Consider lead toxicity due to Ayurvedic medications in patients with unexplained abdominal pain

1. In the past 6 months, we saw 5 patients with unexplained abdominal pain associated with weakness of hands and feet. All were taking Ayurvedic medicines for various reasons.
2. Blood lead levels were high in all of them (>25 mcg/dl). There was no history of occupational lead exposure in any of them.
They were treated with d-penicillamine (chelation therapy). Ayurvedic medicines were stopped.
#MedTwitter #NeuroTwitter #ayurvedicmedicine
3. Abdominal pain resolved. Weakness of hands and legs partially improved. Four patients had anemia and one had kidney damage (these showed only partial improvement).
4. About 9.3 % of patients with unexplained abdominal #pain are due to lead intoxication caused by taking Ayurvedic drugs.
doi.org/10.1080/155636…
5. Ayurvedic medicine Jambrulin caused lead toxicity in a 58-year old woman, leading to abdominal pain, anemia and deranged liver function tests.
doi.org/10.1186/1756-8…
6. Lead encephalopathy as a result of long-term ayurvedic medication intake can cause headache, #memory loss, confusion and worsening of sensorium. MRI brain shows damage and swelling (in basal ganglia and cerebral cortex) in these cases.
doi.org/10.4103/0028-3…
7. Lead was found in 65% of 252 Ayurvedic medicine samples tested. 36% of samples had concentrations of lead per pill that exceeded, up to several thousand times, the recommended daily intake values for pharmaceutical impurities.
doi.org/10.1080/107735…
8. Take home message
In patients with unexplained abdominal pain, anemia, memory loss, peripheral neuropathy or kidney damage, consider lead toxicity and enquire about Ayurvedic medicine intake.

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