A few weeks ago a woman in her late 50s from Kathmandu visited a private hospital, seeking help for persistent abdominal pain and weakness. When doctors at the hospital could not diagnose her condition, she turned to another private hospital in Lalitpur.

“Even there, doctors couldn't figure out her ailment in the general health checks,” said Kabin Maleku, executive director at Ask foundation, a non profit that provides free telemedicine services. “Doctors then carried out a blood test, which showed lead poisoning.”

This has become a common refrain among hundreds of people across the country who have been affected by heavy metal poisoning from various sources, including from dietary foods, health supplements, and some ayurvedic medicines.

Doctors attending the patient say that the actual cause of excessive lead levels in the blood of the woman is not known, though they suspect dietary supplements the woman has been using could be the main culprit.

The acceptable limit for lead in the blood is 3.5 micrograms per deciliter(mcg/dl), but the woman’s levels had reached 65.

Multiple doctors the Post talked to said that the number of people suffering from heavy metal has been rising of late. People often complain about severe abdominal pain, dehydration, diarrhoea, weakness, nausea, vomiting, and numbness in hands and feet, according to them.

Doctors say high lead levels can cause anaemia, weakness, and damage to kidneys and brain. Mercury exposure may cause lung damage, and harm the brain and kidneys, while long-term exposure to arsenic is linked to skin disorders and increased risk of skin, bladder, and lung cancer. Prolonged exposure to cadmium can lead to kidney disease and weakened bones.

“I have come across a few cases of heavy metal poisoning,” said Dr Kunjang Sherpa, a cardiologist at Bir Hospital. “More can be said once I get their reports, but it is clear that heavy metal poisoning in our country has been rising alarmingly of late.”

Experts say people using dietary supplements for weight loss and those using Ayurvedic medicine from online shopping to manage blood sugar and blood pressure have been found to suffer from heavy metal poisoning, including of lead, arsenic, mercury and cadmium.

Research has found that high levels of chemicals of heavy metals including lead, mercury, and arsenic, among others, have been found in certain dietary supplements and traditional health remedies.

A study carried out by the Department of Ayurveda and Alternative Medicine under the Ministry of Health and Population in 2020 found toxic metals like arsenic, cadmium, lead, and mercury in three medicinal plants used in Ayurvedic treatments for common ailments.

The study was carried out in three districts—Manang, Dhading and Parsa.

The Department of Drug Administration, the national drug regulatory body, said it has banned the sale of dietary supplements in pharmacies.

“Neither we grant permission to import nor do we allow sales from pharmacies,” said Pramod KC, spokesperson of the department. “If any are found selling, our drug inspectors confiscate them and take legal action.”

Drug inspectors from the department have found unregistered dietary supplements and nutraceuticals in tablets, capsules, and liquid forms, as well as beauty ointments containing pharmaceutical ingredients being sold in wholesale and retail pharmacies. Such unapproved products could cause more harm than benefits, officials say.

KC concedes that even with the ban on dietary supplements in pharmacies, doctors have been prescribing and patients have been using them.

The Department of Food Technology and Quality Control, which issues import licences, says that it thoroughly checks product licences issued by relevant regulatory bodies in the country of origin before granting licences.

“Dietary supplements are not intended for curative purposes and should not be prescribed by doctors,” said Mohan Shrestha, spokesperson at the department.

“Dietitians can recommend supplements. We also have tested suspicious supplements in our own laboratory and taken action against those that failed to meet standards, but we have not yet found heavy metal poisoning yet.”

Doctors say heavy metal poisoning from dietary supplements and other products, especially those related to Ayurveda and cosmetics, is not a new issue, but what concerns them much is the lack of antidotes for all toxic heavy metals in Nepal.