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Myalgia		Herbal Medicine
		Botanicals; Herbalism; Medicinal Herbs

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Ayurveda quackery flim flam for the wealthy but bored

Lead poisoning due to ingestion of Indian herbal remedies Anne Roche Christopher Florkowski Trevor Walmsley A case of lead poisoning is presented The patient had recently returned to New Zealand from the Indian subcontinent This prompted a search that identified lead contamination of ingested medicinal products that had been prescribed in India There have been several case reports of lead toxicity due to contamination of Indian herbal medicines 1 8 though none to our knowledge previously reported from New Zealand Case report A 51 year old New Zealand European woman presented to Christchurch Hospital with a 4 day history of nausea vomiting abdominal pain and myalgia She had been living in India for 3 years and had returned to New Zealand 10 days prior to admission She had Dengue fever 10 months before and had been non specifically unwell since She had been slightly forgetful and muddled in her thinking She had been taking traditional Ayurvedic medications acquired in India She had no other significant past medical history and took no other regular medications She did not drink alcohol On examination she was dehydrated and her abdomen was tender without peritonism She had normochromic anaemia haemoglobin 113 g L with prominent basophilic stippling seen on blood film She had elevated transaminases AST 97 U L ALT 183 U L but serology for Hepatitis A B C and E was negative Basophilic stippling prompted measurement of lead levels which were markedly elevated whole blood lead 3 35 umol L 69 3 ug dL reference range 0 00 0 35 There was no obvious occupational or domestic exposure There have been case reports of traditional Indian medications containing lead 1 8 and these were a possible source of exposure for our patient She had been removed from the exposure to lead and her level was just below the threshold for chelation therapy Her symptoms improved and we decided not to chelate but instead to monitor lead levels Whole blood lead was 2 92 umol L at 2 weeks later 2 69 umol L