Re: NOT ALL Ayurvedic drugs pose severe health risk

markd_at_toad-net.com
Date: 10/09/04 

Date: 09 Oct 2004 16:46:16 GMT

Fine, we can accept them when testing shows, based on government
regulations, that the drugs are both effective and safe.

>Please Remember there are companies who produce genuine medicines and
>some make non genuine medicines also around the world irrespective of
>system.
>
>It is true that some companies in North India prepare medicines using
>heavy metals. If heavy metals are not prepared properly as explained
>in the proceedure, it can do harm to the body. This happens when the
>companies focus on their revenue but not on quality.
>
>There are several very old traditionals herbal medicine manufactures
>in the south Inida specially in Kerala and Tamil Nadu. These companies
>produce only herrabl medicines and have good reputation in the public
>as well as the goverment. Some examples are The Arya Vaidya Pharmacy
>Coimbatore Ltd, The Arya Vaidya Sala Kottakkal, Vaidya Rathnam
>Oushadha Sala etc. The Arya Vaidya Pharmacy Coimbatore si a very big
>Institution, whcih has already done several reseach projects
>collaborating with the World Health Organisation, The Indian Council
>For Indian Medical Research, National Institute for Health Science USA
>etc.
>
>Those who want to know more about such information may contact such
>companies or even make a visit to India.
>
>I have visited India and many Ayurvedic Institutions also to the
>factories of thse companies. I have found this personally. You can
>also contact Dr. Hari at pallathery@sify.com and may visit
>www.avpayurveda.com
>
>
>
>drug@watchdo.com wrote in message news:<41670650$0$248$4d5ecec7@reader.city-net
>.com>...
>> Toxic Heavy Metals and Undeclared Drugs in Asian Herbal Medicines
>> by Edzard Ernst
>> This article will also appear in Trends in Pharmacological Sciences.
>> Issue 120
>> Abstract Asian herbal medicines are currently used by large sections
>> of the population. Because they are not regulated as medicines and are
>> freely available to everyone, serious safety concerns might be
>> associated with these herbal medicines.
>> In this article, evidence suggesting that some Asian herbal medicines
>> contain toxic heavy metals or undeclared prescription drugs is
>> reviewed. In particular, Indian and Chinese preparations have been
>> implicated.
>> Although adulteration with drugs is by definition fraudulent, the
>> inclusion of heavy metals could be either intentional for alleged
>> medicinal purposes or accidental.
>> Evidence from various countries implies that toxic heavy metals and
>> undeclared prescription drugs in Asian herbal medicines might
>> constitute a serious health problem. However, the majority of the data
>> is anecdotal and insufficient to define prevalence figures.
>> Ways ought to be found to maximize consumer safety.
>> In most developed countries, Asian herbal medicines (AHMs) are
>> becoming more and more popular [1]. However, usually AHMs are not
>> regulated as medicines. Problems might arise as a result of the lack
>> of adequate regulations, the pharmacological complexity of herbal
>> products, and the paucity of information on the pharmacology and
>> toxicity of these compounds. AHMs can be purchased from outlets
>> ranging from health-food stores to Internet sites, and thus a crucial
>> evaluation of their safety is relevant and important.
>> One obvious safety issue relates to the possibility that some AHMs
>> contain heavy metals or undeclared drugs [2]. Based on a review of the
>> recent medical literature (Medline, Embase 1990-2001), this article
>> aims to summarize the recent evidence pertaining to this subject.
>> Indian Remedies Indian medical systems (e.g. Ayurveda and Unani) have
>> a long and rich history of herbal medicine, and heavy metals have been
>> a regular and deliberate constituent of traditional Indian remedies
>> [3]. Thus, to use the term "contamination" with respect to the
>> presence of heavy metals in such remedies might be misleading (see
>> below).
>> A London-based toxicology unit published a case series of adverse
>> events associated with traditional medicines that were reported to
>> them between 1991 and 1995 [4]. Of 12 cases of poisoning with lead,
>> arsenic or mercury, nine cases were associated with herbal remedies
>> from India and the remainder was due to traditional Indian cosmetics
>> (e.g., "surma.")
>> A recent exemplary case report from Italy [5] (box 1) exhibits many
>> hallmarks of such cases: desperate parents, non-medically qualified
>> healers, lack of product standards, undeclared ingredients,
>> nondisclosure of usage and long-term medication, in addition to delay
>> of diagnosis of poisoning and hence delay of effective therapy. Indian
>> authors recently analyzed 31 Ayurvedic formulations obtained in India
>> for their mercury content [6].
>> With the exception of one remedy, all exceeded the legal limits of 1
