Mark Hoofnagle has a MD and PhD in physiology from the University of Virginia, and is now a general surgery resident. His interest in denialism concerns the use of denialist tactics to confuse public understanding of scientific knowledge.
There is an ongoing discussion amongst our Sciblings regarding our German counterparts at scienceblogs.de. Apparently they have some odd folks as science bloggers over there, including people who think ayurvedic heavy metals are good for you. In the tradition of countering speech with speech, I'm giving you this repost. More to come, I'm sure. --PalMD
The Infectious Disease Promotion Movement (let by such intellectual luminaries as Jenny McCarthy) may be worried about "toxins" in vaccines, but the real problem may hiding in plain sight.
Today's issue of JAMA has an interesting study of Ayurvedic (traditional Indian) medicines. It turns out that many of them contain a significant amount of toxic heavy metals.
Let's have a little refresher on the difference between science-based medicine and everything else. Science-based medicine is medicine based on science, everything else is either unproven or bullshit. Appealing to "ancient traditions" is a common practice among the "altmed" crowds. After all, if it's been used for thousands of years, it must have something to it, right? Well, not really. After all, the only thing "ancient" really means is "pre-scientific". Why trust your health to an ossified, thousand-year-old belief system based on superstition?
Well, here's another good reason not to go with "tradition" over science.
Overall, the prevalence of Ayurvedic medicines containing detectable lead, mercury, and/or arsenic was 20.7% (Table 2). Lead was the most commonly found metal, followed by mercury and arsenic. The prevalence of metal-containing products did not differ significantly between US- and Indian-manufactured products. The median lead concentration in Indian-manufactured vs US-manufactured lead-containing products was similar. Mercury was present in greater concentrations in Indian-manufactured products. Rasa shastra compared with non-rasa shastra medicines were more than twice as likely to contain metals. Rasa shastra metal-containing medicines had higher lead and mercury median concentrations than non-rasa shastra metal-containing medicines.[...]
Ayurvedic medicines manufactured in the United States contained primarily lead at concentrations below 25 µg/g, whereas Indian-manufactured medicines contained both lead and mercury at concentrations that reached 104 µg/g. Rasa shastra medicines were more likely to be manufactured in India. Agnitundi Bati, Ekangvir Ras, and Arogyavardhini Bati were Indian-manufactured rasa shastra medicines distributed by US Web sites with extremely elevated lead and mercury concentrations. In contrast, US-manufactured rasa shastra medicines did not contain detectable mercury and had lower lead concentrations than those manufactured in India.
[...]
Manufacturers of 75% of the metal-containing products claimed Good Manufacturing Practices or metal testing, and these claims were not associated with a lower prevalence of toxic metals. Membership in ADMA was not associated with a lower likelihood of metal presence compared with nonmembership. Products made by AHPA members compared with nonmembers were less likely to contain metals. Products containing metals were more likely to be tablets and less likely to be liquids or pastes.
[...]
All metal-containing products would cause ingestions exceeding at least 1 regulatory standard. Indian-manufactured rasa shastra medicines would cause the greatest lead and mercury ingestions, often substantially exceeding all standards [or maximum daily metal intakes].
Well, at least this crap is more likely than, say, Echinacea to be pharmacologically active. It's just that the biologic activity is not particularly desired---heavy metal poisoning is rather unpleasant.
One particular type of Ayurvedic medicine (rasa shastra) has particularly high levels of metals which are included intentionally. What is the justification?
Ayurveda advocates in India maintain that rasa shastra medicines have been used effectively and safely for millennia. They ascribe case reports of metal toxicity to improper commercial manufacturing practices or lack of supervision from a practitioner skilled in rasa shastra...Ayurveda experts in India believe that if bhasmas are properly prepared according to ancient protocols, the metals undergo shodhana ("purification"), rendering them nontoxic and therapeutic.
In other words, the toxins are only toxic because the right person didn't say the right magic spell. This almost makes homeopathy look legit (OK, sorry, just kidding. They're both bullshit, just with different levels of hazard.)
These preparations are widely available both in the U.S. and elsewhere, are intentionally laden with toxic metals, and falsely claim to be "officially" safe. With our available modern understanding of science, biology, and medicine, there is no excuse for this kind of modern shamanism.
Engage the skeptical brain, dear readers. Vaccines don't contain toxins, herbal remedies do.
Referrence
Saper, R., et al, . (2008). Lead, Mercury, and Arsenic in US- and Indian-Manufactured Ayurvedic Medicines Sold via the Internet. Journal of the American Medical Association, 300(8), 915-923.
