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Ayurvedic Medicines Sold Via Internet May Contain Lead, Mercury, or Arsenic

Genetic Variants Associated With Vitamin B12

“Healthy” Individuals May Be at Risk for Heart Disease

Blood Test Could Advance Warning of Alzheimer’s Disease

Ayurvedic Medicines Sold Via Internet May Contain Lead, Mercury, or Arsenic

An analysis of Ayurvedic medicines (based on a traditional medical system commonly used in India) purchased via the Internet found that one-fifth of these products contain levels of lead, mercury, or arsenic that exceed acceptable standards, according to a study in the August 27 issue of JAMA.

Ayurvedic medicines are used by a majority of India's 1.1 billion population and people from South Asia, as well as others. “However, since 1978 more than 80 cases of lead poisoning associated with Ayurvedic medicine use have been reported worldwide,” the authors write. Ayurvedic medicines are divided into 2 major types: herbal-only and rasa shastra, which is an ancient practice of deliberately combining herbs with metals (eg, mercury, lead, iron, zinc), minerals (eg, mica), and gems (eg, pearl). Rasa shastra experts claim that these medicines, if properly prepared and administered, are safe and therapeutic. The prevalence of metals in Ayurvedic medicines sold via the Internet and in those manufactured in the United States is unknown.

Robert B. Saper, MD, MPH, of Boston University School of Medicine and Boston Medical Center, and colleagues conducted a study to determine the prevalence of Ayurvedic medicines available via the Internet containing detectable lead, mercury, or arsenic and compared the prevalence of toxic metals between US- and Indian-manufactured products and in rasa shastra vs non–rasa shastra medicines. The researchers conducted an Internet search using the search terms Ayurveda and Ayurvedic medicine and identified 673 products, of which 230 Ayurvedic medicines were randomly selected for purchase in August through October 2005. Country of manufacturer/website supplier, rasa shastra status, and claims of Good Manufacturing Practices were recorded. Metal concentrations were measured using x-ray fluorescence spectroscopy. One hundred ninety-three of the 230 requested medicines were received and analyzed.

The researchers found that the prevalence of metal-containing products was 20.7% and that the prevalence of metals in US-manufactured products was 21.7%, compared with 19.5% in Indian products. Rasa shastra medicines were more than twice as likely as non–rasa shastra products to contain detectable metals and had higher median (midpoint) concentrations of lead and mercury. Among the metal-containing products, 95% were sold by US websites, and 75% claimed Good Manufacturing Practices. All metal-containing products exceeded 1 or more standards for acceptable daily metal intake. “Several Indian-manufactured rasa shastra medicines could result in lead and/or mercury ingestions 100 to 10 000 times greater than acceptable limits,” the authors write.

Genetic Variants Associated With Vitamin B12

Researchers at the Harvard School of Public Health and their collaborators at Tufts University and the National Cancer Institute have identified a common genetic influence on B12 vitamin levels in the blood, suggesting a new way to approach the biological connections between an important biochemical variable and deficiency-related diseases.

“This is an example of the way we’re going to understand more about how levels of vitamins and other nutrients in the body are partially determined by genetic factors as well as by what we eat,” said David Hunter, the Vincent L. Gregory Professor of Cancer Prevention and director of the Program in Molecular and Genetic Epidemiology at HSPH and senior author of the study.

Other studies have found rare gene mutations with dramatic effects on people’s ability to digest, absorb, and use vitamin B12. This paper found more common variations of a gene that has a much smaller effect by itself, but it may belong to an important biological pathway whose careful study may lead to clinically useful strategies and therapeutic intervention.

The researchers first found the gene, called FUT2, in a genome-wide scan of 1658 women of European ancestry who participated in the Cancer Genetic Markers of Susceptibility project. They replicated the findings in another 1059 women from the Nurses’ Health Study.

