Severe lead poisoning associated with complementary medicine use

01 November 2024

SA Health has been notified of a male in the Adelaide area who developed severe lead poisoning associated with the use of a complementary medicine that was heavily contaminated with lead and mercury. It is also alleged that the medicine may contain opioids which is supported by existing information available on this particular complementary medicine product; Multani Kaminividravana Rasa. The complementary medicine is suspected to originate from overseas, but was purchased locally, and is in the form of dark pellets. Further advice is available from the Therapeutic Goods Administration website.

Lead poisoning related to complementary medicine use has previously been reported to the department and can involve delayed diagnosis. Additionally, due to its illicit nature and likely opium content, users may not initially provide information regarding their use of this substance.

The health effects from lead exposure will differ depending on the source, the amount and length of exposure (chronic vs acute), and the patient’s age and comorbidities. People absorb lead into the body by swallowing lead-contaminated material or breathing lead-contaminated air. Acute lead poisoning from contaminated complementary medicine use may present clinically with predominantly abdominal symptoms.

Doctors are reminded to:

Have a raised index of suspicion of possible lead poisoning in patients presenting with unexplained abdominal pain and constipation. Other effects can include nausea and vomiting, headache, fatigue, irritability, impaired concentration, seizures, coma, myalgia, renal impairment, and anaemia. Severe cases can be fatal.
Include complementary medicines as part of taking a comprehensive patient medical history and have increased suspicion for lead poisoning if products such as Multani Kaminividravana Rasa have been ingested.
Offer blood lead testing for patients presenting with symptoms consistent with lead poisoning, as well as those reporting any complementary medicine or opium use. Elevated blood lead levels may need specialist care. For further advice contact the Poisons Information Centre on 13 11 26 at any time.
Consider support (counselling, withdrawal or replacement therapy) for your patient if the lead exposure is associated with opium use by contacting the Drug and Alcohol Services SA (DASSA) which has a Drug and Alcohol Clinical Advisory Service (DACAS) that provides a telephone and email service for South Australian health professionals, they can be contacted on (08) 7087 1742 (24 hours a day, 7 days a week). Alternatively, DASSA’s Alcohol and Drug Information Service (ADIS) provides confidential telephone counselling, information, and referral service for the general public, concerned family and friends, students and health professionals on 1300 131 340 (8.30 am to 10.00 pm daily).
Contact the Chemical and Environmental Hazards team for suspected cases of lead poisoning associated with complementary medicines by phoning 8226 7100 or emailing Health.ChemicalAndEnvironmentalHazards@sa.gov.au. Public health can assist in investigating cases with highly elevated blood lead levels, this is coordinated by the Scientific Services Branch. More information for health professionals is available at Lead exposure information for health professionals.

Dr Chris Lease – Executive Director, Health Protection and Regulation, Public Health Division

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Last updated: 01 Nov 2024

Severe lead poisoning associated with complementary medicine use

Doctors are reminded to:

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