Lead Poisoning in Ayurvedic Medicine

Do you know about this hidden danger?

Another report of lead poisoning from Ayurvedic medicine has been published, so I think it’s time to review just how dangerous this medicine can be. We’ve reviewed concerns with supplements in general (read here), but people often give Ayurvedic medicines a pass safety-wise because it is an “ancient” therapy. This is a good time to point out that ancient is not synonymous with safe or effective. After all, bloodletting has a long, ancient history. 

The report that caught my eye was in the CMAJ and reminded me that we should discuss Ayurvedic medicine concerns a 39-year-old woman in Canada with abdominal pain, constipation, nausea, and vomiting. She was admitted to the hospital with severe anemia and for evaluation of her pain. She had a lot of tests, including a laparoscopy, and no cause was identified. She continued to do poorly. Eventually, another doctor became involved who recommended testing her blood for lead, and her levels were very high: normal is less than 2 μg/dL, and her level was 55! Yes, 55. When she was questioned further, it was revealed that she had been taking Ayurvedic medication daily for infertility. There was no other potential source of lead exposure identified. She was treated for lead toxicity.

The doctors contacted Public Health Ontario, who arranged for testing of 17 different types of Ayurvedic pills that she had been taking, and a shocking 11 of them were contaminated with lead. One pill was 13% lead by weight!!!! Four pills were contaminated with high levels of mercury.

Lead and other poisoning from Ayurvedic medicine is not uncommon. Many studies have identified unacceptable levels of lead, mercury, and/or arsenic in these products. In one study, 21% of the almost 200 Ayurvedic products purchased online and made in either the US or India were contaminated with lead. In the United States, there have been many reports of lead poisoning from Ayurvedic medicines. In 2011 researchers recruited people who practiced Ayurveda, and 40% had elevated levels of lead in their blood. In this same study, researchers also analyzed some of the medications that were used, and 27.5% of the over 100 products tested were contaminated with lead. In 2012, the CDC reported six cases of lead poisoning among pregnant women from Ayurvedic medicine. Lead exposure in pregnancy can harm the pregnant person and the fetus. When the medications were tested, several also contained mercury and arsenic. 

A group of researchers looked at the issue another way, working backwards from the cases of lead poisoning in the United States from 2004-2014. There were 129 reported cases, and 19% were due to Ayurvedic medicine. And of course, multiple cases of lead poisoning have also been identified in Canada, so we just need to add this most recent case to that tragic list. 

What is Ayurvedic Medicine and Why Does it Have Lead? 

According to the National Center for Complementary and Integrative Health, it is an ancient Indian medical system “based on ancient writings that rely on a “natural” and holistic approach to physical and mental health,” and it “combines products (mainly derived from plants, but may also include animal, metal, and mineral), diet, exercise, and lifestyle.”

Metals and other toxic substances may be added intentionally due to mistaken beliefs that they are medicinal. For example, using lead to calm the stomach or mercury to kill bacteria. Some plants destined for these medicines are sometimes also inadvertently contaminated because the soil in which they are grown is contaminated. And some medications may be contaminated during processing. Some proponents of Ayurvedic medicine have the mistaken belief that there is processing (for example, exposure to buttermilk or cow’s urine or heat) that renders these contaminants nontoxic. 

Lead Poisoning in No Joke and You Apparently Can’t Count on the Government to Protect You

Lead is toxic and it has no place in any medication. Symptoms of lead poisoning include abdominal pain, fatigue, confusion, and anemia. Doctors often don’t think about lead poisoning as a cause of these symptoms and first look elsewhere for the cause. This is almost certainly because we’ve been ingrained to ask about exposure to lead paint, but people forget about Ayurvedic medicines as a source. 

If, as noted in the study mentioned above, 21% of cans of corn were contaminated with lead, it would be all over the news. There would undoubtedly be a special commission about food safety with days of testimony on C-SPAN. If 21% of antidepressants were contaminated with lead, the lawsuits would bankrupt those companies, and the regulators would be so far up their asses they’d see daylight. And yet, neither the U.S. nor the Canadian government is willing to take any substantive action here. It’s a joke that in the garage where I park my car here in California there is a big sign warning me about cancer from the toxins in exhaust, but I can buy Ayurvedic medicines without any warning that there is a 20% or so chance I could be buying lead. 

The next time you consider taking an Ayurvedic medicine, consider that there is a significant chance you are also taking lead, a harmful substance with no health benefits. If you have taken Ayurvedic medicine, you should probably talk with your provider about being tested for lead, mercury, and arsenic. And if you decide to go down the supplement route, it really is buyer beware because Ayurvedic medicine isn’t the only product that has this problem; lead contamination has also been identified in other so-called “natural” remedies. But hey, lead is natural, so I guess there is no false advertising there. 

References

1. Julian Gitelman, Howard An, Vincent Spilchuk, JinHee Kim. Lead toxicity from Ayurvedic medicines. CMAJ Aug 2023, 195 (30) E1010-E1012; DOI: 10.1503/cmaj.230592

2. Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, Paquin J, Thuppil V, Kales SN. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008 Aug 27;300(8):915-23. doi: 10.1001/jama.300.8.915. Erratum in: JAMA. 2008 Oct 8;300(14):1652. PMID: 18728265; PMCID: PMC2755247.

3. Breeher L, Mikulski MA, Czeczok T, Leinenkugel K, Fuortes LJ. A cluster of lead poisoning among consumers of Ayurvedic medicine. Int J Occup Environ Health. 2015;21(4):303-7. doi: 10.1179/2049396715Y.0000000009. Epub 2015 Apr 6. PMID: 25843124; PMCID: PMC4727589.

4. Minnesota Department of Public Health https://www.health.state.mn.us/communities/environment/lead/fs/ayurvedic.html#:~:text=Some%20Ayurvedic%20products%20contain%20heavy,%2C%20lung%20and%20bladder%20cancer).

5. An, HH, Luchak, M, Copes, R. Lead toxicity: a systematic review of recently published cases. Clin Toxicol 2015;53:757–8.