![]() The patient developed muscle weakness and difficulty ambulating by the next morning and sought care at the local ED. Four hours later he developed diarrhea followed by persistent non-bloody vomiting. In an effort to “clean himself out” a 32-year-old previously healthy man ingested approximately six tablespoons of cream of tartar mixed in water. His EKG was also reported as normal after treatment and the patient was discharged the following morning. Shortly after treatment (∼2 h after arrival), his potassium was 7.2 mmol/L and subsequently normalized (4.4 mmol/L) within 4 h of arrival. Recommendations were made for treating the patient for hyperkalemia with intravenous (iv) sodium bicarbonate (50 meq), regular insulin (10 units), calcium gluconate (4.65 meq), nebulized albuterol (20 mg), and sodium polystyrene sulfonate (15 g). ![]() His renal function was reported as normal. His initial laboratory values (5 to 6 h after ingestion) revealed marked hyperkalemia, a mildly elevated chloride level, and evidence of a mild acidemia. ![]() An EKG, obtained shortly after his arrival showed a normal sinus rhythm with a heart rate (HR) of 79 bpm, flattened P waves, and peaked T waves (Fig. On our advice, she called EMS, which transported him to a local emergency department (ED). On the advice of a fellow body builder, a 16-year-old man ingested approximately six tablespoons of cream of tartar mixed in a soft drink to “clean himself out.” Four hours later, his sister called our poison center reporting that he was vomiting and nauseated. We report two cases in which ingestion of cream of tartar, as a purgative, resulted in life-threatening hyperkalemia Despite its myriad uses, there are no cases in the literature describing toxicity from ingesting cream of tartar. In addition, many websites recommend cream of tartar as “natural” remedy for a variety of conditions including cystitis, smoking cessation, and as a laxative. In medical studies, it has been shown to be an effective stool softener and, when combined with sodium bicarbonate in a polyethylene glycol-based suppository, as a treatment for chronic constipation. Cream of tartar has long been used as a remedy for a number of ailments. It has also been used to make homemade play dough and as an environmentally friendly cleaning agent. Cream of tartar (potassium bitartrate) is a common baking ingredient, which can be used to stabilize whipped egg whites (e.g., in meringues) or when combined with baking powder can be used as a leavening agent.
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