Lead contamination in Eugenia dyeriana herbal preparations from different commercial sources in Malaysia

Safety profile of herbal medicines submitted for marketing authorization in Tanzania: a cross-sectional retrospective study

BACKGROUND

The popular use of herbal medicines necessitates national regulatory authorities to have efficient mechanisms for the control of these products including marketing authorization (MA) and safety follow-up. Herbal medicines like conventional medicines require assessment of efficacy, safety and quality information before MA can be granted. However, the complete proof of safety is mainly based on the history of the long-term traditional use. Herbal medicines can cause adverse reactions due to various factors and thus require clinical trials to ensure their safety. Herbal medicines treatment practices involve combinations of different plants to achieve the desired effect while multiple herbal components have been known to cause herbal-herbal toxicity and interactions due to variety of complex active ingredients in plants. Compliance with regulatory requirements on herbal medicines has been shown to be difficult for manufacturers since different countries have different regulatory requirements with wide variations which results in the MA of very few herbal medicines. Limited studies on dossiers of marketing authorization of herbal medicines have been performed in other countries, with no studies in African regulatory system settings. The aim of this study is to determine the type of safety documentation that is submitted on herbal medicines application dossiers to support MA in Tanzania.

METHODS

A cross-sectional retrospective study of herbal medicines dossiers submitted at the Tanzania Medicines and Medical Devices Authority from 2009 to 2020 was conducted.

RESULTS

As many as 75% of the herbal products applications were combination products made by more than one herbal substance or plant. Out of 84 dossiers subjected to analysis the majority did not provide evidence of preclinical (55%) and clinical safety data (68%). Evidence of safety data in humans was mostly from the literature (70%) and not manufacturers' clinical studies. Quality parameters with safety implications were not included in 48% and 23% of the active herbal substance and finished product specifications, respectively.

CONCLUSION

Analysis of the herbal medicine dossiers submitted showed major deficiencies of safety data to support MA. Manufactures need to provide evidence to support the safety of their products for evidence-based regulatory decisions and to avoid multiple reviews of the applications.

Safety assessment of natural products in Malaysia: current practices, challenges, and new strategies

The belief that natural products are inherently safe is a primary reason for consumers to choose traditional medicines and herbal supplements for health maintenance and disease prevention. Unfortunately, some natural products on the market have been found to contain toxic compounds, such as heavy metals and microbes, as well as banned ingredients such as aristolochic acids. It shows that the existing regulatory system is inadequate and highlights the importance of thorough safety evaluations. In Malaysia, the National Pharmaceutical Regulatory Agency is responsible for the regulatory control of medicinal products and cosmetics, including natural products. For registration purpose, the safety of natural products is primarily determined through the review of documents, including monographs, research articles and scientific reports. One of the main factors hampering safety evaluations of natural products is the lack of toxicological data from animal studies. However, international regulatory agencies such as the European Food Safety Authority and the United States Food and Drug Administration are beginning to accept data obtained using alternative strategies such as non-animal predictive toxicological tools. Our paper discusses the use of state-of-the-art techniques, including chemometrics, in silico modelling and omics technologies and their applications to the safety assessments of natural products.

Heavy Metal contamination of Dietary Supplements products available in the UAE markets and the associated risk

A specific safety concern is the possibility that a dietary supplement could be contaminated with heavy metals. This research was undertaken to investigate the daily exposure levels of heavy metals in dietary supplements available in the UAE and to explore the factors associated with the contamination of dietary supplements with heavy metals. A total of 277 dietary supplement samples were collected from the UAE market and prepared for the analysis of selected heavy metal contamination. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine the presence of heavy metals. The average daily intake of cadmium was 0.73 μg [95% CI 0.61-0.85], compared to the acceptable daily intake (ADI) of 6 μg; the daily intake of lead was 0.85 μg [95% CI 0.62-1.07], compared to the acceptable daily intake (ADI) of 20 μg; and the daily intake of arsenic was 0.67 μg [95% CI 0.57-0.78], compared to the acceptable daily intake of 10 μg. Although the dietary supplements available in the UAE have low levels of heavy metal contamination, numerous individuals are consuming a number of different dietary supplements every day and thereby may experience a cumulative level of toxic exposure. Dietary supplements formulations (Categories), dosage forms and country of origin are strong determents of heavy metal contamination in dietary supplements products.

