The Los Angeles County Department of Public Health is warning residents not to use a Vietnamese herbal ointment called “Cao Bôi Trĩ Cây Thầu Dầu” (Castor Oil Hemorrhoid Extract) because it contains lead and can be fatal.

A woman in Sacramento died in March after developing severe lead poisoning from using the Vietnamese herbal ointment, which has been promoted for treating hemorrhoids with a suggested intra-rectal application. The product was purchased on Facebook and mailed to the United States by a friend or relative in Vietnam. It is unclear if this product can be purchased from informal marketplaces in the United States.

According to the California Department of Public Health (CDPH), the ointment was tested and contains 4% lead (39,000 ppm) – a highly dangerous amount of lead. Exposure to any amount of lead can cause harmful effects on the body that create lifelong learning, behavioral, reproductive, cardiovascular, and other health problems.

Lead poisoning may not have visible signs or symptoms and symptoms can vary person to person. Symptoms depend on the amount of lead in a product, how often it is used, and for how long.

Symptoms can include:

 – Mild symptoms: Fatigue, irritability or mood swings, difficulty concentrating, difficulty sleeping

 – Moderate symptoms: Muscle and joint pain, nausea, decrease appetite, stomach cramps, constipation and diarrhea, feeling tired or sleepy, headache, tremors

 – Severe symptoms: Severe stomach cramps; pins and needles sensation, tingling, burning or numbness in hands; seizures, coma, death

The Los Angeles County Department of Public Health, in collaboration with the CDPH, urges anyone who used Cao Bôi Trĩ Cây Thầu Dầu (Castor Oil Hemorrhoid Extract) to:

(1) Stop using the ointment immediately and contact your health provider to get a blood lead test (venous blood test).

(2) Place the jar ointment in a sealed plastic bag and contact the California Department of Public Health (CDPH) at (510) 620-3620 or email toxoutbreak@cdph.ca.gov.

(3) Get a blood lead test for any other household members, especially children, if they have been exposed to the ointment. Children are especially vulnerable to lead poisoning.

Anyone who has used the ointment can download a letter to take to their health care provider with instructions for blood lead testing. You can download the letter from CDPH in English or Vietnamese.

Visit the CDPH website for more information.

For any other questions about childhood lead poisoning prevention in Los Angeles County, contact 1-800-LA-4-LEAD (1-800-524-5323) or visit getyourchildtested.com.