Clinical Snapshot
Accidental Boron Poisoning From a Dietary Supplement
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A 66-year-old otherwise healthy male patient presented to the emergency department with boron poisoning. The previous day, he had ingested approximately 50 g of the dietary supplement “Borax” (disodium tetraborate decahydrate) as a treatment for osteoarthritis. Since the previous evening, he had experienced diarrhea, vomiting, and oliguria. That morning, he had noticed marked erythroderma and considered the possibility of poisoning, whereupon he checked the original Borax dose using a kitchen scale. Initially, he had been unable to find the measuring spoon provided in the package; as a result, he had used a standard household spoon (Figure), leading to him unwittingly taking a 1000-fold—and potentially lethal—dose. Therefore, and due to the severity of symptoms, hemodialysis was performed and N-acetylcysteine was administered. This enabled the boron concentration in EDTA-anticoagulated whole blood to be reduced from 35.1 mg/L to 1.09 mg/L, and the patient was discharged after 3 days in good general condition. The benefits of boron in osteoarthritis have not been demonstrated, unlike its carcinogenicity and toxicity. The German Federal Institute for Risk Assessment (Bundesinstitut für Risikobewertung) recommends a maximum daily dose of 0.5 mg of boron.
Maike Voß, PD Dr. med. Gunnar Brandhorst, Universitätsinstitut für Klinische Chemie und Laboratoriumsmedizin, Klinikum Oldenburg AöR, Oldenburg
maike.voss@uni-oldenburg.de
Dr. med. David Scheer, Universitätsklinik für Innere Medizin – Onkologie und Hämatologie, Klinikum Oldenburg AöR, Oldenburg
Conflict of interest statement: The authors state that no conflict of interest exists.
Translated from the original German by Christine Rye.
Cite this as: Voss M, Scheer D, Brandhorst G: Accidental boron poisoning from a dietary supplement. Dtsch Arztebl Int 2026; 123: 302b.
DOI: 10.3238/arztebl.m2026.0043
Photo: David Scheer