>> ppm mercury and 16 preparations exceeded the limits by more than two
>> orders of magnitude. These authors also noted that huge variability of
>> mercury content existed within one allegedly identical remedy
>> manufactured by different companies.
>> No recent systematic investigations are available about the prevalence
>> of heavy metal content of traditional Indian remedies on sale in
>> developed countries.
>> Thus, a considerable degree of uncertainty continues to surround this
>> area.
>> Chinese Remedies Numerous case reports and case series of heavy metal
>> poisoning associated with the use of traditional Chinese medicines
>> (TCMs) have been published [7]; lead has relatively often been
>> implicated as the cause of such poisoning but mercury, cadmium,
>> arsenic, copper, and thallium have also been found in TCMs [7].
>> Californian officials have screened for undeclared pharmaceuticals and
>> heavy metals in imported Chinese remedies on sale in Californian
>> herbal retail stores [8]. Seven percent of the 251 products tested
>> contained undeclared pharmaceuticals (e.g., ephedrine,
>> chlorpheniramine, methyltestosterone, and phenacetin). Twenty-four
>> products contained at least 10 ppm lead, 36 contained an average of
>> 14.6 ppm arsenic, 35 contained an average of 1,046 ppm mercury, and 23
>> had more than one contaminant and/or adulterant.
>> Koh and Woo [9] reported the detection of toxic heavy metals that
>> exceeded Singapore's legal limits in 42 Chinese proprietary medicines.
>> They collected 2,080 samples of such medicines in Singapore and tested
>> them for heavy metal content. Forty-two different medicines were found
>> to contain metals in amounts exceeding the legal limits.
>> Mercury was found in 28 products, lead in eight, arsenic in six, and
>> copper in one. One product contained both mercury and lead and another
>> product contained both mercury and arsenic. Melchart et al. [10]
>> analyzed all 317 batches of dried Chinese herbs delivered to a German
>> hospital of Chinese medicine.
>> Heavy metal content beyond the legal limits was detected in 3.5% of
>> these samples. Obviously, heavy metals are not the only possible toxic
>> ingredients in herbal remedies; contamination with herbicides,
>> pesticides, microorganisms; or mycotoxins, insects, or undeclared
>> herbal constituents are other relevant possibilities [2,11-13].
>> Moreover, contamination with toxic herbal constituents (e.g., through
>> misidentification of the herbal ingredients) can be a serious problem.
>> In Belgium, the use of a TCM contaminated with plants from the
>> Aristolochia species resulted in an epidemic of subacute intestinal
>> nephropathy. Many of the affected patients required kidney
>> transplantation. When 19 kidneys and urethras removed from ten such
>> patients were examined histologically, there were conclusive signs of
>> neoplasms in 40% of cases [14].
>> Numerous case reports originating from countries such as Australia,
>> Belgium, China, the Netherlands, New Zealand, United Kingdom, and
>> United States demonstrate the adulteration of TCMs with synthetic
>> drugs and associate the use of adultered remedies with health problems
>> of the user [15]. The adulterants include a wide range of
>> pharmaceuticals (box 2). The resulting clinical consequences are often
>> serious and sometimes life threatening: agranulocytosis, Cushing's
>> syndrome, coma, the excessive increase of the international normalized
>> ratio (INR) have all been reported.
>> In other cases, the adulterants caused no symptoms at all and the
>> problem was discovered only through routine check-ups or through the
>> remarkably good clinical response, which turned out to be due not to
>> the TCM but to the undeclared prescription drug.
>> Analyses are available of Chinese herbal medicines collected in
>> Australia [16], Taiwan [17] and UK [18]. The largest of these studies
>> is that of Huang and colleagues from Taiwan [17], who showed that 24%
>> of all 2,609 samples collected contained at least one adulterant.
>> This high prevalence was due to the fact that the samples were
>> associated with reports of adverse effects and poisoning, and possibly
>> included low-grade folk remedies. Examples of recent case reports
>> [19,20] are illustrated in boxes 3 and 4.
>> Concerns About the Safety of Asian Herbal Medicines
>> These data raise concerns about the safety of consumers using AHMs.
>> Both toxic heavy metal content and adulteration with prescription
>> drugs have been reported. To date, few data are available to calculate
>> the prevalence of these problems reliably in developed countries.
>> A recent press release [21] of the British "Medicines Control Agency"
>> stated that this regulatory body "continues to find potentially
>> dangerous and illegal ingredients in TCMs. Recently TCMs have been
>> found to include . . . mercury and arsenic . . . [and] prescription
