Gold

What is Gold?

Gold is element 79, and the oral gold drug auranofin (Ridaura) carries a boxed warning that it "can cause gold toxicity," listing falling blood counts, protein in the urine, rash and persistent diarrhea among the signs. That warning belongs to one kind of gold. The kind sold beside vitamins carries no comparable record, good or bad.

Gold (Au, from the Latin aurum, atomic weight 196.97) is a soft, dense noble metal that does not tarnish in air or dissolve in stomach acid as the bare metal. Its chemistry changes completely once it is bonded to something. Gold in oxidation state +1, held by sulfur, is the active ingredient of the rheumatoid arthritis drugs used from about 1930 onward. Gold bonded to cyanide is an electroplating salt that has killed people who swallowed it. Gold as thin foil is a European food color. Gold as particles a few billionths of a meter across is what a "colloidal gold" bottle says it holds.

This issue keeps those forms apart, because the hazard, the evidence and the regulation all attach to the form, never to the element in general.

Common Names

• Gold, Au, element 79, aurum; homeopathic Aurum metallicum

• Colloidal gold, gold hydrosol, nano gold, gold nanoparticles (AuNPs), "electro-colloidal" gold

• Monatomic or monoatomic gold, ORMUS, ORMEs ("orbitally rearranged monoatomic elements"), "white powder gold"

• Gold leaf, gold flakes, edible gold, E 175 (its EU food additive number)

• Swarna bhasma or suvarna bhasma (incinerated gold ash in Ayurveda); Suvarnaprashana, a gold preparation given to Indian children

• Prescription gold salts: auranofin (Ridaura), sodium aurothiomalate or gold sodium thiomalate (Myochrysine in North America, Myocrisin in the UK), aurothioglucose (Solganal)

• Gold sodium thiosulfate (sold as Sanocrysin for tuberculosis in the 1920s; now the standard patch-test allergen for gold)

• Potassium dicyanoaurate (potassium gold cyanide), hydrogen tetrachloroaurate (chloroauric acid)

Primary Active Compounds

• Gold(0), the metal. Bulk metal, foil fragments in E 175, and nanoparticles in colloids. Inert as a lump, but EFSA notes that gold ions can be released where the metal touches tissue.

• Gold(I) thiolates. Sodium aurothiomalate and aurothioglucose, water-soluble polymeric compounds given by intramuscular injection.

• Auranofin. A lipid-soluble, monomeric gold(I) compound carrying a triethylphosphine and an acetylated thioglucose, absorbed by mouth.

• Gold(I) cyanide. Potassium dicyanoaurate, used in jewelry and electronics plating.

• Gold(III) compounds. Chloroauric acid, the usual starting material for making gold nanoparticles, and experimental anticancer complexes that a 2020 review in Frontiers in Chemistry describes as "inherently unstable and redox-reactive under physiological conditions."

• CNM-Au8. An investigational suspension of clean-surfaced gold nanocrystals from Clene Nanomedicine, the only engineered gold nanoparticle drug taken by mouth in placebo-controlled human trials that this issue could find.

Key Note

No authority treats gold as a nutrient. The Food and Nutrition Board has set no Recommended Dietary Allowance, Adequate Intake or Tolerable Upper Intake Level for it. Gold is absent from the list of minerals the EU allows in food supplements (Annex I of Directive 2002/46/EC). It appears nowhere in FDA's summary of color additives permitted in foods, drugs, cosmetics or medical devices. EFSA's 2016 re-evaluation of E 175 set no acceptable daily intake, because the data were "too limited to perform a risk assessment."

The gold a doctor once prescribed comes with nearly a century of adverse event reports and a shrinking market; the gold sold as a supplement comes with a growing market and almost no human record at all.

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Primary Functions & Benefits

Gold has no function in human physiology, and no gold product sold as a supplement has a demonstrated benefit. Everything below describes prescription gold, which is relevant here only because supplement marketing borrows its history.

