Ayurvedic herbal medicine and lead poisoning

Abstract

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. Chemical analysis of the medication showed high levels of lead. Following treatment with an oral chelating agent, the patient's symptoms resolved and laboratory abnormalities normalized. This case highlights the need for increased awareness that some Ayurvedic medicines may contain potentially harmful levels of heavy metals and people who use them are at risk of developing associated toxicities.

Figure 1

Wright-Giemsa stained smear of peripheral blood. Coarse basophilic stippling of the erythrocytes results from the poisoning of the 5' nucleotidase normally responsible for degrading RNA. Magnification is 1000x.

Figure 2

Trends of hemoglobin and BLLs of the patient at diagnosis and during chelation therapy. First emergency room visit corresponds to day -4; the day of admission during the second emergency room visit is designated as day 1.

Figure 3

Jambrulin tablets. A. The tablets are 1.25 cm black, ovoid pills (ruler is in cm). B. X-ray shows diffusely opaque Jambrulin pills with flakes of high attenuating material.