MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Ayurvedic medicine has become highly popular in Western countries; it originates, of course, from India, and is considered to be one of the world’s oldest health care systems. Its adherents claim to create harmony between the body, mind, and spirit, maintaining that this balance prevents illness, treats acute conditions, and contributes to a long and healthy life. In India Ayurveda is mainstream and more than 90% of the population are said to use it. Outside India, Ayurveda is usually classified as an alternative therapy.

Ayurvedic treatments can consist of a range of modalities, including herbal remedies taken by mouth. These preparations have often been reported to be contaminated with toxic metals. Despite several case reports of poisoning from such contamination, the epidemiological evidence is still limited. A new paper on this important topic is therefore welcome. It reports on a cluster of lead and mercury toxicity cases which occurred 2011 among a community of users of Ayurvedic remedies in the US.

Following the identification of the index case, adherents of Ayurveda were offered heavy metals screening. The results showed that 46 of 115 participants (40%) had elevated blood lead levels (BLLs) of 10 μg/dl or above, with 9.6% of BLLs at or above 50 μg/dl.

The authors issued the following warning: this is the largest cluster of lead and mercury toxicity following use of Ayurvedic supplements described in the literature in the US. Contamination of herbal products is a public health issue of global significance. There are few regulations addressing contamination of “natural” products or supplements.

Rasa shastra, the practice of adding metals, minerals or gems to herbal preparations, is a well-documented part of Ayurveda. Adverse reactions to herbs are described in traditional Ayurvedic texts, but practitioners tend to be reluctant to admit that their remedies could be toxic and that reliable information on their risks is not readily available.

Already in 1990, a study on Ayurvedic medicines in India found that 41% of the products tested contained arsenic, and that 64% contained lead and mercury. A 2004 study found toxic levels of heavy metals in 20% of Ayurvedic preparations sold in the Boston area. A 2008 study of more than 230 products found that approximately 20% of remedies (and 40% of rasa shastra medicines) purchased over the Internet from U.S. and Indian suppliers contained lead, mercury or arsenic.

My 2002 systematic review summarised all the available evidence and concluded that heavy metals, particularly lead, have been a regular constituent of traditional Indian remedies. This has repeatedly caused serious harm to patients taking such remedies. The incidence of heavy metal contamination is not known, but one study shows that 64% of samples collected in India contained significant amounts of lead (64% mercury, 41% arsenic and 9% cadmium). These findings should alert us to the possibility of heavy metal content in traditional Indian remedies and motivate us to consider means of protecting consumers from such risks.

Despite these concerns, Ayurveda-fans continue to believe that the toxicity of these remedies is reduced through the purification processes of Ayurvedic remedy preparation. Bizarrely, they may involve prayers as well as physical pharmacy techniques.

The Indian government ruled that Ayurvedic products must be labelled with their metallic content. However, one Indian expert, has been quoted claiming that “the absence of post-market surveillance and the paucity of test laboratory facilities [in India] make the quality control of Ayurvedic medicines exceedingly difficult at this time”. In the US, most Ayurvedic products are marketed without having been approved by the FDA. Since 2007, the FDA has placed an import alert on some Ayurvedic products in order to prevent them from entering the US.

Protecting consumers from heavy metal poisoning by Ayurvedic remedies is certainly not easy – but, in the interest of public health, it is a task that we must tackle with some ungency.

40 Responses to Heavy metal poisoning as a result of using Ayurvedic remedies

  • Apart from stating what science has exposed on the issue, should a modern free democratic society do aught else to prevent folks from poisoning themselves if they so wish?
    Many states/countries now permit tetrarahydrocanabinol to be used and prohibition against ethyl alcohol usage has ended.

    What is Hindi for ‘caveat emptor’?

    • Sadly, I suspect that many of Ayurveda’s true believers wouldn’t even believe this if you put the warning in big letters right on the package: “CONTINUED USE OF THIS POTION MAY CAUSE IRREVERSIBLE ORGAN DAMAGE AND DEATH.”

