Supplementary Material for: A case report of adult lead-poisoning followed by use of non-prescription Ayurvedic medication in Germany

Abstract
Introduction: This case report describes a 65-year-old female patient from Germany who developed clinically significant lead poisoning following the use of Ayurvedic herbal preparations provided by an unlicensed practitioner in a major German city.
Case Presentation: Although the patient presented with nonspecific symptoms such as weight loss, fatigue, and gastrointestinal complaints—possible indicators of heavy metal toxicity—these warning signs were initially overlooked by the practitioner. It was only after a colleague at the same institute raised concerns that appropriate diagnostic investigations were initiated.
Laboratory analyses revealed a markedly elevated blood lead level (BLL) of 574 µg/L (reference: <70 µg/L), prompting hospitalization and initiation of chelation therapy with dimercaptosuccinic acid (DMSA). The patient responded well to DMSA therapy, with subsequent serum lead levels showing a marked decrease to 86 µg/L at 10-month follow-up. She tolerated the treatment without significant adverse effects and is in good health, able to engage fully in both her personal and professional life.
Despite this adverse experience with lead toxicity resulting from advice given by an unlicensed Ayurvedic practitioner, the patient remains interested in Ayurveda—now with a strong preference for treatment by qualified and licensed professionals.
Conclusion: This case underscores a key lesson: adverse outcomes in traditional medicine often result not from the therapeutic system itself, but from its use outside of regulatory and ethical frameworks. It highlights the importance of seeking care from trained and licensed practitioners and emphasizes the necessity of sourcing botanical products only from rigorously tested, quality-controlled, and legally registered suppliers within the European Union or other places outside Ayurveda´s countries of origin. Using preparations following rasa-sastra-practise is contraindicated in the EU because of possibly toxic doses of heavy metals.