Metal Content of Ayurvedic Herbal Medicine Products

[Guest guest]

Vol. 292 No. 23, December 15, 2004

Journal of American Medicine Article Abstract 292:2868-2873

http://jama.ama-assn.org/cgi/content/abstract/292/23/2868

Heavy Metal Content of Ayurvedic Herbal Medicine Products

B. Saper, MD, MPH; Stefanos N. Kales, MD, MPH; Janet Paquin, PhD;

J. Burns, MD; M. Eisenberg, MD; B. , ScD; S. ,

MD

Context: Lead, mercury, and arsenic intoxication have been associated with the

use of Ayurvedic herbal medicine product (HMPs).

Objectives: To determine the prevalence and concentration of heavy metals in

Ayurvedic HMPs manufactured in South Asia and sold in Boston-area stores and to

compare estimated daily metal ingestion with regulatory standards.

Design and Setting: Systematic search strategy to identify all stores 20 miles

or less from Boston City Hall that sold Ayurvedic HMPs from South Asia by

searching online Yellow Pages using the categories markets, supermarkets, and

convenience stores, and business names containing the word India, Indian cities,

and Indian words. An online national directory of Indian grocery stores, a South

Asian community business directory, and a newspaper were also searched. We

visited each store and purchased all unique Ayurvedic HMPs between April 25 and

October 24, 2003.

Main Outcome Measures: Concentrations (µg/g) of lead, mercury, and arsenic in

each HMP as measured by x-ray fluorescence spectroscopy. Estimates of daily

metal ingestion for adults and children estimated using manufacturers’ dosage

recommendations with comparisons to US Pharmacopeia and US Environmental

Protection Agency regulatory standards.

Results: A total of 14 (20%) of 70 HMPs (95% confidence interval, 11%-31%)

contained heavy metals: lead (n = 13; median concentration, 40 µg/g; range, 5-37

000), mercury (n = 6; median concentration, 20 225 µg/g; range, 28-104 000),

and/or arsenic (n = 6; median concentration, 430 µg/g; range, 37-8130). If taken

as recommended by the manufacturers, each of these 14 could result in heavy

metal intakes above published regulatory standards.

Conclusions: One of 5 Ayurvedic HMPs produced in South Asia and available in

Boston South Asian grocery stores contains potentially harmful levels of lead,

mercury, and/or arsenic. Users of Ayurvedic medicine may be at risk for heavy

metal toxicity, and testing of Ayurvedic HMPs for toxic heavy metals should be

mandatory.

Author Affiliations: Division for Research and Education in Complementary and

Integrative Medical Therapies, Osher Institute, Harvard Medical School, Boston

(Drs Saper, Eisenberg, , and ); Division of General Medicine and

Primary Care, Department of Medicine (Drs Saper, Eisenberg, , and

), and Division of Toxicology, Department of Emergency Medicine (Dr Burns),

Beth Israel Deaconess Medical Center, Boston; The Cambridge Hospital, Harvard

Medical School, Cambridge (Dr Kales); Occupational Health Program, Department of

Environmental Health, Harvard School of Public Health, Boston (Dr Kales); and

New England Regional Laboratory, Environmental Protection Agency, North

Chelmsford (Dr Paquin), Mass. Dr Saper is now with the Department of Family

Medicine, Boston University School of Medicine, Boston, Mass.