Medicine & Health
Comments
I wonder how many antivax loonies are "treating" their autistic children with ayurvedic medicines.
Posted by: tresmal | August 27, 2008 7:46 PM
Over here in the UK, although a lot of alternative "therapies" don't need to prove their effectiveness they do need to prove that they're not actively dangerous. (I believe the situation is similar in the USA?) If this information is borne out it could put a serious damper on such medicines.
Posted by: SimonG | August 27, 2008 8:02 PM
Why do you say "At least ... pharmacologically active?" It's almost always better to use an alt med that doesn't do anything (other than be a placebo) than one that does something.
Posted by: Anthony | August 27, 2008 8:38 PM
Let me guess; mercury doesn't cause autism(or any of the things it actually does cause) if you are ingesting it according to an alternate modality of knowing...
Posted by: phisrow | August 27, 2008 9:12 PM
I think the book Suckers makes this point ab out both TCM and Ayurvedic.
Posted by: Thadd | August 27, 2008 9:13 PM
please bare in mind neither homeopathic medicines nor herbal extracts in potencied form of ayurveda contain toxins .That is why our scientists are yet to understand how homeopathy works .Instead 0f trying to understand / investigate the case studies of every diseases on a personal merit,they outright condemn it as placebo effect .I have been an engineer and scientist having put myself and my family for the last 40 years on homeopathy and ayurveda .In fact to my surprise many families whom i treat(who depend only on my treatment)rarely fall sick and enjoy very good health .In fact deadly incurable diseases as deemed by allopathy school of thought ,find def eatable in most gentle way, under homeopathy or ayurveda or siddha system of medicine which are basically scientific(and just not only traditional ) in most natural way . Indians are known for their tradition and strong scientific out look thousand's of years back and just not today.In fact so called modern scientists who condemn alt medicine are really unaware of it ,just because they are unable to understand the science in these systems and are mentally blocked .
In fact as a scientist, i request "those critise these system of medicine " to have a fresh look ,with an open mind so that if at all(!!)possibility of any minor errors creeping in, during manufacturing process,can be identified and rectified inline with present scientific outlook for the ultimate use of human kind .
Posted by: dr bala | August 28, 2008 2:14 AM
Dr. Bala, are you too mentally blocked to use your shift key?
Seriously, I lost count of the logical fallacies and woo woo bingo words in your post. But that's just my allopathic western closed mind outright condemning this natural healing modality.
And what is it with engineers and alt med or creationism and 9/11 truthers? Can somebody do a case study on that?
Posted by: Niobe | August 28, 2008 3:27 AM
And what is it with engineers and alt med or creationism and 9/11 truthers?
Just speculation, and says nothing about creationism or general conspiracy nuttery, but engineers are generally more interested in what works than how it works: practice over theory. As such, they might be more easily swayed by a "therapy" that claims to be super wonderful regardless of the fact that there's no viable mechanism for it.
I guess with herbal remedies and the like they can partly be excused since the herbs are "pharmacologically active" although it is dismaying that presumedly intelligent people buy into the idea of there being some arcane process involved, instead of going for a proper medicine which doesn't have all manner of added poisons.
Posted by: SimonG | August 28, 2008 5:07 AM
But what harm could there be? Mercury is organic, straight from Mother Earth.
Posted by: I am so wise | August 28, 2008 8:43 AM
Non-organic mercury is of course not as much of a problem as certain organic mercuries such as methyl-Hg
Posted by: PalMD
| August 28, 2008 9:09 AM
JAMA had a similar article three years ago - Ayurvedic medicines contain heavy metals.
Posted by: Skeptico | August 28, 2008 10:37 AM
But, but, "dr." bala said that they don't! Whomever should I believe? Actual, you know, science, or the guy who *calls* himself a scientist? I'm so conflicted!
BTW, Best unintentional truth of the week:Indians are known for their tradition and strong scientific out look thousand's of years back and just not today.
Just not today, indeed. In the past, perhaps. In the future, maybe. But not today.
Posted by: LanceR | August 28, 2008 11:10 AM
Hey, would this stuff be any good at curing my echinacea? It grows like 5 flowers just at rabbit-eating height, and nothing more all summer.
Posted by: Johnny Vector | August 28, 2008 1:06 PM
Recently, I've been using vaccines as a homeopathic remedy for autism.
