Background:
Millions worldwide use Ayurvedic (traditional Indian) medicines. These medications are increasingly associated with lead poisoning, often accompanied by anemia. We compared the relative hematopoietic toxicity of Ayurvedic lead poisoning with a common form of occupational lead poisoning.
Material/Methods:
We retrospectively studied 66 adult lead intoxications: 43 published Ayurvedic cases identified in published reports by searching MEDLINE (1966 to November 2005); 4 Ayurvedic patients seen at a referral center; and 19 lead paint intoxications from the same center. We considered patients’ age, gender and blood lead at presentation, and then compared the groups with respect to hematopoietic parameters.
Results:
Ayurvedic lead poisoning was associated with higher blood lead (p<0.001), more basophilic stippling (p<0.001), lower hemoglobin (p<0.001) and higher protoporphyrin (p<0.001). Multiple regression adjusted for blood lead and gender found Ayurvedic lead poisoning associated with a 36.2 g/L (95% CI –48.8, –23.6 g/L) greater decrement in hemoglobin (p<0.001) as compared to paint-removal poisoning.
Conclusions: Ayurvedic poisoning produces greater hematopoietic toxicity than paint-removal poisoning. Ayurvedic ingestion should be considered in patients with anemia. Ayurveda users should be screened for lead exposure and strongly encouraged to discontinue metal–containing remedies.

Keywords: Anemia - etiology, Complementary Therapies, Diagnosis, Differential, Hematopoietic System - drug effects, Lead - toxicity, Lead Poisoning - etiology, Medicine, Ayurvedic, Protoporphyrins - metabolism