      I’m now reading “Trick or Treatment” and interested to find out the fundamental difference between eastern and western medicine, i.e., that folks in the east decided not to dissect the body to find out how it works but instead created elaborate myths about what’s inside us, while in the west they decided to dig in, observe, and test. The differences in how these treatments play out now makes so much sense to me, in explaining how they really are a religion that requires faith. I shall use this knowledge whenever I hear any of my woo-inspired friends turn up their noses at “Western medicine.”

      • I agree with you – but are folks not to be free to make mistakes?
        Providing those of us who do know better have advised them accordingly.

        Of course, it is us who could be wrong…

        Which is why my conscience is clear if folks do not accept my advice.

        • Unfortunately, people give this sh*t to children and other vulnerable people. Some of these woo practitioners have undue influence over their victims. One friend of mine, a homeopath, took her elderly mother off her heart meds and gave her homeopathic remedies instead. She did a similar thing taking a friend with a mood disorder off her psych meds; the result wasn’t pretty.

          That’s the problem with these snake oil peddlers. They don’t wait for people to come to them, they go out and evangelize. So of course they’re not going to tell people about the hidden dangers.

        • And they should be free to give their children and other dependents poison?

        • I agree with you – but are folks not to be free to make mistakes?
          Providing those of us who do know better have advised them accordingly.

          Of course, it is us who could be wrong…

          Which is why my conscience is clear if folks do not accept my advice.

          Good point. It is something I have been struggling with for years.

        • Mistakes committed regarding your health often cannot be corrected. And what about children? What is their mistake? Being born to stupid (or uninformed) parents?

      • For most of recent history, there is no such distinction as Eastern or Western medicine–just medicine. This false drives me batsh*t crazy. People are so weirdly fascinated by “eastern” and what amounts to mysticism. I always remind them when they start in about “ancient Chinese….”, that these are the same people who bound women’s feet (for “beauty” no less!).

        • @darwinslapdog: People’s distinction between eastern and western medicine drives me crazy too, because I’m kind of a history buff. As a result of years of family history research, I can see the benefits of modern medicine, where outbreaks of communicable diseases now make the news instead of being an expected aspect of daily life. When people say “Look at how people survived on those wonderful natural ancient medicines,” they have no idea how much they may have survived DESPITE reliance on untested magical cures, and they don’t consider the quality or duration of their lives compared to today.

          • Yes, Linnie, and also they forget that these same people who rely on “ancient medicine” swarm to the clinics that arrive in their part of the world.–which sadly, does not stop them being superstitious. They seem to know on one level that modern medicine can save their child, but still cling to the “healer” nonsense. This is why “complementary medicine” is so popular. People want “the best of both worlds”. It’s just an evolutionary flaw. Sometimes I feel it must be ME that is defective for being such a skeptic!

          • People want “the best of both worlds”. It’s just an evolutionary flaw. Sometimes I feel it must be ME that is defective for being such a skeptic!

            Yes, the social dilemma is the hardest part of changing your mind about stuff like this. A few months ago, National Geographic put out a great article, The War on Science, which proposes that the biggest predictor of what people believe is what “tribe” they belong to.

            How have y’all dealt with the social fallout of no longer feeling like you belong to your “tribe”? When I’m in a gathering of friends where they’re discussing the latest woo, I don’t want to be seen as a wet blanket but at the same time, I don’t want people to think I agree with it and I want to bring some rationality to the discussion. How does one do that diplomatically? Is it better to just change the subject? Maybe new friends are in order? I don’t know.

          • @Linnie

            I confess that I have had to disengage from a couple of former friendships. A couple of others I have been able to reach and “reeducate”–that is, once informed about the science and the lack of evidence for whatever, they tended to drop their interest in woo. At parties and such, I state my dedication to the scientific method, make it clear that I am alive because of pharmaceuticals and modern medicine, and then let it go. Sometimes I have to excuse myself in order not to go into a rant.

            My spouse gets the brunt of all this as I tend to rant at him after such social gatherings. Poor man.