Posted by: mark | August 28, 2008 2:32 PM
Lots of ancient peoples took preparations of mercury and mercuric compounds, believing that mercury would somehow magically give them good health or eternal life. Where did people get those ideas from??? I mean, mercury is all shiny and liquid and special, but why would you think ingesting it would do you any good?
Posted by: synapse | August 28, 2008 3:26 PM
tastes like chicken
Posted by: Anonymous | August 28, 2008 3:47 PM
synapse, some of those mercury compounds had immediate, readily apparent effects- for example, calomel (mercurous chloride) was used as a diuretic and laxative on into the 19th century. For societies that believed in removing "impurities" from the body, a drug that would make the patient piss and shit copiously must have semed like just what the docgtor ordered- never mind that you were getting rid of the impurities by dosing the patient with an actual poison.
Something else that come to mind is that gold and silver are both soluble in mercury, and this capacity to form amalgams was used in extracting gold and silver from their ores well back into the past. Possibly a mystteriously liquid metal that could dissolve precious metals would acquire a mystical reputation by virtue of those properties.
Posted by: Ktesibios | August 28, 2008 6:17 PM
PalMD said: Well, at least this crap is more likely than, say, Echinacea to be pharmacologically active.
FYI, Echinacea is pharmacologically active.
First, it stimulates phagocytosis. That makes it useful in the "clean up" phase of upper respiratory viruses, but it's not at alluseful for preventing them. Second, it inhibits histamine release from mast cells, which tends to minimize allergic inflammation. It's useful for controlling respiratory allergies, although it's not fast-acting.
Posted by: Tsu Dho Nimh | August 28, 2008 7:17 PM
Just speculation, and says nothing about creationism or general conspiracy nuttery, but engineers are generally more interested in what works than how it works: practice over theory.
Huh?
Do you have actual information to back this up? Is there some study of the percentage of whackjob engineers? Or do you "have a friend" who happens to be a lazy engineer?
In case anyone's wondering, the best way to spot an engineer is to go check out some marvelously high-tech contraption and look for the person saying, "That's awesome! How does it work?!" (If you wait until they think everyone else is gone, you will see them sneaking back to take the gizmo apart and figure it out for themselves.)
As for my own anecdotal evidence, I know at least 30 engineers very well, having been one myself. Of those, I know of one who was a creationist and one who bought into the 9/11 "truth" crap. Granted there may have been a few more harboring irrational beliefs and keeping them quiet, but even allowing for five or six more in each category--that's a MUCH lower percentage of whackjobs than in the US population at large, eh? Of course, this doesn't prove anything. It's anecdotal.
Posted by: Michelle | September 3, 2008 8:47 AM
I think the question of engineers/crazy beliefs is partly confirmation bias and partly "squeaky wheel" bias. (I just made that up...)
Engineers who believe crazy things are often promoted by those who promote such things as "men of science". "Listen to this guy! He does actual science-y stuff!" So the "squeaky wheel" engineers get all the press.
Whenever we hear of these engineer/nuts we think "There's another one!" and forget all about the millions of engineers who believe no such garbage.
Posted by: LanceR | September 3, 2008 10:10 AM
@Mr. Nimh,
Sure, lots of weeds are pharmacologically active. The question remains: is echinacea clinically useful? Do you have good-quality, clinical research that backs up your claims?
Posted by: Joe | December 1, 2008 3:26 PM
I love nature and plants, such as
- foxglove (beutiful flower with violet or yellow flowers)
- deadly nightshade (aka atropa belladona)
- hemlock (many philosophical considerations)
- wolfsbane (decorative plant with blue, purple, white, yellow or pink flowers)
- mezereon (attractive flowers, beautiful red berries, a simple touch can harm sensitive people)
- autumn crocus (so pretty at the end of summer)
- death cap (said to taste good)
and so on and so forth.
Anyone who absorbs a sufficient dose of these plants or mushrooms can die a very "natural" death.
Posted by: Michelle Schatzman | December 1, 2008 5:49 PM
I mean, mercury is all shiny and liquid and special, but why would you think ingesting it would do you any good?
Shiiiiiinyyyyyy!!!
Posted by: D. C. Sessions | December 1, 2008 6:00 PM
@Mr. Nimh,
FYI, that's Ms. Nimh.
Posted by: D. C. Sessions | December 1, 2008 6:04 PM
"Overall, the prevalence of Ayurvedic medicines containing detectable lead, mercury, and/or arsenic was 20.7% (Table 2)."
