Silver products for medical indications: risk-benefit assessment.

Background: Legitimate medicinal use of silver-containing products has dramatically diminished over the last several decades. Recently, however, some manufacturers have begun to enthusiastically promote oral colloidal silver proteins as mineral supplements and for prevention and treatment of many diseases. Indiscriminate use of silver products can lead to toxicity such as argyria.

Objective: To assist health care professionals in a risk versus benefit assessment of over-the-counter silver-containing products, we herein examine the following issues: historical uses, chemistry, pharmacology, clinical toxicology, case reports of adverse events in the literature, and the recent promotion of over-the-counter silver products. Other sources of silver exposure (including environmental and dietary) and EPA exposure standards are discussed. A list of currently available silver products is provided for easy reference and screening.

Conclusions: We emphasize the lack of established effectiveness and potential toxicity of these products.