State of California—Health and Human Services Agency
California Department of Public Health

Health Advisory

TO: Healthcare Providers

Fatality from Lead Poisoning Linked to Use of Hemorrhoid Ointment from Vietnam

4/9/2024

Key Messages

If healthcare providers have patients that have used this hemorrhoid ointment, urge them to stop using it and order a venous blood lead test immediately.

Background

In March 2024, a woman in Sacramento developed severe lead poisoning and died after using a hemorrhoid ointment from Vietnam called, Cao Bôi Trĩ Cây Thầu Dầu (Castor Oil Hemorrhoid Extract). The woman purchased the product on Facebook and a relative in Vietnam shipped it to the U.S. Testing of the product found that it contained 4% lead (39,000 ppm), a highly dangerous amount of lead. Lead may be absorbed through the skin.

Lead poisoning symptoms can be non-specific but may include those below. While some individuals can be asymptomatic, others can experience symptoms.

Mild symptoms: Fatigue, irritability or mood swings, difficulty concentrating, difficulty sleeping
Moderate symptoms: Muscle and joint pain, nausea, decreased appetite, stomach cramps, constipation and diarrhea, feeling tired or sleepy, headache, tremor
Severe symptoms: Severe stomach cramping, pins and needles sensation, tingling, burning or numbness in hands, seizures, coma, death

Recommendations

If your patients have used a hemorrhoid ointment from Vietnam called, Cao Bôi Trĩ Cây Thầu Dầu, urge them to stop using the ointment immediately.
Patients who have used this ointment should receive a venous blood lead test immediately. We also recommend blood lead testing for all household members, especially children, since they may have had contact with the ointment.
Contact California Poison Control at 1-800-222-1222 for clinical guidance on lead poisoning. See Health-Based Guidelines for Blood Lead Levels in Adults (PDF) for specific recommendations based on your patient's blood lead level results.