Lead toxicity from Ayurvedic medicines
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KEY POINTS A 39-year-old woman presented to the emergency department 3 times over 6 weeks with abdominal pain, constipation, nausea and vomiting. She had a medical history of hypothyroidism and infertility, and was taking levothyroxine, follitropin alfa injections and folic acid. She lived in a

KEY POINTS

  • Use of Ayurvedic medications is relatively common; these medications may be contaminated with lead and other heavy metals.
  • Clinicians should consider lead toxicity in patients with microcytic anemia of unknown cause, particularly if basophilic stippling is present, or in patients with abdominal pain, headache, fatigue, new or worsening cognitive impairment and a suspicious exposure history.
  • An elevated lead level in blood samples confirms the diagnosis of lead toxicity.
  • Clinicians should contact public health organizations to identify and remove Ayurvedic medications that are contaminated with lead from the market.