Theobromine poisoning in humans?

My ladyfriend believes she may have been poisoned by theobromine the other day. She consumed a large volume (about 4 grams) of "RAW" chocolate recently available at some health food stores in the form of a shake mix (what liquid she mixed it with I can't be sure likely either water or unsweetened soy milk and raw honey. Soon she begin to act strange and intoxicated(that was her goal too...a chocolate high). Also before she went to bed she took an unprescribed amoxicillan(I'm not sure of the spelling here) pill to treat an ear problem she's been complaining about. That night I noticed she was sleeping very poorly, light and jittery, the next morning I saw her wake up to go to the bathroom staggering and with poor motor and slurred speech. When she came back to bed she complained of rapid heart beats and she sat up breathing heavily...I lisatened to her heart beat and noticed it would race and then slow to extremes somewhat in key with her heavy breathing. I told her to try to breathe normally and calm down...When she couldn't slow her breathing for long, we called the EMT to take her to the nearby hospital. The EMTs said her blood pressure was a little high and that she was getting 100% oxygen (THATs good right?) before they left she began to complain of numbness in her hands and feet...nausea, inability to speak through her breathing.
They got her to the hospital (Midwestern Regional in Zion, IL)
The Emergengy room services in the hospitals around her go from very bad to worse. Through her poor speech problems she tried to explain everything that happened while they grilled her and treated her like a junkie (I regret that I didn't ride in the ambulance with her to the ER because of this, but I arrived a short while later.) When I got there they asked me if she'd had a stressor or a history of psychosis I said no, but she has been under a great deal of stress lately...so i guess they were under the impression she had just lost her marbles..since she tried to tell them about the raw chocolate...so without running any more tests than what a school nurse would run, not even checking her ears, despite the fact that we told them about the amoxicillan and the ear poblems, after monitering her vitals(with the ekg machine they did a very traumatic venupuncture she still has bruising from) they write her off as hyperventillating give her benadryl to slow her heart down and tell her to rest and follow up with the md..(and later after I learned how they treated her I called up there for answers and i wanted them to run those tests since we will inevitably PAY for the visit right? they recommended the same md that runs that ER...the same md that just saw her there...Ptui! they MAKE you sick around here!)
Well anyway to kinda shorten things here...the benadryl helped control her pulse and i stayed with as she rested that day...the problem is and why i'm still on here looking for answers is because she still complains about the problems a week later it seems she was damaged into frailty by this experience...her pulse rate seems to increase periodically, particularly in the morning...she also has complained about pains in the area about her pancreas and spleen...she binged on fruity pebbles cereal once and she got sick again though less severely, one day she got more bad news and decided she would risk drinking a beer, we thouogh since she had been feeling better it'd be ok but no she got sick, we think anything with refined sugar or that becomes sugar in the blody(like alcohol does) will cause her to get sick, were struggling to get her to the doctor with no medical coverage no money and no time off from work (Quill corporation should be investigated for their treatment of workers particularly ethnic ones she said there was only like 3 black people working in her entire building until Staples bought them out, they didn't even want to excuse her absence the day she was hospitalized even though I called her supervisor for her and left a message telling him I sent her to the ER!)
anyway she still complains about her abdominal pains (spleen,etc), sometimes she says she feels intense and fluctuting points of high "pressure" in her sinus areas, ears ,head,neck,and jaw near the lymph nodes, she gets headaches every day...
We know that cocao (theobromine) can kill dogs, and many other mammals but we've yet to read anything about it even hurting non allergic humans, but then we don't think there are any studies on the matter...does anyone have any ideas about this?

