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Did Karen Carpenter Die From Refeeding Syndrome?


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#1 jpi332

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Posted 17 January 2021 - 04:22 PM

I've been watching documentaries and stuff recently and going down the 70's rabbit hole. I've read some stuff about her and her passing and tbh I'm a big fan of hers, both from her music and as someone who relates to having anorexia, the whole story about her simultaneously depresses me while also being a huge trigger. One thing that I've been confused on after reading about her is whether refeeding syndrome (rapid weight gain during recovery) caused her death. Some sources, including a coroner, say it was due to emetics, while I've seen other things saying it was due to refeeding, or thyroid enhancement, or general potassium loss. The whole story is behind her death is odd since she tested for only .5 mg of emetine and had through the roof blood sugar. Do people know what caused her passing? Or was the science around EDs back then so blurry that people weren't able to draw a concise conclusion?

 

Edit: so sorry about how the post went through so many times for some reason. Apparently this has been happening alot, it's occured before.


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#2 MindOverFatter

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Posted 17 January 2021 - 05:58 PM

I always thought it was due to a bad b/p episode, coupled with taking ipecac. I could be wrong though
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#3 jpi332

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Posted 01 May 2021 - 10:07 PM

I always thought it was due to a bad b/p episode, coupled with taking ipecac. I could be wrong though

oof just saw this response. Yeah, that's what some places I saw said, but then another said she had a relatively small amount of ipecac present. Plus, does b-p cause your blood sugar to go up super high?


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#4 PaperThinGangster

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Posted 01 May 2021 - 10:38 PM

maybe it was drugs + ED = bad reaction over time? similar to Amy Winehouse .. RIP </3 loved her voice


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#5 deleted89909

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Posted 01 May 2021 - 11:31 PM

My assumption based on what's out there was always that she had already developed chronic heart failure from the AN, binged, and went into cardiac arrest as a result of the bodily stress. Died before she could purge/consume enough ipecac to see it through, that kind of thing. I'm far from a doctor or a Karen Carpenter historian, though; just where my mind immediately goes. Don't think there's any officially accepted consensus outside of the coroner's ipecac diagnosis. 


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#6 NoFlyBy

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Posted 01 May 2021 - 11:42 PM

oof just saw this response. Yeah, that's what some places I saw said, but then another said she had a relatively small amount of ipecac present. Plus, does b-p cause your blood sugar to go up super high?

Maybe the ipecac had already come up or something? Binging definitely raises it; it goes up when you eat just about anything, so if you eat tons, and particularly sugary/carby stuff which is pretty common binge food, it'll skyrocket.
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#7 notslimkindashady

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Posted 01 May 2021 - 11:47 PM

You can read her autopsy report here if you're interested.

http://www.autopsyfi...g/celebauto.htm

She died from heart failure due to chronic Ipecac use. Not the amount she had in her body at the time of death, but the damage that came from long term use.
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#8 Frozen Grape

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Posted 02 May 2021 - 12:06 AM

Nope, from chronic use of ipecac syrup.. died of emetine cardiotoxicity. 



#9 MindOverFatter

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Posted 02 May 2021 - 04:30 AM

oof just saw this response. Yeah, that's what some places I saw said, but then another said she had a relatively small amount of ipecac present. Plus, does b-p cause your blood sugar to go up super high?


A binge will definitely spike your blood sugar, since you're forcing tons of food/calories in relatively quickly.

Then purging will mess up and deplete your electrolytes.

It's a horrible combo.

#10 jpi332

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Posted 02 May 2021 - 05:43 PM

You can read her autopsy report here if you're interested.

http://www.autopsyfi...g/celebauto.htm

She died from heart failure due to chronic Ipecac use. Not the amount she had in her body at the time of death, but the damage that came from long term use.

Yeah,   I saw that said too. Some people in her family thought she never used it though, saying they thought it would have screwed up her singing voice, and that they thought she passed due to gaining 30lbs in 6 weeks, and that the night before she passed she ate with her parents then went to bed a couple hrs later. At that link it said it was due to chemical imbalances due to her ED.


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#11 jpi332

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Posted 02 May 2021 - 05:51 PM

Maybe the ipecac had already come up or something? Binging definitely raises it; it goes up when you eat just about anything, so if you eat tons, and particularly sugary/carby stuff which is pretty common binge food, it'll skyrocket.