What gold drugs actually did, in controlled trials

• Injectable gold. The Empire Rheumatism Council's multicenter placebo-controlled trial (Annals of the Rheumatic Diseases, 1960 and 1961) was singled out in Kirwan and Currey's 1983 review as a well-designed study providing "strong evidence" of a benefit lasting about 18 months, with no established advantage beyond that. Cochrane's 2000 pooled analysis of four trials (415 patients) found an effect size of minus 0.5 for swollen joint count at six months, which the authors translated to a 30 percent improvement over placebo.

• Oral auranofin. A separate Cochrane review (Suarez-Almazor and colleagues, 2000) found small, statistically significant gains over placebo in tender joints, pain and ESR, and called the benefit "modest compared to drugs such as methotrexate or parenteral gold." The 2010 systematic review behind EULAR's rheumatoid arthritis recommendations (Gaujoux-Viala and colleagues, 97 trials, 14,159 patients) concluded that auranofin showed "no significant superiority over placebo."

• In children. The joint USA and USSR trial of auranofin in 231 children with juvenile rheumatoid arthritis (Giannini and colleagues, Arthritis and Rheumatism 1990) found clinically significant improvement in 69 percent on auranofin and 61 percent on placebo after six months, P = 0.24.

What none of that supports

Every positive result above came from a gold(I) thiolate drug in people with an autoimmune joint disease, under laboratory monitoring. None involved metallic gold particles, gold leaf, or anything sold as a dietary supplement.

Forms & Standardization

For gold, this section is the chemistry and toxicology of each form, because the form decides what reaches the blood and what it does there. No supplement form has an official standard for purity, particle size or concentration.

Metallic gold foil and leaf (E 175)

Food-grade gold is beaten foil broken into flakes. Evariste and colleagues (Particle and Fibre Toxicology 2023) imaged a commercial E 175 powder and found foil fragments close to pure gold, a mean 119 nanometers thick (range 60 to 240), with 28 percent of the objects by number qualifying as nanomaterial because one dimension was under 100 nanometers. EFSA's 2016 opinion expected low systemic availability because the metal barely dissolves, noted that ionic gold can be released locally where it touches tissue, and found no genotoxicity data for elemental gold at all. In mice fed E 175 for 90 days at 0.1, 1 and 10 micrograms per kilogram of body weight a day, there was no tissue damage or genotoxicity, but the gut microbiota and colonic cytokines shifted, differently in males and females: inflammatory cytokines rose in females at 1 microgram, a dose the authors call close to human intake, and dysbiosis appeared in females at 10.

Colloidal gold (metallic nanoparticles in water)

Bute and colleagues (International Journal of Molecular Sciences 2026) bought three Romanian colloidal gold supplements labeled 30, 55 and 110 mg per liter. Electron microscopy of the 55 mg per liter product showed metallic gold particles averaging 6.53 nanometers (none above 11), enough to classify the products as nanomaterials under the EU's 2022 definition. None declared a stabilizer. In cell culture, the supplement formulation cut the viability of HEK293 human embryonic kidney cells to zero at 5.5 and 11 mg per liter and by about 30 percent even at 0.55 mg per liter, while reference citrate-stabilized gold particles cut it by 25 to 30 percent. That is a test-tube finding, not a human outcome, and the authors concluded these products "should not be regarded as biologically inert."

In the US, a Source Naturals "Ultra Colloidal Gold" label filed in the NIH Dietary Supplement Label Database (ID 78672) lists gold at 10 ppm, a serving of 1/4 teaspoon, and other ingredients of distilled water, hydrogen tetrachloroaurate (a gold(III) salt, the usual chemical precursor), EDTA, agar and methylparaben. Its directions read "1/4 to 1/2 teaspoon daily. This product is not intended for children or for continuous use." The label states no particle size and no test for unreacted precursor.

