Lead in Mineral or Multivitamin-Multimineral Products

Title	Lead in Mineral or Multivitamin-Multimineral Products
Authors	C. Michael White
Magazine	Annals of Pharmacotherapy
Date	06/06/2021
DOI	10.1177/10600280211023328
Introduction	This review evaluates the current daily interim reference level for lead and the quantity present in contemporary mineral and multivitamin-multimineral (MVM) products. Data was gathered through a PubMed search spanning from 1980 to 15/05/2021, limited to English-language studies, utilising a specific search strategy involving minerals, vitamins, and heavy metals including lead. The selection and data extraction involved a narrative review of studies that assessed lead content in mineral or MVM items. The synthesis of data indicates that products containing various calcium forms, such as dolomite, bone meal, and natural carbonate, historically exhibited elevated lead levels compared to other forms like refined carbonate, lactate, gluconate, acetate, and sevelamer. However, this discrepancy has significantly narrowed since 2000. Limited evaluations of magnesium and zinc supplements have not revealed concerning average lead amounts. MVM products assessed since 2007 generally displayed low median or mean lead concentrations. Nevertheless, substantial differences exist among products, with many containing minimal lead while others present worrying quantities. For patient care and clinical practice, it remains challenging for pharmacists and consumers to ascertain the actual lead content of a product unless it undergoes testing by an independent third-party laboratory. While organisations like the United States Pharmacopeia and NSF International provide seals indicating low lead levels, children might still consume more lead than the Food and Drug Administration’s Interim Reference Level. In conclusion, the risk of lead exposure from mineral and MVM products has considerably lessened over time, yet some products can still contain excessive amounts. Without independent third-party testing, healthcare professionals and consumers cannot readily identify which outlier products to avoid.
Quote	C. Michael White. Lead in Mineral or Multivitamin-Multimineral Products. Annals of Pharmacotherapy. 2021. DOI: 10.1177/10600280211023328
Element	Calcium (Ca) , Magnesium (Mg) , Copper (Cu) , Zinc (Zn) , Chromium (Cr) , Selenium (Se)
Industry	Pharmaceutical Industry