      • You ignorant christ fool.we indians were the fist to do surgery and even plastic surgery and you people were leading the life of barbarian.just google it.

        • we indians were the fist to do surgery and even plastic surgery

          Was that before or after the ritual human sacrifice?

          • Both are correct , to be precise in the different Yugas. 1st yuga people lived for 1 million years , 2nd yuga people lived for 100,000 years , 3rd yuga people lived for 10,000 years , 4th yuga people lived for 1000 years and 5th yuga which is our current time we live for 100 years . ( can say scientifically due to the high oxygen content in air they lived very Long is those times ) . So for the 1st 4 yugas when the Husband dies the Wife too follow as life is meaning to live so Long when their children all grown up .

          • Mental confusion is one of the signs of mercury poisoning.

          • So for the 1st 4 yugas when the Husband dies the Wife too follow as life is meaning to live so Long when their children all grown up .

            Did you use a roulette wheel to create this text, or was it made by ‘ever-better’ machine translation? After all, medicine isn’t the only field attacked by charlatans.

            Mental confusion is one of the signs of mercury poisoning.

            A distinct possibility in this case.

      • Actually, if you get the medicine from a trustworthy source, and study a little bit of ayurveda, you’ll realize that although the medicines contain such metals, they are prepared in a such a way that no metal poisoning occurs.

        • this is a very dangerous myth which you are promoting here. there is no way to prepare a heavy metal such that it becomes non-poisonous. it is what alchemists believed, but it is obsolete nonsense.

    • We try to protect the public from financial charlatans (fraudsters) by prosecuting the fraudsters.
      We also try to protect the safety of the public in other areas by legislating against, and prosecuting, negligent producers and service providers.
      So vendors of Ayurvedic claptrap should be prosecuted if their products cause heavy metal poisoning or any other kind of injury. And it’s not in the realms of fantasy to set legal limits for heavy metal content of said Ayurvedic claptrap.

    • There are three groups of persons that can wish to consume poisons: first (knowingly) suicidal characters and those who do not know about heavy meatal poisoning (one can say to some extent knowingly). And then there are those who have no idea about poisons being present. OK. maybe those, who do not want to live anyway (but do not want to end it quickly) should be left to do it (how many there are such people?) but what about the others?

    • Hi Richard,

      Although I am a firm supporter of western medicine, and rarely prefer Ayurvedic medicine over Western medicine, I strongly doubt the source of these Ayurvedic medicines that were tested. I invite rigorous testing of the products of the oldest and most reputed Ayurvedic systems in India, like the Arya Vaidya Sala Kottakkal (AVS), and see if the same conclusions are drawn from these medicines.

      Regards,
      Nitin

  • I know very little about ayurveda beyond the general impression that it ranges from merely irrational to downright bizarre and that in view of the longevity of the Indian population in comparison with most Westerners, ayurveda is either a fringe practice or simply doesn’t do much to encourage its practitioners to defy death for very long.

    That said, I have a question that has bothered me for well over a decade now. Why is it, that “contamination” with rather undesirable metals is always mentioned, if these metals are actual ingredients of these preparations? Isn’t that a bit like saying that Hollandaise sauce is “contaminated” with butter?

    • good point!
      for the most part, it is a wilful addition, as far as I know.

    • “contaminate
      kənˈtamɪneɪt/
      verb
      verb: contaminate; 3rd person present: contaminates; past tense: contaminated; past participle: contaminated; gerund or present participle: contaminating

      make (something) impure by exposure to or addition of a poisonous or polluting substance.”

      That is different from adding a substance which is supposed to be in the recipie for positve reasons.
      Hollandaise without butter? You could try a substitute, but it wont be as nice!

      • In case of heavy metals and other substances, result is the same: the severity of bad consequences to the patient will develop only on the dose of e.g. cadmium, and not on intentions.

      • That is different from adding a substance which is supposed to be in the recipie for positve reasons.

        The point is that mercury is indeed added for positive reasons, except that these reasons are nonsense, but just because these reasons are nonsense is not a good reason to talk about contamination.

