This case report details the death of a 59-year-old woman who succumbed to complications from lead poisoning (cerebral edema and encephalopathy) following the use of an herbal cream to treat hemorrhoids.
The patient with a past medical history of prediabetes was admitted to the emergency department after her husband found her experiencing seizure-like activity that morning. She had been in normal health the previous night, but suffered another seizure in the emergency department that lasted about three minutes and was subsequently started on Levetiracetam. During her most recent physical exam one week ago, her lab workup prompted a follow-up with
hematology due to anemia of unknown etiology. This time, her laboratory results indicated an elevated lactate level of 9.3 mmol/L, and her urine drug screen was negative. Additional labs showed elevations in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALKP) while her complete blood count still showed signs of anemia.
During her hospital stay, the patient developed neurogenic shock and diabetes insipidus. On the fourth day, a serum lead level drawn on the second day returned, showing a level greater than 200 µg/dL Physicians considered various potential sources of her lead exposure, including environmental or occupational contact, accidental ingestion or inhalation of lead particles, unregulated imported cosmetics, or contaminated herbal supplements.
After asking about her use of herbal medications, suspicion arose around a hemorrhoid ointment that the patient had recently purchased from Vietnam through a Facebook advertisement. Consequently, chelation therapy with oral succimer and a continuous infusion of ethylenediaminetetraacetic acid
was immediately initiated.
Cao Bôi Trĩ Cây Thầu Dầu (Castor Oil Hemorrhoid Extract) was promoted for the treatment of hemorrhoids via intra-rectal application . Testing by the California Department of Public Health (CDPH) revealed that the hemorrhoid ointment contained 4% lead (39,000 ppm), a highly lethal concentration. Even minimal lead exposure can be harmful and potentially lead to illness or death; thus, it is advised to avoid products likely to contain lead, especially imported items from other countries with inadequate lead testing standards.
As the patient’s condition continued to deteriorate, concerns for brain death arose. After being informed, the patient’s family consented to proceed with brain death testing. A second exam and a nuclear medicine (NM) brain perfusion scan were completed on the eighth day and it shows the absence of brain perfusion. Despite aggressive management, including seizure control, treatment of cerebral edema, and chelation for severe lead poisoning, the patient passed away on the eighth day due to acute neurological complications from severe lead toxicity complicated by cerebral edema.
As we have often discussed, so-called alternative medicines (SCAMs) can often be contaminated with harmful substances including heavy metals such as lead, e.g.:
- Heavy metal poisoning as a result of using Ayurvedic remedies
- If you ask me, Chinese herbal medicines are best avoided
- Death by homeopathy
- Inadequate regulation of Kratom supplements put consumers at risk
- Another death by homeopathy
- Ayurvedic medicines to die for
- Lead and arsenic intoxications due to ‘natural health products’
- How safe are herbal medicines?
- Ayurvedic medicines: efficacy doubtful with considerable risks
- Contamination and adulteration of herbal remedies
- Another death caused by ‘traditional wisdom’
This case underscores the urgent need for stricter regulations and oversight in the herbal medicine industry to prevent such health hazards. Implementing stronger regulatory measures is essential to ensure that all medicinal and cosmetic products are free from harmful contaminants and to safeguard public health against the significant risks associated with SCAMs.
One Response to Fatal Lead Poisoning From An Herbal Hemorrhoid Cream
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I think it is important to warn consumers about the serious risks of buying anything online directly from Asian countries – because it’s not just ‘medicines’ of dubious origin that can harm and even kill people:
– Many harmless-looking products, including clothing and children’s toys, may contain toxic pigments based on heavy metals such as lead, mercury, and cadmium(*).
– (My personal expertise) Many cheap electronic products are unsafe, in several different ways. Products with rechargeable batteries are often badly designed, causing the battery to catch fire. Other products use inferior or underrated components, presenting fire and shock hazards, and/or do not conform to minimally safe insulation distances between high voltage parts and parts that can be touched by consumers. And some electronics designers don’t even bother with insulating high voltages parts from users at all. Yes, USB chargers have been sold in which the USB port was basically connected to the mains voltage, because one simple resistor plus capacitor is way cheaper than an insulating circuit with a transformer.
– Many other products have mechanical issues, with parts snapping off and causing injury, or small parts that come off easily, posing a choking hazard for children.
But I agree that toxic ‘medicines’ deserve priority – as those are actively advertised as being beneficial for people’s health, and many people fall for the SCAM scam of ‘traditional’ and ‘alternative’ medicines.
*: Incredible as it may sound, the Chinese are not just using toxic paint in household products, some of them are even so stupid as to to put it into children’s food. It’s not just that these people are indifferent to what happens with foreign customers on the other side of the globe, but they even poison and harm their own community.