Toxic Metals in Ayurvedic Preparations from a Public Health Lead Poisoning Cluster Investigation

Overview

Journal Int J Occup Environ Health

Specialty Environmental Health

Date 2018 Mar 13

PMID 29528276

Citations 18

Authors

Marek A Mikulski

Michael D Wichman

Donald L Simmons

Anthony N Pham

Valentina Clottey

Laurence J Fuortes

Affiliations

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Abstract

Background Herbal formulations, traditional medicine, and complementary and alternative medicine are used by the majority of the world's population. Toxicity associated with use of Ayurvedic products due to metal content is an increasingly recognized potential public health problem. Objectives Report on toxic metals content of Ayurvedic products obtained during an investigation of lead poisoning among users of Ayurvedic medicine. Methods Samples of Ayurvedic formulations were analyzed for metals and metalloids following established US. Environmental Protection Agency methods. Results Lead was found in 65% of 252 Ayurvedic medicine samples with mercury and arsenic found in 38 and 32% of samples, respectively. Almost half of samples containing mercury, 36% of samples containing lead and 39% of samples containing arsenic had concentrations of those metals per pill that exceeded, up to several thousand times, the recommended daily intake values for pharmaceutical impurities. Conclusions Lack of regulations regarding manufacturing and content or purity of Ayurvedic and other herbal formulations poses a significant global public health problem.

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References

Tchounwou P, Yedjou C, Patlolla A, Sutton D . Heavy metal toxicity and the environment. Exp Suppl. 2012; 101:133-64. PMC: 4144270. DOI: 10.1007/978-3-7643-8340-4_6. View

Bardia A, Nisly N, Zimmerman M, Gryzlak B, Wallace R . Use of herbs among adults based on evidence-based indications: findings from the National Health Interview Survey. Mayo Clin Proc. 2007; 82(5):561-6. PMC: 1964882. DOI: 10.4065/82.5.561. View

Kales S, Saper R . Ayurvedic lead poisoning: an under-recognized, international problem. Indian J Med Sci. 2009; 63(9):379-81. View

EISENBERG D, Davis R, Ettner S, Appel S, Wilkey S, Van Rompay M . Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998; 280(18):1569-75. DOI: 10.1001/jama.280.18.1569. View

Ness J, Cirillo D, Weir D, Nisly N, Wallace R . Use of complementary medicine in older Americans: results from the Health and Retirement Study. Gerontologist. 2005; 45(4):516-24. PMC: 1557639. DOI: 10.1093/geront/45.4.516. View

Kumar A, Nair A, Reddy A, Garg A . Bhasmas: unique ayurvedic metallic-herbal preparations, chemical characterization. Biol Trace Elem Res. 2006; 109(3):231-54. DOI: 10.1385/bter:109:3:231. View

Khandpur S, Malhotra A, Bhatia V, Gupta S, Sharma V, Mishra R . Chronic arsenic toxicity from Ayurvedic medicines. Int J Dermatol. 2008; 47(6):618-21. DOI: 10.1111/j.1365-4632.2008.03475.x. View

Kales S, Christophi C, Saper R . Hematopoietic toxicity from lead-containing Ayurvedic medications. Med Sci Monit. 2007; 13(7):CR295-8. PMC: 2538618. View

Pal D, Sahu C, Haldar A . Bhasma : The ancient Indian nanomedicine. J Adv Pharm Technol Res. 2014; 5(1):4-12. PMC: 3960793. DOI: 10.4103/2231-4040.126980. View

10.

Phua D, Zosel A, Heard K . Dietary supplements and herbal medicine toxicities-when to anticipate them and how to manage them. Int J Emerg Med. 2010; 2(2):69-76. PMC: 2700222. DOI: 10.1007/s12245-009-0105-z. View

11.

Chopra A, Doiphode V . Ayurvedic medicine. Core concept, therapeutic principles, and current relevance. Med Clin North Am. 2002; 86(1):75-89, vii. DOI: 10.1016/s0025-7125(03)00073-7. View

12.

Aslam M, Davis S, Healy M . Heavy metals in some Asian medicines and cosmetics. Public Health. 1979; 93(5):274-84. DOI: 10.1016/s0033-3506(79)80078-5. View

13.

Savrikar S, Ravishankar B . Introduction to 'Rasashaastra' the Iatrochemistry of Ayurveda. Afr J Tradit Complement Altern Med. 2012; 8(5 Suppl):66-82. PMC: 3252715. DOI: 10.4314/ajtcam.v8i5S.1. View

14.

Saper R, Phillips R, Sehgal A, Khouri N, Davis R, Paquin J . Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008; 300(8):915-23. PMC: 2755247. DOI: 10.1001/jama.300.8.915. View

15.

. Lead poisoning associated with ayurvedic medications--five states, 2000-2003. MMWR Morb Mortal Wkly Rep. 2004; 53(26):582-4. PMC: 2768057. View

16.

Ernst E . Heavy metals in traditional Indian remedies. Eur J Clin Pharmacol. 2002; 57(12):891-6. DOI: 10.1007/s00228-001-0400-y. View

17.

Gogtay N, Bhatt H, Dalvi S, Kshirsagar N . The use and safety of non-allopathic Indian medicines. Drug Saf. 2002; 25(14):1005-19. DOI: 10.2165/00002018-200225140-00003. View

18.

Breeher L, Mikulski M, Czeczok T, Leinenkugel K, Fuortes L . A cluster of lead poisoning among consumers of Ayurvedic medicine. Int J Occup Environ Health. 2015; 21(4):303-7. PMC: 4727589. DOI: 10.1179/2049396715Y.0000000009. View

19.

Raviraja A, Vishal Babu G, Sehgal A, Saper R, Jayawardene I, Amarasiriwardena C . Three cases of lead toxicity associated with consumption of ayurvedic medicines. Indian J Clin Biochem. 2011; 25(3):326-9. PMC: 3001842. DOI: 10.1007/s12291-010-0051-9. View

20.

Breeher L, Gerr F, Fuortes L . A case report of adult lead toxicity following use of Ayurvedic herbal medication. J Occup Med Toxicol. 2013; 8(1):26. PMC: 3850721. DOI: 10.1186/1745-6673-8-26. View