What is “mad honey” and why is it not a danger in the United States?

“Mad honey" is honey from the nectar of certain plants, particularly the Ericaceae family, which includes rhododendron, pieris and other genera that might sound familiar to gardeners. Symptoms of poisoning by ingesting this honey include dizziness, weakness, excessive perspiration, hypersalivation, nausea, vomiting and paresthesia, cardiac complications and possibly death. However, in the United States, honey bees have other sources of forage and rarely collect the nectar of this plant family. If they do collect it, it is in such small quantities that it is diluted by extraction to the point that it does not cause poisoning. However, in other parts of the world, such as Turkey it can be a problem. A number of free articles about grayanotoxin poisoning can be found at PubMed-NCBI, for example https://pubmed.ncbi.nlm.nih.gov/22528814/ . Citation: Jansen SA, Kleerekooper I, Hofman ZL, Kappen IF, Stary-Weinzinger A, van der Heyden MA. Grayanotoxin poisoning: 'mad honey disease' and beyond. Cardiovasc Toxicol. 2012 Sep;12(3):208-15. doi: 10.1007/s12012-012-9162-2. PMID: 22528814; PMCID: PMC3404272.