Recent papers published in CMAJ (Canadian Medical Association Journal) highlights a case of lead poisoning in a young woman from an Ayurvedic drug and the complexity of diagnosing a rare condition.
“Given that lead toxicity is rare and its symptoms are non-specific, patients are often seen by many health care providers before a diagnosis is made,” said Dalla Lana Public Health, University of Toronto. Dr. Julian Gitelman of the Graduate School writes with co-authors. “A careful exposure history is essential to suggest a diagnosis.”
The patient was a 39-year-old woman who presented to the emergency department three times in a six-week period with abdominal pain, constipation, nausea, and vomiting. On her third visit, she was admitted for anemia and possible gastrointestinal bleeding. Many invasive investigations revealed no cause for her symptoms. At a follow-up visit a few weeks later, she reported that she had been taking Ayurvedic medicines daily for over a year to treat her infertility. Her blood lead level was high at 55 µg/dL, and the normal value was less than 2 µg/dL. The patient discontinued Ayurvedic treatment and started chelation therapy. Her blood lead levels decreased and her symptoms resolved.
Once the diagnosis of lead toxicity was made, the medical team contacted Public Health Ontario (PHO) and tested 17 pill samples provided by the patient. After testing revealed that most of the tablets contained high levels of lead, PHO involved the local public health authority that regulates natural health products, Toronto Public Health Agency, and Health Canada. I did. As a result of a joint investigation by an Ayurvedic clinic, hundreds of tablets were seized due to violation of regulations. Regulations regarding natural health products. Health Canada and Toronto Public Health have both issued public advisories warning people that this particular company’s products pose a health risk.
The authors emphasize the importance of communication and collaboration between clinicians and public health to minimize the health risks of lead in consumer products. “A recent systematic review of case reports on lead poisoning found that traditional and herbal medicines were common causes,” the authors write. “Heavy metals are sometimes added intentionally for perceived healing properties.”
“When a consumer product may be contaminated with lead, or when lead exposure is associated with a community source, public health can be involved to identify other people at risk. “This may encourage broader actions to reduce and prevent human exposure,” the researchers concluded.
References: “Lead Toxicity from Ayurvedic Medicines” by Julian Gitelman, Howard Ahn, Vincent Spielchuk, and Jinhee Kim, August 8, 2023. Canadian Medical Association Journal.
DOI: 10.1503/cmaj.230592