"Monatomic" or ORMUS gold

The concept traces to David Radius Hudson, whose patent family on "non-metallic, monoatomic forms of transition elements" claims a US priority date of June 21, 1988. Google Patents lists the British member, GB2219995, as expired for unpaid fees, the German application as withdrawn, and an Italian patent granted in 1993; it lists no US grant in that family. A typical current product, Thalira's "Aultra Monatomic Gold Ormus" ($95, marked down from $113), claims "pure crystalline monoatomic gold at 1000 PPM," says it is "not colloidal gold," describes each batch as "energetically prepared with intention," directs 3 to 10 drops under the tongue, and links no certificate of analysis. A crystalline solid is by definition many atoms arranged in a lattice, so the label's own phrase contradicts itself. This issue found no independent published analysis of any ORMUS product's gold content.

Gold(I) thiolate injections: sodium aurothiomalate and aurothioglucose

More than 95 percent bioavailable by intramuscular injection. After a standard 50 mg injection of gold sodium thiomalate, serum gold peaks at 4 to 8 mg per liter in about two hours and is still near 3 mg per liter a week later (Blocka and colleagues, Clinical Pharmacokinetics 1986). More than 70 percent of the absorbed gold leaves through the kidneys, and more than half of a single labeled dose is still in the body at 100 days. Injected gold concentrates in the reticuloendothelial system, the adrenal cortex and the kidney, the organ where gold nephropathy appears.

Auranofin (oral gold(I))

About 25 percent of the gold is absorbed. The Ridaura label gives a mean terminal plasma half-life of 26 days at steady state and a terminal body half-life of 80 days. Steady-state serum gold runs 0.5 to 0.7 mg per liter, well below the 3 to 5 mg per liter reached with weekly injections, and less than 5 percent of a tracer dose remains at 100 days. Diarrhea, not kidney injury, dominates its side-effect profile.

Gold(I) cyanide (plating salt)

The most acutely dangerous form a consumer could plausibly encounter. Swallowed potassium gold cyanide has caused fatal lactic acidosis and multiorgan failure even when measured cyanide was below the usual toxic threshold, and the case authors suggest gold toxicity contributed (Harmon and colleagues, BMJ Case Reports 2019). A 27-year-old who drank 5 mL of plating solution developed cholestatic hepatitis with whole-blood gold of 4,361 micrograms per liter (Wu and colleagues, 2001).

Swarna bhasma (Ayurvedic gold ash)

Gold processed by repeated heating with plant materials. Biswas and colleagues (Journal of Ethnopharmacology 2019) found two particle populations in one commercial product: irregular particles around 60 micrometers and spheres from about 10 nanometers, coated with iron, silicon, oxygen, phosphorus and sodium. Rats given 3 to 30 mg per kg daily for 90 days showed no treatment-related organ damage. Bhasmas belong to rasa shastra, the metal-mineral branch of Ayurveda, and Saper and colleagues (JAMA 2008) found lead, mercury or arsenic in 40.6 percent of rasa shastra products bought online, against 17.1 percent of other Ayurvedic products.

Gold sodium thiosulfate

Sold as Sanocrysin for tuberculosis in Denmark in the 1920s and out of favor by the 1930s, after controlled trials and toxicity reports. Today its use is diagnostic: it is the patch-test reagent dermatologists use to detect gold allergy, at 0.5 or 2 percent.

Engineered medical gold nanoparticles

Silica-core gold nanoshells enabled laser ablation of prostate tumors in 15 of 16 men (Rastinehad and colleagues, PNAS 2019). CNM-Au8 is an investigational oral drug made under pharmaceutical controls. Neither result transfers to a supplement.

Food Sources

Gold is not a dietary requirement, so this section covers the routes by which gold reaches people, from the smallest exposure to the largest.

