Herbal remedies and heavy metals

Ayurvedic medicine is a holistic form of healing--embracing diet, exercise and meditation--that is closely linked to yoga. It is widely accepted in India, where practitioners train for years to receive medical degrees and operate alongside doctors trained in Western medicine. For thousands of years, ayurvedic treatments have been used to ease stomach ailments, stop fevers and treat chronic ailments such as diabetes and arthritis.

The report also raises a red flag about other traditional remedies brought into the U.S. and used by millions of immigrants and devotees of alternative medicine. Most of these products aren't tested for safety and their contents often aren't fully known, experts noted.

Supplement testing urged

Lead and mercury have been found in traditional medicines from China, Africa, Mexico, the Middle East and Malaysia, said the authors of the journal article, who are calling for mandatory testing of all imported dietary supplements for heavy metal contamination.

"There is a problem, big time, with these products," said Wynn Werner of the Ayurvedic Institute in Albuquerque.

"I always have had a concern that we don't know what is in them," said Dr. Vijay Arekapudi, a Chicago obstetrician who has many patients who practice ayurvedic medicine.

The problem first caught the attention of the Boston researchers when an Indian man in his 50s was admitted to a local hospital with non-stop seizures. Blood tests showed he had severe lead poisoning; further investigation identified an ayurvedic medicine the patient was taking for arthritis as a possible cause. When the product was analyzed, its lead content turned out to be 14,000 parts per million, almost ten thousand times more than the maximum level recommended under U.S. pharmacy standards.

A medical literature search then turned up 55 cases of heavy metal poisoning in adults and children taking ayurvedic remedies over the last 35 years.

"We think this may be just the tip of the iceberg in terms of the true numbers of people experiencing toxic effects," said Dr. Robert Saper, director of integrative medicine at Boston University's School of Medicine.

U.S. herbal suppliers do not appear to be implicated, said Michael McGuffin, president of the American Herbal Products Association. He suggested the Food and Drug Administration might want to step up inspections of ayurvedic products from South Asia. A FDA official said regulations for supplements were being strengthened.

The potential dangers are very real. Lead can contribute to several dangerous medical conditions, including kidney disease, high blood pressure, anemia and central nervous system damage. Mercury can cause memory problems and tremors and be fatal in excess doses; arsenic is associated with lung and skin cancers as well as other disorders.

Pollution and poor manufacturing factors may contribute to heavy metals being mixed accidentally in imported herbal medicines. But some metals are added intentionally, and these may be the larger concern.

In ayurvedic medicine there is a long tradition of combining the "botanical and mineral kingdoms," as Werner put it, with the intent of multiplying the potency of medicines. The process of rendering metals into beneficial instead of toxic agents is a closely guarded secret, handed down orally from generation to generation. It often took years of patient work to produce the resulting cures.

But with India's modernization, these traditions are being lost, shortcuts are being taken, and "it's impossible now to know with a particular preparation if it's toxic or medicinal," Werner said. As a result, his institute, a national training center for ayurvedic medicine, will prescribe only "straight botanicals from reputable sources that do contaminant checking."

The Boston researchers are advising people who use traditional ayurvedic remedies to consult with their doctors about heavy metal screening, especially if they buy products imported from South Asia. But many South Asian immigrants who follow ayurvedic medicine don't have regular physicians or feel comfortable talking about their traditional practices, said Shiva Singh Khalsa, community liaison with the Lake Shore Healthcare and Rehabilitation Center in Rogers Park, which serves a large South Asian population.

Gaining popularity

Some 750,000 Americans have consulted an ayurvedic practitioner, according to a recent survey. A full 80 percent of India's 1 billion population is thought to practice at least some type of ayurvedic medicine.

Anecdotal reports indicate the practice is gaining popularity in Chicago and across the country.

"All different people are asking for [ayurvedic herbs], not just Indians," said Hemant Patel, a manager at Patel Brothers on Devon Avenue, where mustard- and green-colored herbs shipped directly from India are stacked in clear plastic bottles on shelves at the front of the store. Typically, he said, customers get advice and recipes from herbal doctors, and they mix remedies together themselves.

"There's a kind of wave of people who are interested in ayurvedic learning," said Janell Cox, associate director of Chicago's Moksha Yoga Studio, which sells books on the subject and special sesame massage oils. "It's becoming a lot more popular."