  • This is wrong information! If there is any metal added, then its not ayurveda. Ayurvedic medicine is prepared from plants and only plants. There is other term called “Homeopathy” which includes using both plants and chemicals for curing disease.

    Mercury and other harmful chemicals present in ayurvedic medicine is due to the use of fertilizer and pesticides, while growing the plants.

    • are you sure? any evidence?

    • @Neil
      Wikipedia may not be the most authoritative source of information, but I’m impressed by this from the first paragraph on ayurvedic medicine: “Ayurvedic practices include the use of herbal medicines, mineral or metal supplementation (rasa shastra), surgical techniques, opium, and application of oil by massages.” (My italics) Do any of the supporters of witchcraft medicine actually know what the hell they’re talking about?!

    • @Neil

      Reading up on a subject before making public statements about them is a habit you should adapt.
      If you had done a little research, which is so very easy nowadays, you could have spared yourself the little embarrassment of being demonstrably wrong.

      It takes no more than ten minutes to find information supporting Professor Ernsts information in the original post, about the Rasa Shastra Ayurvedic nostrums using among other hazardous ingredients, Cinnabar, which is a mineral laden with mercury.
      If you look up “Bhasma” and “Narayana” you will find that the terms relate to the archaic Ayurvedic practice of making nostrums by combining herbs and minerals, many of which are poisonous heavy metals. Modern day practitioners think that the complicated process that is involved somehow neutralises the poisons but this is unfortunately wrong or at best unreliable. Most serious and sometimes deadly poisonings by Ayurvedic heavy-metal contaminated nostrums have been in children who have a much lower tolerance even if the poisonous effects can go unnoticed, albeit not unharmful, in adults.
      No wonder life expectancy in India is not so great.

  • In the Netherlands we have also seen a few cases of patients in hospital who suffered from lead poisening after using Ayurvedic medicine. Mr Martijn Martena has written a book about the Dutch situation.

  • Nice article but i see some important details missing which i think might be necessary to know before we form an opinion here. Can you care to give the names of medicine that caused the serious health conditions you mentioned in the article? If you can provide the names of the pharma companies that produced these medicines(so we can stay away from them)? In the reported cases were medicines prescribed the licensed Ayurvedic practitioner or sold over the counter?
    Also i see only Rasa shastra being mentioned in the article. What about the other half of ayurveda Kashta aushadi, which deals with preparing medicine only with natural occurring herbs? Do herbs contain some heavy metals naturally?

    Also I am sharing the following links to get both sides of the coin:
    https://sksrinivas.wordpress.com/2013/10/14/heavy-metals-in-ayurveda/
    http://ayurveda-foryou.com/heavy_metals/ayurvedahm1.html
    http://ayurveda-foryou.com/heavy_metals/aretheyheavy1.html

    • I took a quick look at the second link, and that was enough to make me angry.

      I suggest that, before you discuss safety, you discuss evidence that this ancient witchcraft actually works. Given the average life expectancy of the Indian population in comparison with populations that make extensive use of modern medicine, I would estimate that if it works, it does not work very well.

      I also suggest that, even if modern medicine were the most evil and deadly system every designed by humans, that changes nothing with respect to the benefits of ayurveda.

      • Thanks for your useless reply as it does not answer any of the questions I posted but just seems like an angry rant.

        For your question about if it works? I can tell you it does work from personal experience but you have to be careful about the sources you get your prescription from or if the medication is govt approved or not. I did use the Triphala product and it worked really well for me. I used it for about 2 weeks before i changed my dietary habits for long term effect but I did not experience any side effects during the time is used it. Also a few years back i had gastric problems for which i went to many Allopathic doctors for over an year and have zero improvements!

        Moreover your analogy of life expectancy related in Indian context is completely baseless and shows complete lack of understanding and bias. Most of the population in India(at least in cities) moves to ayurvedic medicine only after the modern or allopathic treatment does not provide any positive results. In Indian villages the life expectancy is less due to the lack of good healthcare facilities in general. Also the life expectancy is not solely related to ayurvedic treatment but air quality, water quality and health services in general among many other factors.

