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      Adverse events with ayurvedic medicines- possible adulteration and some inherent toxicities

      case-report

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          Abstract

          Ayurvedic medicine, a traditional system of medicine practiced in the Indian subcontinent is considered to be devoid of adverse events. We report three cases which highlight the possibility of adverse events related with the use of ayurvedic products. A 35 year old woman with hepatitis took ayurvedic powder medicine and swarnabhasma (gold salt) and had her liver injury worsened, possibly due to alkaloids, and developed nephrotic syndrome, possibly due to gold salt. A 57 year old hypertensive man was taking ayurvedic medicine containing reserpine which had long been withdrawn from the allopathic system of medicine due to wide range of side effects. A 47 year old woman with rheumatoid arthritis was taking an unknown tablet containing steroid as an adulterant for 2 years and developed side effects typical of steroid excess. We would like to highlight the fact that ayurvedic medicines do have propensity to cause adverse events due to adulteration or inherent constituents like alkaloids, and hence may not always be completely safe.

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          Most cited references22

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          2018 ESC/ESH Guidelines for the management of arterial hypertension

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            Long-term Systemic Corticosteroid Exposure: A Systematic Literature Review

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              Toxic heavy metals and undeclared drugs in Asian herbal medicines.

              Asian herbal medicines are currently used by large sections of the population. Because they are not regulated as medicines and are freely available to everyone, serious safety concerns might be associated with these herbal medicines. In this article, evidence suggesting that some Asian herbal medicines contain toxic heavy metals or undeclared prescription drugs is reviewed. In particular, Indian and Chinese preparations have been implicated. Although adulteration with drugs is by definition fraudulent, the inclusion of heavy metals could be either intentional for alleged medicinal purposes or accidental. Evidence from various countries implies that toxic heavy metals and undeclared prescription drugs in Asian herbal medicines might constitute a serious health problem. However, the majority of the data is anecdotal and insufficient to define prevalence figures. Ways ought to be found to maximize consumer safety.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data CurationRole: SupervisionRole: Writing – Review & Editing
                Role: Data CurationRole: Writing – Original Draft Preparation
                Role: Data CurationRole: SupervisionRole: Writing – Review & Editing
                Role: Formal AnalysisRole: SupervisionRole: Writing – Review & Editing
                Role: ConceptualizationRole: SupervisionRole: Writing – Review & Editing
                Journal
                Wellcome Open Res
                Wellcome Open Res
                Wellcome Open Res
                Wellcome Open Research
                F1000 Research Limited (London, UK )
                2398-502X
                1 November 2019
                2019
                : 4
                : 23
                Affiliations
                [1 ]Department of Internal Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
                [2 ]Oxford University Clinical Research Unit, Patan Hospital, Lalitpur, Nepal
                [1 ]Mahidol-Oxford University Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
                Patan Academy of Health Sciences, Nepal
                [1 ]National Research Institute of Ayurvedic Drug Development, Kolkata, West Bengal, India
                [1 ]National Research Institute of Ayurvedic Drug Development, Kolkata, West Bengal, India
                Patan Academy of Health Sciences, Nepal
                [1 ]Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
                Patan Academy of Health Sciences, Nepal
                Author notes

                No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: none

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: none

                Competing interests: No competing interests were disclosed.

                Competing interests: none

                Author information
                https://orcid.org/0000-0002-5119-4082
                https://orcid.org/0000-0002-4374-0338
                https://orcid.org/0000-0003-2659-3425
                https://orcid.org/0000-0002-1125-2743
                Article
                10.12688/wellcomeopenres.15096.3
                6790910
                31641694
                bb632411-5f6e-4700-8ba7-6a65bc915c02
                Copyright: © 2019 Paudyal B et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 October 2019
                Funding
                Funded by: Wellcome Trust
                Award ID: 106680
                This work was supported by the Wellcome Trust [106680].
                The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Clinical Practice Article
                Articles

                ayurvedic medicine,heavy metals,alkaloids,adulteration
                ayurvedic medicine, heavy metals, alkaloids, adulteration

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