Maui Discussion

Ask a Maui Doctor: How Much Poke is Too Much?

April 22, 2017, 10:00 AM HST
* Updated April 22, 11:33 AM
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Doctors at Minit Medical answer some of the questions submitted by readers.

Each week, a doctor from Minit Medical Kahului or Lahaina will answer questions that have been submitted by readers. Submit your own medical related questions to our doctors at [email protected].

Questions submitted will be considered for inclusion in the “Ask a Maui Doctor” column.

Tamura’s poke. Photo credit: Tamura’s.

Q: I love eating poke but what is the limit on eating seafood to avoid the risk of mercury poison?

A: Mercury poisoning can occur from exposure to mercury, a toxic metal. The most important toxic form of mercury in seafood is methylmercury.


Symptoms of mercury poisoning are stumbling gait, difficulty speaking, impaired vision and hearing, muscle weakness, fatigue, headache and irritability.


It’s clear that extremely high consumption rates of fish with great mercury concentrations, poisoning can occur. The concentrations are in areas with high pollution.

However, Hawaiʻi is at little risk when considering the naturally occurring background levels of mercury found in open ocean fish like tuna.

In fact, no single case of mercury poisoning from the consumption of Hawaiʻi fish has been reported. Also, no cases have ever been reported that specifically implicate open ocean fish like swordfish, tuna or marlin anywhere in the world.


There is very little consensus on what constitutes a recommended daily intake of fish due to mercury concerns as studies have drawn quite different conclusions. There is some guidance for pregnant women aimed at reducing prenatal mercury exposure of their children, although those conclusions vary as well.

Pregnant women guidelines:

EPA-FDA Joint Advisory 2004: 1 meal/week

World Health Organization: 3 meals/week

Agency for Toxic Substance and Disease Registry: 3 meals/week

Seychelle Island Child Development Study (Univ. Rochester): 12 meals/week**

* A “meal” is a 6 oz. portion of fish. **Average fish consumption without any adverse health effects

If you are pregnant and concerned, stick to the guidelines above. Otherwise, it is highly unlikely you will develop mercury poisoning from poke.

***The contents of this article such as text, graphics, images, and other material contained in this article (“Content”) are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by in this article is solely at your own risk.

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