Eating improperly chilled Tuna or Mahi Mahi
• D. Eating improperly cooked Escolar fish

Answer: (A)

Grayanotoxin poisoning occurs when people eat honey made from the nectar of rhododendron plants. The grayanotoxins in that honey affect nerve and muscle cells by keeping sodium channels open, leading to abnormal depolarization and autonomic effects. Clinically this shows up as dizziness, nausea, vomiting, sweating, and often low blood pressure with a slow heart rate—classic signs of “mad honey” intoxication.

Other exposures listed cause different fish-related toxins, not grayanotoxins. Improperly stored tuna or mahi-mahi can lead to histamine (scombroid) poisoning, while escolar contains a different toxin that can cause GI distress; these are not due to rhododendron-derived grayanotoxins.