For what it is worth, a good lab can detect lead and/or mercury at obscenely low levels. pico- and femtogram blanks are not uncommon in a good isotope lab. So saying something is detectable doesn't tell us much unless the DL and/or methodology are given.
That being said, 100ppm is a huge blank- you're doing something wrong- like using Pb-stabilized plastics in your manufacturing process- if you get that by accident.
Posted by: Lab Lemming | December 1, 2008 9:10 PM
It's not just Ayurvedic traditional medicine. Cinnabar (red mercury) is a common ingredient in some Chinese traditional medicines too. There's a long history of mercury use in all sorts of ways. It seems strange that autism is on the rise when mercury contamination is a lot lower than in previous centuries.
http://drvitelli.typepad.com/providentia/2008/05/the-mercury-mav.html
Posted by: Anonymous | December 1, 2008 10:26 PM
Sanitation engineer, perhaps. Seems anyone can call themselves an engineer. Maybe he's a train driver.
Posted by: Paul Murray | December 1, 2008 10:40 PM
As for mercury's magical properties: ancient peoples seemed to think that anything that moved by itself was alive. This includes astronomical objects and liquids - rivers and springs and whatnot. The "Quick" in "quicksilver" is an old word meaning "alive".
Posted by: Paul Murray | December 1, 2008 10:43 PM
Michelle,
"- hemlock (many philosophical considerations)"
Brilliant.
Posted by: sng | December 2, 2008 12:20 AM
Michelle wins the thread!
Posted by: Kathryn | December 2, 2008 2:27 AM
synapse, some of those mercury compounds had immediate, readily apparent effects- for example, calomel (mercurous chloride) was used as a diuretic and laxative on into the 19th century.Actually, 20th century.
Posted by: Blind Squirrel FCD | December 2, 2008 3:24 AM
Not only heavy metals are in eastern medicines.
One can also find potent carcinogens such as aristolochia acid.
Overweight ladies in Belgium made a chinese tea diet, which resulted in prophylactic nephrectomy.
Details here:
N Engl J Med. 2000 Jun 8;342(23):1686-92.
Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi)
Nortier JL, Martinez MC, Schmeiser HH, Arlt VM, Bieler CA, Petein M, Depierreux MF, De Pauw L, Abramowicz D, Vereerstraeten P, Vanherweghem JL.
Department of Nephrology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium. jnortier@ulb.ac.be
BACKGROUND: Chinese-herb nephropathy is a progressive form of renal fibrosis that develops in some patients who take weight-reducing pills containing Chinese herbs. Because of a manufacturing error, one of the herbs in these pills (Stephania tetrandra) was inadvertently replaced by Aristolochia fangchi, which is nephrotoxic and carcinogenic. METHODS: The diagnosis of a neoplastic lesion in the native urinary tract of a renal-transplant recipient who had Chinese-herb nephropathy prompted us to propose regular cystoscopic examinations and the prophylactic removal of the native kidneys and ureters in all our patients with end-stage Chinese-herb nephropathy who were being treated with either transplantation or dialysis. Surgical specimens were examined histologically and analyzed for the presence of DNA adducts formed by aristolochic acid. All prescriptions written for Chinese-herb weight-reducing compounds during the period of exposure (1990 to 1992) in these patients were obtained, and the cumulative doses were calculated. RESULTS: Among 39 patients who agreed to undergo prophylactic surgery, there were 18 cases of urothelial carcinoma (prevalence, 46 percent; 95 percent confidence interval, 29 to 62 percent): 17 cases of carcinoma of the ureter, renal pelvis, or both and 1 papillary bladder tumor. Nineteen of the remaining patients had mild-to-moderate urothelial dysplasia, and two had normal urothelium. All tissue samples analyzed contained aristolochic acid-related DNA adducts. The cumulative dose of aristolochia was a significant risk factor for urothelial carcinoma, with total doses of more than 200 g associated with a higher risk of urothelial carcinoma. CONCLUSIONS: The prevalence of urothelial carcinoma among patients with end-stage Chinese-herb nephropathy (caused by aristolochia species) is a high.
Posted by: Wolfgang | December 2, 2008 3:29 AM
@Wolfgang
You've got to love that legendary Chinese quality control - lead in childrens toys, melamine in pet food etc.
I used to take a Chinese herbal combination that was supposed to boost my immune system (recommended by a dumb ass MD). Then I remembered that Chinese made tools (and nearly everything else made the the PRC) are low quality crap and realized who insane it is to put anything made in China into my body.
With regard to Ayurvedic medicine and tradition in general - usually all tradition provides is a template for repeating mistakes.
