title: Hematopoietic toxicity from lead-containing Ayurvedic medications.
abstract: BACKGROUND
  Millions worldwide use Ayurvedic (traditional Indian) medicines. These medications are increasingly associated with lead poisoning, often accompanied by anemia. We compared the relative hematopoietic toxicity of Ayurvedic lead poisoning with a common form of occupational lead poisoning.
  
  
  METHODS
  We retrospectively studied 66 adult lead intoxications: 43 published Ayurvedic cases identified in published reports by searching MEDLINE (1966 to November 2005); 4 Ayurvedic patients seen at a referral center; and 19 lead paint intoxications from the same center. We considered patients' age, gender and blood lead at presentation, and then compared the groups with respect to hematopoietic parameters.
  
  
  RESULTS
  Ayurvedic lead poisoning was associated with higher blood lead (p<0.001), more basophilic stippling (p<0.001), lower hemoglobin (p<0.001) and higher protoporphyrin (p<0.001). Multiple regression adjusted for blood lead and gender found Ayurvedic lead poisoning associated with a 36.2 g/L (95% CI -48.8, -23.6 g/L) greater decrement in hemoglobin (p<0.001) as compared to paint-removal poisoning.
  
  
  CONCLUSIONS
  Ayurvedic poisoning produces greater hematopoietic toxicity than paint-removal poisoning. Ayurvedic ingestion should be considered in patients with anemia. Ayurveda users should be screened for lead exposure and strongly encouraged to discontinue metal-containing remedies.
authors.affiliation: Department of Medicine, Cambridge Health Alliance, Cambridge, MA 02139, USA. skales@challiance.org
authors.forename: Stefanos N
authors.initials: SN
authors.lastname: Kales
authors.forename: Costas A
authors.initials: CA
authors.lastname: Christophi
authors.forename: Robert B
authors.initials: RB
authors.lastname: Saper
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology; D000529:Complementary Therapies; D003937:Diagnosis, Differential; D005260:Female; D006413:Hematopoietic System / Q000187:drug effects*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007854:Lead / Q000633:toxicity*; D007855:Lead Poisoning / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008515:Medicine, Ayurvedic; D008875:Middle Aged; D011524:Protoporphyrins / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins; D011524:Protoporphyrins; D007854:Lead