MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Traditional and folk remedies have been repeatedly been reported to contain toxic amounts of lead. I discussed this problem before; see here, here, and here. Recently, two further papers were published which are relevant in this context.

In the first article, Indian researchers presented a large series of patients with lead poisoning due to intake of Ayurvedic medicines, all of whom presented with unexplained abdominal pain.

In a retrospective, observational case series from a tertiary care center in India, the charts of patients who underwent blood lead level (BLL) testing as a part of workup for unexplained abdominal pain between 2005 and 2013 were reviewed. The patients with lead intoxication (BLLs >25 μg/dl) were identified and demographics, history, possible risk factors, clinical presentation and investigations were reviewed. Treatment details, duration, time to symptomatic recovery, laboratory follow-up and adverse events during therapy were recorded.

BLLs were tested in 786 patients with unexplained abdominal pain, and high levels were identified in 75 (9.5%) patients of which a majority (73 patients, 9.3%) had history of Ayurvedic medication intake and only two had occupational exposure. Five randomly chosen Ayurvedic medications were analyzed and lead levels were impermissibly high (14-34,950 ppm) in all of them. Besides pain in abdomen, other presenting complaints were constipation, hypertension, neurological symptoms and acute kidney injury. Anemia and abnormal liver biochemical tests were observed in all the 73 patients. Discontinuing the Ayurvedic medicines and chelation with d-penicillamine led to improvement in symptoms and reduction in BLLs in all patients within 3-4 months.

The authors of this paper concluded that the patients presenting with severe recurrent abdominal pain, anemia and history of use of Ayurvedic medicines should be evaluated for lead toxicity. Early diagnosis in such cases can prevent unnecessary investigations and interventions, and permits early commencement of the treatment.

The second article German researchers analysed 20 such ‘natural health products’ (NHPs) from patients with intoxication symptoms. Their findings revealed alarming high concentrations of mercury and/or lead (the first one in “therapeutic” doses). 82 % of the studied NHPs contained lead concentrations above the EU limit for dietary supplements. 62 % of the samples exceeded the limit values for mercury. Elevated blood lead and mercury levels in patients along with clinical intoxication symptoms corroborate the causal assumption of intoxication (s).

The authors concluded that, for NHPs there is evidence on a distinct toxicological risk with alarming low awareness for a possible intoxication which prevents potentially life-saving diagnostic steps in affected cases. In many cases patients do not communicate the events to their physicians or the local health authority so that case reports (e.g. the BfR-DocCentre) are missing. Thus, there is an urgent need to raise awareness and to initiate more suitable monitory systems (e.g. National Monitoring of Poisonings) and control practice protecting the public.

The authors of the 2nd paper also reported a detailed case report:

Patient, male, 31 with BMI slightly below normal, non-smoker, was referred to the neurological department of the university clinic with severe peripheral poly neuropathy and sensory motor symptoms with neuropathic pain. The patient was in good general state of health until approximately 3 weeks before hospital admission; he spent his holiday in Himalaya region and came back with headaches and fatigue. He was taking pain medication without any relieve; his routine blood values were normal. He claimed to take no further medications. Since poly neuropathy and fatigue could be caused by pesticides or other poisoning, i.e. heavy metals, we have been consulted for taking a detailed exposure history. While in the clinic, 3 different NHPs were found in form of globules, (a, b, c for morning, lunch time and evening respectively), which he imported from his trip to Asia and ingested 3 times a day against stress. We have analyzed these 3 NHPs and found: 45 μg/g, 53,000 μg/g and 28 μg/g lead (for morning, midday and evening globules, respectively) and additionally 15.72 μg/g mercury in the “evening globules”. Since, his blood metal levels were: 340 μg/L Pb and 15 μg/L Hg a diagnosis of heavy metal intoxication was made. Slowly occurring clinical recovery after starting chelation therapy corroborated with the causal assumption proposed. He was released for further consultancy to his family physician. The administrated treatment and the improvement of his status corroborate lead and mercury intoxication.