Decorated food and drink

In the EU, E 175 is authorized at "quantum satis" (no numeric limit) in only three food categories under Annex II of Regulation (EC) 1333/2008: the external coating of confectionery, the decoration of chocolates, and liqueurs. EFSA's 2016 exposure estimate reached 1.32 micrograms per kilogram of body weight a day in its worst-case, maximum-level scenario and 0.33 in its refined scenario. In the US, gold appears in no FDA color additive listing, yet gold-flake liqueurs are sold. Russell and colleagues (Journal of the American Academy of Dermatology 1997) analyzed one such cinnamon schnapps and found gold both in the visible flakes and dissolved in the liquid.

Jewelry, piercings and dental work

Paulsen and colleagues (Dermatitis 2019) found that 88 percent of their gold-sensitized patients had been exposed, with earrings and dental gold the important sources. Gold crowns and alloys sit in the mouth for decades, and Scalf and colleagues (American Journal of Contact Dermatitis 2001) found gold sensitization significantly more common in 51 patients with lichen planus or lichenoid lesions than in the North American Contact Dermatitis Group's routine population.

Cosmetic procedures

Gold microparticles applied to facial skin before acne laser treatment left a blue-gray macule that took eight months to fade (Fuchs and colleagues, Lasers in Surgery and Medicine 2019).

Workplaces

Goldsmiths and plating workers handle potassium gold cyanide, a white powder, and a 1980 German report described occupational contact dermatitis from it (Raith and colleagues).

Medicine

Rheumatoid arthritis treatment delivered gram quantities: most of the five patients with laser-induced chrysiasis reviewed by Cohen and Ross (2015) had received more than 8 g of systemic gold over 3 to 13 years. Injected gold stays in the dermis for life, which is why it can surface decades later (see Toxicity Symptoms).

Supplements

Colloidal, "monatomic" and bhasma products are how a healthy person ends up swallowing gold daily for months.

Is dietary intake enough?

The question does not apply. The body needs no gold, so the useful target intake is none beyond the trace in an occasional decorated chocolate.

Who Should Take Gold

No one should take a gold supplement. No population has a demonstrated need for gold or a measured benefit from colloidal, monatomic, ORMUS or ash forms.

Who is exposed anyway

• Adults treated with injectable gold for rheumatoid arthritis, mostly before 2019, who retain tissue gold for life

• The small number still prescribed auranofin under specialist monitoring

• People with gold dental work, piercings or daily-worn gold jewelry

• Jewelers, goldsmiths and electroplating workers

• Users of Ayurvedic rasa shastra products, and children given Suvarnaprashana

• Participants in CNM-Au8 trials and its US expanded access program for ALS

Who should consider testing

• Anyone with a persistent rash, eyelid or facial dermatitis, or oral lichenoid lesions who wears gold or has gold dental work: patch testing with gold sodium thiosulfate is the diagnostic step, read with clinical judgment because positive reactions often lack a matching exposure.

• Anyone planning Q-switched laser treatment who ever received injected gold: no blood test predicts the reaction, so Cohen and Ross advise asking about gold history before Q-switched treatment.

• Anyone who has taken an Ayurvedic metal preparation for months: blood lead, and urine mercury and arsenic as a clinician directs, given the Saper contamination findings.

Who Should AVOID or Use Caution

Contraindications

• A gold allergy, confirmed by patch test or by a reaction to gold jewelry. Russell and colleagues documented lichenoid and pruritic eruptions after gold-flake liqueur, and Guenthner and colleagues (1999) reported a reaction to Goldschläger in a patient already allergic to gold jewelry. Source Naturals' own colloidal gold label says "Do not use this product if you are allergic to gold."

• Pregnancy and breastfeeding. Auranofin's label says use "by pregnant women is not recommended"; in rabbits given 0.5 to 6 mg per kg a day it increased resorptions, abortions and congenital abnormalities, mainly abdominal defects. No reproductive data exist for colloidal or monatomic gold.

• Children. The Source Naturals label states its product "is not intended for children." The one randomized trial of Suvarnaprashana found in PubMed (Bhaskaran and colleagues, Ayu 2021) gave gold ash in ghee and honey, or ghee and honey alone, to healthy infants for four weeks. With 81 of 102 infants completing and 8 weeks of follow-up, it could detect only common, short-term harms, and found none.