>> only steroids." It is notable that the majority of clinical problems
>> occur with self-prescription of AHMs.
>> One could therefore argue that consulting an experienced herbal
>> practitioner might avert adverse events; however, evidence is required
>> to support this claim. Several possibilities exist to explain the
>> presence of heavy metals in AHMs. First, heavy metals could be
>> included intentionally for alleged medicinal properties.
>> Some Indian schools of medicine emphasize the importance of metals
>> such as lead, copper, gold, iron, mercury, silver, tin and zinc for
>> the proper function of the human body [22]. Ayurvedic textbooks, for
>> example, take note of the toxicity of heavy metals and recommend
>> special physicochemical processes that, according to ancient Indian
>> belief, "detoxify" such toxic heavy metals (e.g. by heating them until
>> they glow [23]).
>> In traditional Chinese medicine, mercury is part of some preparations
>> under the terminology of "cinnabaris" (mercury sulfide), "calomel"
>> (mercury chloride) or "hydrargyri oxydum rubrum" (mercury oxide). Such
>> products are used for a variety of indications including, for example,
>> as a tranquilliser, an anti-epileptic, for ulcers or to treat insomnia
>> [9]. Lead is used as "Mi Tuo Seng" (Lithargyrum) [24] and arsenic as
>> "Xiong Huang" (Realgar) [25] in the manufacture of several TCMs.
>> Strictly speaking, these constituents are thus not contaminants but
>> ingredients deliberately included for a specific curative purpose.
>> Second, the presence of heavy metals might be the result of
>> contamination during manufacture, for example, from grinding weights
>> or lead-increasing containers or other manufacturing utensils [9].
>> Third, AHMs might contain heavy metals when grown on seriously
>> polluted soil [26].
>> In this context it is relevant to note that TCMs might also contain
>> animal and mineral products and that these too might be contaminated
>> with heavy metals [27].
>> Although contamination can be accidental, adulteration is, by
>> definition, fraudulent. The reasons why some AHMs contain prescription
>> drugs are speculative. I suspect that some manufacturers include such
>> ingredients to render their products more clinically effective. If
>> this is the case, it seems obvious that the inclusion of prescription
>> drugs is fraudulent and illegal.
>> Many consumers are motivated to try AHMs through a misconception that
>> these remedies are inherently safe [28], and there is evidence that
>> the (UK) daily press have their share in perpetuating this myth [29].
>> Approximately half of the individuals using herbal medicines do not
>> tell their physician [30]. This level of non-communication further
>> increases the risk to the consumer because doctors might fail to
>> diagnose adverse effects caused by treatments of which they are not
>> aware. The majority of people taking herbal remedies combine them with
>> conventional drugs [30]. This opens the possibility of herb-drug
>> interactions [31,32], which, in turn, further raises concern about
>> consumer safety.
>> Recent evidence suggests that consumers are beginning to become
>> concerned about the risks of under-regulation of dietary supplements,
>> and the majority of US consumers now seem to support [33]: (1) the
>> requirement that the Food and Drug Administration (FDA) review the
>> safety of new dietary supplements before their sale; (2) increased
>> authority to remove from sale those products shown to be unsafe; and
>> (3) increased government regulation to ensure that advertising claims
>> about the health benefits of dietary supplements are true.
>> How can the risk to patients be minimized? An appropriate strategy
>> [34,35] (box 5) should follow several avenues. The consumer should be
>> informed that "natural" does not necessarily mean 'free from risk' and
>> that adverse effects as a result of AHMs are an undeniable reality.
>> Patients and physicians should be encouraged to talk about the use of
>> AHMs and other complementary/alternative treatments [34] and the
>> possibility of interactions of herbal medicines with prescribed drugs
>> [31,32].
>> Regulators should consider measures to control this sector of
>> healthcare more effectively. It is concluded that toxic herbal metals
>> and undeclared drugs in AHM represent a potentially serious problem
>> that puts consumers at risk. Means of minimizing this risk must be
>> found and implemented.
>> Wang, Ang, b. 1615; Hu, Tsung-wen Shen-nung pen ts'ao pei yao i fang
>> ho pien (Herbal and Prescriptions) China, 1740. 6 vols. from The
>> National Library of Medicine.
>> ==================================================================
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>>
>> Remember we are NOT Doctors and have NO medical training.

Relevant Pages

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