Health

How can you overdose on BenGay?

- asks Jason from Virginia

August 13, 2007
[Credit: BBC]
[Credit: BBC]

While most of the time consumers pick BenGay up off the shelf without a second thought, the recent death of a 17-year-old track star—because of the ointment—made the public pause. Arielle Newman, who regularly used BenGay to relieve the aches and pains resulting from her track training, died from an accidental overdose of methyl salicylate, the active ingredient found in BenGay.

Methyl salicylate is found in many over-the-counter creams, ointments and lotions that are used to help relieve muscle aches and pains. Products like Icy Hot, Bayer Muscle Joint Cream, BenGay and Tiger Balm all have varying levels of the chemical, which is found not only in liniments, but also in aspirin products.

The most potent form of methyl salicylate is oil of wintergreen, a liquid concentrate that comes from wintergreen leaf fermentation (or, now, can be made synthetically). The oil is used medicinally, either in herbal treatments or more traditional methods, to treat headaches, muscle pains and stomach disorders. It’s also included in food, candy, gum and toothpaste as flavoring, while other companies use it for air fresheners.

Oil of wintergreen contains 98 percent methyl salicylate, so it’s highly toxic in its pure form. In young children, a teaspoon of oil of wintergreen is equivalent to taking 22 adult aspirins—and, therefore, is lethal. (Keep in mind, however, that one would have to eat spoonfuls of ointment to ingest a teaspoon’s worth of the oil.) While common, over-the-counter ache-relief products contain a much lower percentage of methyl salicylate than is contained in oil of wintergreen—for example, both Icy Hot and BenGay Extra Strength contain 30 percent, the highest percentage of all topical creams—their toxic potential is real: The U.S. Food and Drug Administration mandate that any product containing five percent or more of methyl salicylate carry a warning label stating it must be used as directed and kept out of the reach of children. Lethal, however, is never mentioned—so what circumstances lead to Newman’s death?

One of the warnings on the BenGay label explains the cream shouldn’t be used with a heating pad. These devices open pores and also cause the cream to melt, spreading it over a larger surface area. These two seemingly innocuous circumstances increase absorption of the cream into the body, and can lead to an overdose of methyl salicylate. While Newman never used a heating pad, she applied BenGay before a track meet, where her running and sweating acted as a sort of heating pad, resulting in over-absorption and toxicity.

Liniments can also become toxic when the creams are mixed with other members of the salicylate family, such as aspirin or the stomach-calmer Pepto-Bismol. A topical cream sinks into pores, reaching muscles and nerves close to the skin. However, some of that medicine also enters the bloodstream. If you were to then ingest a type of salicylate, like aspirin, on top of using an ointment, the chemical could build-up in your bloodstream, acting as a poison. Not only that, poisoning can result from mixing several different brands that contain methyl salicylate. In fact, Newman’s autopsy results showed that she was not only using BenGay, but she was also using adhesive pads which contained the anti-inflammatory and an additional third unidentified product. Doctors said the combination of salicylate products lead to the high levels of methyl salicylate, which caused Newman’s death.

According to an article in the Journal of Emergency Medicine, while there are several case studies of methyl salicylate mortality, there are no dedicated reviews. The author writes, “A medical literature search found many case reports and a few case series involving methyl salicylate intoxication, yet failed to reveal any clinical studies.”

It is extremely rare for individuals over the age of 12 to experience methyl salicylate poisoning, mostly because of the greater body mass of an adult compared to a child. Additionally, the JEM article notes the consistency of creams and ointments containing methyl salicylate makes ingestion of large volumes difficult. That, combined with the low concentration in the creams, makes significant toxicity from liniments unlikely.

But unlikely is not impossible: The widespread over-the-counter availability of these products makes consumers mistakenly assume that they’re all safe, all the time. This assumption usually only holds when any drug is used as directed and by itself.

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Discussion

51 Comments

Paul Jaffe says:

Dang, I would never have guessed it possible to OD on BG!

dajaa says:

My husband put on bengay this morning after his shower and his skin turned beet red and started burning. The tube we had was about 9 years old so I wonder if it separated and he only got the methyl salicylate. He actually started having trouble breathing and was standing in an ice cold shower because his skin was burning. We washed it off with soap and he soaked in a cold tub and about an hour later was feeling better. I never thought bengay could be so bad.

JMailbox says:

I have many times used both the ointment and then the patches, alternating them, and then using an oral pain and antiinflammatory as well. Makes one think.

