Salt is found in nearly every kitchen across the world; however, it is not typically thought of to be a means for suicide. Depending on the age and size of the person, anywhere from 2 to 4 tablespoons of salt consumed rapidly can be lethal. To put that in perspective, the average person in the United States consumes approximately 0.5 tablespoons of salt over the course of the day, which is still above what is recommended. Most cases discussing salt overdose or salt poisoning happen accidentally, however there are case studies and reviews discussing intentional salt overdoses that mostly occur either as exorcism rituals in adults or parents poisoning their young children in cases of factitious disorder imposed on another.

Alana Hull and Abhishek Reddy, writing in Psychopharmacology Bulletin, describe

a case of an adolescent female who consumed approximately 4 dessertspoons of kosher salt (equivalent to 2–3 tablespoons) to kill herself after reportedly seeing the idea on social media. Although this patient had a favorable outcome with no signs of neurological damage, our goal is to bring awareness to the dangers of salt overdose and warn about a potential rise in cases due to circulating videos on popular apps social media apps.

Per patient report, after consuming the salt she very quickly experienced a burning sensation in her throat and stomach, which was then followed by headache, dizziness, and nausea, but no vomiting. She also reports going in and out of consciousness and she does not remember the ambulance ride to the hospital. Per EMS report, the patient had red eyes, altered mental status, and was complaining of stomach pain. EMS vital signs documented as BP of 139/88, HR of 103 bpm, and SpO2 of 95% on room air. Emergency room triage noted a “dazed” appearance and slight stumbling when walking. The patient’s mother reports that the patient was very thirsty before and during the ambulance ride and drank four or five large cups of water. Approximately two hours after the ingestion of salt, Emergency Department physicians noted that the patient was fully alert and oriented with stable vitals and no ongoing pain or symptoms besides depressed mood and suicidal ideation.

The patient was medically cleared in the Emergency Department and transferred to the child and adolescent inpatient psychiatric unit for acute crisis stabilization. Labs obtained on the psychiatric unit approximately 13 hours after initial salt ingestion revealed normal blood sodium (139 mmol/L), high normal chloride (107 mmol/L), and a slight elevation in BUN to Creatine ratio (21.3) suggesting mild dehydration. CBC with differential was all within normal range. The absence of hypernatremia may be due to the to the large amount of water the patient consumed after the salt ingestion or may be due to the delay in obtaining a blood work. It may also suggest that the patient consumed less salt than initially reported. The patient’s mother clarifies that the spoon the patient used for the salt was part of a flatware cutlery set and was the smaller of the two spoon sizes in the set. The spoon was likely a dessertspoon, which is in between a standard teaspoon (6 g of NaCl) and a tablespoon (18 g of NaCl) indicating the patient consumed approximately 12 g NaCl per spoonful, or 48 g total.3.

The patient denied any ongoing symptoms of nausea, dizziness, or headache, and reported normal thirst and urination. She was diagnosed with major depressive disorder and post-traumatic stress disorder and started on 10 mg daily Fluoxetine (Prozac). The medication was well-tolerated, and the patient reported an early decrease in flashbacks to the past sexual trauma. She was discharged home after a six-day admission with no ongoing suicidal ideation, and referrals were made to continue with outpatient psychiatry and mental health therapy.

References not included