Scans of his head and neck showed the kind of constriction in some arteries that can cause intense headaches, doctors reported on Monday in BMJ Case Reports. The scientific term for this temporary narrowing of arteries is reversible cerebral vasoconstriction syndrome.
Dr. Kulothungan Gunasekaran, one of the report’s authors, now at the Henry Ford Hospital in Detroit, said that for some reason the man must have been particularly sensitive to capsaicin. The Carolina Reaper is a popular pepper, and many people eat them and experience nothing worse than the desire to cut out their own tongues.
“I was discussing the case with a nurse who had eaten three Carolina Reapers,” Dr. Gunasekaran recalled.
The Reaper has been measured at more than two million Scoville heat units, the accepted scale for how hot peppers are. Measurements vary, but a really hot habanero might come in at 500,000 Scoville units.
The patient was fine, with no lingering damage, but thunderclap headaches are not to be dismissed. For one thing, there’s the pain, which seems to surpass even the normal effect of the peppers.
Dr. Lawrence C. Newman, a neurologist and director of the headache division at NYU Langone Health, said, “On a one to ten scale, it’s off the charts.” And it can indicate the kind of stroke that results from bleeding in the brain.
It happens instantaneously. If that kind of headache hits you, it makes sense to seek medical attention “whether you’ve bitten into a pepper or not,” Dr. Newman said.
The new study does suggest that capsaicin, being investigated for its role in alleviating pain and lowering blood pressure, can have unexpected effects on certain people.
But “we are not advising anything against the Carolina Reaper,” Dr. Gunasekaran said.
The Reaper was bred to reach record levels of heat. Reached by phone at the PuckerButt Pepper Company in Fort Mill, S.C., the Reaper’s creator, Ed Currie, offered mixed advice on pepper consumption.
On the one hand, he said, “People who eat whole Reapers are just being stupid.” But Smokin’ Ed, as he calls himself, also gave the impression that wasn’t such a bad thing. “We eat them all the time,” he said, with no ill consequences beyond pain.
Mr. Currie indulges in other competitions of suffering. For instance, he said, he had recently taken the Death Nut Challenge, which involves eating insanely hot peanuts. He has a partnership with a company that produces them.
“I knew beforehand I shouldn’t do it,” Mr. Currie said. “I was in pain for two hours.”
For the average person interested in spice, not suffering, he advised using small amounts of any really hot pepper in food preparation, as they were intended.
So if you happen to go beyond your limits — having, say, entered a hot-pepper-eating competition?
“Citric acid seems to work the best to alleviate the pain,” he said. “Don’t chug milk because you’ll just throw it up.”
An earlier version of this article misstated the journal in which the case was published. It was in BMJ Case Reports, not the British Medical Journal.