Unintentional and Sequential Lead Exposure from a Ceramic Mug and Maca (Lepidium meyenii).

Although the incidence of lead poisoning has decreased in the USA over the last 30 years, human exposures to lead-containing products are still reported. We present a case of unintentional lead exposure from a store-bought ceramic mug and a nutritional supplement. A 32-year-old female was found to have a whole blood lead concentration of 44 μg/dL. Evaluation of her home, occupation, and hobbies initially did not identify a source of lead exposure. Further investigation revealed that the likely etiology of the exposure was lead leaching from a ceramic mug used by the patient to drink hot lemon water while she was pregnant. She stopped drinking from the mug and her blood lead levels decreased, but increased a year later after she began to ingest a maca root powder supplement. Upon discontinuation of maca root powder ingestion, her blood lead levels decreased further. Over time, the acidity and heat of the hot lemon water used in the ceramic mug enhanced the breakdown of its leaded glaze. Maca powder, which is available as a nutritional supplement and is used to treat fatigue and enhance fertility, may contain lead and other minerals. Consumers, particularly women of childbearing age, and their physicians should be aware that imported products available from commercial retailers and internet vendors may contain significant amounts of lead.