Alternative drugs go global: possible lead and/ or mercury intoxication from imported natural health products and a need for scientifically evaluated poisoning monitoring from environmental exposures

Abstract

BackgroundWith increases in globalization, cultural remedies from Chinese, Ayurvedic, Arab and other traditions have become more available to international consumers, offering unfamiliar “Natural Health Products” (NHP), used as alternative medicine or supplementary medicine.Contamination with toxic ingredients including lead, mercury, arsenic, and other toxic elements has been documented in several of these products from various parts of the globe, particularly from some parts of Asia and the Orient.FindingsWe have been following this development in the last 6 years and have analyzed n = 20 such products (60 analyses) from patients with intoxication symptoms in a pilot study, showing alarming high concentrations of mercury and/or lead (the first one in “therapeutic” doses). 82 % of the studied NHP contained lead concentrations above the EU limit for dietary supplements. 62 % of the samples exceeded the limit values for mercury. Elevated blood lead and mercury levels in patients along with clinical intoxication symptoms corroborate the causal assumption of intoxication (s). We present one detailed clinical case report of severe lead and mercury intoxications and give an overview about blood concentration related symptoms and signs of n = 41 case reports of mercury intoxications of the German monitoring BfR-DocCenter.ConclusionsFor NHP there is evidence on a distinct toxicological risk with alarming low awareness for a possible intoxication which prevents potentially life-saving diagnostic steps in affected cases. In many cases patients do not communicate the events to their physicians or the local health authority so that case reports (e.g. the BfR-DocCentre) are missing. Thus, there is an urgent need to raise awareness and to initiate more suitable monitory systems (e.g. National Monitoring of Poisonings) and control practice protecting the public.

The Content of Mercury in Herbal Dietary Supplements

“…The return to herbalism and traditional therapies is on the rise, and among people there is a widespread belief that an herbal product is a healthy one. However, this is a misconception because such products can be a threat to humans, interact with other drugs, and contain heavy metals such as Hg [ 28 , 30 , 33 ].…”

Comparative Analysis of Heavy Metal and Arsenic Content in Various Herbal Dosage Forms Marketed in Russia

“…Содержание ртути превышает нормируемые значения главным образом в морской биоте [40,41] и в искусственно созданных биодобавках [41][42][43][44][45]. В связи с этим USP 8 рекомендует определять содержание ртути на уровне 1,0 мг/кг (наиболее токсичную ее форму -метилртуть на уровне 0,2 мг/кг).…”

Fragen Sie Ihren Arzt oder Apotheker? Gesundheitliche und juristische Aspekte des Konsums von Nahrungsergänzungsmitteln aus dem Internet

“…Demgegenüber steht, dass insbesondere bei als "natürlich" oder "pflanzlich" beworbenen NEM wiederholt Verunreinigungen mit gesundheitsgefährdenden Substanzen, z. B. Blei, Cadmium, Quecksilber, Arsen oder Aluminium beobachtet wurden [19,20]. Das Ausmaß der nachgewiesenen Grenzwert-Überschreitungen variiert erheblich.…”

“…Vor allem bei den NHP ist daher von einem Toxizitätsrisiko auszugehen. Gleichzeitig ist die Risikowahrnehmung und -antizipation bei NHP durch die Verbraucher mutmaßlich sehr gering, da sie als natürliche Alternative zu Medikamenten wahrgenommen werden [19,21].…”