Lead Poisoning

Publication Title: 
JAMA

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.

Author(s): 
Saper, Robert B.
Kales, Stefanos N.
Paquin, Janet
Burns, Michael J.
Eisenberg, David M.
Davis, Roger B.
Phillips, Russell S.
Publication Title: 
Journal of Ethnopharmacology

ETHNOPHARMACOLOGICAL RELEVANCE: Herbal and herbo-mineral preparations are being traditionally used in Indian medicines. The herbo-mineral preparations have several benefits that have been instrumental in their widespread use in treatment of different disorders by traditional medicinal practitioners. These include better stability, lower dosage, ease of storability and sustained availability.

Author(s): 
Nagarajan, Surya
Sivaji, Kalaiarasi
Krishnaswamy, Sridharan
Pemiah, Brindha
Rajan, Kalpoondi Sekar
Krishnan, Uma Maheswari
Sethuraman, Swaminathan
Publication Title: 
Occupational and Environmental Medicine

Lead intoxication in adults without occupational exposure is a rare and unexpected event. The case of a western European is reported who had severe anaemia after ingestion of several ayurvedic drugs, obtained during a trip to India. Laboratory findings showed high blood lead concentrations, an increased urinary lead concentration, and an increased urinary excretion of delta-aminolaevulinic acid. Also, slightly increased urinary concentrations of arsenic and silver were found.

Author(s): 
Spriewald, B. M.
Rascu, A.
Schaller, K. H.
Angerer, J.
Kalden, J. R.
Harrer, T.
Publication Title: 
MMWR. Morbidity and mortality weekly report

Although approximately 95% of lead poisoning among U.S. adults results from occupational exposure, lead poisoning also can occur from use of traditional or folk remedies. Ayurveda is a traditional form of medicine practiced in India and other South Asian countries. Ayurvedic medications can contain herbs, minerals, metals, or animal products and are made in standardized and nonstandardized formulations. During 2000-2003, a total of 12 cases of lead poisoning among adults in five states associated with ayurvedic medications or remedies were reported to CDC.

Author(s): 
Centers for Disease Control and Prevention (CDC)
Publication Title: 
Medical Science Monitor: International Medical Journal of Experimental and Clinical Research

BACKGROUND: Millions worldwide use Ayurvedic (traditional Indian) medicines. These medications are increasingly associated with lead poisoning, often accompanied by anemia. We compared the relative hematopoietic toxicity of Ayurvedic lead poisoning with a common form of occupational lead poisoning. MATERIAL/METHODS: We retrospectively studied 66 adult lead intoxications: 43 published Ayurvedic cases identified in published reports by searching MEDLINE (1966 to November 2005); 4 Ayurvedic patients seen at a referral center; and 19 lead paint intoxications from the same center.

Author(s): 
Kales, Stefanos N.
Christophi, Costas A.
Saper, Robert B.
Publication Title: 
Journal of General Internal Medicine

BACKGROUND: Some herbal supplements may contain lead. OBJECTIVE: To examine whether use of specific herbal dietary supplements during the last 30 days is associated with blood lead levels in US men and women. DESIGN: Cross-sectional analysis. STUDY POPULATION: NHANES participants from 1999-2004, a representative sample of the civilian non-institutionalized US population. MEASUREMENTS: Lead was measured in blood. Associations between lead and self-reported supplement use were estimated using multivariable regression weighted to account for NHANES sampling.

Author(s): 
Buettner, Catherine
Mukamal, Kenneth J.
Gardiner, Paula
Davis, Roger B.
Phillips, Russell S.
Mittleman, Murray A.
Publication Title: 
Journal of Hematology & Oncology

Although the majority of published cases of lead poisoning come from occupational exposures, some traditional remedies may also contain toxic amounts of lead. Ayurveda is a system of traditional medicine that is native to India and is used in many parts of world as an alternative to standard treatment regimens. Here, we report the case of a 58-year-old woman who presented with abdominal pain, anemia, liver function abnormalities, and an elevated blood lead level. The patient was found to have been taking the Ayurvedic medicine Jambrulin prior to presentation.

Author(s): 
Gunturu, Krishna S.
Nagarajan, Priyadharsini
McPhedran, Peter
Goodman, Thomas R.
Hodsdon, Michael E.
Strout, Matthew P.
Publication Title: 
Journal of General Internal Medicine

A 29-year-old man, who recently emigrated from India, presented with a 2-week history of abdominal pain, as well as nausea, constipation, and fatigue. He underwent removal of a parathyroid adenoma 6 weeks prior to admission and received a locally made Indian traditional medicine (Ayurveda) for pain control; however, this information was not initially available. He was instructed to take approximately 15 g/day. Initial evaluation revealed a normocytic anemia, but other workup including imaging and endoscopy was unrevealing.

Author(s): 
Pierce, J. Matthew R.
Estrada, Carlos A.
Mathews, Ronnie E.
Publication Title: 
MMWR. Morbidity and mortality weekly report

Lead poisoning still occurs in the United States despite extensive prevention efforts and strict regulations. Exposure to lead can damage the brain, kidneys, and nervous and reproductive systems. Fetal exposure to lead can adversely affect neurodevelopment, decrease fetal growth, and increase the risk for premature birth and miscarriage. During 2011-2012, the New York City Department of Health and Mental Hygiene (DOHMH) investigated six cases of lead poisoning associated with the use of 10 oral Ayurvedic medications made in India.

Author(s): 
Centers for Disease Control and Prevention (CDC)
Publication Title: 
Journal of Toxicology. Clinical Toxicology

OBJECTIVE: The aim of this study was to confirm the connection between lead poisoning and the use of traditional Ayurvedic metal mineral tonics. METHODS: The study group comprised 29 subjects (26 adults and three children) who had previously taken Ayurvedic metal mineral tonics. All subjects were tested for lead absorption by blood lead, erythrocyte delta-aminolevulinic acid dehydratase activity and erythrocyte protoporphyrin. RESULTS: Eighteen samples of Ayurvedic preparations were obtained from 15 subjects and analyzed for lead content.

Author(s): 
Prpić-Majić, D.
Pizent, A.
Jurasović, J.
Pongracić, J.
Restek-Samarzija, N.

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