A 34-year-old man went to the ER with severe headaches after eating a Carolina Reaper pepper.
The man ate one excruciatingly spicy Carolina Reaper — aka the world's hottest chili pepper — during a hot pepper–eating contest, according to an article published in BMJ Case Reports.
Shortly after eating the pepper, he began dry heaving and developed severe neck and head pain. Over the next few days, he experienced headaches so severe that he went to the ER.
It turns out that he was having "thunderclap headaches," which, just like their name suggests, tend to strike fast and hard, with pain peaking within about 60 seconds. The pain is so excruciating that it can often cause nausea or vomiting, and may be associated with fevers, seizures, confusion, and even a temporary loss of vision or speech.
These types of headaches are not common, and they can also be a sign of a serious condition, such as a blood clot or bleeding in the brain. If you experience these symptoms, you should seek medical attention right away.
At the ER, a CT scan of the man's brain showed that his arteries were narrowed, which is known as reversible cerebral vasoconstriction syndrome (RCVS).
This rare condition is caused by the sudden narrowing of the major blood vessels in the brain. The main symptom of RCVS is a thunderclap headache. It's not always clear what causes RCVS, but it can sometimes be due to unusual reactions to medications like serotonin reuptake inhibitors (which are antidepressants like Prozac or Zoloft) or illicit drugs such as cocaine or amphetamines.
However, the man tested negative for those and had no significant medical history or conditions that could explain his reaction, according to study author Dr. Satish Boddhula of Bassett Medical Center in Cooperstown, New York, and colleagues.
People with RCVS require supportive care like fluids and rest, and the condition typically goes away on its own within days to weeks. However, some people can develop brain damage.
There have been no known cases of RCVS associated with hot peppers. However, eating cayenne pepper has been linked to heart attacks and a narrowing of the blood vessels in the heart, known as coronary vasospasm, according to the report. So in other words, hot peppers are known to have vasoactive properties, meaning that they can affect the size of blood vessels.
Given that the man developed the symptoms after consuming a vasoactive substance, the doctors concluded that eating the Carolina Reaper could have been the reason he developed RCVS. So in addition to making your mouth burn and turning you into a teary-eyed, snotty mess, extremely hot peppers may have more serious health consequences.
So you should watch out for severe symptoms after you eat a Carolina Reaper...or maybe just stay away from the peppers altogether.
Since 2013, Carolina Reapers have held the Guinness World Record for the world's hottest chili pepper. They have an average rating of 1,641,183 Scoville heat units (SHU) with some individual Carolina Reapers as high as 2.2 million SHU.
The Scoville scale is a measure of spiciness, which is based on the concentration of capsaicin in a substance — the compound that makes peppers hot. In comparison, a jalapeño has a spiciness of about 5,000 SHU and a habanero has 200,000 SHU. Pepper spray has 2 million SHU. So the Carolina Reaper is almost as hot as a substance used to temporarily blind people.
In 2016, a YouTube video of two girls trying the Carolina Reaper went viral after it sent both of the girls into...complete chaos. The pair went from smiles and excitement to screaming through sobs and shaking in pain — one of them even needed oxygen. Not long after, the "Carolina Reaper Challenge" took the internet by storm. Even BuzzFeed employees tried the pepper for a video. It did not go well.
So given that this pepper obviously causes a lot of pain and discomfort and, potentially, a severe headache or cerebral vasoconstriction, you should exercise caution when eating it. Actually, you should probably just not eat this thing at all and stick to acceptably spicy peppers that will get you sweating but won't actually hurt you.
BuzzFeed News has reached out to the study authors for comment.
This case is from an article published in the journal BMJ Case Reports. An earlier version of this story misidentified the journal.