Bob J says:

There is also the third “unknown product” which could be anything from heroin to LSD.

devi m says:

My sister back in India wants me to get her a Bengay for her leg aches. After reading these pages , wonder if i should at all.. which indian product will be near enough to bengay?

devi m says:

can some one recommend, another product?

bean says:

icy hot is very good, i use it often. it relieves me from all of my pain that i feel, sometimes when i get sad, i just rub it on and it makess me feel like i belong. thanks icy hot for always being there for me!

nmiosdhfkj says:

I agree with bean infact sometimes when i feel sad i rub it on my special area and it makes me happy again. Or sometimes i put it in my soup because it tastes good!!!! :)

althea says:

i drank a bottle of wintergreen 4 years ago.the experience was terrible,i ended up telling my mom what i had done,was rushed to hospital,they pumped charcoal into my stomach.the doctor said that it was a miracle that i survived,because with the amount that i consumed nobody could have survived.i regret trying to end my life.my liver is damaged and i will need a transplant soon.
i thank god for sparing my life.

Liz says:

“anything from heroin to LSD?” Why would she take drugs before a track meet??

Kman says:

If you want to try an all natural pain cream that also has some healing qualities try MYO-MED.

I have used it on a chronic knee with great success. It is milder than most creams has no salicylate and I use it everyday. I find I have 90% less daily pain and even more range of motion.

MYO-MED was developed with help of professional athelets including NFL quarterback Tom Brady, who says he also uses it everyday.

JJ says:

I have tried at least 20 different things over the past 30 years for arthritis in my knee. MYO-MED was amazing and i use it every day and no longer take any pills for pain

cyndi howarth says:

Hi,

i found out that absorbine jr is no longer making their original pain patches. i’ve used two every day for the last several years. one on my shoulder and another on my back. it had been my life saver. i was naturally upset when i found i could not get them. now i have tried your new pain patches the ultra strength patches for the arm and back and they have proven to be excellent. i would love it if you could get this product into walmart. i am going to bring them a package so they can see it. none of the other stuff works…at all. i have fibromyalgia and a couple of forms of arthritus. i work 45-50 hours each week and i’m so glad to have these patches so that i can sleep at night.

thank you,
cyndi howarth,
603.892.0532

Judy Lane says:

I used Mineral Ice for years when I worked in a factory. I hear it on the radio and because at the time they were offering a money back if not happy. I gave it a try. It worked great for me. It is around $8 dollars at Walmart

Tracey TieF says:

I am an aromatherapist and I teach others how to use essential oils and make creams, lotions, sal;ves, liniments etc.

The percentage of wintergreen oil in as responsible formula is 2%, not 30%. You can see my Cougar Balm alternative to Tiger Balm. With only 2%, it works so well that I once numbed an area for many hours.

The reason that the husband in earlier comments had a burning reaction after getting out of the shower and applying Ben Gay was because his pores were opened from the heat and hot water.

The althlete died from a combined overdose of three methyl slicylate containing products, not from two such products plus a street drug. It is simply that the third product containing MS has not been identified.

As a natural health practitioner, if I made a product with more than 10% essential oil, even with a consultation, health history and Individual Prescription, I could get shut down, lose my designations and my house and assetts. It makes you wonder how Ben Gay, Tiger Balm and other toxin peddlers can get away with it all!

Joe says:

Post #2, dajaa, the exact thing happened to me last night. I took a shower, got out, put some kinda old Ben-Gay on my sore lower back and it immediately started burning. My skin became really red and it was SO painful. I jumped back into the shower, soaped my body, and rinsed in cold water. I eventually felt better, but for the first 10 minutes, the pain was very intense. Anyone have any thoughts on why this happened?

Katie says:

Post #2/#16…Last night I did the exact same thing. I have never been in so much pain in my life. I felt like my skin was on fire! I had to take a cold shower and insulate my body in towels for half an hour before I could even move. It was so horrible!

Lilly says:

Re: Tracey TieF

Only two Tiger Balm products contain methyl salicylate. The rest have none. Do some research before you talk badly about a company.

gonsalves says:

In which medical department (MUmbai) showroom should i get Icy hot balm

Esmey C. Camus says:

Arielle Newman Died from an accidental overdose of METHYL SALICYLATE, The Wintergreen-Scented ingredients found in Liniments Like BENGAY, TIGER BALM EVEN IN ICY HOT,Icy Hot products contain menthol or a combination of menthol and
methyl salicylate. These ingredients create cooling and warming sensations that
divert attention from the actual pain and help block the pain signals being sent
to the brain.

