Ciguatera Toxin

Scientific Name(s): Gambierdiscus toxicus (dinoflagellate)
Common Name(s): Ciguatera toxin, Ciguatoxin, CTX, Dinoflagellate toxin

Medically reviewed by Drugs.com. Last updated on Mar 22, 2022.

Clinical Overview

Use

Research reveals no clinical applications for ciguatera toxins.

Dosing

Due to a lack of documentation of any clinical application, dosing recommendations are not available for ciguatera toxin. Safe concentrations of ciguatoxins in fish consumed as meals have not been determined.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avoid use. Documented adverse reactions.

Interactions

None well documented.

Adverse Reactions

Research reveals no clinical trial data identifying possible adverse effects, aside from known toxicological effects (see Toxicology).

Toxicology

Ciguatoxic fish appear normal in all ways, including smell and taste. The toxin cannot be deactivated by freezing or cooking. Symptoms of ciguatera poisoning are varied and complex; diagnosis is based largely on clinical symptoms and history of fish consumption. Symptoms include GI effects (nausea, vomiting, diarrhea), neurologic effects (numbness, tingling, joint pain, headache, dizziness, temperature inversion [cold perceived as hot]), and cardiovascular effects (dysrhythmia, increased heart rate, hypotension). In severe cases, shock, muscular paralysis, and, rarely, death may occur.

There is no antidote for ciguatera poisoning; therapy includes appropriate rehydration and symptomatic and supportive treatments. Mannitol is the most widely studied therapy.

Source

Ciguatera toxins are produced by the dinoflagellate Gambierdiscus toxicus algae and accumulate throughout the marine food chain in a wide variety of fish.Achaibar 2007 Ciguatoxic fish (including sturgeon, reef sharks, moray eels, parrotfish, jacks, snappers, sea bass, and barracuda) are generally larger predatory fish that accumulate toxins by feeding on smaller tropical reef fish that feed on dinoflagellates, such as G. toxicus. The toxin is concentrated in the flesh and viscera of the larger fish.Achaibar 2007 The environmental factors responsible for G. toxicus blooms are not well understood. Natural disturbances causing damage to reefs may increase the growth of marine algae and ciguatera toxin–producing organisms. Several studies have also linked anthropogenic effects to upsurges of ciguatera; however, the specific factors involved have not been identified, and many human and natural disturbances do not trigger an increase in ciguatera risk.Gingold 2014, Lewis 2006

History

Ciguatera poisoning has reputedly been documented since the T'ang Dynasty (AD 618 to 907), and was also reported by Captain James Cook during his travels to the Pacific Islands in the late 18th century. Case reports and surveillance reports continue to appear in the literature.Achaibar 2007, CDC 2006, CDC 2013, Gingold 2014, Goodman 2013 Many traditional methods for detecting toxicity in fish, such as discoloration of silver and copper metals or repulsion of flies and ants, have been discredited.Dickey 2010

Chemistry

Multiple ciguatoxins have been identified and are often collectively termed "ciguatoxin" or "CTX."Achaibar 2007, Dickey 2010, Yasumoto 2001 Other compounds possibly involved in ciguatera poisoning include maitotoxin, lysophosphatidylcholine,...