A new clinical case underscores the dangers of following unvetted AI health advice. A 60-year-old man in Thailand developed bromism after replacing table salt with industrial sodium bromide based on information he claimed to obtain from an AI chatbot. Reported in medical literature, the case raises urgent questions about AI safety in consumer health guidance as Thailand scales up its national salt-reduction efforts to combat hypertension and cardiovascular disease. Investigators documented that the patient mistook a chemical used for cleaning and pool maintenance for a safe dietary substitute, leading to severe psychosis and a prolonged hospital stay. Media coverage and expert commentary note the broader implications for AI governance in health information and highlight safer pathways for sodium reduction.
Clinicians describe a dramatic presentation at the emergency department: severe hallucinations, paranoid thinking, and beliefs of poisoning. After stabilization with fluids, the patient disclosed a three-month history of eliminating chloride from his diet and replacing salt with industrial bromide he bought online. Investigators state the patient consulted an AI tool during his decision-making, misinterpreting guidance about substituting chloride with bromide—likely mixing industrial and culinary contexts rather than safe dietary advice. The patient’s condition worsened, and he required brief psychiatric observation. Blood tests showed dangerously high bromide levels, prompting aggressive saline diuresis to hasten elimination. Full recovery occurred after about three weeks of inpatient care.
In Thailand, the public health context adds gravity to this extraordinary case. National sodium intake averages around 3,636 mg daily—nearly two-thirds higher than the World Health Organization’s recommended limit of 2,000 mg per day. The Low Salt Network, supported by the Thai Health Promotion Foundation and other partners, has driven 24-hour urinary sodium surveillance, front-of-pack labeling reforms, and reformulation targets for staple products. The bromide case serves as a stark reminder that reducing sodium is essential, but substituting with industrial chemicals or unregulated substances is dangerous and unacceptable.
Bromism is a historical psychiatric and neurological condition caused by excessive bromide exposure. It was once a common risk when bromide salts were used as sedatives, but modern medicine and regulation have largely removed bromides from human therapy. Contemporary awareness emphasizes that bromide is not a food ingredient and should never be used for cooking. Veterinary medicine retains limited bromide use under supervision, but this does not translate to human dietary applications. Regulatory bodies have long prohibited bromide in human medications and food, reflecting evolving safety standards.
The case also highlights diagnostic challenges: bromide can interfere with laboratory measurements, occasionally mimicking abnormal chloride readings and complicating interpretation. Toxicology teams emphasize maintaining suspicion when unusual lab results occur alongside neuropsychiatric symptoms and possible exposure to bromide-containing substances. Treatment centers on rapid elimination through fluids and, in severe cases, dialysis.
Globally, health authorities stress that AI chatbots and online medical information are not substitutes for professional care. The World Health Organization has issued cautions and recommendations for safe AI use in health contexts, including transparency, risk management, and clear escalation pathways to licensed clinicians. ASEAN and Thai agencies are pursuing local-language AI initiatives, but safety guardrails and human oversight remain essential.
The takeaway for Thai households is clear: pursue sodium reduction through proven public health strategies rather than DIY chemical substitutions. Practical steps include choosing low-sodium products, practicing mindful seasoning with herbs and citrus, and consulting healthcare professionals before using any salt substitutes, especially for individuals with kidney disease or those on specific medications. Emphasizing education and community-based approaches will help Thailand achieve its sodium-reduction goals without risking dangerous improvisations.
For those seeking guidance, rely on licensed health professionals and trusted public health resources. When using digital tools, verify health claims with authoritative sources such as WHO and Thailand’s Ministry of Public Health, and avoid practices based on AI outputs that encourage unsafe chemical substitutions. If any unusual confusion, skin reactions, or psychiatric symptoms arise after exposure to a supplement or salt substitute, seek immediate medical attention and disclose all substances consumed.
This case does not signal a failure of technology but a reminder of the limits of AI in health contexts. With robust safety standards, transparent guidance, and continued emphasis on evidence-based nutrition, Thailand can advance its salt-reduction agenda while ensuring public safety and trust.