OLEIA TOPICAL OIL is a scented natural oil that helps relieve all types of aches and pains FAST.

Applied topically on the aching body part, Oleia Oil readily penetrates the skin and helps control pain. Recommended for all types of body pains such as HEADACHE, MIGRAINE, SINUSITIS, FROZEN SHOULDER, UPPER AND LOWER BACK PAIN, STIFF NECK, JOINT PAIN, WRIST PAIN (CARPAL TUNNEL SYNDROME), DYSMENORRHEA, MUSCLE PAIN, SPRAINS AND SPORT INJURIES.

Trinette says:

I used bengay cold therapy on my neck and shoulder a week ago. It relieved the pain but since then my neck and shoulder feel like the skin has been burned or scratched badly. There is no redness or sign of injury, it has been a week since I used the bengay, could anyone give me an idea of why?

Tonia says:

Devi if you read this article correctly ALL the similar products have the same ingredients, The problem is in HOW you use them and what ELSE you are using its all about being CONSCIENCE of what you are doing and using common sense.

shirl says:

i didnt realize there was so much to abe concerned aboout as far ass using oral meds with bengay. wow. I accidentally put bengay on my toothbrush. ugh, quickly realized my eror and rinsed repeatedly, hoping all will be ok. washed lips and gums with soap and water. all feel tingly. heere’s hoping alls well

chris says:

I was out working in my garden and came inside and put some ultra strength on all over my shoulder and literally thought i was going to die from the burning and got really really bad nauseous!I had my shirt off and i assume the heat of the sun on my shoulder and the strength of the product was not a good combination!I have used this stuff for 25 years and never had such a bad reaction! Great stuff just use as directed and with certain logical precautions!

Kelly says:

Pathologist are overworked. I am sorry I don’t believe it. Wouldn’t she be in pain from using too much, it burns.

Kelly says:

This country is in serious need of pathologists that’s what the real story should be. I’m going to go knock on some wood, and do a hail mary…lol. o.O

Evelyn says:

I am reading this now and am totally freaked out!! My boyfriend works in a factory and pulled his shoulder really bad a few days ago and for days has been in horrible pain. Tonight I ran to the store and got him some Bengal knowing it’s what professional athletes use and physical therapists that treat them reccomend it. I soaked a towel in hit water, put some lavender oil on it (to relax his nerves) (he was in tears from the throbbing muscle pain) and then applied an over generous amount of Ben gay. He’s sleeping like a baby, said it helped him alot…. I’m not sure if I’m going to sleep very well tonight knowing this information here ): he’s also on prescribed medication for a bad tooth infection. I’ll have to use alternative methods in the future. I had no idea.

Jeff says:

I did this once: Icy Hot and a heating pad. And I thought I hurt before I put the stuff on. The result was something like a burn, but it was inside my muscles. It took me off my feet for several days in unrelievable pain; I couldn’t move my arm.

Scott says:

I put on Bengay extra strength just now, after a hot bath, and my lower back is ON FIRE….

It was fine last night…but post bath its a whole new game…what is up with that? Maybe the hot water opened my pores??? BURNING….ouch!!!

George says:

It’s probably not related, but my late mother slathered generic Ben Gay all over herself for 50 years, and later in life had Macular Degeneration and bleeding in her eyes. The doctors told her to avoid blood thinners, and I’ll bet she never thought about salicylates in her muscle rub.

I must have tried 40 different over the counter creams and nothing works even close to MYONATURAL. I have been using it for 8 years and it works every time. Also ZERO methyl salicylate so it is safe for continuous use

jc says:

I think I OD on pain cream today similar to bengay I’ve been having bad stomach pain since 3 pm today. I never get stomach pains especially at that time of the day. All I did was use a lot in one area floor about an hour .

Joe Green says:

I’ve scoured these labels looking for ones that don’t contain salicylate. Most of them do, but Biofreeze, Flexall, Tiger Balm Neck and Shoulder Rub, and only the Icyhot 4oz Spray and 2.5oz roll on don’t have it. Other Icyhot products have it. I don’t recommend taking a chance. If you want to use salicylate, only use it once or twice a day. Salicylate works for the pain, but when I use it I feel sweaty and feverish. That can’t be good.

