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The Beuttner study 1 in this issue of JGIM used NHANES data to draw an association between lead levels and the use of herbal supplements, but the findings should raise more caution about interpretations than herbs. Although geometric means of blood lead levels were 10% higher among women who used herbs, compared to nonusers, all geometric means were low. Only 0.6% of the population had elevated (>10 mcg/dL) blood levels and the authors provide no evidence that elevated lead levels were more common in users of herbs. Increased lead levels, even if statistically significant, are of questionable clinical significance when levels remain in the low-normal range. As the authors note, men had higher blood lead levels than women, and although the use of supplements was similar in men and women, no association between lead levels and herb use was found among men.

Don’t Be ‘Mis-led’: Few Herbal Products have Been Implicated in Lead Poisoning