Thread by @NaturesPoisons

Happy Monday!
I'm often asked what the "best" poison to die from is - i.e. quick or painless. Well, the other day a colleague asked me what I thought the "worst" poison was. There's no right answer, but I almost always go with colchicine. A 🧵

Colchicine is a prescription drug used to treat gout but it also has the most lovely natural sources, like the autumn crocus and the flame lily 😍. I'm sure you can figure out which is which.

As a drug, colchicine has a very narrow therapeutic window - meaning the difference in the amount of drug that does good, to that which harms, is small. This means the risk of toxicity is high.

So why is this bad? Colchicine inhibits mitosis - if you remember, mitosis is the cell cycle process of splitting chromosomes into two identical nuclei. It's how our cells replicate, and they are replicating all the time. All. The. Time.

If you want to get super dorky, colchicine inhibits microtubule polymerization during metaphase. This is also how a lot of chemotherapeutic (anticancer) agents work. If cancer cells can't replicate, cancer can't grow...but neither do non-cancerous cells.

So colchicine poisoning is like getting chemotherapy, and if you've had it, or witnessed it, it's not pleasant. Clinically, poisoning manifests itself in three stages.

The first stage: Gastrointestinal distress. The fast-growing cells in your GI tract are unable to replicate and become a shredded mess. There's a lot of pain, nausea, vomiting, and diarrhea. This starts ~8-24 hours after ingestion. It's bad, but it gets worse.

The second phase is organ failure. You're probably in the hospital already because of stage 1 - and you'll be there a while. Over the next week, your kidneys and liver stop working, and it's hard to breathe on your own. This is where most people die, often from cardiac arrest.

If you somehow make it to stage three, congratulations! You'll probably live and you're rewarded by all your hair falling out - but hey, you're alive. You'll probably spend another week in the hospital.

That's why I think it's so bad. It is a slow, messy, painful, dramatic, drawn-out death. And there's no magical antidote or Harry Potter bezoar to save you, just supportive care from the doctors and nurses busting their asses to keep you alive.

Most poisonings are accidental - sometimes the flame lily tuber (root) is confused for a yam and eaten, with drastic results, or autumn crocus bulbs confused with wild onions. But colchicine has been used for murder!

In 2015 Mary Yoder, a chiropractor in New York, died from colchicine poisoning. It was horrific and shocking, and the case confusing as hell. I'm not sure we'll ever fully know what exactly happened, but here is a recap of it: truecrimedaily.com/2016/10/26/rec…

It was also the subject of the Oxygen channel's TV show "Killer Motive" - Season 2, Episode 4: "A Healthy Dose of Murder."

So that's one of my "worst ways to die": Colchicine, an ugly drug from a beautiful source. So happy Monday, and if you're in the U.S., enjoy the short week due to Thanksgiving if you've got time off.

BONUS: I should also point out that colchicine has agricultural uses. It is used to inhibit mitosis and induce polyploidy - "multiple chromosomes." It can make some plants and fruits bigger and is used on things like orchids and cannabis. It's also how we get seedless waermelons!