Reducing salt intake is often a solid way to improve your overall health. However, swapping out classic sodium chloride for sodium bromide is a solid way to give yourself acne, involuntary muscle spasms, and paranoid psychosis. Knowing this, it’s probably best to avoid that chemical compound entirely—even if ChatGPT tells you otherwise. In the recent case, one patient that was allegedly following the generative AI’s nutritional suggestion was placed in hospital’s involuntary psychiatric hold for three weeks.
During the early 20th century, bromide salts were available in an array of over-the-counter medications aimed at issues like anxiety, insomnia, and hysteria. As a result, historical records indicate 5 to 10 percent of psychiatric institution admissions at that time were attributable to bromide poisoning, or bromism. While it isn’t nearly as big of a medical issue today, ingesting too much of the compound often leads to serious problems including pustular rashes, nausea, and vomiting, as well as neurological conditions like confusion and hallucinatory behavior.
Cases of bromide poisoning largely disappeared once the US Food and Drug Administration started prohibiting its use in 1975, but that number is ticking upwards in recent years thanks to its reintroduction into unregulated dietary supplements and sedatives. Couple that with reports of generative AI programs repeatedly providing inaccurate (if not outright dangerous) suggestions, and it was probably only a matter of time before a situation arose like the one detailed in a case report published in the Annals of Internal Medicine.
According to physicians, a 60-year-old man with no prior psychiatric or medical history arrived at their hospital’s emergency room claiming a neighbor poisoned him. He initially didn’t disclose any medications or dietary supplements, and received “normal” evaluations for his vital signs and physical examination.
Things started going downhill soon after hospital staff admitted him to a room. Once there, he admitted to multiple dietary restrictions and stated that he distilled his own water at home. Although he told the staff he was extremely thirsty, he became paranoid about the water they offered him. It only got worse from there.
“In the first 24 hours of admission, he expressed increasing paranoia and auditory and visual hallucinations, which, after attempting to escape, resulted in an involuntary psychiatric hold for grave disability,” the physicians recounted.
Subsequent consultations with poison control experts along with additional lab tests led the medical team to believe bromism to be the likeliest explanation for their patient’s erratic behavior. After a multi-day regimen of intravenous fluids and electrolyte repletion and the antipsychotic risperidone, doctors were finally able to get the full story.
According to the patient, he began researching ways to cut salt from his diet after recently reading about its potential negative health effects. But the man wasn’t trying to simply decrease his sodium intake. He was allegedly trying to eliminate it entirely.
“He was surprised that he could only find literature related to reducing sodium from one’s diet,” the doctors wrote. “Inspired by his history of studying nutrition in college, he decided to conduct a personal experiment to eliminate chloride from his diet.”
After consulting ChatGPT, the bot allegedly suggested swapping chloride for bromide. He then proceeded to do just that—for three months.
The case report’s authors note it’s possible their patient misinterpreted ChatGPT’s suggestion due to how he phrased his prompt. The program may have not registered it as a medical query, and offered bromide “likely for other purposes, such as cleaning.”
The team unfortunately never received access to the man’s chat logs transcripts, so they cautioned this theory was only speculation. Despite this, their own experiment with ChatGPT 3.5 indicated the hypothesis is certainly plausible.
“[W]hen we asked ChatGPT 3.5 what chloride can be replaced with, we also produced a response that included bromide,” they wrote. “Though the reply stated that context matters, it did not provide a specific health warning, nor did it inquire about why we wanted to know, as we presume a medical professional would do.”
The patient’s physical condition eventually normalized and his psychotic symptoms subsided during his three-week hospital stint. He received an all-clear at his post-discharge check-in two weeks’ later. It’s as good a reminder as any that while AI may be decent at some things, it’s in your best interest to leave the medical consultations to the human professionals.
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