• Any prior gold-induced disorder. The Ridaura label contraindicates it after gold-induced anaphylaxis, necrotizing enterocolitis, pulmonary fibrosis, exfoliative dermatitis, bone marrow aplasia or other severe blood disorders.

Use Caution

• Kidney disease. Injected gold leaves mainly through the kidney and caused membranous nephropathy in patients treated for arthritis.

• Lichen planus or oral lichenoid lesions, given the gold sensitization finding in Scalf's patients.

• ACE inhibitors (lisinopril, enalapril and others) with injectable gold, because of reported flushing and collapse (see Interactions).

• Planned cosmetic laser work after any past gold injections or gold-containing skin procedures.

Critical Safety Point

The gold compound that kills is a plating chemical, and it has been swallowed by mistake for a supplement. A 77-year-old Korean gold craftsman took a white powder used in goldsmithing, "mistaking the powder for a health supplement," and died about 8.5 hours later; his blood held 79.8 mg per liter of gold, and investigators attributed death to gold and cyanide together (Seol and colleagues, Journal of Forensic Sciences 2024). Potassium gold cyanide must never share a shelf with anything taken by mouth.

Recommended Dosages

No recommended dose of gold exists in any form, and no authority has set one. The figures below are regulatory ceilings and exposure estimates, not amounts to consume.

Nutrient reference values

None. No RDA, Adequate Intake or Tolerable Upper Intake Level exists, and FDA has set no Daily Value.

EU food additive E 175

Authorized at quantum satis, but only for confectionery coating, chocolate decoration and liqueurs. EFSA's worst-case estimate of exposure from those uses is 1.32 micrograms per kilogram of body weight a day. That is an estimate of what decoration delivers, not a safe limit; EFSA set no acceptable daily intake.

EU food supplements

Gold is not a permitted mineral source under Directive 2002/46/EC, and Bute and colleagues note that colloidal gold has no authorization for oral use in the EU and has never been assessed under the Novel Food Regulation.

US

No color additive listing, no nutrient value, and per Bute and colleagues, no GRAS status for gold nanoparticles taken by mouth.

Prescription gold

Supervised doses exist only as part of a prescribing decision and are kept in Special Considerations, away from this section.

Duration

No duration is safe by default, because no study has followed a supplement user. The longest placebo-controlled exposure to an oral gold nanoparticle product this issue found is 36 weeks, in 45 adults with ALS randomized to CNM-Au8 or placebo (RESCUE-ALS), followed by an open-label extension.

Timing & Administration

Not applicable for a substance with no recommended use. Supplement directions such as "best taken alone on an empty stomach" (Source Naturals) or Thalira's instruction to hold drops under the tongue rest on no absorption study of those products.

Timeline of Effects

No benefit timeline exists for any supplement form, so this section gives the measured timelines from drug trials and harm reports, for scale only.

Drug benefits, when they came

The Empire Rheumatism Council trial and the Cochrane reviews measured injectable and oral gold at six months. Kirwan and Currey judged the injectable effect to last about 18 months, with no shown advantage beyond. A 1996 review of radiographic studies by Rau noted that the Empire Rheumatism Council trial's patients had been adequately treated for only five months.

Gold nanocrystal trials, when they were judged

HEALEY ALS judged CNM-Au8 at 24 weeks and found a disease rate ratio of 0.97 (95 percent credible interval 0.783 to 1.175), no benefit. RESCUE-ALS judged its primary nerve-function outcome at 36 weeks and found no significant difference (p = 0.43). The REPAIR studies measured brain energy metabolites after 12 or more weeks in 24 evaluable people with multiple sclerosis or Parkinson's disease.

Harms, when they came

• Kidney: in Hall and colleagues' 21 patients with gold nephropathy (BMJ 1987), proteinuria began within 6 months of injections in 10, within 12 months in 15 and within 24 months in 18; after stopping, it resolved in a median 11 months and in all patients by 39 months.