        In some cases i have seen Ayurveda work better than Allopathic medicine and the other cases the other way around as well. I am trying to understand the risks in using ayurvedic medicine and if something is bad then why it is and would it be possible to make it better? Trying to understand if there is something wrong with the ayurvedic system itself or the way the medicines are prepared? Is all all of it garbage or are there parts of it which are useful as well.

        No one said modern medicine is evil or but your comment certainly has that view about ayurveda calling it “witchcraft”.
        Do you call anything you don’t understand from eastern culture “witchcraft” and “wizardry”? Or are you trying to suggest no medicine worked before modern medicine existed because witchcraft surely doesn’t heal people. Even modern medicine has side effects, reactions and there have been cases where people have died after prescribed medicine but we don’t call it evil. So please refrain from using terms such as “most evil” and “witchcraft” in a logical conversation.

        I am not here to engage in a battle about which one is better but trying to understand the reasoning here and to get answer to my follow up questions which, for me are important to make an informed choice. What the articles provides us with are the conclusion but nothing about how these conclusion were drawn or, for example, the 2011 article used as reference is vague at best as it states and i quote “among a community of adherents of traditional medical practice of Ayurveda.”. I mean really that tell so much about what medicine were used, if they were govt approved or prescribed by a licensed practitioner. If there was a wilful contamination in those sample of medicines or contamination in herbs due to use by pesticides or water. I am trying understand the root of the problem here because it seems to me the article is also trying to generalize these things to whole of ayurveda. Of course these is tons of bad shit being produced in the name of ayurveda but in my personal experience it’s not completely useless either. There hasn’t been as much research done in ayurveda as in modern medicine. Surely Ayurveda is not as advanced or effective as modern medicine in today’s age but i am trying to figure out what out of ayurveda can be used safely because it does seem to work in some cases.

        P.S. I will not be replying to any more of your comment if don’t have the answers to my queries other than your random name calling to alternative medicines.

  • Medicines like Turmeric is an Ayurvedic medicine. Pubmed, cancer clinics and others publish the health effects of Turmeric and Curcumin all the time on Pubmed. Medicines we get prescribed to us from our doctors have killed more people than most herbs. The whole medical system is defective in many ways. I just found out that the Turmeric I have been buying from Big Lots has high levels of lead in it. Look on Pubmed and see how many times Turmeric is on there and how many health benefits it claims to have. I’m not using it now. I probably have a whole lot of lead in my body from taking it since 2004.

  • The real witchcraft for me is the pharmaceutical companies selling Epi-pens for $600! That is true woo. 🙂 Greed leads to bad doctors, bad medicines, bad ‘science’. And this is everywhere-east, west, north, south where ever humans are. From ancient to modern times.
    In my experience, here is what I have come to conclude: Eastern medicine accounts for mind, breath and body harmony. Modern science today majorly focuses only on body. It does acknowledge the power of the mind through the ‘placebo’ effect tests and studies. Both sets use natural (herbal, plant, animal, fish based) and chemical ingredients. Ex: Dental amalgams have mercury!
    So where does that leave us : Effectiveness of treatment depends on the expertise and experience of the doctor. And in all cases, always go for a second/third opinion, do additional tests, question, observe and do your due diligence. Intelligence, common sense are not concentrated in just one part of the world.

  • I am 66 years old living a healthy life before I started taking ayurvedic medicine for a sustained period of six months to cure my BPH problem. I had a borderline level of cholesterol and blood sugar which were under control. However, I suffered coronary thrombosis and was rushed to ICU where 3 stents were implanted during angioplasty. I believe the high levels of lead and other heavy metals in the ayurvedic medicine were the cause. I request all taking ayurveda to be very careful as bishmas are made using metalloids in the process. While allopathy also has its side-effects, it comes at least under the purview of the FDA and side-effects are made known by the authorities. Not so for ayurvedic medicines.

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