Toxic squash syndrome: If it’s bitter, it’s not dinner
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The bottom line
Toxic squash syndrome is caused by eating gourds that contain high levels of cucurbitacin. These squashes look and smell normal, but taste very bitter. Toxicity occurs when a very small amount of high-cucurbitacin squash is ingested. Symptoms include diarrhea, nausea, vomiting, and abdominal pain, which may lead to dehydration, low blood pressure, fast heart rate, headache, and dizziness. Treatment includes taking oral or intravenous fluids.
Prevention tips
Take a very small taste of raw squash, pumpkin, zucchini, and cucumber to check if it is bitter.
If it is bitter, spit it out and throw it away.
Do not cook, boil, or bake bitter-tasting squash. The toxin cannot be inactivated by heat.
Do not eat wild squash that you did not plant in your garden.
Buy seeds from a garden center with a good reputation.
Buy new seeds each year.
In your garden, be sure plants are kept hydrated and the soil contains nutrients, including fertilizer.
Do not plant edible and nonedible varieties of squash close to each other.
This really happened
A 55-year-old woman ate bitter-tasting spaghetti squash. She developed nausea and abdominal pain initially, and then 90 minutes later experienced vomiting, diarrhea, and an altered mental status. The next day, she developed a rash on her arms and face, which gradually resolved. Five days after ingestion she experienced hair loss. At 3 months she had dry skin and short, brittle hair. One month later, her hair was regrowing. The final diagnosis was squash poisoning.
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What is toxic squash syndrome?
Toxic squash syndrome is caused by eating gourds that contain high levels of cucurbitacin. Cucurbitacin is a bitter-tasting chemical sometimes found in squash (including spaghetti squash, butternut squash, winter squash), pumpkins, zucchini, and cucumbers.
Plants produce cucurbitacin as a defense mechanism against insects and animals that feed on plants. Decorative squashes such as colocynths are not edible since they contain high concentrations of cucurbitacin.
What does toxic squash taste like?
Squash with a high level of cucurbitacin will taste very bitter but otherwise look and smell normal.
What should I do if I ate bitter-tasting squash?
If you take a small taste, spit it out. Discard the rest of it. If you ate it and are experiencing gastrointestinal symptoms, make sure you stay hydrated. Seek medical attention if you cannot tolerate oral fluids because of vomiting, or if symptoms are severe, consist of more than just gastrointestinal symptoms, or last more than a day.
If you suspect you are experiencing toxic squash syndrome or have questions about toxic squash syndrome, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
Why do some squashes become toxic?
When squash and other gourds are under stress due to conditions such as high heat, drought, poor soil, or insect damage, the plant produces high levels of cucurbitacin.
Farmed gourds that are sold in grocery stores are bred to contain only very small amounts of cucurbitacin. However, sometimes wild toxic gourds that contain high levels of cucurbitacin accidentally cross-pollinate with domestic gourds.
What are the symptoms of toxic squash syndrome?
Symptoms occur within minutes to hours after ingestion. The symptoms are mostly gastrointestinal, including diarrhea, nausea, vomiting, and abdominal pain. This may lead to dehydration, low blood pressure, fast heart rate, headache, and dizziness. Rarely, ingestion can lead to temporary hair loss.
How is toxic squash syndrome treated?
Toxic squash syndrome is treated supportively. If symptoms are relatively mild, dehydration is prevented by administration of oral fluids. More severe cases in which dehydration occurs may require intravenous fluid administration. If blood pressure does not increase with fluids, drugs that constrict blood vessels (vasopressors) are administered.