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Here's why eating chili peppers could trigger thunderclap headaches

By Shannan Rouss ; Updated April 12, 2018

Because apparently eating Tide Pods and snorting condoms (yep, that’s a thing) isn’t insane enough, the latest headlines are about a man who downed a Carolina Reaper — basically the equivalent of eating pepper spray — only to end up in the emergency room with something called “thunderclap headaches.”

A little background on the ominously named Carolina Reaper: In 2017, Guinness World Records named it the hottest chili pepper in the world, reaching up to 2.2 million Scoville Heat Units (SHU). The Scoville number — a measurement of a pepper’s spiciness — depends on the concentration of capsaicin, an oil-like compound found mostly in the white membrane that holds the seeds. For comparison, a habanero pepper registers between 100,000 and 350,000 SHU, while pepper spray starts at 2 million SHU.

The tale of the unnamed 34-year-old man who polished off a Caroline Reaper in a pepper-eating contest was first published in the medical journal BMJ Case Reports. “The patient ate the pepper and immediately started having a severe headache that started in the back of the head and spread all over within two seconds,” Dr. Kulothungan Gunasekaran, lead author of the report, told CNN.

Over the next few days he continued to experience the excruciating thunderclap headaches, which are as bad as they sound. Named for how quickly and intensely they come on (like, well, thunder), the headaches can be felt around the head, neck and sometimes even upper back, explains WebMD. Other symptoms may include nausea, vomiting, confusion and numbness.

The pepper-eating man ended up in the ER, where he was quickly evaluated for bleeding in the brain, a common cause of thunderclap headaches, according to Mayo Clinic. While doctors didn’t find any bleeding, they did see that the vessels supplying blood to the brain were narrowed. The diagnosis? Reversible cerebral vasoconstriction syndrome, or RCVS, likely caused by the peppers.

“Capsaicin, the key ingredient in the pepper, is a vasoactive substance, so it could potentially narrow the blood vessels to the most important organs like the heart and brain,” explained Dr. Gunasekaran.

As with most cases of RCVS, the pepper-eating man’s symptoms resolved on their own within a few days, and subsequent brain-imaging scans showed that his blood vessels had returned to normal. The takeaway for doctors (according to the report’s authors): RCVS should be considered for patients who experience intense headaches after eating hot peppers.

The takeaway for the rest of us: Don’t eat atomically hot peppers. Just don’t.

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