If the emetics had come up, then I wonder why the report said she had tea leaf like things in her stomach? And apparently the throat showed no gastric material. It's weird, if this had happened in modern times I bet there would've been alot more investigation and all.


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#12 notslimkindashady

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Posted 03 May 2021 - 06:56 PM

Yeah, I saw that said too. Some people in her family thought she never used it though, saying they thought it would have screwed up her singing voice, and that they thought she passed due to gaining 30lbs in 6 weeks, and that the night before she passed she ate with her parents then went to bed a couple hrs later. At that link it said it was due to chemical imbalances due to her ED.


Emetine poisoning causes some specific changes in the blood and in the heart muscle fibers that a pathologist would recognize.

https://pubmed.ncbi....ih.gov/8264462/

Personally, I doubt very much that her family would know if she was actually abusing emetics. Most people tend to hide such things.
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#13 jpi332

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Posted 03 May 2021 - 07:32 PM

Emetine poisoning causes some specific changes in the blood and in the heart muscle fibers that a pathologist would recognize.

https://pubmed.ncbi....ih.gov/8264462/

Personally, I doubt very much that her family would know if she was actually abusing emetics. Most people tend to hide such things.

That study linking emetine with myopathy was released a decade after her death, it was still a pretty easy to get thing back then that was routine to have in your cabinet. That's the weird part, if this had happened in this decade, there probably would've been a lot more studies done. That's a good point about hiding it. Apparently her family and friends said it was never in her house, but someone else said she used it on occasion.

 

 

But, her parents had seen her eating and going up to bed 2 hours later, and she didn't pass until the following morning, while having with an unexplained blood sugar spike which caused a hyperosmolar coma which was apparently the original cause of death by the hospital, no gastric matter in the throat which seems antithetical to purging and apparently there was only a tea leaf like thing in the stomach, which there was no further info on what that was. 

 

She had been hospitalized a few months before for similar heart issues and dehydration, and was forced to gain 30lb in a short time. She admitted to using laxatives and overusing thyroid meds. When asked what the doctors and the family had been able to link to her passing 9 months after the fact, her brother said the only thing they knew was the weight gain. Ig I'm mainly wondering what caused it then? If the emetic use had been ceased recently, which apparently the doctors thought, then what could've occured to cause the blood sugar and eventual collapse?

 


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#14 miss_catherine

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Posted 03 May 2021 - 09:07 PM

Is it a conspiracy that I have a feeling it might have been suicide? Something that possibly wasn’t picked up in the autopsy or untraceable by the time she was autopsied. Life after a lot of gaining gets real hard idk
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#15 notslimkindashady

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Posted 03 May 2021 - 11:36 PM

That study linking emetine with myopathy was released a decade after her death, it was still a pretty easy to get thing back then that was routine to have in your cabinet. That's the weird part, if this had happened in this decade, there probably would've been a lot more studies done. That's a good point about hiding it. Apparently her family and friends said it was never in her house, but someone else said she used it on occasion.


But, her parents had seen her eating and going up to bed 2 hours later, and she didn't pass until the following morning, while having with an unexplained blood sugar spike which caused a hyperosmolar coma which was apparently the original cause of death by the hospital, no gastric matter in the throat which seems antithetical to purging and apparently there was only a tea leaf like thing in the stomach, which there was no further info on what that was.

She had been hospitalized a few months before for similar heart issues and dehydration, and was forced to gain 30lb in a short time. She admitted to using laxatives and overusing thyroid meds. When asked what the doctors and the family had been able to link to her passing 9 months after the fact, her brother said the only thing they knew was the weight gain. Ig I'm mainly wondering what caused it then? If the emetic use had been ceased recently, which apparently the doctors thought, then what could've occured to cause the blood sugar and eventual collapse?

https://youtu.be/kMhEhvuBbdw


I don't think the attached case study had anything to do with Karen specifically, I only included it as I thought it was a good description of the physiologic changes found with emetic poisoning. Sorry, I guess that really wasn't clear at all, my bad. The dangers of Ipecac abuse were known long before 1993, I also didn't mean to imply that this case study was the basis for that. I find it interesting that as late as 1995-1996 (maybe later?)it was still available over the counter. But many things that are potentially fatal if misused are still sold over the counter, Tylenol is a perfect example.

