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Robert B Saper, MD MPH1, Stephanos N Kales, MD, MPH2, Janet Paquin, PhD3, David M Eisenberg, MD4, Roger B Davis, ScD5, and Russell S Phillips, MD5. (1) Department of Family Medicine, Boston University School of Medicine, One Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, 617 414 6276, robert.saper@bmc.org, (2) Occupational and Environmental Health Center, Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA 02139, (3) Northeast Regional EPA Laboratory, Technology Drive, North Chelmsford, MA 01863, (4) Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, 401 Landmark Drive, Suite 22a West, Boston, MA 02215, (5) Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215
BACKGROUND: Case reports of individuals taking Ayurvedic herbal medicine products (HMPs) suggest that they may contain lead, mercury, and/or arsenic. We analyzed the heavy metal content of Ayurvedic HMPs manufactured in India and Pakistan, available in South Asian grocery stores in the Boston area, and intended for oral use. METHODS: We searched online yellow pages, business directories, and newspapers to identify grocery stores selling products from South Asia which were < 20 miles from Boston City Hall. We visited each store, purchased each unique Ayurvedic HMP, and recorded labeling information. We analyzed each HMP for lead, mercury, and arsenic using X-ray fluorescence. For HMPs containing heavy metals, estimated ranges of daily heavy metal intake for adults and children were calculated using manufacturer’s dosage recommendations and compared to EPA, ATSDR, and/or USP allowable standards. RESULTS: Seventy HMPs from 30 stores were identified and purchased. Fourteen of the 70 (20%, 95% C.I. 11%-31%) contained measurable levels of heavy metals: lead (n=13, median concentration 40 mcg/g, range 5-37,000), mercury (n=6, median concentration 20,225 mcg/g, range 28-104,000), and/or arsenic (n=6, median concentration 430 mcg/g, range 37-8,130). If taken as recommended, each of these 14 HMPs may result in heavy metal intakes above published allowable standards. CONCLUSION: One of five Ayurvedic HMPs produced in South Asia and available in Boston Indian groceries contains potentially harmful levels of lead, mercury, and/or arsenic. Ayurvedic medicine users may be at risk for heavy metal toxicity. Stricter regulation of Ayurvedic herbal product imports is needed.
Learning Objectives: At the conclusion of this session the participant will be able to
Keywords: Herbal Medicine, Lead
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.