Should you be eating poison oak?
Guest: Jeff Horwitz, reporter at the Wall Street Journal; and Mahmoud ElSohly, professor of pharmaceutics at the University of Mississippi
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Every year, tens of millions of Americans get poison ivy, poison oak, or poison sumac rashes.
Tens of thousands of them end up in the ER.
And these rashes are the number one cause of disability and sick leave for firefighters in the Forest Service, more than fire.
So you'd think we'd have some kind of fix by now, right?
Like, we don't tell people to just stay out of the sun or totally avoid mosquitoes when they go on a hike.
We've got sunscreen, we've got bug spray.
And then for for poison ivy, all we've got is just telling people to avoid it, which is what most people try to do.
But a couple months ago, I talked to someone who's not exactly a runaway from problems kind of guy, he's more of a swallow-the-problem hole kind of guy.
So, he decided to try and make himself immune to poison oak by eating it.
Now, I assume your first question is just: why would someone do that?
I mean,
I'm kind of an idiot.
Jeff Horowitz loves to forage for these big orange mushrooms called chantrelles.
But the thing is that the habitat for chanterelles and the habitat for poison oak are pretty much identical.
It's kind of almost rare that you'd find chanterelles in a place where poison oak isn't.
And you still wanted to go get these mushrooms?
Yeah, no, I'm like, I'm real dumb.
Like, I would see a mushroom in the middle of an obvious thicket of Poison Oak where I'm just going to be crawling hands and knees through Poison Oak to get to it.
And I'd go in.
I'd go in, yeah.
Is it just because they taste so good?
They're really good.
And look, one of my strengths as an investigative porter is that I'm pretty tenacious.
You know, once committed to a thing, I will get there.
Yeah, when he's not crawling through Poison Oak, Jeff works as an investigative reporter at the Wall Street Journal.
If you've heard of the Facebook files, that was him.
You know, I have a hard time, shall we say, not pursuing the target.
You know, once committed to a thing, I will get there, barring like some insurmountable impediment.
And a future rash does not count as an impediment.
So over the years, Jeff kind of just got used to rashes.
You'll go home and be like absent-mindedly scratching.
And that's when it's too late.
The oil has soaked into your skin.
And within another 24 hours, redness appears,
which then graduates into like a oozy blistering mess that makes you want to scratch your skin off like down to the bone did you ever try to not get poison oak yeah um i mean i'd try to wear long sleeve clothing you know as soon as i got home i would basically strip throw everything i was wearing into the washing machine And then I would go shower in cold water with dish soap.
So like just a bottle of dawn.
And that usually did it, but like sometimes you'd miss a patch.
So it was not a foolproof system.
Eventually, Jeff got so frustrated with getting rash after rash that he started poking around in some online forums.
People were writing things in all caps like, it worked, I'm immune to poison oak, and then describing how they'd been eating the leaves.
But keep in mind, I cover social media and Facebook.
So like, I am very aware of the weaknesses of seeking confirmation, particularly for something that you want to believe.
And like dermatologist organizations, Backpacker Magazine, NPR, various hospital systems answered the question of like, can you become immune to poison oak?
And the answer to that was, hell no, you can't.
But remember, I'm kind of an idiot.
I'm Noam Hassenfeld, and this week on Unexplainable, Jeff puts his body and specifically his butt on the line to answer a seemingly straightforward question.
Is it possible to build up a tolerance to poison oak by eating it?
And if it is,
where are all our poison oak pills?
So, we've been talking about poison ivy, poison oak, poison sumac.
They're different plants, but they all have the same chemical called urushiol, which causes an allergic reaction in almost 90% of the population.
It's not a toxin.
It's just that most people's immune systems kind of go nuts when they touch it.
So, just like you can build up a tolerance to other kinds of allergens, Jeff thought he might be able to build up a tolerance to poison oak.
The whole idea here is that you're training your your immune system to stop freaking out when it encounters urushiol.
And so the plan was to like get to the point when I could just eat the leaves off of the plant and, you know, have poison oak salads.
There is a big issue here, though, right?
Like just touching the thing gives you a rash.
And Jeff was planning to eat it.
So he was worried it might give him this kind of inside out poison oak rash, like poison oak on the inside of his throat or his stomach.
But he had a plan.
Yurushiol doesn't work well across certain mucous membranes.
So the inside of the mouth, the throat, the stomach, all okay.
The main issues would be his lips.
So I got a straw for drinking poison oak smoothies and poison oak tea.
And his butt.
I definitely learned early on the Latin for, I believe it's puritis ani,
aka itchy butthole.
And just to be clear, itchy butthole might sound like it's not so bad, just a little annoying, but it's a real excruciating pain in the ass.
Like, I definitely, that was like kind of the thing that like I was most afraid of, if I'm being honest, is like having to show up to the doctor and be like, yeah, so I ate a whole bunch of poison oak and I regret that.