• Skin pigment: chrysiasis appeared 22 years after the last gold injection in one woman reported in 2021 (Ravi and colleagues), and laser-induced chrysiasis has occurred as long as 26 years after gold therapy stopped.

• Gold-liqueur dermatitis: one of Russell's patients still had raised blood and urine gold three months after the last drink.

When to stop

For a supplement, before starting. For anyone who has already taken one and developed a rash, mouth sores, foamy urine, new shortness of breath or easy bruising, stop and tell a clinician exactly which product was used.

Benefits of Taking Gold

There are no benefits of taking gold as a supplement: no controlled trial of a colloidal, monatomic, ORMUS or gold-leaf product that this issue found has shown one. What follows is history, and the human studies of gold forms outside the prescription record.

Potable gold and tuberculosis

Alchemists recommended "potable gold" almost as a panacea. Robert Koch found gold cyanide effective against the tuberculosis bacillus in culture, and in the mid-1920s Danish physicians led by Holger Mollgaard, Knud Secher and Knud Faber treated tuberculosis with Sanocrysin (gold sodium thiosulfate). Guinea pig experiments had not shown a convincing effect, and the treatment declined in the 1930s under controlled trials and toxicity reports (Norn and colleagues, Dansk Medicinhistorisk Arbog 2011).

The bichloride of gold "cure"

Leslie Keeley's institute in Dwight, Illinois sold a treatment for alcohol and opium addiction under the name "bichloride of gold." An April 1892 editorial in the Atlanta Medical and Surgical Journal reported that the chemist said to have originated the formula denied it contained any gold, naming instead cinchona bark and nux vomica.

Rheumatoid arthritis

The belief that rheumatoid arthritis was a form of tuberculosis carried gold into rheumatology, where Jacques Forestier in France reported results with gold salts and argued they modified the disease. That record, real but toxic, is summarized in Primary Functions.

Human studies of non-prescription gold forms

• Colloidal gold. Sellers cite pilot studies of colloidal gold in rheumatoid arthritis and cognition by Guy Abraham and colleagues (1997 and 1998). Neither is indexed in PubMed, this issue could not obtain either paper, and online summaries of them disagree on design and outcome.

• Swarna bhasma in infants. In Bhaskaran's randomized trial, gold ash made no significant difference in serum IgG against ghee and honey alone in either age group. The authors' claim of benefit rests on a secondary "normalization" count, 32 of 39 analyzed infants against 18 of 30, in which an IgG change in either direction counted as success.

• Nano Swarna Bhasma in breast cancer. A 2020 pilot (Khoobchandani and colleagues, International Journal of Nanomedicine) reported "100% clinical benefits" when capsules combining gold nanoparticles with plant phytochemicals were added to standard care. Four of the nine authors listed affiliations with Dhanvantari Nano Ayushadi, an Indian company, and the abstract does not state how many patients were treated.

• CNM-Au8. No benefit on the primary outcome of either randomized ALS trial. RESCUE-ALS reported fewer deaths on CNM-Au8 (hazard ratio 0.408, 95 percent confidence interval 0.166 to 1.001, log-rank p = 0.0429) as an exploratory long-term analysis in 45 randomized patients. Clene's October 2026 application for accelerated approval rests on neurofilament light chain biomarker data and clinical outcomes, and it is a drug application, not evidence about any supplement.

Potential Negatives & Side Effects

Gold allergy is common in people who are patch tested

A 2024 meta-analysis in Contact Dermatitis (Jensen and colleagues) pooled 16 studies of 14,887 dermatitis patients and found gold sensitization in 14.1 percent (95 percent confidence interval 9.5 to 19.4), with extreme variation between centers. At Mayo Clinic, gold sodium thiosulfate tied for the most frequent positive reaction on its extended series from 2010 to 2023, at 10.4 percent of 3,767 patients. In Japan's baseline series it reached 25.7 percent of 5,865 patients. Relevance is the catch: Paulsen's group judged only 21 percent of positive reactions clinically relevant, and these are patients referred for dermatitis, not the general public.