Other studies have linked B12 deficiency with pernicious anemia, cardiovascular disease, cancer, and neurodegenerative disorders. Lower B12 levels have been associated with cognitive impairment. A key player in the B-vitamin pathway, B12 helps maintain healthy nerve cells, form red blood cells, and synthesize DNA.

In the diet, B12 comes from meat, fish, dairy, other animal products, and fortified breakfast cereals. As many as a quarter of elderly people may have mild B12 deficiency. Strict vegetarians, who avoid meat, and vegans, who avoid all animal products, are also at risk of B12 deficiency.

Anything in the stomach that affects the normal acidity and digestive processes, ranging from infections to acid reflux medicine to aging, may also interfere with B12 absorption, studies suggest. B12 is first separated from food by stomach acid and then escorted from there by a protein called intrinsic factor to the small intestine, where the complex is absorbed and B12 is released into the blood.

“Healthy” Individuals May Be at Risk for Heart Disease

In the face of the growing obesity epidemic in the United States, researchers at Wake Forest University Baptist Medical Center have new study results that indicate that how much fat a person has is not as important as where that fat is located when assessing risk for cardiovascular events and metabolic disease.

The findings of the study, funded by the National Heart, Lung and Blood Institute and the National Institutes of Health, will appear in the September issue of the American Journal of Clinical Nutrition.

For the study, researchers used cardiac and CT scans to measure multiple fat depots in 398 white and black participants from Forsyth County, North Carolina, ages 47 to 86 years. They found that the amount of fat a person had deposited around organs and in between muscles (nonsubcutaneous fat) had a direct correlation to the amount of hard, calcified plaque they had. Calcified plaque itself is not considered risky, but it is associated with the development of atherosclerosis or the presence of less stable, fatty deposits in the blood vessels that can lead to heart attack and stroke.

“Our hypothesis was that this kind of fat is quite different from subcutaneous fat or fat just below the skin,” said Jingzhong Ding, MD, lead researcher and an assistant professor of gerontology. “Subcutaneous fat may not be as bad as having fat deposited around organs and in between muscles.”

Last month, Ding published results of a similar study showing that fat deposited around the heart (pericardial fat) is associated with calcified plaque in the arteries and therefore may be worse than having a high BMI or a thick waist.

“We know that even thin people could have excessive nonsubcutaneous fat,” Ding said. “If this hypothesis is confirmed, we should look for ways to specifically target the nonsubcutaneous fat depot.”

Blood Test Could Advance Warning of Alzheimer’s Disease

A simple blood test to detect whether a person might develop Alzheimer’s disease is within sight and could eventually help scientists in their quest to reverse the disease’s onset in those likely to develop the debilitating neurological condition, Columbia University Medical Center researchers have announced.

Building on a study that started 20 years ago with an elderly population in Northern Manhattan at risk of or in various stages of developing Alzheimer’s disease, the Columbia research group has yielded ground-breaking findings that could change the way the disease is treated or someday prevented. These findings suggest that by looking at the blood, doctors may be able to detect a person’s predisposition to developing the dementia-inducing disease that robs a person of his or memory and ability to carry out essential tasks.

Results presented online in the Proceedings of the National Academy of Sciences during the week of September 8, 2008, suggest that individuals with elevated levels of a certain peptide in the blood plasma, Amyloid Beta 42 (Aß42), are at increased risk of developing Alzheimer’s disease and that the decline of AB42 in the bloodstream may reflect the compartmentalization or “traffic jam” of AB42 in the brain, which occurs in people with Alzheimer’s.

In this study, researchers found that plasma levels of AB42 appear to increase before the onset of Alzheimer’s disease and decline shortly after the onset of dementia. Researchers surmise that AB42 may become trapped in the brain, which could account for the decrease in levels post-dementia.

Although the cognitive impairments of Alzheimer’s can be monitored throughout the disease course, clinicians have had no reliable way to monitor the pathologic progression of the disease. Being able to reliably measure AB levels in the blood could provide clinicians with a tool that forecasts the onset of Alzheimer’s much earlier.