Home > Uncategorized > Eating Too Much Bok Choy Puts 88-Year-Old Woman in Coma

Eating Too Much Bok Choy Puts 88-Year-Old Woman in Coma

A daily diet of more than two pounds of raw bok choy, a vegetable often used in Thai and other Asian dishes, sent an 88-year-old Chinese woman into a coma — and doctors determined an enzyme in the uncooked produce was the culprit.

The woman, who wasn’t identified in the “New England Journal of Medicine” report about her case, was rushed to the emergency room of New York University’s hospital in New York City last summer by her family after she became lethargic and lost her ability to walk and swallow for a period of three days.

She had been eating between 2 and 3 pounds of raw bok choy, or Chinese white cabbage, each day for several months in the belief that it would help manage symptoms of her diabetes.

But when she arrived at the hospital, the woman was suffering from extreme hypothyroidism, respiratory failure and a thyroid-linked, potentially life-threatening type of coma, according to the NEJM study and NYU’s Dr. Michael Chu, a resident who helped treat her with endocrinologist Dr. Terry F. Seltzer.

The patient, who also had coarse hair, dry skin and other symptoms, was admitted to the intensive care unit. Chu said she ate about two to three large heads of the bitter-tasting cabbage without any seasonings, salt or dressing.

“The patient was eating large amounts of raw bok choy, and the majority she was eating plain,” Chu told AOL Health. “It didn’t really ever come across that it was burdensome for her. … At one point when she was in the hospital, her family was asking if she could continue eating it. We recommended that she did not.”

But though she thought she could stomach it, her body couldn’t process so many stalks of the leafy vegetable, which along with other types of cabbage contains an enzyme called myrosinase that, in excess, can shut down the thyroid. Cooking the bok choy would have taken the dangerous enzyme out. The woman had no history of thyroid disease.

“Certain food types within the cabbage family are known to cause the thyroid to stop producing or increase production of the thyroid hormone,” said Chu. “The enzyme decreases the uptake of iodine into the thyroid, and iodine is necessary for production of the thyroid hormone.”

Hypothyroidism happens when the butterfly-shaped thyroid gland in the throat, which controls metabolism, becomes underactive and produces abnormally low levels of the thyroid hormone — causing fatigue, weight gain, problems breathing, thinning and brittle hair, dry skin and a slowed heart rate. A complete shut-down of the gland, as experienced by this patient, can be deadly.

“It’s kind of a unique thing — you really have to have the intention to eat so much in order for it to have such effects,” Chu told AOL Health, adding that the doctors weren’t able to determine exactly how much raw bok choy is too much. “She was pretty sick when she came into the ER.”

Though her condition was described as a myxedema coma, Chu said the term can be misleading because the patient didn’t slip into unconsciousness.

Doctors intravenously administered significant amounts of a synthetic thyroid hormone and a strong anti-inflammatory medication in order to save the elderly woman’s life, according to Chu. After four to six weeks in the hospital, she got better and was transferred to a nursing rehabilitation facility.

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