Like that, that seemed like it would be like really, really bad, you know, just a little mortifying.
So Jeff reached out to a scientist, Mahmoud El-Soli, who has spent a lot of time researching Yurushiol.
But unlike Jeff, he's been doing that research in a lab, not on internet forums.
And I kept on being like, yeah, but what if I eat it?
And so the good doctor was like, I'm not saying it wouldn't work.
I'm just saying that you probably don't want to do that.
And I was like, yeah, but you're saying it might work.
And he's like, yeah, but you're going to get regretted.
I was like, yeah, but that's a personal choice.
Like, you're saying this can work.
And he's like, I wanted to tell you, Jeff, if you really take the extract orally, you're going to absolutely get peri-analytermatites.
So this, this is, but basically your sense is that for it to work,
it's going to be very unpleasant.
Yes.
He's like, you're going to get a really itchy butt.
Still, Jeff is stubborn, kind of a glutton for punishment.
That is an identity, and yes, I do identify as such.
So he decided on a pretty extreme strategy.
He was going to take a full-on shower immediately after he took a crap, like every single time for months.
So any of that poison oak coming through his digestive system wouldn't end up doing what Mahmoud was worried about.
The concern was that perhaps using the bathroom and then not taking a shower might make things worse.
But Jeff had bigger worries than an itchy butthole, like whether this could kill him.
He did find a reference to potential death from smoke inhalation, like burning a bunch of poison oak and poison ivy, breathing it all in, getting it on your lungs.
But Jeff was just planning to eat the stuff.
Correct me if I'm wrong on this, but I haven't seen very much in the way of deaths from this.
You're not going to get that because you're going to get some kidney or liver issues, but not really lethal.
I'll cut back on drinking.
But your sense here is that, and correct me if I'm wrong here, I'm probably not taking any massive long-term health risks by doing this, right?
It's uh I wouldn't think so.
So this past January, Jeff started eating poison oak.
I dug up some roots while wearing latex gloves just to keep it off my skin and then, you know, made some tea.
It was like kind of earthy and, you know, not an unpleasant beverage.
I've definitely had much grosser herbal teas.
And then a few days later, again, wearing some gloves, I picked some early spring buds, like, you know, half the size of a pea, popped them on in, chewed them up, swallowed, and went back to foraging for mushrooms.
Jeff ate poison oak leaves while hiking.
He made omelets, he made tea, he made poison oak smoothies.
And then every few days, I would up dosage, with the idea being that if I, say, hit the point when it was going to start being a problem for me, I would at least like not have gone far past that line.
What does poison oak actually taste like?
So poison oak, like the leaves themselves, they're like kind of
vaguely tart, have like a kind of that like a little bit of the unripe fruit cottony feel.
Slightly sour, but like not bad.
Like honestly, like in a salad, if you're eating them, you would not be like, this is bad.
They're maybe a little bitter, but like so are endives, right?
And Radicchio.
So like they're perfectly pleasant enough to eat.
So if you kept eating more and more poison oak, how
big of a dose did you get up to?
You know, at first it was like maybe like one or two leaves, but you know, I was graduating up to like maybe 10 or 12 or so, you know, per smoothie, once every couple of days.
And then meanwhile, when I was out in the woods, I would continue just to like eat a leaf or two off the plant.
And did anything happen?
Not for a while.
And in fact, I get to a point where I'm like, okay, like, you know, moment of truth, let's see how this is working.
And so I take three or four leaves and I crush them up, you know, between my fingers, like roll them around.
And then I just smeared this paste on my back.
Oh, my God.
And then I put a bandage on top of it and then went to sleep for the night.
To like really smush it in?
Yeah, something like that.
Yeah.
So the idea here was like direct hit.
And so two days went by.
I thought I was like completely in the clear.
And then it started itching.
But here's the thing.
It was like a little localized redness.
And then it kind of like dried up and went away without ever graduating to like blisters.
So at this point, I'm like, holy hell, I'm onto something.
Like this actually is working for me because like pre-treatment, Jeff would have had like one gigantic boil.
But then a couple months ago, Jeff flew too close to the sun.
At this point, I was like, I thought I was pretty much to full immunity.
And man, I went big.
I went, I went.
I had like a full poison oak salad.
I had a smoothie that must have had like
50 or 60 leaves
ground up in there.
It was like a mega dosage.
Like I just went huge.
And
I had a somewhat difficult week.
What happened?
Basically, the Arushi all went systemic.
Systemic, like all over your body?
Yeah, this was bloodborne.
I had it popping up behind my ears, like down my jawline, my neck, my inner thighs.
It was starting to like run down my arm.
So I did manage to get full body poison oak.
Do you regret going so hard?
I mean, I think particularly at this point, because I was writing a story about it, I was like, okay, that's funny.