This same thing just happened to me. I know better than to eat chocolate before bedtime because it makes me sleep poorly. Regardless, I ate a big brownie before bed two nights ago. I just returned from a long-distance flight, so I was also jet-lagged. I woke up in the middle of the night feeling very disoriented. I got up to let the dogs out, and discovered that my motor skills were impaired too. I woke my husband up and told him I thought that something was very wrong. We tried to take my temperature (I was starting to shiver) and blood pressure (my heart was racing), but I my symptoms were escalating so quickly that I told my husband to take me to the hospital immediately. By the time we made it to the hospital, it was really bad. It was as though I was intoxicated. My speech was slurred, I had trouble focusing, and my motor skills were impaired. My symptoms seems to come in "waves." It would get really bad, and then subside for a few minutes. I was totally disoriented as I had trouble answering the doctor's questions, time was distorted, and all my social inhibitions were gone (I was yelling, crying uncontrollably, talking total jibberish, etc.) During the times that my symptoms were better, I was "with it" enough to be embarrassed about my behavior. I could do nothing about it though. I felt like I was "stuck" somewhere between being asleep and being awake. It was like I was high on drugs or alcohol (which I was definitely NOT...I did not have alcohol or drugs before this episode.) I felt like they were interrogating me as though I were on drugs, though. Which made me feel even worse! My husband kept confirming, "She has NEVER behaved like this before." I was so disoriented, I kept asking him if I was making this up. He kept confirming, "No, something is really wrong here, you are acting as though you were really drunk." After a few hours, my symptoms had subsided slightly, so they checked me out of the hospital. After ruling out drugs, a stroke, aneurysm, etc., they said I was having a panic attack. This made me very upset. I was NOT having a panic attack. Something very strange happened to me, and I believe it is related to eating a lot of chocolate before bed. I have researched chocolate poisioning, but it looks very rare in humans. Does anyone have any idea of what may have happened to me?

I have had severe reactions to chocolate my entire life. Small amounts are ok, but anything over a piece or two of candy and im screwed. It starts several hours after eating it with a very specific pinpoint headache that gradually gets worse and worse until it feels like a spike is being driven in between my eyes, as this progresses i start to feel what i can only describe as "greasy" inside and out, my heart beats irregularly, my blood pressure goes up, i get shakey, weak, cold, and feel like i have to vomit. The more i eat the worse it ends up. Sleep is the only cure, ive yet to find a painkiller that helps. It will competely ruin an entire day. The symptoms are so specific i can tell when ive accidentally eaten something containing chocolate. I would rather have the worst hangover ive ever had multiplied by 100 than feel the way i do after eating chocolate.

Your friend has a serious problem with theobromine. I had the same first I thought im allergic to caffeine but the truth is its theobromine. So no chocolate, coffe, tea or anything that contains xantines (caffeine, thobromine, teine) as all of them are eventualy metabolised to theobromine.
She will slowly recover - it took me about 2 years to get back to normal.
After a month she should not have any major symptoms.
In the mean time cut on food that is stresfull - red meat, fat, milk and cooked food instead eat loads of greens.
If she would continue to consume xantines she would experience even more traumatic things: delusions, toxic psychosis, numbnes, low body temperature and death.

Unfortunetely she wont get any help form doctors (other than isolation in psychiatric ward )as there are very few that ever heard about it.

mat

I just came down with the worst poisining.....I had bought some HIGH quality chocolate about 3 weeks ago...Dark, Belgian....an 8$ bar anyway it has been sitting in the office uneaten..I went to town on it at about 5:30. By 6:30 I couldn`t even stand up in the store, I started having tremors and decided to go to my wifes apartment (were split rite now) anyway I`m lying down and of course she is not taking me serious at all.

The worst part is she is studying to be a nurse.

I couldn`t take it anymore, I linked it to the chocolate and induced vomiting.
Brown , My diareha was brown, my throw up always taste like chocolate. Everytime I moved I would get tremors. Actualy I am still getting tremors a bit now.

5 hours until it was all gone.........the worst experience of my life, my X was just like, oh, you have the stomach flu, grow up, im busy.........I wanted to slap her!!

(*&?%$/ Dark Chocolate forever!!!!!!!!!!!!!

