Complementary and alternative medicine Medicine Quackery

Ah, the irony of it!

This is just too rich.

As you know a few months ago, I commented about a British report that found high levels of mercury and other heavy metals in Chinese herbal medicines sold in the U.K. Some contained as much as 11% mercury by weight! It turns out that a JAMA paper from 2004 did the same thing for Ayurvedic medicines and found some of them also contaminated with mercury and other heavy metals, concluding:

If taken as recommended by the manufacturers, each of these 14 could result in heavy metal intakes above published regulatory standards

Indeed, in the compounds that tested postive for heavy metals, investigators found median levels of 430 μg/g arsenic, 20,225 μg/g mercury, and 40 μg/g of lead.

As has been pointed out, one of the most common causes of a variety of ills, according to alties, is mercury. If you listen to them, you’d think that mercury causes autism, Alzheimer’s disease, ALS, chronic fatigue syndrome, fibromyalgia, allergies, depression, cancer, skin diseases, intestinal problems, and many others. In fact, it would be much faster to list the number of chronic diseases that alties have never tried to tie to mercury, because that list would be very short. It would probably be zero, in fact.

And what is the source of this mercury? Well, if you’re an altie, they come from one of two sources. The source you will hear the most about on the Internet (and you know that, if it’s on the Internet, it must be true) is dental amalgams. Never mind that two large recent studies have shown amalgams to be safe. The second source that alties blame is mercury in the preservative of vaccines. I don’t really think that I need to go into this much, given how many times I’ve written about that particular topic, particularly with regard to activists who blame mercury in vaccines for autism despite the overwhelming epidemiological evidence that, contrary to the position of Generation Rescue, a major activist in this area, autism is not a “misdiagnosis” for mercury poisoning.

Yes, mercury “toxicity” appears to be near the top of the list of things alties fear the most when it comes to their health. To many of them, no amount of mercury is acceptable. (I just hope they don’t eat much fish, particularly tuna; there’s way more mercury exposure from that and other dietary and environmental sources.) No, I’m not denying that mercury can be hazardous if exposure levels are too high. That is surely true. However, the concept of “the dose makes the poison” is completely lost on many alties, and to them no amount of mercury can ever be considered “safe.” The argument is over whether the minuscule amounts of mercury exposure resulting from dental amalgams causes harm or whether the 187.5 μg of mercury that a typical American infant could conceivably have received during its first six months of life when the largest number of thimerosal-containing vaccines were given, before thimerosal was removed in early 2003 was safe. So far, there is no good evidence that either are or were unsafe, but that doesn’t stop alties from undergoing invasive dental procedures to have their amalgam fillings removed because they believe they are being poisoned, and quacks will urge people to remove their amalgam fillings in order to “cure” disease. Parents even refuse vaccination because they fear thimerosal, despite the fact that the last lots of thimerosal-containing vaccines in the U.S. expired over three years ago.

How ironic, then, to see this report claiming that the levels of mercury and other metals in Ayurvedic herbal medicines are perfectly safe:

Prof. Rajamanickam questioned the scientific validity of an article that appeared in the Journal of American Medical Association (JAMA) in December 2004. The authors had analysed 14 Ayurvedic formulations manufactured in India and concluded that they contained heavy metals such as mercury, arsenic and lead.

Prof. Rajamanickam said the authors had failed to analyse the different forms by which the elements are bound but have projected only the quantum of elemental distribution.

This was critical since these elements could be chelated in the formulation and will be safe to use.

Moreover, the final product in Bhasmas and Rasa yogas are different from the raw materials since they would be transformed to therapeutic compounds by different processes like detoxification, titration, heating, etc.

Hence it is unlikely that free elements would be present in these products that may cause damage as claimed by the authors.

“Unlikely”? did anyone bother to–oh–actually check whether free metals were present? And what about “chelated”? How, exactly, would substances in the herbs “chelate” the mercury and how?

This is actually not the first time I’ve heard this sort of excuse from boosters of Chinese and Indian herbal medicines, the claim that, even if there’s mercury in them, it’s “safe” because it’s somehow different, rendered nontoxic by unspecified compounds in the herbal goodness in the remedies (either that, or that the laboratory results come from an evil conspiracy between big pharma, the government, and greedy doctors). Even more ironic, though, this is exactly the explanation as to why the mercury in amalgams is safe (it’s bound up with the silver, tin, copper, and zinc in the amalgam). Try explaining that to anti-amalgam alties, and they’ll have none of it.

The story then describes studies in rats using three drugs from the JAMA study using a dose ten times that prescribed for humans and concluding that these drugs were perfectly safe for people:

Multi-centric investigation under the leadership of Prof. Rajamanickam conducted pre-clinical studies in rats using three drugs that were reported in JAMA by administering a ten times higher dose prescribed for humans.

End stage analysis of the animals after acute, sub-acute, and chronic toxicity studies showed no neuro-toxicity, nephro-toxicity, haemopoetic-toxicity and hepato-toxicity and the higher dosages were found to be safe in all respects.

The study at SASTRA was conducted in collaboration with Prof. G. P. Dubey and his team at Banaras Hindu University, Varanasi and Prof. R. Venkatakrishnan Murali and his team, at the University of Madras.

The results of the clinical studies conducted by Banaras Hindu University, Varanasi, showed no adverse medical consequence due to heavy metal toxicity.

Well, that’s a load off my mind. One thing they failed to mention is that the JAMA article found that it was 20% of specimens that had high levels of heavy metals. Unless the researchers tested samples from many different lots, they could easily see no effect. Also, no mention is made of whether they actually tested the heavy metal concentrations of the herbal medicines they tested, to determine if they contained mercury and other metals, or if they measured heavy metal concentrations in the blood and tissues of the experimental animals. Hopefully this study will actually be published somewhere, so that I can actually see what they did. In fact, I think I’ll save a PubMed search on these authors’ names, so that I’ll know about it if it’s published in a journal indexed by MEDLINE. (So far, I only see one article listed by Professor Rajamanickam, who appears to be a geologist or minerologist by training.)

On the other hand, this study could be looked at another way. (I’m not saying that it should be looked at that way, only that it could be.) If this study was done correctly and large amounts of mercury-laden herbs did the rats no harm, its results could be considered preclinical evidence that the safe dose for mercury and other heavy metals may actually be considerably higher than what the FDA says it is.

I wonder if alties will be reassured. After all, if Dr. Rajamanickam’s results are correct and there was mercury in the herbs he tested, it could be indicative that the FDA left a wide margin of safety in its estimates for what constitutes a safe dose of mercury.

I’m guessing they won’t be–except when it comes to Chinese and Ayurvedic medicines. To many of them, it seems, any mercury at all, no matter how small, is a deadly poison–except, of course, when it’s in “alternative” medicines.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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