Like a man has fucked around and he has found out.
You know, and I enjoy both both those processes, both the fucking around and the finding out.
Jeff's Icarus moment is a good reminder for anyone else trying to do something like this.
The bottom line is that everyone's body and everyone's butt is different.
We've all got vastly different responses to allergens.
We've got different pain tolerances.
And we've obviously got different tolerances for risk.
I wouldn't want to convey to readers that this was something that could be done with zero cost.
There's some element of luck here, right?
Like some people respond super well to the treatment, other people get less from it, and there is more of a cost.
But in the end, despite a week of full body poison oak, which again, Jeff absolutely could have avoided.
I probably could have done this in a way that didn't involve a full body rash, but you know, where's the fun in that?
It still seems like mission accomplished.
I think at this point I am functionally immune.
I've been exposed to it and you know have sort of dispensed with the old dawn dish soap routine.
So like at this point I'm pretty much all the way there.
It's important to eat some leaves every spring just sort of to maintain that.
And plus, I mean, how could I ever possibly give up that party trick?
Okay, but if this ended up working for Jeff, why is like every single source from NPR to Backpack or Magazine so dead set against it?
Where's my poison oak pill?
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Charlie Sheen is an icon of decadence.
I lit the fuse and my life turns into everything it wasn't supposed to be.
He's going the distance.
He was the highest paid TV star of all time.
When it started to change, it was quick.
He kept saying, no, no, no, I'm in the hospital now, but next week I'll be ready for the show.
Now, Charlie's sober.
He's gonna tell you the truth.
How do I present this with any class?
I think we're past that, Charlie.
We're past that, yeah.
Somebody call action.
Aka Charlie Sheen, only on Netflix, September 10th.
And you are
poison.
Poison Ivy.
So if Jeff was able to DIY a poison oak fix, why isn't everyone talking about this or doing it themselves?
Especially because people have been doing things like this for a long time.
Some Native American tribes in California used to drink poison oak tea to desensitize themselves.
And it worked so well that they could actually weave baskets out of the stuff without getting rashes.
Yeah, there are like letters to the AMA.
back in the 1910s about people effectively treating severe cases of poison ivy.
And a lot of these letters came from scientists who were kind of like Jeff, you know, getting real results, but in a kind of rear ends justify the means sort of way.
Still, Jeff was doing this on his own butt.
Like most of these scientists were not that brave.
Like this one scientist in Texas in the 30s who ran experiments on his eight-year-old neighbor.
This kid was referred to in the medical literature as $2 Richard, who for the price of $2
would allow said scientist to basically intentionally expose him.
That same scientist also experimented on his kid's nurse, and it's honestly kind of horrifying.
Limbs swilled up to double their size, entire body turned fiery red.
But it did work.
She did, after a couple of months of just this like shock and awe, poison ivy treatment end up resistant.
These methods weren't great, to say the least, but they got results.
And And more reputable scientists started to see the potential here.
They started developing drugs and running real double-blind studies, like this one study on a drug named Aqua Ivy, which looked at a group of over 100 Coast Guard cadets.
They were assigned to like clear brush along the Mississippi River, so it just like poison ivy infested.
Half of them received poison ivy extract pills.
The other half received placebos.
And this stuff worked overwhelmingly.
Like all but one or two of them were like fully immune and then the remaining two had only like very moderate reactions.
Like very clearly this was doable.
Pretty soon these drugs started taking off.
They were being made by big companies like the predecessors of Merck and Pfizer.
They were given to people on military bases.
They were handed out to all kinds of outdoor workers.
There were literally ads in Time magazine.
You know, you'd have a picture of this kid with a straw hat fishing and the tagline would be like, he's up to his hips in poison ivy, but all he's going to catch is trout.
So the big question then is just what happened?
We had these double-blind tests.
We had publicly available drugs.
We had magazine ads.
Where did all that go?
Yeah.
So in the 60s, the FDA started reviewing what were called grandfathered drugs.
So these are drugs that like existed before the FDA did and were widely used.
And it turns out that some of them were bullshit, right?
There were a lot of drugs that just simply didn't work.
You know, they'd been around for decades, but like there just wasn't evidence for them.
And so the FDA formed these various commissions to sort of review which of these medicines are real, which of them need more testing, and which of them should just be thrown in the bin.
And the advisory panel on plant-based allergies, they were like the Arushiol-based treatments, fully effective, fully safe.
We just need to see some of the drug companies put together a study or two demonstrating the appropriate standardized dosage.
And
this never happened.
They like never gave the data to the FDA?
The drug companies didn't turn it in.
The FDA extended the deadline a couple of times, and then the stuff never got turned in.
Do we know why?
So we basically lost track of some of these records.
And I checked in with Merck and Pfizer about this.
They They don't have records either, because this is like, you know, five drug company mergers ago.