The researchers finish their paper with this stark warning: In many countries, even in Germany, no comprehensive nutria vigilance- or poisoning monitoring system exists, from which the application of natural health products and the consequent intoxication can be estimated. There is also an urgent need for comprehensive scientifically evaluated studies based on efficient national monitoring to protect the consumer from heavy metal intoxications. There are no comparable surveillance systems like the US ABLES program for lead- and no surveillance systems for mercury exposures allowing any comparisons. Exposure to lead and mercury from environmental sources remains an overlooked and serious public health risk.

11 Responses to Lead and arsenic intoxications due to ‘natural health products’

  • “There is also an urgent need for comprehensive scientifically evaluated studies based on efficient national monitoring to protect the consumer from heavy metal intoxications.”

    The consumer has all the protection they need from the many articles posted in print and web media by knowledgeable scientists such as Professor Ernst.
    If ‘the consumer’ ignores the clear advice repeatedly given – to avoid ‘natural’ / ‘Ayurvedic’ products – caveat emptor.

    If journalists and the media in general fail to make this advice clear and continue to promote, endorse and support pseudo-scientific practices – that is a separate matter of ‘false news’ integrating with ‘false claims’.

    Perhaps that is the real meaning of ‘integrated medicine’: ‘Healthcare provided by the integration of false news with false claims’.

  • The consumer has all the protection they need from the many articles posted in print and web media by knowledgeable scientists such as Professor Ernst.

    I disagree. We banned thalidomide for a good reason, in spite of its benefits (and are now allowing it again under very strict conditions). We should ban dangerous products for which there is no evidence of benefits for much the same reason. Warnings are simply not enough. If they were, Dr. Oz would not be the success he is, except perhaps as a circus clown.

  • We keep coming back to the problem ,mentioned by Ben Goldacre and others, of science/ medicine stories being shunted off to eager, gullible journalists as opposed to science experts( including, if I remember rightly, annex- football reporter being given the job of interviewing, and being impressed by, Andrew Wakefield).
    All this on top of a large public only too willing- as the ‘Leave’ and Trump votes showed- to believe any fairy stories which fit their prejudices.
    Educating the public is one thing. Finding people willing to be educated is another.The American woman whose Mexican husband is about to be deported by Trump may be floundering in a fog of this type even now.

    • Yawn….. Your tale of the deportation of a Mexican husband was interesting. You do know that spouses of American citizens get green cards, right? A possible exception is if the American citizen has married an illegal, undocumented foreigner.

      The “leave” and “Trump” votes were more protest votes against the corruption of political systems and their pols than they were testimonials to folks’ believing in fairy stories. To Barrie, of course, people who don’t agree with his often baseless comments must be deemed unwilling to be educated. lol

      • Wrong.
        Spouses can apply for green cards. Not all who do so get them.
        Check out the facts on the web. If you can find any you can trust!

        • I’m not wrong. The vast majority of spouses of American citizens get green cards quickly, often within 6 months. A friend of mine married a Central American woman and she had her application expedited; she had it in a month. Of course there will be denials/delays if the foreign-born spouse has a criminal history.

    • The fool could easily have looked up this story before blurbing about baseless comments. It thinks US is the centre of the world. USA is actually fast loosing its prior pride and importance.
      The White House Clown, laughing stock of the world and its bungling amateur band of an administration are not only perpetrating inhumane atrocities like this, but also doing their damnedest (trying) to make the US health care system even worse than it has ever been.

      • My, my…..such anti-American noise from an Icelander whose country pays virtually squat (.1% of GDP) for defense, choosing instead to nestle itself under the loving “axilla”of the USA(vis a vis NATO) for protection: absolutely hilarious comment from Geir who continues to display his apparent collectivist bent.

        Read my posts more closely, dear Geir. This last one to which you ignorantly responded clearly stated that marriages to undocumented people represented possible exceptions to green-card or citizenship status. Why was this so difficult for you to comprehend? Try reading it m o r e s l o w l y. You’re welcome!