Determination of the Cadmium, Chromium, Nickel, and Lead Ions Relays in Selected Polish Medicinal Plants and Their Infusion

Concentration of Cd, Cr, Ni, and Pb were determined in peppermint leaves (Folium Menthae piperitae), chamomile blossom (Anthodium Chamomillae), and their infusions by atomic absorption spectrometry (AAS) after microwave digestion of plants samples. Peppermint and chamomile preparations by five different producers were purchased at various pharmacies in Poland. Infusions were made from herbs according to prescription for patients, provided by the producer of medicine on the package. Results show that in exam of medicinal plants the content of cadmium exceeds World Health Organization (WHO) standards. The highest level of extraction was observed for Ni (50-70% of the total content in herb), Cr (28-36%), Cd (14-16%), and the lowest for Pb (about 6%). The calculated daily intake all analyzed elements was very low. Phytotherapy with using of these herbs is safe for health of patient even in case of long time therapy.

Heavy metals in contaminated environment: Destiny of secondary metabolite biosynthesis, oxidative status and phytoextraction in medicinal plants

Contamination of soils, water and air with toxic heavy metals by various human activities is a crucial environmental problem in both developing and developed countries. Heavy metals could be introduced into medicinal plant products through contaminated environment (soil, water and air resources) and/or poor production practices. Growing of medicinal plants in heavy metal polluted environments may eventually affect the biosynthesis of secondary metabolites, causing significant changes in the quantity and quality of these compounds. Certain medicinal and aromatic plants can absorb and accumulate metal contaminants in the harvestable foliage and, therefore, considered to be a feasible alternative for remediation of polluted sites without any contamination of essential oils. Plants use different strategies and complex arrays of enzymatic and non-enzymatic anti-oxidative defense systems to cope with overproduction of ROS causes from the heavy metals entered their cells through foliar and/or root systems. This review summarizes the reports of recent investigations involving heavy metal accumulation by medicinal plants and its effects on elicitation of secondary metabolites, toxicity and detoxification pathways, international standards regarding in plants and plant-based products, and human health risk assessment of heavy metals in soil-medicinal plants systems.

Quality assessment of trace Cd and Pb contaminants in Thai herbal medicines using ultrasound-assisted digestion prior to flame atomic absorption spectrometry

A simple, efficient, and reliable ultrasound-assisted digestion (UAD) procedure was used for sample preparation prior to quantitative determination of trace Cd and Pb contaminants in herbal medicines using flame atomic absorption spectrometry. The parameters influencing UAD such as the solvent system, sample mass, presonication time, sonication time, and digestion temperature were evaluated. The efficiency of the proposed UAD procedure was evaluated by comparing with conventional acid digestion (CAD) procedure. Under the optimum conditions, linear calibration graphs in a range of 2–250 μg/L for Cd, and 50–1000 μg/L for Pb were obtained with detection limits of 0.56 μg/L and 10.7 μg/L for Cd and Pb, respectively. The limit of quantification for Cd and Pb were 1.87 μg/L and 40.3 μg/L, respectively. The repeatability for analysis of 10 μg/L for Cd and 100 μg/L for Pb was 2.3% and 2.6%, respectively. The accuracy of the proposed method was evaluated by rice flour certified reference materials. The proposed method was successfully applied for analysis of trace Cd and Pb in samples of various types of medicinal plant and traditional medicine consumed in Thailand. Most herbal medicine samples were not contaminated with Cd or Pb. The contaminant levels for both metals were still lower than the maximum permissible levels of elements in medicinal plant materials and finished herbal products sets by the Ministry of Public Health of Thailand. The exception was the high level of Cd contamination found in two samples of processed medicinal plants.

Method development for the determination of elements in Hypericum perforatum L. (St John's wort) herb and preparations using inductively coupled plasma–optical emission spectroscopy and microwave digestion

Objectives

A method was developed to analyze St John's wort (Hypericum perforatum L.) herb and preparations using inductively coupled plasma–optical emission spectroscopy (ICP-OES) to determine the quantity of 11 elements (Al, B, Ba, Ca, Cu, Fe, Mg, Mn, Ni, Sr and Zn).

Methods

This study includes the evaluation of digestion acids and calibration methods, as well as instrumental parameters such as choice of nebulizer and emission wavelength.

Key findings

Two nebulizers (Conikal and SeaSpray) performed similarly for most elements, and two optimum wavelengths were determined for each element. Five acids were evaluated for the digestion of the Polish Certified Reference Material Tea Leaves (INCT-TL-1), while three were taken forward to use for the different St John's wort formulations (i.e. herb, capsule and tablet). A simple protocol using 5 ml HNO3 was sufficient in most cases; however, variability was observed for elements often bound in silicates (e.g. Al, Fe and Zn). An external weighted calibration was also found to be preferential over unweighted, and the use of standard addition affected some concentration values up to 20%.