Now, it's hard to say exactly what happened here, but there are a few possibilities.
One is that they retested the drugs and couldn't conclusively show they worked.
You know, back then, you didn't have to report failed results.
It's also possible that there just wasn't enough money in it for the drug companies, especially when people could just make this stuff at home.
Or, and this is the explanation that I find most compelling, it might have just been too hard to give the FDA what they asked for, this safe, standardized dosage, because people have all kinds of different reactions to Yurushio.
Yeah, so my brother gets it really bad.
Like, seriously, it looks like monster movie survivor makeup.
I
get it a moderate amount.
And then on the other end, my wife just isn't allergic.
Most people don't get a reaction the first time they're exposed, but they only do once they've come in contact with it a few times.
It's what's called sensitization.
So companies might have pushed this dose too high at first, you know, just to make sure it actually produced an effect, which has some pretty obvious backsides.
I mean, downsides.
Like, there was a point in the 70s where there was a recall on a Yarushiol drug.
There were absolutely instances where people received extremely bad butt rashes slash some level of systemic skin-based outbreak.
On the other hand, drug companies might have pushed the dosages too far the other way, trying to play it safe.
Because again, like massive anal rash is not a side effect that I think many people are like cool with, even if it works.
The issue here really is it's not like it doesn't work or it works.
The issue is the level of how much it works relative to the problems that you get as a result of ingesting those mega-doses of poison ivy extract.
That's what scientist Mahmoud Al-Soli told Jeff when they talked at the beginning of this process.
Mahmoud has been doing research on potential treatments for poison ivy and poison oak for decades.
So I called him up and I asked him how he first got the itch to work on poison ivy.
I personally, where I come from, I come from Egypt.
We have no woods, we have no poison ivy, we have no nothing.
So I didn't even know what the heck poison ivy is.
But then I got to the University of Mississippi in 1975.
And when I got through working with the people in the institute, I got to realize this is really a major problem.
This is a condition that's really serious, affects a lot of people, but there is no answer to it on the market.
I figured there's got to be a way to take care of that.
Mahmoud knew that when you swallow Yerushiol, most of it ends up getting processed by your gut, by your kidneys.
So you need a lot of it to have any real effect.
That's why he wanted his drug to be an injection.
With an injection, he'd be able to take a derivative of urushiol and precisely target specific cells.
But the drug companies he was working with, they kept pushing for a pill.
We told them that it's not going to work orally.
But they said, well, we have to try that because eventually we want to have that as a over-the-counter thing.
And you couldn't have an injectable over-the-counter.
So that's why they wanted to go with the oral.
Those over-the-counter oral pills ended up failing.
The last one was taken off the market in the 90s, which is why Mahmoud thinks the injectable is still the best way forward, the best way to get a useful effect without leading to massive rashes.
And he is making progress.
His company, Hapton Sciences, is heading into phase two trials on an injectable right now.
And when he looks at what Jeff did with his smoothies and salads plan, even though it was successful, Mahmoud isn't convinced it's a legitimate alternative option here.
It's a one-subject experiment.
Is that something that would stand scientific scrutiny?
No.
So we can't really make conclusions based on that.
Could oral ingestion of poison IV extract lead, no matter what the cost is, to some degree of desensitization or tolerance, maybe,
but I don't believe that it is worth the risk.
And then, how many people would be willing to go through what he went through to do this?
Remember, Jeff isn't a normal person.
I mean,
I'm kind of an idiot.
And that might be the thing that made it work for him.
Most people aren't going to go take a full-on shower every time they go to the bathroom for for months.
My personal view and the whole story is this is someone who was curious enough to take the risk of doing something that is out of the norm to see where this is going to take me.
I mean, I admire him for doing this, but if it tells me anything, it tells me that's not the way, that's for sure.
But who knows?
Sometimes it takes an idiot to move science forward.
Maybe Jeff will end up being someone else's $2 Richard, the kind of reckless one-subject experiment that inspires someone else to take the baton and come up with a new, testable solution.
Maybe many years from now, science museums are going to have giant busts of Jeff's rash-free butt,
even if Jeff isn't exactly having a lot of luck getting people to try out his plan.
You know, I respect that.
Makes a lot of sense.
Probably the wiser choice.
This episode was reported and produced by me, Noam Hasenfeld.
We had editing from Jorge Just with help from Meredith Hodenat, who runs our team.
Mixing and sound design from Christian Ayala, music from me, and fact-checking from Melissa Hirsch.
Manding Wynn is looking through the lost and found, and Bird Pinkerton made her pitch to the tortoises.
She told them about the octopuses, about the platypuses, about the birds.
The head tortoise slowly moved his head up, and slowly, slowly moved his head down.
The tortoises were in.
Or at least that's what Bird assumed.
They were nodding really, really slowly.
Thanks to Raymond Fag for his help this week.
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