Human & Experimental Toxicology (2006) 25: 405 -412 www.hetournal.com
Mercury in traditional Tibetan medicine panacea or problem? S Sallon* l, T Namdul2, S Dolma2, P Dorjee2, D Dolma2, T Sadutshang3, P Ever-Hadani4, T Bdolah-Abram1, S Apter5, S Almog6 and S Roberts7
1Louis L Borick Natural Medicine Research Center, (NMRC), Hadassah Medical Organization, Jerusalem, Israel; 2Men-Tsee-Khang Tibetan Medical and Astrology Institute, (MTKI), Dharamsala, HP, India; 3Delek Hospital, Dharamsala, HP, India; 4Braun School of Public Health, Hadassah Hebrew University School of Medicine, Jerusalem, Israel; 5Department of Chemistry, University of Liverpool, Liverpoof, UK; 6Department of Toxicology, Sheba Medical Center, Tel Aviv, Israel; 7Department of Chemistry, University of Manchester, UK Symptoms of mercury toxicity, biochemical changes, and blood/urine mercury levels were evaluated in a small group of patients. Six patients attending Delek Hospital, Dharamsala, India, taking mercury-containing traditional Tibetan medicine (TTM) (Group 1), were compared with three patients taking non-mercury containing TTM (Group II) and healthy volunteers (Group III). Quantitative estimation of mercury ingestion based on chemical analysis was compared with US regulatory standards. Results: Group I were significantly older (mean 55 years+SE 6.4) range 26-69 years, than Group II (26.7 years+SE 5) range 17-34 years and Group III (32.5 years+SE 0.5) range 33-34 years (P=0.05). Group 1 took TM on average for 51 months and had a mean of 2.5 non-specific, mercury-related symptoms. Group I had higher mean diastolic pressures (85 nunHg) than Group II (73 mmHg) (P=0.06) and more loose teeth.
Mean daily mercury intake for Group I was 674 fg, estimated as 10 pg/kg per day. (Established reference dose for chronic oral exposure: 0.3 fig/kg per day.) Blood mercury levels were non-detectable, but mean urinary mercury levels for Group 1 were 67 ig/L (EPA levels
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Mercury in traditional Tibetan medicine - panacea or problem? S Sallon et al.
409 Table 2 Comparison of non-specific symptoms of mercury toxicity between patient groups Symptomsa
Overall No. (%) Mean no./patient No. developing only after taking TTM (%) Mean no./patient No. present before taking TTM (%) Mean no./patient
=Group I (n 6
Group II (n = 3)
15 (10.9%) 2.5 (±0.022)
15 (22%) 5 (+2.3)
4c (2.3%)
3 (4.7%)
0.7 (±0.3) 11 (8.0) 1.83 (±0.54)
p
0.058 NS
1 (+1) 12.0 (17%) 4 (±1.5)
NS
aBased on 23 non-specific symptoms of mercury toxicity.'4 For Group 1, the maximum possible number of symptoms was 138 (6 x 23) and for Group II, 69 (3 x 23). bMissing data = 1. 9None reported as worsening.
who was concurrently taking the drug Nifadapine for hypertension.
Laboratory tests Mean serum levels for liver and renal function tests were within the normal clinical range and did not differ significantly between groups. All urine samples were negative for red blood cells and proteinurea. Blood mercury levels were not detectable in all groups. Mean urinary mercury levels for Group I were 67 fg/L (±SE 37.3) (range 0-173 j.g/L), Group II 1.7 jig/L (one sample positive), and not detectable in Group III. The Environmental Protection Agency (EPA) Biological Exposure Index (BEI) for urinary mercury levels in chronic oral exposure is