Theobromine breaks down into the same metabolites as marijuana. Read an organic chemistry book. Theorhetically you can get high on chocolate. The darker the chocolate the more theobromine it has. These various symptoms very well could have sent you into a panic attack which are more common than people think. The first reports numbness was due to hyperventilating - your extremities and face get numb and tingly due to your blood pH being alkolotic (>7.45). Eventually you will pass out and return to normal by slowing your respirations and returning your blood pH to normal - 7.35-7.45. Being a nursing student doesn't mean a thing about understanding the body and its normal and abnormal functions. I am an RN, have been a nursing student (obviously), and am currently a nursing instructor of 12 student nurses. Everybody thinks nurses and doctors know everything which is totally false. Experience counts more than anything. I have seen nursing and medical students who could get A's on every test who I wouldn't let touch my family or myself for all the money in China (where most of our money is currently coming from). I've known 20 year LPN's who no more than MD's and 20 year MD's who can know what is wrong with a pt in the first 5 minutes of questioning. And so do you if you think about it. I never had blood taken or labs done when I was a kid because my doctor knew what was wrong without all that crap. The lawyers/insurance companies make todays MD's prove everything with either positive or negative tests so they can approve or deny claims. Lab tests and or xrays basically tell lawyers or insurance companies that the MD had a clue what they were looking for in the first place. CYA runs medicine now, not MD's. Why do you get a $1500 head CT when you go to an ER and complain of a headache. CYA. Cover Your Ass for those of you who don't know what that means. Most people would be cured of their headache with some OTC's and a little caffeine. The CT just rules out a 1 in 10,000 chance of a head bleed that the MD would get his but sued off for if he missed.
At the same time, people in medicine are held to high standards (as they should be) but we get screwed when we can't help a patient right away who has no idea what medication they are on or even why or can't tell us if they even have any existing medical problems. "I take a blue pill in the morning and a little white one when I go to bed." What are those medications for? "I don't know, the Dr just told me to take them." Meanwhile let me go out and smoke and don't worry that I'm 30-150 pounds overweight and I haven't exercised in 12 years and I don't have money to pay the inflated hospital bill (thanks again to the lawyers) but I can buy $5/pack cigarettes and an iphone/$100 per month cell bill. Any questions? Call 1-719-589-2510 and ask to speak to the CEO of our hospital. He'll be glad to help you since your a customer.

[Teepo]

I'm just another ignorant MD, so take what I say with a big grain of salt...but here goes.
Theobromine is in chocolate at highly variable levels, usually highest in quality dark chocolates. It is a member of the chemical family known as methylxanthines, with other popular members including caffeine and the medication (formerly) often used in treating asthma, theophylline. Theobromine is broken down to various metabolic products in the liver by the CYP enzyme system. High blood levels of theobromine are quite toxic - that is why dogs can easily die from eating chocolate - fortunately most of the commercially available inexpensive chocolates have low levels of theobromine, so many a dog keeper have been lucky with the level of ingested by their sweet-toothed friends. Toxicity in humans has been described as relatively rare because the makeup and levels of the liver CYP enzymes that break down theobromine are such that the blood levels are kept low (where is the first place blood goes after absorbing substances from the intestines? --> that's right, straight through the liver, often referred to as "first pass metabolism", and it protects from large amounts of toxins getting circulated around the body). The problem is that the particular CYP enzymes made by the liver vary quite a bit in humans - thus, there are people who are "slow metabolizers" for certain substances because the CYP enzyme(s) that breaks down the substance may be at low levels in particular individuals. This is based on genetics of the individual. An analogy can be made here with the breakdown of alcohol by certain ethnic groups --> the body first breaks down alcohol to acetaldehyde, a highly toxic substance; but levels of acetaldehyde do not normally build up to toxic levels because of a second enzyme known as acetaldehyde dehydrogenase, which quickly metabolizes acetaldehyde to the harmless molecule acetic acid (like in vinegar) - yet some persons of far eastern decent have a dominant mutation in the gene that codes for this enzyme - when they drink, acetaldehyde quickly builds up. To take the analogy further, certain drugs can inhibit the activity of acetaldehyde dehydrogenage, like the antiparasite medication metronidazole (Flagyl) or the drug disulfiram (Antabuse) used to prevent use of alcohol in alcoholics. If someone who is normally tolerant of alchohol takes disulfiram, any later ingested alcohol will result in high levels of acetaldehyde - with its characteristic flushing, increased respiration and heart rate, nausea, etc. So, back to theobromine. Genetically your DNA may code for little of the CYP enzymes that break down theobromine, and, further, you may have had other substances that impair the efficiency of the theobromine-metabolizing enzymes that you do have - I am not sure if amoxicillin is on the list, but something to consider - also, particular foods and beverages can impair the efficiency of certain CYP enzymes - consider that caffeine probably uses a similar array of enzymes, so if a lot of caffeine is on board, it may make theobromine toxicity more likely. It sounds like the amount of that particular chocolate you had (and potentially other items in your system inhibiting the efficiency of the particular CYP enzymes - amox? caffeine?) was enough to put your life in serious jeopardy. You should look up the various ways methylxanthine toxicity can manifest - such as hyperventilation causing secondary alkalosis, hypokalemia, cardiac arrhythmias, seizures, etc. - it ain't a pretty picture, and is easily fatal. In addition to the ER measures taken, you should have been given activated charcoal to absorb any remaining theobromine still in your gut - otherwise more of the poison keeps going into your system. The hypotension is usually treated with IV fluids and vasopressors such as alpha agonists (such as phenylephrine), and beta-antagonists are often cautiously used if hypotension does not respond to the above. Benzodiazepines are often used if seizures are present.
But the take home message for you is STAY AWAY FROM CHOCOLATE!

