Paracelsus' poison

Traditional Ayurvedic medicines without TGA registration may have toxic levels of heavy metals

On the weekend the Sydney Morning Herald reported that Health authorities had raided Indian grocery stores in Sydney’s southwest, confiscating traditional Indian medicines that they thought might contain toxic levels of lead.

Traditional Indian (Ayurvedic) medicine uses a variety of treatment modalities, from massage to herbal remedies. Ayurvedic herbal remedies are usually complex, and some may contain ground up gemstones, pearls or even heavy metals.

Heavy metals are added to Ayurvedic medicines as they are thought by Ayurvedic practitioners to contribute to the healing process. While Ayurvedic practitioners claim the processing of these medicines reduces toxicity, surveys of Ayurvedic medicines have consistently shown toxic levels of heavy metals (lead, mercury, arsenic) in around 1 in 5 Ayurvedic medicines (see here, here, here and here).

Australia, unlike the United States and several other countries, requires herbal and traditional medicines that are sold in Australia must ensure that levels of potentially toxic substances (such as heavy metals or toxic herbs or other material) are below the levels associated with harm.

There are exceptions, people are allowed to purchase small amounts of unapproved traditional remedies for personal use, and anything purchased on overseas websites is out of the control of the Therapeutic Goods Administration.

Given the high incidence of Ayurvedic medicines with toxic levels of heavy metals in them, people buying traditional medicines over the internet need to be extremely careful. Especially as e-pharmacies tend to be of low quality.

The Ayurvedic medicines that have been seized in Sydney were in Indian grocery stores. At the moment they are only suspected to have high levels of lead. The medicines were seized after a woman who had been using them showed high levels of lead.

If they are found to have high levels of lead (and or other heavy metals) then there appears to be a way to circumvent Australian regulations on traditional medicines that needs to be dealt with urgently. Consumers should always check for the registration number that means the medicine has been approved by the Therapeutic Goods Administration via the Australian Register of Therapeutic goods.

The medicine should carry prominently on the packaging and the label a number of the form AUST R 123456 (for registered medicines, one brand of paracetamol is AUST R 11122) or AUST L 123456 (for Listed medicines, most traditional and herbal medicines will be Listed). The numbers should usually be on the front of the packaging.

If the medicine does not carry a registration number do not purchase it, as there is no guarantee of quality or safety. If you have some of these medicines already, dispose of them safely (you can usually hand them in to pharmacies for disposal).

(the Sydney Morning Herald article says “Consumers need to be aware that safety, quality and effectiveness cannot be assured if the products have not been approved by the TGA”, but this claim about effectiveness is strictly true for registered medicines only, the therapeutic claims (and very limited claims for health maintenance and health enhancement are allowed) on listed medicines are not evaluated by the TGA at the time of listing, and it may be a long time before the claims are reviewed)