|San Francisco Department of Public Health|
It became crucial to find out how the lead poisoning was getting into the man's body, and Dr. Bhalla, at the time working at San Francisco General Hospital, enlisted an investigator from the San Francisco Department of Public Health to figure it out.
The job went to environmental health investigator Ihsan DuJaili, who interviewed the man and learned that he was taking an herbal supplement from India, commonly referred to as an Ayurvedic remedy. There are many different kinds, and these particular, unnamed tablets were round and golden. DuJaili sent them to a lab, and the test results showed that the tablets had "massive" amounts of lead. The man -- who believed that the Ayurvedic remedy was helping his kidneys -- had been swallowing one a day.
He's not the first, and its likely he won't be the last. Studies have shown that approximately 20 percent of Ayurvedic remedies contain toxic metals such as lead, mercury, and arsenic. In South Asia where the remedies are prepared, there is a practice called Rasa Shastra, which involves infusing herbal remedies with metals, gems, and minerals that are considered therapeutic. Unfortunately, that also increases the likelihood that toxic metals will find their way in.
When asked if he thought many others had been harmed by their Ayurvedic remedies, investigator DuJaili -- who in the past decade has identified dozens of sources of lead poisoning -- said, "I have no doubt."
Dr. Bhalla instructed the man to immediately stop taking the golden tablets, and also began treating him for the lead contamination. The man's lead levels returned to normal. "I'm fairly confidant that if we did not do what we did, it would have adversely affected his kidneys," said Bhalla.
The successful collaboration between the doctor and the investigator, along with Dr. Suma Prakash, resulted in a case study published this month in Nature Reviews Nephrology, a monthly magazine on kidney health.