Swallowed gold can trigger it

Russell and colleagues described three patients whose itchy, lichenoid rashes began after drinking a gold-flake cinnamon schnapps and improved after they stopped; one had raised blood and urine gold three months after the last drink, another a positive gold patch test. A separate report in the New England Journal of Medicine (1996) described lichen planus after the same kind of liqueur. This is the clearest human evidence this issue found that food-grade gold is absorbed enough to matter, and it comes from decoration-level exposure.

Metallic gold inside the body

Kastrati's team in Munich began from the premise that "gold is a highly biocompatible material." In their trial of 731 patients randomized to identical coronary stents with or without a gold coating, angiographic restenosis was 49.7 percent with gold against 38.1 percent without (P = 0.003), and one-year event-free survival was 62.9 against 73.9 percent (Kastrati and colleagues, Circulation 2000). At five years, death, heart attack or repeat revascularization had occurred in 51 percent versus 40 percent, and gold coating was independently associated with five-year mortality (hazard ratio 1.46, 95 percent confidence interval 1.02 to 2.09) (Pache and colleagues, 2006). Contact with metallic gold is not automatically benign.

Prescription gold adverse effects

From the Ridaura label: loose stools or diarrhea 47 percent, rash 24 percent, itching 17 percent, mouth sores 13 percent, proteinuria 3 to 9 percent, low platelets 1 to 3 percent. A Dutch trial of 269 patients starting auranofin 6 mg a day found loose stools or diarrhea in only about 15 percent over six months (van Beusekom and colleagues, Clinical Rheumatology 1997), so the label figure is the high end of the reported range. The injectable record adds nephropathy, interstitial lung disease, blood dyscrasias and chrysiasis (Toxicity Symptoms).

Supplement-specific findings

One human case is published: a woman who drank colloidal gold and silver as an "energy tonic" developed dilated cardiomyopathy and left bundle branch block, reversed within two months by dimercaprol chelation and vitamin E (Archer, Canadian Journal of Cardiology 2008); silver's share is unknown. Beyond that, the Romanian colloidal gold formulation's toxicity to kidney-derived cells, and E 175's sex-dependent effects on mouse gut bacteria and colon inflammation, are signals rather than outcomes. No supplement company has run the human study that would turn them into either.

Deficiency Symptoms

What gold addresses

No deficiency state exists. No symptom, sign or laboratory value is attributed to too little gold, and no human enzyme or transporter is known to require it.

The instructive contrast is selenium, because gold's best-characterized molecular target is a selenium enzyme. Selenium is essential: adults need 55 micrograms a day (the RDA), the upper limit is 400 micrograms, and its job is done as selenocysteine, the amino acid at the active site of enzymes such as thioredoxin reductase and glutathione peroxidase. Auranofin targets selenocysteine 496 of human thioredoxin reductase (Becker and colleagues, European Journal of Biochemistry 2000) and inhibits the enzyme at a Ki of 4 nanomolar (Gromer and colleagues, Journal of Biological Chemistry 1998). An essential trace element is one whose absence breaks an enzyme. Gold is an element whose presence does.

Bottom line

Fatigue, joint pain, low mood or poor focus have causes worth finding, and gold deficiency is not among them. A label that implies the body runs short of gold is inventing the condition it sells against.

Toxicity Symptoms

Gold toxicity is sorted by chemical form, not by dose of "gold," and the forms do not overlap much.

At high intake

• Gold(I) drugs, cumulative over months: itchy rash and exfoliative dermatitis; mouth ulcers; protein in the urine from membranous nephropathy (15 of Hall's 21 biopsied patients); falling white cells, platelets or hemoglobin, with bone marrow aplasia the feared extreme; interstitial pneumonitis (140 cases collected from 110 reports by Tomioka and King in 1997, and a fatal case reported in 2003); enterocolitis; and with auranofin, diarrhea above all.

