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Herbal Supplement Use and Blood Lead Levels of United States Adults

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ABSTRACT

BACKGROUND

Some herbal supplements may contain lead.

OBJECTIVE

To examine whether use of specific herbal dietary supplements during the last 30 days is associated with blood lead levels in US men and women.

DESIGN

Cross-sectional analysis.

STUDY POPULATION

NHANES participants from 1999–2004, a representative sample of the civilian non-institutionalized US population.

MEASUREMENTS

Lead was measured in blood. Associations between lead and self-reported supplement use were estimated using multivariable regression weighted to account for NHANES sampling. Herbal supplements investigated were those previously reported to contain high heavy metal content: Ayurvedic or traditional Chinese medicine herbs, echinacea, ginkgo, ginseng, St. John’s wort, and “other” herbs (specifically, kava, valerian, black cohosh, bee pollen, and nettle).

MAIN RESULTS

Among 6,712 women ≥20 years, those using herbal supplements had lead levels that were 10% higher than non-users (95% CI 3%–17%, p = 0.005). Women using Ayurvedic or traditional Chinese medicine herbs, St. John’s wort, and “other” herbs had lead levels 24% (95% CI 5%–45%, p = 0.01), 23% (95% CI 4%–46%), p = 0.02), and 21% (95% CI 2%–44%, p = 0.03) higher, respectively, than non-users. No significant associations were observed between herb use and lead levels among men (n = 6,095). Among reproductive-aged women (16–45 years), herbal supplement users had lead levels 20% higher than non-users (95% CI 5%–34%, p = 0.008). In contrast, garlic and other dietary supplements were not associated with higher lead levels.

CONCLUSION

Use of specific herbal supplements is associated with higher blood lead levels among women. Our data suggest testing guidelines for herbal supplements and regulations limiting lead in supplements are needed.

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Acknowledgments

This work was presented in part at the Society of General Internal Medicine 31st Annual Meeting April 9–12, 2008. No internal or external funding supported this research project.

Conflict of Interests

None of the authors have conflicts of interest, financial interests, or relationships or affiliations relevant to the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Atrium Suite, Boston, MA, 02215, USA

    Catherine Buettner MD, MPH & Russell S. Phillips MD

  2. Harvard Medical School, Boston, MA, USA

    Catherine Buettner MD, MPH, Kenneth J. Mukamal MD, MPH, MA, Roger B. Davis ScD, Russell S. Phillips MD & Murray A. Mittleman MD, DrPH

  3. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Brookline, MA, USA

    Kenneth J. Mukamal MD, MPH, MA & Roger B. Davis ScD

  4. Department of Family Medicine, Boston University Medical Center, Boston, MA, USA

    Paula Gardiner MD, MPH

  5. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Roger B. Davis ScD

  6. Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Murray A. Mittleman MD, DrPH

  7. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Murray A. Mittleman MD, DrPH

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  1. Catherine Buettner MD, MPH
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  3. Paula Gardiner MD, MPH
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Correspondence to Catherine Buettner MD, MPH.

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Buettner, C., Mukamal, K.J., Gardiner, P. et al. Herbal Supplement Use and Blood Lead Levels of United States Adults. J GEN INTERN MED 24, 1175–1182 (2009). https://doi.org/10.1007/s11606-009-1050-5

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  • DOI: https://doi.org/10.1007/s11606-009-1050-5

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