One in five herbal products tied to an ancient Indian form of alternative medicine could contain potentially toxic levels of heavy metals such as lead, mercury and arsenic, a new survey finds.
Although the health hazards posed by these products vary depending on the level of metal and the characteristics of the person taking them, they are nevertheless real, say the authors of the study, which appears in the Dec. 15 issue of the Journal of the American Medical Association.
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Heavy metal toxicity risks
"Users of certain Ayurvedic medicines that are manufactured in India and Pakistan may be at risk for heavy metal toxicity," said study author Dr Robert Saper, director of integrative medicine at Boston University School of Medicine. Saper did the study while at Harvard Medical School.
Ayurveda, which originated in India about 2 000 years ago, combines diet and spirit to heal disease, and includes the use of herbal remedies. About 80 percent of India's population uses Ayurvedic products, and it is becoming increasingly popular in the United States, with one analysis estimating that 750 000 adults had consulted an Ayurvedic practitioner.
Ayurvedic products are among dietary supplements that have come under recent criticism. The products are regulated under the Dietary Supplement Health and Education Act (DSHEA), which many people believe to be too lax.
Patient experiences intractable seizures
The impetus for the current study came from a patient at who was admitted not too long ago to a Boston hospital with intractable seizures. Tests showed his blood lead level to be 89 (the normal level for adults is less than 2). Interviews with the family revealed that the man, an Indian-born professional in his 50s, had been taking Guggulu, an Ayurvedic arthritis medicine, for the past six years. The product was then analysed and found to have very high levels of lead, mercury and arsenic.
Saper then scoured the medical literature and found, since 1978, more than 50 published accounts of heavy metal poisoning in infants, children and adults associated with Ayurvedic medicine. The cases occurred in various countries and included the death of an infant, congenital paralysis, deafness and mental retardation.
How the research was done
This led Saper to conduct his own study. Along with his colleagues, he identified every store within a 20-mile radius of Boston City Hall that sold Ayurvedic herbal medicine products made in South Asia. Between April and October 2003, Saper's team visited each of these stores and purchased the Ayurvedic products that were intended for oral consumption. In total, 70 different products were purchased and then tested at the New England Environmental Protection Agency lab.
Overall, 14 of the 70 products contained one or more of lead, mercury or arsenic. Thirteen products contained lead, six contained mercury, and six contained arsenic. "Moreover, half of the products that contained heavy metals had labels recommending their use for infants and children," Saper added.
Twenty-four of the 30 stores visited sold at least one Ayurvedic product containing a heavy metal.
Many questions remain
It's not clear if these results can be generalised to apply to all Ayurvedic products for sale. "It's very possibly that most of these products are from ethnic Indian grocery stores and not found in mass distribution," said Mark Blumenthal, founder and executive director of the American Botanical Council.
It's also not clear why the heavy metals have found their way into these products, although two possibilities are accidental contamination during the manufacturing process and intentional inclusion.
All products should be tested
The authors of the study called for mandatory testing of all such products. "This study points to the need for Congress to pass regulations that make heavy metal testing mandatory for all dietary supplements, including Ayurvedic products," Saper said.
Blumenthal noted that the DSHEA already has provisions for new good manufacturing practices (GMPs) for dietary supplements. The US Food and Drug Administration is expected to publish the final rules soon.
"The contamination issue is a result of poor manufacturing practices, most of which can be dealt with when new FDA GMPs are finally published and enforced," Blumenthal said. "They'll take one, two or three years to go into effect, based on whether it is a small, medium or large firm." – (HealthDayNews)
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