You can't die from chocolate - give me a break. You'd have to eat maybe 50g of theobromine (g not mg) which is like 20 lbs of chocolate! Here is the material data safety sheet for theobromine: http://www.tciamerica.com/catalog/T0178.html.

Your ladyfriend most likely suffered from a panic attack. I've been in that ambulance ride when I had a panic attack and they ask you all those junkie questions. Those people see 300 junkies a day, on top of blood and guts. They don't really care about people('s emotions). Your friend was just another body to them.

I eat super dark chocolate all the time, and yes I get jittery. A whole bar in one day is too much for me. And yes, you can even give it to your dog, but only a sliver at a time. Dogs can eat a ton of white chocolate, maybe a square of milk chocolate, and maybe a fleck of dark chocolate. Luckily my cat hates chocolate.

Chloe S.

[Teepo]

"Dogs can eat a ton of white chocolate, maybe a square of milk chocolate, and maybe a fleck of dark chocolate."

Wow, did you really say that??! That is akin to saying dogs can ingest lots of water that has no arsenic in it, a small amount of water with a little arsenic in it, and a drop of water with more concentrated arsenic in it!

I really do hope that you do not keep any dogs!!!

I had the same symptom about 21 years ago as this lady. I did wind up going to the ER and the doctors were at a loss to diagnose the illness. Its real sad that when a doctor can't find a cause they simply blame the victim with a psychological issue rather than admit they simply don't know... I can't think of a more arrogant diagnosis. Probably more than half of their knowledge comes from pharmaceutical companies who provide their medical school with free samples and instructions on what free sample to use based on various symptoms.
I have been ill for 21 years.. disabled for 10. I had several doctors tell me it was a panic attacks. But then they said it was epstein barr virus, then I was told chronic undiagnosable Lymes Disease then Chronic Fatigue Syndrome then I was told Fibromyalgia. My family who are not understanding because of the blue collar hard work in a white collar job mentality that we were raised are at a loss and simply ignore me cause they are baffled and lack compassion. There are some symptoms that you can't imagine like chronic ringing in my ears some days worst than others, gums bleeding very easily, numbness on the side of my face, cold night sweats 9 out of ten nights, nightmare for a year and a half, hair falling out of my head in clumps, hair falling out like eye brows, nasal hairs and in the last 5 years I noticed an acceleration of leg hair falling out, insomnia when exausted, waking up feeling like I have a hang over or feeling i need to get 12 hours of sleep.
I have a lady friend who thinks i have MS yet when I told this to the doctor who diagnose the Fibromyalgia recently she is very very skeptical. Now I am showing signs of Glaucoma at age 48 with no family history and not treatable (normal eyeball presure)
SOMEBODY PLEASE TELL ME WHAT THE &^*( I HAVE BEFORE IT MAKES ME GO BLIND!!!!
I am convinced somewhere along the way I was exposed to some type of heavy metals or radioactive plutonium growing up 8 miles by air from a nuke plant. Or I am leaning more toward something nasty in a vaccine shot. I had an operation one year before this took place and they gave me a tetanis shot. I was noticing I had memory problems for six months before I went to the er back 21 years ago. The doc who gave me a physical then about 22 years ago said "you're fine" but deep down I knew something was not right and it wasn't in my head.