Ayurvedic medicines — herbal mixtures dating back thousands of years in India and increasingly popular in the West — are frequently contaminated with lead, mercury or arsenic, according to a study published today.
A fifth of the nearly 200 concoctions tested contained levels of the toxic metals that, if taken at the maximum recommended doses, would surpass California’s safety guidelines.
Dr. Robert Saper, a Boston University professor of family medicine who led the study, said the findings should spur the Food and Drug Administration to start clamping down on the largely unregulated world of pills, herbs and powders classified as dietary supplements.
Ayurveda is a traditional Indian practice that takes a holistic approach to wellness, employing herbal medicine, meditation and exercise to promote good health. It exists alongside modern medicine in India, with its own network of clinics, hospitals and colleges serving hundreds of millions of patients.
It has spread to the U.S. and Europe with the migration of South Asians around the world and been popularized by figures such as bestselling author Deepak Chopra.
There are about two dozen ayurvedic training programs in the United States. A 2002 survey estimated that 750,000 U.S. residents have used the herbal preparations, sold under both traditional Indian names and more marketable labels such as GlucoRite and Ezi Slim.
Saper got interested in the supplements in 2003 after a man of Indian origin showed up at a Boston-area emergency room with seizures. The culprit turned out to be lead in the man’s ayurvedic medicines. In an initial study published in 2004, Saper bought 70 ayurvedic products imported from India and found that toxic metals were common components.
It was an unsettling finding, because most of the preparations are intended to be taken as part of a daily regimen to improve health.
“Many, many studies are showing that even small levels of lead in the blood can increase the risk of high blood pressure, kidney dysfunction and decreased IQ,” Saper said.
Ayurvedic practitioners lashed out at the research as alarmist, saying that it only showed there were problems with mixtures from India, not with U.S.-made products.
They pointed out that in India, many of these metals are purposely blended with herbs as part of the medicinal recipe. Those metallic mixtures are rarely used in the United States, they said.
The FDA does not specify any limits for metal content in dietary supplements, leaving it to the manufacturers to ensure that their products are safe.
Jennifer Rioux, a medical anthropologist who runs the Integral Ayurveda clinic in Chapel Hill, N.C., said the research underscored the need for consumers to consult with ayurvedic experts instead of buying and taking products on their own.
On a related note, see this book review of Trick or Treatment, by Simon Singh and Edzard Ernst, M.D.
Luckily, hundreds of studies have examined the purported benefits of various alternative-medicine treatments. In “Trick or Treatment,” Simon Singh and Dr. Edzard Ernst report on the results. Ginseng has been proposed as a cure-all for everything from cancer to common colds, but there’s no evidence that it does any good. Shiatsu massage appears to be a “waste of effort and expense,” the authors say. Many aspects of traditional Chinese medicine, like the use of the herbs aristolochia and liquorice, are potentially harmful. Aromatherapy can relieve stress, but there is not a lick of evidence that it can treat a specific illness. Chelation therapy — a legitimate method of removing heavy metals such as lead or mercury from the body, but now pitched in alternative-medicine circles as a cure for heart disease and other ailments — is “disproven, expensive, and dangerous,” according to Mr. Singh and Dr. Ernst. They urge patients “not to use this treatment.”
Some alternative remedies, it should be said, do appear to have value.
Dr. Ernst is not a dispassionate observer. He is a pioneer in the field of complementary medicine — a branch of the medical profession whose practitioners prescribe selective alternative treatments. But he is also a scourge of too-large claims made for his field. Based at the University of Exeter in England, he leads a research group that has spent 15 years studying alternative remedies, trying to separate snake oil from science. Mr. Singh, his co-author, is a science journalist whose books include “Fermat’s Enigma” and “Big Bang.” Together they conclude, after cataloging the evidence, that most of the popular forms of alternative medicine are “a throwback to the dark ages.” Too many alternative practitioners, they say, are “uninterested in determining the safety and efficacy of their interventions.”
And safety is a real concern. “Chiropractors who manipulate the neck can cause a stroke . . . some herbs can cause adverse reactions or can interfere with conventional drugs.” The authors are particularly hard on homeopathy, the practice of using ultradilute solutions of common substances. The solutions are so dilute, though, that they are often little more than water. “Homeopathic remedies, which of course contain no active ingredient, can be dangerous if they delay or replace a more orthodox treatment,” Mr. Singh and Dr. Ernst write, calling homeopathy “the worst therapy encountered so far — it is an implausible therapy that has failed to prove itself after two centuries and some 200 clinical studies.”
“Trick or Treatment” includes a brisk history of our evidence-based approach to medicine, tracing the development of the modern clinical trial from its earliest days, when scurvy was shown to be caused by insufficient vitamin C and bleeding was debunked as a medical cure. Unfortunately, the evidence of clinical trials is largely ignored when it comes to alternative medicine.
So the treatments persist: Americans spend an astonishing $3 billion annually on chiropractors and about $1.5 billion on homeopathy, not to mention billions more for herbal remedies.
Dr. Gottlieb, a resident fellow at the American Enterprise Institute, is a former official at the Food and Drug Administration and the Centers for Medicare and Medicaid Services.