  • Oh my, another of L-B’s ignorant excrements. Green cards or legality of residence are not the issue here. My words on the Clown’s inhumane policy against his own inhabitants stand.

    The idiot keeps filling this blog with noise. Professor Ernst did remind the crowd recently to keep on topic.
    I will in the future try even harder to ignore this troll. Its comments are almost never relevant to the subject anyway. It almost never contributes anything to the conversation but belligerent blurbs and grandiose ad hominem insults out of context and relevance. This is getting tiresome.
    I would have ignored this one too if it were not for the fake and misleading information about my country, echoed from the GOP collection of fake and misleading propaganda.

    L-B would do well with going back to school and learn some geography and history. USA is not the centre of the universe and not the mainstay of NATO even if it spends most on its toy’s of war. It is not the most important country in the world, even less as time goes.
    As to anti-american sentiments, I have actually always liked America but I am “anti-” the clown they have as a president and its band og bungling amateurs, which is another matter altogether.
    I was in the US a couple of weeks ago and heard nothing but laments over the situation. After some cautious questions to see where I stood, I was almost asked to forgive their countries mistakes in calling this curse upon themselves and many even asked if Iceland could help in getting rid of it. Even those who had supported Drumpf admitted their mistake.
    It will be interesting to see what happens to USA under this narcissistic ignoramus who bears an eerie resemblance to Mussolini.

    I don’t mind L-B’s lame attempts at putting me down personally.
    But for the audience, who might be misled by its belching of fake and inaccurate information echoed from the GOP propaganda, here are some items of information on the matter:

    Iceland has a population of 330.000 and even 50% GDP spent on military expenses would be lika a piss in Mississippi in relative terms to the total military expenditure of the NATO members. Instead Iceland contributes generously to peace keeping missions, international humanitarian aid, ocean rescue and safety.
    Iceland has no military of its own but we have contributed to several peace-keeping missions through the years. The NATO member’s respective contributions are and have been in accordance with mutual agreement. Even if the GOP propaganda machine has said otherwise, Iceland owes no one nothing in this respect. It has with the consent of its partner nations chosen to spend on humanitarian aid and peace-keeping instead of bombs and fighter planes. We have e.g. had a coast guard vessel and flight in the mediterranean for extended periods helping rescue the poor people fleeing from the terror in the middle east, a problem in part aggravated by the conduct of USA.
    USA had military bases on Iceland and Greenland. As soon as technology made it unnecessary for their own purposes, they left many years ago. In Greenland they even left some serious radioactive pollution in the ice. Their presence in the region has always been primarily in their own interest.

    Now back to ignoring anal orifices …

    • Geir, with obvious angst, stated an objection to my allegedly not staying on topic, ” Professor Ernst did remind the crowd recently to keep on topic.” It would seem the dullard has problems with following the flow of conversation. Had he been even slightly fastidious in reviewing the comment to which I responded, Geir perhaps would have realized I was addressing a comment of Barrie’s which insulted the American president. Instead, the dullard typed a long response (off-topic, I might add) regarding Iceland. Go figure!

      Geir alleged I wrote fake information about Iceland:

      “I would have ignored this one too if it were not for the fake and misleading information about my country, echoed from the GOP collection of fake and misleading propaganda.” It’s ironical that Geir would state that the one FACT I wrote about Iceland was fake but then implicitly admitted, albeit with heavy “spin,” the very truth I wrote: talk about paradoxical communication! My dear Geir, Iceland’s honorable contributions to peaceful missions and humanitarian aid do not render my factual statement less true. For a presumably competent representative of bariatric medicine, you surely do sound a lot like a politician (loose with facts but big on pomposity).

    • I see that Geir has apparently ceded, via having withdrawn from attempting to justify his erroneous assertion, to the reality that nothing I posted about Iceland was incorrect. Smart move, dear Geir!

Leave a Reply

Your email address will not be published. Required fields are marked *

Please answer the following: *

Gravityscan Badge

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted.


Click here for a comprehensive list of recent comments.

Categories