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Azaleas and Rhododendrons

The Bottom Line

Serious poisoning is unlikely when small pieces of azalea or rhododendron are swallowed. But swallowing large amounts of any part of the plant or honey made from these flowering plants can cause life-threatening symptoms.

The Full Story

One of the earliest accounts of mass poisoning dates back to the first century BCE when Roman troops were allegedly poisoned with honey by the Heptakometes of Turkey. The Roman soldiers were reported to be confused and vomiting and subsequently defeated in battle after eating the honey. We now believe that they were given honey made from the nectar of the flowering plant Rhododendron luteum.

Azaleas are very close relatives of rhododendrons and can cause the same type of toxicity. The toxic component of rhododendrons and azaleas can be found in very high concentrations in honey made by bees that feed on them. This usually occurs in dense populations of these plants, particularly in the Mediterranean region. In fact, the majority of more recent reports of poisoning from rhododendron and azaleas occurred in Turkey where people ingested the poisonous honey produced accidentally by small-scale beekeepers. There are also a few reports of toxicity in people who intentionally ate the honey because of a false belief that it could help with some ailments.

The poisonous honey is commonly referred to as "mad honey," a nickname earned because of the confusion it is known to cause. The toxin can cause very low blood pressure and heart rate as well as irregular heart rhythm. These symptoms could be life threatening.

Ingestion of the "mad honey" is not the only way people have been poisoned by azaleas and rhododendrons. Eating the leaves, nectar, or flowers of the plants can also lead to toxicity. Although rare, serious and life-threatening toxicity has occurred when people intentionally ate the plant. Similar to myths surrounding “mad honey,” there are some areas of the world where the plant is believed to have medicinal properties.

Poison Control is often called in the spring and early summer about children who put the flowers or leaves in their mouths or try to eat them, or when children mistake the flowers for honeysuckle and suck on the nectar of the azalea flower. Generally, only mild symptoms such as mouth irritation, nausea, and vomiting are expected from such cases. Still, it is important to keep a close eye on children and pets when they play outdoors to be sure they do not eat any flowers, leaves, fruits, or seeds. If azaleas or rhododendrons are kept indoors for decoration, be sure to keep them out of reach of children and pets. Finally, do not prepare food or tea from plants growing in the wild or in your yard. 

Serkalem Mekonnen, RN, BSN, MPH
Certified Specialist in Poison Information


For More Information

Skin Problems from Outdoor Plants (The Poison Post®)

True Stories for Springtime (The Poison Post®)

Poisonous and Non-Poisonous Plants: An Illustrated List

Daffodils (The Poison Post®)

Foxglove: Toxic to the Heart (The Poison Post®)


References

Hoffman RS, Howland MA, Lewin NA, Nelson LS, Goldfrank LR. Goldfrank’s toxicologic emergencies. 10th ed. New York: McGraw Hill; c2015. Chapter 121, Plants; p. 153-26.

Islam MN, Khalil MI, Islam MA, Gan SH. Toxic compounds in honey. J Appl Toxicol. 2014;34(7):733-42.

Jansen SA, Kleerekooper I, Hofman ZLM, Kappen IFPM, Stary-Weinzinger A, van der Heyden MAG. Grayanotoxin poisoning: ”mad honey disease” and beyond. Cardiovasc Toxicol. 2012;12(3):208-15.

Klein-Schwartz W, Litovitz T. Azalea toxicity: an overrated problem? Clin Toxicol. 1985;23(2-3):91-101.

Lee SW, Choi SH, Hong YS, Lim SI. Grayanotoxin poisoning from flower of Rhodondendron mucronulatum in humans. Bull Environ Contam Toxicol. 2007;78(1):122-3. 

Poisoned?

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Prevention Tips

  • When outdoors, watch children and pets closely to be sure they do not eat unknown plants, seeds, or berries.
  • Do not prepare your own herbal medicines.
  • Do not prepare food or tea from plants growing in the wild or in your yard unless you are an expert and know how to do so safely.

This Really Happened

A 5-year-old child sucked on three azalea flowers after mistaking them for honeysuckle. Her mother called Poison Control for advice when the child complained of a stomachache. Poison Control told the mother that toxicity was not expected from such a small amount. The mother was advised to give child fluids to drink and to observe her.

Poison Control called back the mother 3 hours later. The child had no symptoms.