BACKGROUND: Millions worldwide use Ayurvedic (traditional Indian) medicines. These medications are increasingly associated with lead poisoning, often accompanied by anemia. We compared the relative hematopoietic toxicity of Ayurvedic lead poisoning with a common form of occupational lead poisoning. MATERIAL/ METHODS: We retrospectively studied 66 adult lead intoxications: 43 published Ayurvedic cases identified in published reports by searching MEDLINE (1966 to November 2005); 4 Ayurvedic patients seen at a referral center; and 19 lead paint intoxications from the same center. We considered patients' age, gender and blood lead at presentation, and then compared the groups with respect to hematopoietic parameters. RESULTS: Ayurvedic lead poisoning was associated with higher blood lead (p<0.001), more basophilic stippling (p<0.001), lower hemoglobin (p<0.001) and higher protoporphyrin (p<0.001). Multiple regression adjusted for blood lead and gender found Ayurvedic lead poisoning associated with a 36.2 g/L (95% CI -48.8, -23.6 g/L) greater decrement in hemoglobin (p<0.001) as compared to paint-removal poisoning. CONCLUSIONS: Ayurvedic poisoning produces greater hematopoietic toxicity than paint-removal poisoning. Ayurvedic ingestion should be considered in patients with anemia. Ayurveda users should be screened for lead exposure and strongly encouraged to discontinue metal-containing remedies.
BACKGROUND: Millions worldwide use Ayurvedic (traditional Indian) medicines. These medications are increasingly associated with lead poisoning, often accompanied by anemia. We compared the relative hematopoietic toxicity of Ayurvedic lead poisoning with a common form of occupational lead poisoning. MATERIAL/ METHODS: We retrospectively studied 66 adult lead intoxications: 43 published Ayurvedic cases identified in published reports by searching MEDLINE (1966 to November 2005); 4 Ayurvedic patients seen at a referral center; and 19 lead paint intoxications from the same center. We considered patients' age, gender and blood lead at presentation, and then compared the groups with respect to hematopoietic parameters. RESULTS: Ayurvedic lead poisoning was associated with higher blood lead (p<0.001), more basophilic stippling (p<0.001), lower hemoglobin (p<0.001) and higher protoporphyrin (p<0.001). Multiple regression adjusted for blood lead and gender found Ayurvedic lead poisoning associated with a 36.2 g/L (95% CI -48.8, -23.6 g/L) greater decrement in hemoglobin (p<0.001) as compared to paint-removal poisoning. CONCLUSIONS: Ayurvedic poisoning produces greater hematopoietic toxicity than paint-removal poisoning. Ayurvedic ingestion should be considered in patients with anemia. Ayurveda users should be screened for lead exposure and strongly encouraged to discontinue metal-containing remedies.
Authors: Marek A Mikulski; Michael D Wichman; Donald L Simmons; Anthony N Pham; Valentina Clottey; Laurence J Fuortes Journal: Int J Occup Environ Health Date: 2018-03-12
Authors: Robert B Saper; Russell S Phillips; Anusha Sehgal; Nadia Khouri; Roger B Davis; Janet Paquin; Venkatesh Thuppil; Stefanos N Kales Journal: JAMA Date: 2008-08-27 Impact factor: 56.272