Conclusions

Therefore, this paper presents the development and optimized method parameters to be used with ICP-OES that will allow the analysis of 11 key elements present in St John's wort herb and preparations.

Determination of heavy metals in the common smokeless tobacco afzal in oman

OBJECTIVES

Afzal is an illegally sold smokeless tobacco product (STP) commonly used by youths and teenagers in Oman. The aim of this study was to analyse the composition of Afzal, also commonly known as sweekah, as it is believed to contain many carcinogens and toxic components. In particular, Afzal's heavy metal content includes cadmium (Cd), chromium (Cr), lead (Pb) and nickel (Ni).

METHODS

This study was conducted between March and June 2013. Three samples of Afzal were first dried and then ground to form a homogenous powder. The powder was digested prior to the heavy metal analysis by inductively coupled plasma-mass spectrometry (ICP-MS).

RESULTS

Afzal was shown to have high levels of all heavy metals except for Ni and Pb, which were detected in quantities below acceptable international limits. The concentrations of the tested metals were 15.75 μg/g, 1.85 μg/g, 1.62 μg/g and 1.57 μg/g for Cr, Cd, Pb and Ni, respectively. The estimated daily intake of heavy metals from Afzal was below the maximum permissible limit accepted by the Food and Agriculture Organization and World Health Organization, except for Cr and Ni which were found to be dangerously elevated when compared with international standards.

CONCLUSION

The results of this study showed that Afzal contains a number of heavy metals that may cause health problems. Therefore, urgent regulation of the illegal sale of Afzal is needed at the national level in Oman along with a campaign to address public health education and awareness of Afzal and its health risks.

Microbial and heavy metal contamination in commonly consumed traditional Chinese herbal medicines

OBJECTIVE

The increasing popularity and widespread use of traditional Chinese herbs as alternative medicine have sparked an interest in understanding their biosafety, especially in decoctions that are consumed. This study aimed to assess the level of microbial and heavy metal contamination in commonly consumed herbal medicine in Malaysia and the effects of boiling on these contamination levels.

METHODS

Four commonly consumed Chinese herbal medicine in Malaysia-"Eight Treasure Herbal Tea", "Herbal Tea", Xiyangshen (Radix Panacis Quinquefolii) and Dangshen (Radix Codonopsis) were evaluated in this study. Herbal medicines were prepared as boiled and non-boiled decoctions, and their microbial enumeration and heavy metal detection were conducted with plate assay and atomic absorption spectroscopy, respectively.

RESULTS

Findings revealed that herbal medicines generally had 6 log10cfu/mL microbial cells and that boiling had significantly reduced microbial contaminants, where no Bacillus spp., Staphylococcus spp. and Clostridium spp. were recovered. Heavy metals such as Mn, Cu, Cd, Pb, Fe and Zn were also detected from all the samples, generally in low concentrations (< 1 mg/L) except for Mn (18.545 mg/L). All decoctions (after boiling) have reduced concentrations of Cu, while others were not significantly different. Comparisons between samples with single and multi-herbs suggest level of microbial and metal contamination is not influenced by number of herbs in sample.

CONCLUSION

Herbal medicines generally have microbial and heavy metal contaminants. However, the boiling process to generate decoctions was able to successfully reduce the number of microbes and Cu, ensuring safety of herbal medicines for consumption.

Evaluation of heavy metals content in dietary supplements in Lebanon

BACKGROUND

The consumption of dietary supplements is widely spread and on the rise. These dietary supplements are generally used without prescriptions, proper counseling or any awareness of their health risk. The current study aimed at analyzing the metals in 33 samples of imported dietary supplements highly consumed by the Lebanese population, using 3 different techniques, to ensure the safety and increase the awareness of the citizen to benefit from these dietary supplements.

RESULTS

Some samples had levels of metals above their maximum allowable levels (Fe: 24%, Zn: 33%, Mn: 27%, Se: 15%, Mo: 12% of samples), but did not pose any health risk because they were below permitted daily exposure limit and recommended daily allowance except for Fe in 6% of the samples. On the other hand, 34% of the samples had Cu levels above allowable limit where 18% of them were above their permitted daily exposure and recommended daily allowance. In contrast, all samples had concentration of Cr, Hg, and Pb below allowable limits and daily exposure. Whereas, 30% of analyzed samples had levels of Cd above allowable levels, and were statistically correlated with Ca, and Zn essential minerals. Similarly 62% of the samples had levels of As above allowable limits and As levels were associated with Fe and Mn essential minerals.

CONCLUSION

Dietary supplements consumed as essential nutrients for their Ca, Zn, Fe and Mn content should be monitored for toxic metal levels due to their natural geochemical association with these essential metals to provide citizens the safe allowable amounts.

Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews

PURPOSE

The aim of this overview of systematic reviews is to summarise and critically evaluate the evidence from systematic reviews of the adulteration and contamination of herbal medicinal products (HMPs).

METHODS

Five electronic databases were searched to identify all relevant systematic reviews.

RESULTS

Twenty-six systematic reviews met our inclusion criteria. The most commonly HMPs were adulterated or contaminated with dust, pollens, insects, rodents, parasites, microbes, fungi, mould, toxins, pesticides, toxic heavy metals and/or prescription drugs. The most severe adverse effects caused by these adulterations were agranulocytosis, meningitis, multi-organ failure, perinatal stroke, arsenic, lead or mercury poisoning, malignancies or carcinomas, hepatic encephalopathy, hepatorenal syndrome, nephrotoxicity, rhabdomyolysis, metabolic acidosis, renal or liver failure, cerebral edema, coma, intracerebral haemorrhage, and death. Adulteration and contamination of HMPs were most commonly noted for traditional Indian and Chinese remedies, respectively.

CONCLUSIONS

Collectively these data suggest that there are reasons for concerns with regards to the quality of HMPs. Adulteration and contamination of HMPs can cause serious adverse effects. More stringent quality control and its enforcement seem to be necessary to avoid health risks.

Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews

PURPOSE

The aim of this overview of systematic reviews is to summarise and critically evaluate the evidence from systematic reviews of the adulteration and contamination of herbal medicinal products (HMPs).

METHODS

Five electronic databases were searched to identify all relevant systematic reviews.

RESULTS

Twenty-six systematic reviews met our inclusion criteria. The most commonly HMPs were adulterated or contaminated with dust, pollens, insects, rodents, parasites, microbes, fungi, mould, toxins, pesticides, toxic heavy metals and/or prescription drugs. The most severe adverse effects caused by these adulterations were agranulocytosis, meningitis, multi-organ failure, perinatal stroke, arsenic, lead or mercury poisoning, malignancies or carcinomas, hepatic encephalopathy, hepatorenal syndrome, nephrotoxicity, rhabdomyolysis, metabolic acidosis, renal or liver failure, cerebral edema, coma, intracerebral haemorrhage, and death. Adulteration and contamination of HMPs were most commonly noted for traditional Indian and Chinese remedies, respectively.

CONCLUSIONS

Collectively these data suggest that there are reasons for concerns with regards to the quality of HMPs. Adulteration and contamination of HMPs can cause serious adverse effects. More stringent quality control and its enforcement seem to be necessary to avoid health risks.

Monitoring of mercury, arsenic, cadmium and lead in Ayurvedic formulations marketed in Delhi by flame AAS and confirmation by ICP-MS

The quality and safety of Ayurvedic formulations has become a serious issue, as this Indian system of medicine is used by 80% of the Indian population. Hence, the present study was performed to evaluate heavy metals contents by flame atomic absorbance spectroscopy (AAS) measurements and confirmation by inductive coupled plasma-mass spectroscopy (ICP-MS). A total of 78 formulations (56 herbal, 19 herbometallic and 3 metallic) were sampled. In herbal formulations, lead in 19.6% (11/56), cadmium in 21.4% (12/56), mercury and arsenic in 5.3% (3/56) were above the limit. Lead in 52.6% (10/19) of samples, cadmium in 26.3% (5/19) and mercury and arsenic contained in one herbometallic sample was above the limit. Heavy metals in all metal formulations were above the WHO limit. Significant batch variation was observed. The analytical results of flame AAS and ICP-MS did not differ significantly in the range of measurements in this study, which proves that both methods are satisfactory for estimation of heavy metals in these type of samples.

Quality of herbal medicines: challenges and solutions

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts.

Lead content in pot marigold (Calendula officinalis L.) inflorescences and leaves: impact of precipitations and vicinity of motorway

Trace metal contamination is a major environmental and health problem virtually in all countries. The present study was aimed to estimate the lead content of pot marigold (Calendula officinalis L.) inflorescences and leaves collected from a nonpolluted test field. The lead content in dry pot marigold inflorescences was 9.34 ± 0.79 µg/g, in dry leaves 11.57 ± 0.47 µg/g, and in soil 0.649 ± 0.012 µg/g. The distance of pot marigold collection beds (30-220 m from the motorway) had no effect on lead content. There was a strong positive correlation between the amount of precipitations and lead content of pot marigold leaves but not inflorescences indicating the soil as primarily the source of increased lead content. In conclusion, no effect of motorway vicinity was found for pot marigold inflorescences or leaves lead content; however, as a precaution, it is not recommended to collect the plants during or just after showers.