A young woman developed lead toxicity after consuming Ayurvedic medicines for more than a year, initially presenting with nonspecific symptoms such as abdominal pain and anemia. After her diagnosis, investigations led to the seizure of hundreds of pills with high levels of lead at an Ayurvedic clinic, prompting public alerts from health authorities.
A recent article published in the CMJ (Journal of the Canadian Medical Association) highlights a case of lead poisoning in a young woman due to Ayurvedic medications and the complexity of diagnosing this rare disease.
“Because lead toxicity is rare and its presentation is nonspecific, patients are typically seen by many health care providers before a diagnosis is made,” writes Dr. Julian Gitelman of the Dalla Lana School of Public Health in the University of Toronto, with co-authors. “A careful exposure history is essential to suggest the diagnosis.”
The patient, a 39-year-old woman, went to the emergency room 3 times in 6 weeks for abdominal pain, constipation, nausea, and vomiting. On her third visit, she was admitted to the hospital for anemia and possible gastrointestinal bleeding. Numerous invasive investigations failed to reveal the cause of her symptoms. At a follow-up visit weeks later, she reported taking Ayurvedic medications daily for more than a year to treat infertility. Her blood lead level was high, 55 µg/dL, compared to a normal level of less than 2 µg/dL. The patient stopped taking Ayurvedic treatments and started chelation therapy. Her blood lead level decreased and her symptoms disappeared.
Once the diagnosis of lead toxicity was made, the medical team contacted Public Health Ontario (PHO), which analyzed 17 different pill samples provided by the patient. After testing revealed high levels of lead in most pills, the PHO involved the local public health unit, Toronto Public Health and Health Canada, as it regulates natural health products. Joint Ayurvedic clinic investigation resulted in seizure of hundreds of pills for non-compliance Regulation of Natural Health Products. Both Health Canada and Toronto Public Health issued public notices warning people that products from this specific business were hazardous to their health.
The authors emphasize the importance of communication and collaboration between physicians and public health to minimize the health risk of lead in consumer products. “A recent systematic review of lead poisoning case reports found that traditional or herbal medications are a common cause.” the authors write. “Sometimes heavy metals are added intentionally for their perceived healing properties.”
“When consumer products may be contaminated with lead, or when lead exposure is related to sources in the community, involving public health can facilitate broader actions to reduce and prevent exposure of others at risk,” they conclude. .
Reference: “Lead toxicity of Ayurvedic medicines” by Julian Gitelman, Howard An, Vincent Spilchuk and JinHee Kim, August 8, 2023, Journal of the Canadian Medical Association.
DOI: 10.1503/cmaj.230592