According to a report on the American Fun Science website on August 8, a man changed his eating habits after consulting the chat generation pre-training converter (ChatGPT). Three months into this dietary change, he ended up in the emergency department with new psychotic symptoms such as paranoia and hallucinations.
It turned out that the 60-year-old man suffered from bromine toxicity, a syndrome caused by long-term overexposure to bromide or its close cousin bromine. In this case, the man had been taking sodium bromide that he purchased online.
A report on the case was published in the American "Annals of Internal Medicine: Clinical Cases" on August 5.
A reporter from the Fun Science website contacted the Open Artificial Intelligence Research Center (OpenAI), the developer of ChatGPT, about this case. A spokesman for the company directed reporters to its terms of service. The terms state that its services are not intended to diagnose or treat any health problems. Its terms say: "You should not rely on our Service output as the sole source of truth or factual information or as a substitute for professional advice."
In the 19th and 20th centuries, bromide was widely used in prescription and over-the-counter medicines, including sedatives, anticonvulsants, and sleep aids. However, over time, people gradually realized that long-term exposure can lead to bromine poisoning.
In the 1970s and 1980s, U.S. regulators removed several forms of bromide, including sodium bromide, from over-the-counter drugs. Thereafter, the incidence of bromine poisoning dropped significantly. Despite this, occasional cases do occur. Some recent cases have been linked to dietary supplements containing bromide that people purchased online.
Prior to his recent onset of bromine poisoning, the above patient had been reading about the negative health effects of consuming too much table salt (i.e., sodium chloride). "To his surprise, he could only find literature on reducing sodium in the diet" but not chloride, the report noted. "Inspired by the nutrition he studied in college, he decided to conduct his own experiments to remove chloride from the diet."
The patient consulted ChatGPT about this. The patient said that ChatGPT said it could replace chloride with bromide, so he replaced all the sodium chloride in his diet with sodium bromide.
To simulate what the patient might be experiencing, the patient's doctor tried asking ChatGPT what could be used instead of chloride, and received answers that also included bromide. The large language model did mention that "context matters," but it neither raised a specific health warning nor tried to learn more context around why the question was asked, as medical professionals would do, the report authors wrote.
Three months after replacing table salt with sodium bromide, the patient reported to the emergency department that he was concerned that his neighbors were poisoning him. His lab results at the time showed increased levels of carbon dioxide and alkalinity in his blood.
The chloride levels in his blood also appeared to be elevated, but the sodium levels were normal. Upon further investigation, it was discovered that this was a case of "pseudohyperchloremia," where a laboratory chloride test gives false results because other compounds in the blood (i.e., large amounts of bromide) interfere with the measurement. After reviewing the medical literature and consulting with a poison control center, the patient's physician determined that the most likely diagnosis was bromine toxicity.
After being admitted to the hospital for electrolyte monitoring and replacement, the patient reported being thirsty but suspicious of the water he was given. After a full day in the hospital, his delusions intensified and he began to hallucinate. He then tried to escape from the hospital and was involuntarily admitted to a mental hospital and started on antipsychotic medication.
As mental status improves with treatment, patients are able to tell their doctors that they use ChatGPT. He also mentioned other symptoms he'd noticed recently, such as facial acne and small red bumps on his skin, which could be an allergic reaction to bromide. He also mentioned insomnia, fatigue, muscle coordination problems and excessive thirst, "further suggesting that (it was) bromine toxicity," the doctor wrote.
The report authors concluded: "While artificial intelligence (AI) is a promising tool for building bridges between scientists and non-academic populations, it also risks disseminating decontextualized messages. When patients seek viable alternatives to sodium chloride, medical experts are less likely to recommend sodium bromide."