Lead, Mercury, and Arsenic in US- and Indian-Manufactured Ayurvedic Medicines Sold via the Internet

Ayurveda is a traditional medical system used by a majority of India’s 1.1 billion population.1 Ayurveda is also used worldwide by the South Asian diaspora and others.1 However, since 1978 more than 80 cases of lead poisoning associated with Ayurvedic medicine use have been reported worldwide.2,3 Ayurvedic medicines are divided into 2 major types: herbal-only and rasa shastra. Rasa shastra is an ancient practice of deliberately combining herbs with metals (eg, mercury, lead, iron, zinc), minerals (eg, mica), and gems (eg, pearl).4,5 Rasa shastra experts claim that these medicines, if properly prepared and administered, are safe and therapeutic.4,5 Of 70 Ayurvedic medicines manufactured in South Asia and sold in Boston, Massachusetts, stores in 2003, we found that 20% contained lead, mercury, and/or arsenic.6 Estimated daily lead, mercury, and arsenic intakes for these products were all higher than regulatory limits. We identified several rasa shastra medicines that could cause lead and mercury ingestions exceeding US Environmental Protection Agency (EPA) limits by 3 to 4 orders of magnitude. Similar results have been found in other North American cities.7–10 The prevalence of metals in Ayurvedic medicines sold via the Internet and in those manufactured in the United States is unknown. Whether rasa shastra medicines account for most Ayurvedic medicines containing metals and whether they are manufactured by US companies or widely available to US consumers is also unknown. Thus, this investigation was designed with 3 major objectives: (1) to determine the prevalence of Ayurvedic medicines available via the Internet containing detectable lead, mercury, or arsenic; (2) to compare the prevalence of toxic metals between US-and Indian-manufactured products; and (3) to compare the prevalence of toxic metals in rasa shastra vs non–rasa shastra medicines. We also compared the daily amounts of lead, mercury, and arsenic that would be ingested by persons taking these products according to packaging recommendations with acceptable metal consumption limits suggested by government, industry, and the World Health Organization.