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A recent study reported in JAMA found some interesting results relating to the quality of toxic compounds in herbal and Ayurvedic medicines.  The authors started out intending to investigate whether:

“Lead, mercury, and arsenic have been detectedin a substantial proportion of Indian-manufactured traditional Ayurvedic medicines. Metals may be present due to the practice of rasa shastra (combining herbs with metals, minerals, and gems). Whether toxic metals are present in both US- and Indian-manufactured Ayurvedic medicines is unknown.”

What they actually found was that one fifth of both US-manufactured and Indian-manufactured Ayurvedic medicines purchased via the Internet contain detectable lead, mercury, or arsenic.  Obviously, quality is never guarenteed with herbal medications, but it does beg the question of whether they should be more tightly regulated and approved by the FDA and EMEA if they produce a drug-like effect on patients and potentially have dangerously high levels of toxins in them.

USA Today produced a table showing which products were purchased and what toxins were present.  They also spoke to some of the companies concerned:

Maharishi Ayurveda Products International, for example, tests its
products both before and after they are shipped from India to the USA,
company president Ted Wallace says. Supplements are examined for
purity, heavy metals such as lead, arsenic, cadmium and mercury,
residual pesticides and biological contaminants.

Sharangdhar Pharmaceuticals says it also tests its products for heavy metals before exporting them.”

They tested them before exporting them?  Hmmm, so how did the contaminants end up in the drug?  Makes you wonder just how many bottles and batches were actually tested based on 20% of the samples having heavy metal problems.

Another manufacturer stated that they followed WHO guidelines:

“Kush Khanna of Bazaar of India, Inc., says his company tests its
supplements to make sure they conform to World Health Organization
standards, which allow higher levels of metals in supplements than the
state of California and other agencies.”

Clearly, different standards may have different levels of what’s acceptable or not, but I’m not sure that treating one health problem with a herbal medication and ending up with lead poisoning is an acceptable risk-benefit profile, especially if cancer, HIV or transplant patients were involved with already immuno-compromised systems.  The WHO is renowned for accepting lower standards than the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH), which are ruthlessly adhered to by the FDA and EMEA.

The authors suggested that the FDA should set maximum daily dose limits for
toxic metals in dietary supplements because they do not currently
specify how much lead is permitted in these products, for example.  However, the FDA can (and does) force
herbal product withdrawals from the market if they’re found to be unsafe.

Would you feel safe taking herbal supplements?

Sources:

JAMA
USA Today

The Guardian
ICH
FDA

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