Caution When Opening the Complementary Medicine Cabinet

A while back, a patient was transferred to our hospital for specialized treatment for what was presumed to be a rare metabolic disorder. It turned out that the young woman actually suffered from lead poisoning linked to self-treatment with traditional medications containing toxic levels of that metal.

This patient’s case was not all that unusual, although the incorrect presumptive diagnosis of the metabolic disorder porphyria (the disease that some argue turned George into “Mad King George”) added a special twist to the story (http://www.ncbi.nlm.nih.gov/pubmed/25446301). The self-treatment in this specific example came from the Ayuvedric healing tradition. This originally emerged out of the Indian subcontinent, but thanks to travel, greater cultural diversity, widespread complementary medicine popularity and, most importantly, ease of sale via the internet, today Ayuvedra is a worldwide practice.

In 2012, the Centers for Disease Control reported the details on half a dozen cases of lead overexposure among young in women in New York City who were taking such medicines (http://www.ncbi.nlm.nih.gov/pubmed/22914225). When these and similar Ayuvedric medications were tested, in addition to lead, many also contained mercury and arsenic. All of the cases from were detected through routine blood testing carried out because the women were pregnant and were seen for prenatal assessments.

Toxicity from lead in these medicines is often described as due to “contamination,” but the use of such metals is inherent to selected Ayuvedric treatment regiments. Indeed, an entire class of metal-based medicaments is subsumed under the class of “Bhasmas.” Defenders of the efficacy of such regimens have made various arguments in support of such therapies, although the most creative I have come across is that the Bhasma formulation process produces very tiny bits of material, technically known as nanoparticles, that render what would be toxic not only harmless, but good for you. Or, as Rameshwar Adhikari argued in a recent publication, “Bhasmas are generally safe drugs for human beings in spite of the presence of seemingly toxic elements and compounds as indicated by recent studies using modern analytical techniques. Nevertheless, more systematic nanomaterialistic investigations on Bhasmas are recommended for gaining the complete and reliable composition-processing-structure-effectiveness picture of these drugs (http://www.ncbi.nlm.nih.gov/pubmed/24619616).

Back here in the macromaterialistic West, heavy metal poisoning can be hard to diagnose because physicians aren’t expecting it. And when it comes to alternative treatments, health care providers don’t always ask the right questions. Another recently reported case of lead poisoning also had to be admitted to a second hospital before the true cause emerged. Initially, no one thought to ask a retired Midwestern lawyer if he used any Ayuvedric therapies (http://www.ncbi.nlm.nih.gov/pubmed/24083830).

Bhasmas (which also can include copper, tin, gold, or silver, as examples) are not the only source of metals in the Ayuvedric pharmacopeia. Herbal products can contain toxic metals, too. A recent survey of such medications from the Himalayan region identified several with elevated lead content, possibly from plants harvested from lead gasoline exhaust-contaminated roadsides. Nor is Ayuvedra the only traditional treatment discipline that can be problem-ridden. Siddha healing from South India similarly values metal-based interventions; Chinese herbal products can be tainted with metals (although organic toxic plant substances are a bigger problem), and other self-treatments also can be dangerous. One of the most important of these appears to be mercury-laced skin lightening cream, which has been described as world-wide problem with a particular niche in imports from Mexico (http://www.cdph.ca.gov/Pages/NR14-046.aspx)).

Otherwise toxic metals can play a therapeutic role in certain conditions. In recent years, for example, arsenic has returned to the allopathic medical armamentarium in the treatment of selected cancers. And tested prescription drugs can be approved only later to be taken off the market when hidden hazards emerge. When it comes to complementary and alternative medical practices, appropriate caution should be balanced against over-reaching, a point made exceedingly well in a recent posting by a keen observer who refers to himself only as “A Country Doctor” (https://acountrydoctorwrites.wordpress.com/category/cave/). All the same, saying “no” to lead is not a stretch. Lead shouldn’t be in the gas tank and it shouldn’t be in the household medicine cabinet, either.