Clinical Pharmacist and Master’s student in Clinical Pharmacy with research interests in pharmacovigilance, behavioral interventions in mental health, and AI applications in clinical decision support. Experience includes digital health research with Bloomsbury Health (London) and pharmacovigilance practice in patient support programs. Published work covers drug awareness among healthcare providers, postpartum depression management, and patient safety reporting. 
Clinical Pharmacist and Master’s student in Clinical Pharmacy with research interests in pharmacovigilance, behavioral interventions in mental health, and AI applications in clinical decision support. Experience includes digital health research with Bloomsbury Health (London) and pharmacovigilance practice in patient support programs. Published work covers drug awareness among healthcare providers, postpartum depression management, and patient safety reporting. What was reviewed?
This review article evaluates Ayurvedic medicine’s heavy metal poisoning by synthesizing evidence on the intentional and unintentional incorporation of mercury, arsenic, and lead into Ayurvedic preparations, their toxicokinetics and organ targets, documented poisonings, and current gaps in manufacturing controls. It traces Rasashastra’s doctrinal basis for metal use, summarizes prevalence data for contamination in marketed products, and details toxic effects, especially hepatotoxicity, nephrotoxicity, neurotoxicity, and endocrine disruption relevant to certification and regulatory oversight. The review also outlines recommended quality-control analytics for detecting heavy metals and other adulterants, while emphasizing inconsistent regulation and batch-to-batch variability in products sold in India and the United States.
Who was reviewed?
Populations and materials discussed include classical Ayurvedic formulations incorporating bhasmas and arsenicals, commercial herbal medicine products marketed online and in health stores in India and the United States, and preclinical animal studies in Sprague–Dawley rats that characterize organ-specific toxicity. The review cites at least 55 reported cases of heavy metal intoxication tied to Ayurvedic products since 1978, and prevalence studies showing substantial proportions of Ayurvedic items containing lead, mercury, and/or arsenic. It also references pediatric and adult exposures, as well as practitioner use cases in oncology-adjacent contexts.
Most important findings
| Critical point | Details |
|---|---|
| Metals are intentionally used in Rasashastra | Mercury (Parad), lead, and arsenic are incorporated after “purification,” with doctrinal claims of therapeutic synergy; however, improper processing leaves toxic residues and is linked to organ damage. |
| High prevalence of contamination | Surveys found heavy metals in many formulations; one investigation detected lead in 65% of 252 medicines and broader analyses identified mercury, lead, arsenic, and chromium in most sampled products. |
| Documented poisonings | At least 55 adult and pediatric intoxication cases associated with Ayurvedic products have been reported in the U.S. and abroad since 1978, underscoring ongoing exposure risk. |
| Mercury-specific hazards | Methylmercury causes neurodevelopmental, cardiovascular, hepatic, renal, and immune dysfunction; the text lists traditional “doshas” of mercury and stresses purification steps rarely standardized in commerce. |
| Arsenic in formulations | Orpiment, realgar, and arsenic trioxide are used in multiple remedies; arsenic trioxide’s cytotoxicity is acknowledged, yet gastrointestinal absorption and high inherent toxicity pose major safety concerns. |
| Lead toxicodynamics | Lead accumulates in blood, bone, and viscera with oxidative damage and genomic effects; even low-dose, chronic exposure elevates cardiovascular and developmental risks. |
| Manufacturing variability | Non-standardized production leads to potency and safety differences across manufacturers; over-the-counter access and supplement labeling in the U.S. limit premarket oversight. |
| Quality-control toolkit exists | Recommended analytics include heavy metal panels, pesticide and aflatoxin testing, microbial load assessment, and chromatographic methods (HPTLC/HPLC/GC–MS/NMR) to standardize raw materials and finished products. |
| Broader phytotoxin context | Beyond metals, multiple plant-derived toxins (e.g., pyrrolizidine alkaloids) can confound safety; thus, comprehensive screens must accompany metal testing. |
| Regulatory call to action | The article urges strict regulation, prescription-only access for validated remedies, mandatory heavy metal testing, and science-based education akin to TCM integration models. |
Key implications
For primary regulatory impacts, Ayurvedic medicine heavy metal poisoning evidence supports mandatory premarket metal testing with enforceable limits, lot traceability, and corrective action plans. Certification requirements for HTMC should include validated digestion methods and multi-element quantitation, supplier qualification, and periodic market surveillance. Industry applications hinge on standardized analytics and transparent labeling to enable compliant export. Research gaps include dose–response in chronic low-level exposures and real-world bioaccessibility. Practical recommendations prioritize GMP-aligned production, third-party verification, and physician counseling to mitigate consumer risk.
Citation
Sikder MM. Ayurvedic Medicine: A Traditional Medical System and Its Heavy Metal Poisoning. Chonnam Medical Journal. 2024;60(2):97-104. doi:10.4068/cmj.2024.60.2.97