Interesting discussion. I certainly don't have an explanation for all the signs and symptoms around the time of Karen's death but I think cardiomyopathy fits the best and I would put more weight on the autopsy findings than any working diagnosis prior to death. Eating disorders were not as well known at that time, most physicians received little if any training on them. It seems obvious looking back with the benefit of hindsight but may not have even occurred to her medical team at the time she was brought in. I don't know about being forced to gain 30 lbs but she certainly didn't seem weight restored when she died. Ultimately, I doubt we'll ever know the full story but either way it was a tragedy.

#16 jpi332

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Posted 04 May 2021 - 04:25 PM

I don't think the attached case study had anything to do with Karen specifically, I only included it as I thought it was a good description of the physiologic changes found with emetic poisoning. Sorry, I guess that really wasn't clear at all, my bad. The dangers of Ipecac abuse were known long before 1993, I also didn't mean to imply that this case study was the basis for that. I find it interesting that as late as 1995-1996 (maybe later?)it was still available over the counter. But many things that are potentially fatal if misused are still sold over the counter, Tylenol is a perfect example.

Interesting discussion. I certainly don't have an explanation for all the signs and symptoms around the time of Karen's death but I think cardiomyopathy fits the best and I would put more weight on the autopsy findings than any working diagnosis prior to death. Eating disorders were not as well known at that time, most physicians received little if any training on them. It seems obvious looking back with the benefit of hindsight but may not have even occurred to her medical team at the time she was brought in. I don't know about being forced to gain 30 lbs but she certainly didn't seem weight restored when she died. Ultimately, I doubt we'll ever know the full story but either way it was a tragedy.

When she passed, she was at a bmi of 18.5, so right on the cusp of normal-underweight. Wait so whats cardiomyopathy? Is that caused by cardiac stress do to weight gain as well, or overall cardiac degradation from starvation and medicinal abuse (she was known to use thyroid meds and tons of laxes)?

 

Also, had zero clue that tylenol was dangerous. What is wrong with it? I know that it's bad if you take to much of it, but then again that's how it is for most medicines.


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#17 MorbidFixation

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Posted 04 May 2021 - 05:04 PM

When she passed, she was at a bmi of 18.5, so right on the cusp of normal-underweight. Wait so whats cardiomyopathy? Is that caused by cardiac stress do to weight gain as well, or overall cardiac degradation from starvation and medicinal abuse (she was known to use thyroid meds and tons of laxes)?

Also, had zero clue that tylenol was dangerous. What is wrong with it? I know that it's bad if you take to much of it, but then again that's how it is for most medicines.

Cardiomyopathy is just a general term for any heart damage, in this case likely from malnutrition and med abuse.

I'm going to toe the line because I don't want anyone to get any ideas, but basically Tylenol will fuck your liver if you take more than the recommended amount. Obviously it's worse if it's a large overdose, but even slightly higher than recommended use can cause damage.

#18 jpi332

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Posted 04 May 2021 - 06:40 PM

Cardiomyopathy is just a general term for any heart damage, in this case likely from malnutrition and med abuse.

I'm going to toe the line because I don't want anyone to get any ideas, but basically Tylenol will fuck your liver if you take more than the recommended amount. Obviously it's worse if it's a large overdose, but even slightly higher than recommended use can cause damage.

dang, yeah od stuff has always seemed so scary to me. Doubt it will cause ideas, ik for me it literally deters me from ever trying it. Chances are you'll just end up needing a transplant like an alcoholic does or something.


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#19 wrenoct

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Posted 04 May 2021 - 06:50 PM

yeah, apparently when she was found she had a REALLY slow heartbeat, and then she died at the hospital. ipecac is particularly dangerous because it doesn't only act on the stomach, but it does stuff in your brain, too, to make it sort of "panic". scary stuff.

I loved her music, too, OP. tragic, for sure. ):


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#20 Diet_Coke_Head

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Posted 04 May 2021 - 06:55 PM

The psychiatric drugs they had people on in the 70's were TERRIBLE for your heart. I imagine the stress of sudden gain+barbituates+ipecac was available but whether or not she even knew about it is unknown. She couldn't just google tips and tricks. 


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