Ayurveda is a traditional medical system used by a majority of India's 1.1 billion population.¹ Ayurveda is also used worldwide by the South Asian diaspora and others.¹ However, since 1978 more than 80 cases of lead poisoning associated with Ayurvedic medicine use have been reported worldwide.²^,3 Ayurvedic medicines are divided into 2 major types: herbal-only and rasa shastra. Rasa shastra is an ancient practice of deliberately combining herbs with metals (eg, mercury, lead, iron, zinc), minerals (eg, mica), and gems (eg, pearl).⁴^,5 Rasa shastra experts claim that these medicines, if properly prepared and administered, are safe and therapeutic.⁴^,5 Of 70 Ayurvedic medicines manufactured in South Asia and sold in Boston, Massachusetts, stores in 2003, we found that 20% contained lead, mercury, and/or arsenic.⁶ Estimated daily lead, mercury, and arsenic intakes for these products were all higher than regulatory limits. We identified several rasa shastra medicines that could cause lead and mercury ingestions exceeding US Environmental Protection Agency (EPA) limits by 3 to 4 orders of magnitude. Similar results have been found in other North American cities.⁷^-10

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