An analysis of Ayurvedic medicines purchased online found that 20% contain levels of lead, mercury or arsenic that exceed acceptable standards, according to a study published in this week’s edition of JAMA.
Ayurvedic medicines are used by a majority of India’s 1.1 billion population and worldwide by people from South Asia. But “since 1978 more than 80 cases of lead poisoning associated with Ayurvedic medicine use have been reported worldwide,” the authors write.
Ayurvedic medicines are divided into two major types: herbal-only and rasa shastra, which is an ancient practice of deliberately combining herbs with metals (e.g., mercury, lead, iron, zinc), minerals (e.g., mica) and gems (e.g., pearl). Rasa shastra experts believe these medicines, if properly prepared and administered, are safe and therapeutic.
The study was conducted by Robert B. Saper, MD, MPH, of Boston University School of Medicine and Boston Medical Center, and his colleagues. They wanted to examine toxic-metal levels in Ayurvedic medicines made here and in India, as well as in rasa shastra vs. non–rasa shastra medicines.
The researchers conducted an Internet search, using the search terms “Ayurveda” and “Ayurvedic medicine.” It identified 673 products, and they randomly selected 230 of them, which they purchased between August and October 2005. Country of manufacturer/website supplier, rasa shastra status and claims of Good Manufacturing Practices were recorded.
Metal concentrations were measured using x-ray fluorescence spectroscopy; 193 of the 230 requested medicines were received and analyzed.
The researchers found the prevalence of metal-containing products was 20.7%. The prevalence of metals in U.S.-manufactured products was 21.7%, compared with 19.5% in Indian products. Rasa shastra medicines were more than twice as likely as non–rasa shastra products to contain detectable metals and had higher median (midpoint) concentrations of lead and mercury.
Among the metal-containing products, 95% were sold by U.S. websites, and 75% claimed Good Manufacturing Practices. All metal-containing products exceeded one or more standards for acceptable daily metal intake.
“Several Indian-manufactured rasa shastra medicines could result in lead and/or mercury ingestions 100 to 10,000 times greater than acceptable limits,” the authors write.
“A 2005 Institute of Medicine report concluded that ‘the regulatory mechanisms for monitoring the safety of dietary supplements … [should] be revised.’ The constraints imposed on FDA with regard to ensuring the absence of unreasonable risk associated with the use of dietary supplements make it difficult for the health of the American public to be adequately protected. New FDA regulations and current Indian policies do not specify any maximum acceptable concentrations or daily dose limits for metals in dietary supplements for domestic use. We suggest strictly enforced, government-mandated daily dose limits for toxic metals in all dietary supplements and requirements that all manufacturers demonstrate compliance through independent third-party testing.”