Dolores Bowling says:

A little over two years ago I had an injury in my hip. I went to see my doctor, and had an xray which showed nothing. My doctor recomended physical therapy. I took her advice and started physical therapy but before going for a session I took my husband’s advise and applied Bengay. Each time I arrived for physical therapy they applied a heating pad first thing. This went on for a month and one day I realized I was having a different pain, plus watery eyes, and feeling awful. The musles in my hip hurt so bad at times I could hardly walk. My doctor’s advice was to exercise and to drink plenty of water to get it out of my system. The chemical slowly moved down my legs and into my knees. It leaves my legs and knees very sore for a month or longer as it moves. Finally, I think I am getting it out of my system but there is still some soreness left. Has anyone else experienced this type of reaction?

Jess says:

I used a strong cream used for horses when they have sore muscles. I put too many layers on my back and 5 days later I have an invisible rash on my back. Small itchy bumps.

Richard G. Burns, M.D. says:

About 3 years agoI became aware of this Teen athlete’s tragic accident, If memory serves me, saw it online N.Y. Times. The Medical Examiner of NY City was in his ?70’s and had been the Med. Examiner for many years. His bona fides were exceptionaly good.I was surprised at how few mentions appeared in the NYTimes over
many years. The replacement ME was compitant. I had one of the ” hot spells” as described by many of the commenters. It was truly frightening. I have never used Ben Gay again.I told all who would listen at the time and plan to bring it up again before a group that meets as part of their management for chronic pain.
RGB

Christopher Nowak says:

I never used Bengay, BUT I tried Aleve, Voltaren extra strength and Kalaya for tennis elbow in early March of 2016.
I believe that like Arielle, my intense exercise drastically increased the absorption of these medications.
My life has been hell since March, 2016 and I believe that I shall soon die of respiratory depression in 2017.

Keith Cunningham says:

Wow – I had no idea.

So, applied an older Ben gay to my shingles affected arm. I’m not contagious, but now working through the nerve pain. My wife helped me work it into my shoulder. Afterwards she touched herself is a very sensitive area, and it is hurting – badly. After taking a shower it didn’t help much.

Is there another cream or rub of some kind that will somehow negate the burning and stinging affect of Ben Gay and other creams like it?

What have you done as an antidote ?

Christopher Nowak says:

Unfortunately, there is no antidote. I believe that when I was taken to emergency over a year ago, the ultrasound missed the poison in my stomach.
I was a competitive runner and during my last 2.5KM run, I actually felt the poison shifting from my lower stomach to my upper stomach.
This is a lousy way to go!

Deb says:

I love Icy Hot!!!…works for sore, as well as tired, muscles…I enjoy not only the icy-hot effects, but I personally LOVE the herbal scent!!! I feel it actually stimulates my endorphins bc I feel so relaxed and peaceful, after using at night…and then drift off to a good night’s sleep. :)

Patty says:

I have used a Young Living product called PanAway for knee pain. It has wintergreen in it but not the synthetic form. It has helped me a lot. :)

Sophia Regara says:

The girl who died was actually drunk and ran into a tree in the woods. She went to my school

James says:

I have a complex tear in the meniscus of my left knee. I use a variety of essential oilsoils for various health concrns. I use a mixture of wintergreen peppermint, ginger, and black pepper oils diluted quite a bit with sweet almond oil.
It works wonders.

James says:

Pores don’t “open”. Heat increases skin permeability through a number of effects, but pore sizes remain constant.

Juliz says:

I have used bengay, and other generic products for years with a heating pad no less,, Several times day!! It’s always helped me, I have rheumatoid arthritis osteoarthritis, fibromyalgia.. I will use it 3-4 times as directed from now on. Never had any issues.. better to be safe and they need to list a warning on the package..seriously. that’s scary

Dennis says:

I have COPD and arthritis and carpal tunnel. The other day I was having trouble breathing so I ended up in emergency when I was discharged , went to the store and purchased bengay extra strength to rub on my hand. Needless to say the vapors from the bengay was opening my sinuses so i was making sure to keep my hand close to my nose the next day my neck started to stiffen up I put some on my neck and figure that it would help. This whole time approximately 4 days my neck kept getting worse and now it traveled down to my ankles and knees. I can hardly walk and thinking about going back to the emergency.

Dennis says:

Any suggestions will be appropriated

Christopher Nowak BFA MLIS says:

I am still alive today but am SUFFERING TERRIBLY!!!

Sal Tomeo says:

I just bought ultra strength bengay and it just doesn’t heat up like the original bengay. It doesn’t help at all.

pat jorgensen says:

so how do i wash it off my body without dying.

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