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What Is NDMA and Why Is It Dangerous?

Author
Alicia Betz
March 11, 2021

NDMA, or N-nitroso-dimethylamine is a probable human carcinogen that is found naturally in small amounts in soil and air. The yellow, odorless liquid is also a by-product of the chlorination process at wastewater plants. 

The chemical breaks down in sunlight, and our liver does a great job of breaking down small amounts as well. When the exposure to NDMA becomes high, however, it is toxic to our bodies.

zantac heartburn lawsuit

Why is NDMA Dangerous?

NDMA, which was used to produce rocket fuel, antioxidants, and lubricants in the past, can cause kidney, liver, and lung damage at high levels. NDMA is a Group 2A probable human carcinogen. 

It was found to induce liver and lung cancer in animals, and although it has not yet been proven to cause cancer in humans, studies have observed higher incidences of cancer among people exposed to high levels of NDMA. Other studies found that ingesting NDMA is a risk factor for developing cancer. 

The chemical can cause damage to organs with low levels of exposure over a long period of time or with high levels of exposure over a short period of time. It is found naturally at low levels in our environment, but these small amounts do not typically cause a problem for most people.

Symptoms of NDMA Overexposure

If you believe you have a high level of exposure to NDMA, talk to your healthcare provider and monitor yourself for these symptoms: 

  • Headache
  • Fever
  • Nausea and vomiting
  • Jaundice (yellowing of the skin and eyes)
  • Abdominal cramps

ndma dangers

It is difficult to definitively test and diagnose overexposure because there are currently no standardized blood levels for NDMA. Your doctor may use activated charcoal or inhaled oxygen to treat suspected exposure

NDMA in the Environment

In addition to being found in the soil and air, NDMA is also found in:

  • Food
  • Tap water
  • Tobacco
  • Shampoo and other cleansers
  • Pesticides
  • Beer
  • Whiskey

It’s commonly found in cured or processed meat, vegetables, and dairy products. Some chemicals in food turn into NDMA in the stomach. 

Although it seems like our daily amount of NDMA exposure is alarming, our bodies work hard to eliminate this toxin. Excessive amounts delivered to the body daily via medication, however, may be problematic. 

NDMA dangers

NDMA in Medications

The NDMA found in medications is more likely to cause low, long-term exposure (as opposed to high, short-term exposure). In recent years, the FDA has issued several recalls on drugs found to contain higher than recommended levels of NDMA. These drugs include: 

  • Valsartan
  • Zantac (ranitidine) 
  • Metformin
  • Angiotensin II receptor blockers (ARBs)

In the case of Zantac, the levels of NDMA were found to increase over time, even when the drug was stored properly. This has led to the FDA requesting that all manufacturers and retailers pull Zantac, as well as many people filing lawsuits against the manufacturers of Zantac

Typically, drugs are only approved by the FDA if the benefit of the medication outweighs the risk. In the case of Zantac, the benefit of reducing heartburn is not worth the potential risk of cancer. 

The finding of NDMA in medications is complicated by the fact that the recorded levels have not been consistent. The levels of NDMA vary based on the tester, the manufacturer, and the batch. The levels in Zantac increased over time, so NDMA may not have been detectable when the medication was manufactured. By the time it reached consumers, however, the level might have been excessively high.

When to Worry About NDMA

Low levels of NDMA are easily filtered by our bodies, but when do you know if your personal levels are excessive? A small amount from one source might not be problematic, but when your body is inundated with NDMA from various sources, the level may become toxic. One person can be exposed to NDMA through:

  • The air
  • Water
  • Food
  • Tobacco
  • Cosmetics
  • Medication

If you tend to eat foods that have higher levels of NDMA, take a medication that was recalled due to the presence of NDMA, and you smoke, you might want to talk to your doctor. He or she can speak to you more about signs of overexposure and devise a treatment or monitoring plan. 

If you currently take a medication that is known to contain NDMA, do not stop taking your medication abruptly. Contact your doctor as soon as possible to find a safe alternative and to create a weaning schedule if necessary.

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