Posted by: Militant Agnostic | December 2, 2008 5:03 AM
Hey, this "Dr" Bala called him/herself an engineer, scientist *and* a doctor. If you only remember the "engineer" part, then start asking yourself why there seem to be so many crazy engineers, look at thyself.
@Paul Murray: "Sanitation engineers", nice point!
Posted by: Thomas | December 2, 2008 5:44 AM
@Mr. Nimh,
"FYI, that's Ms. Nimh." Posted by: D. C. Sessions
Sorry, on the Net it's hard to distinguish among male, female and Republican.
Posted by: Joe | December 2, 2008 8:08 AM
Dr. Bala says deadly incurable diseases as deemed by allopathy school of thought ,find def eatable in most gentle way, under homeopathy or ayurveda or siddha system of medicine
So what was the mortality rate of smallpox or cholera back in the old days?
Posted by: Anonymous | December 2, 2008 10:01 AM
Joe ...
Rininger, J.A., Kickner, S., Chigurupati,P., Mclean, A., Franck, Z., (2000),Immunopharmacological activity of Echinacea preparations following simulated digestion on murine macrophages and human peripheral blood mononuclear cells, Journal ofleukocyte biology, 68: 503-510
Trying to prevent colds with Echinacea is like trying to prevent them with penicillin. It's not going to work, but that doesn't mean penicillin is useless. Echinacea is useful for shortening the "toxic sludge" stage after the cold.
Posted by: Tsu Dho Nimh | December 2, 2008 10:17 AM
So what was the mortality rate of smallpox or cholera back in the old days?
Lovely question that!
Homeopathy advocates like to cite the 1854 London cholera outbreak, where "homeopathic hospitals" had a case mortality rate of about 20% compared to about twice as high in the mainstream hospitals nearby.
There are all sorts of reasonable explanations. For one, the mainstream hospitals may well have been killing their patients; it was a popular practice of the times. The "homeopathic hospitals," from all accounts, also practiced supportive care in advance of the times.
However, the key statistic is that the overall mortality for the London outbreaks was 53,000 deaths for at least 250,000 cases. Do the math.
Posted by: D. C. Sessions | December 2, 2008 10:33 AM
Living very close to NYC, I've come in contact with some, shall we say,*interesting* products in Indian grocery stores, Korean supermarkets,and of course, herb and food stores in NYC's Chinatown,including:Hong Kong antibiotics,some lethal-looking black Indian hair dye( absolutely not henna),OTC "cure-all" skin salves,Ayurvedic remedies,and myriad Chinese formulas in pill form containing who-knows-what.Of course, I'm only talking about product labels that I *could* read.I've always wondered how this is possible? OK,I know - there are tiny alleyways crammed with little disorganized shops where shelves are packed with minuscule bottles with labels written in ... actual Chinese!But really. If I could find this stuff so easily...
Posted by: Denice Walter | December 2, 2008 12:46 PM
@TD Nimh,
That is not a clinical study. Don't you know the old saying "in vivo veritas"?
I don't know what the "toxic sludge stage of a cold" is; but I doubt you have compelling, clinical data. I am familiar with penicillin and stuff like that- yes we do know when it is useful and when it is not. However, if there is a pharmaceutically useful component in echinacea it has yet to be discovered- either as the herb or (preferably) as purified components.
Posted by: Joe | December 2, 2008 1:13 PM
I don't know what the "toxic sludge stage of a cold" is
It's that extended period after the active infection when your head and respiratory system fill up with thick mucus.
IMHO, much worse than the relatively brief cold itself (but then I'm there today.)
Posted by: D. C. Sessions | December 2, 2008 1:33 PM
Why is there a Schering-Plough ad on your website, NTTAWWT?
Posted by: Marilyn Mann | December 2, 2008 7:32 PM
"Engage the skeptical brain, dear readers. Vaccines don't contain toxins, herbal remedies do."
Great!
Artmann engaged his brain:
_______________________________________
"Worldwide 74% lesser deaths from measles
One of the mostly odd name-callings i learned at scienceblogs, is the term antivaccionist..."
("Weltweit 74 Prozent weniger Maserntote
Zu den seltsamsten Beschimpfungen, die ich bei ScienceBlogs gelernt habe, geh�rt die Bezeichnung: Impfgegner....")
http://www.scienceblogs.de/medlog/2008/12/weltweit-74-prozent-weniger-maserntote.php
__________________________________________
I hope the ayurveda-thing was a faux pas.
Thank you.
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