• Gold(I) drugs, pigment: chrysiasis, a permanent blue-gray color of light-exposed skin from gold deposited in dermal macrophages. Mayo Clinic authors warned in 1982 that it can be mistaken for cyanosis. Gold can also deposit in the cornea after long injectable therapy; an Italian report described deposits through every corneal layer after 32 years of gold sodium thiomalate, while a 1985 study found no appreciable corneal gold in patients on oral auranofin for 8 to 34 months. Chrysiasis is gold's counterpart to argyria, with one difference that matters decades later: a Q-switched laser can provoke it in a person whose skin showed nothing before.

• Gold(I) cyanide, acute: vomiting, lactic acidosis, multiorgan failure and death within hours, as in the 2019 and 2024 fatal cases; or, in one survivor, cholestatic hepatitis with blood gold above 4 mg per liter.

• Metallic gold, food or supplement exposure: pruritic or lichenoid skin eruptions in sensitized people, and one case of reversible dilated cardiomyopathy after drinking colloidal gold and silver (Archer, 2008).

Signs to reduce or stop

• New rash or itching anywhere, especially after starting a gold product or drinking a gold-flake liqueur

• Mouth sores or a sore tongue

• Foamy urine or ankle swelling

• Bruising, nosebleeds or unusual infections

• Dry cough or breathlessness that is new

• Gray or blue discoloration of facial skin, particularly after a cosmetic laser session

• Any swallowed white powder from a jewelry or plating workshop: an emergency needing treatment for cyanide poisoning, even before symptoms

General note

Many of gold's harms look more immunological than dose-proportional. In Tomioka and King's series of gold lung disease, 38 percent also had eosinophilia and 38 percent a rash; 7 of Hall's 21 nephropathy patients carried the HLA-B8 or DR3 immune types; and the gold-liqueur rashes came from a drink, not a drug regimen. For a supplement buyer, that means a "small" daily amount offers less protection than the word suggests, because the reaction depends on the person as much as the milligrams.

How Gold Works

Gold does nothing a human body needs, so this section explains how its forms behave once inside one.

Gold(I) seeks sulfur and selenium

Gold(I) is a soft metal ion that binds most tightly to soft partners, the thiol of cysteine and, more tightly still, the selenol of selenocysteine. The drugs are delivered as gold(I) already bound to a sulfur carrier (thiomalate, thioglucose), which it trades for sulfur and selenium sites on proteins. Gromer's group showed auranofin inhibiting thioredoxin reductase at 4 nanomolar and needing roughly 1,000-fold higher, micromolar concentrations to inhibit glutathione reductase and the selenoenzyme glutathione peroxidase. Thioredoxin reductase keeps cells' redox systems running, which is why auranofin has since been studied against parasites and cancers; the same reactivity is not confined to diseased cells. Exactly how gold drugs eased arthritis was never settled; Blocka's 1986 review noted that attempts to link gold levels to clinical response or toxicity had been "largely unsuccessful."

Metallic gold mostly passes through, but not entirely

Gold(0) is insoluble in water and resists stomach acid. EFSA and Hadrup and colleagues (Regulatory Toxicology and Pharmacology 2015) both conclude that some ionic gold is released from metal surfaces and that elemental gold or its ions are absorbed "to some extent," then distributed to liver, kidneys, heart and lungs and excreted mainly in urine. Hadrup's group judged that, at low human exposure, oral elemental gold is not a general health concern, while noting that repeated-dose data are "very limited" and mammalian genotoxicity studies are lacking. Particle size governs absorption, and the studies Bute's group reviews found that smaller particles cross the gut more readily. The Romanian supplements' 4 to 11 nanometer particles sit at the small end of that range.

Why skin turns gray-blue

Biopsies in chrysiasis show gold particles inside dermal macrophages, confirmed by electron microscopy and X-ray microanalysis (Beckett and colleagues, Mayo Clinic Proceedings 1982). A 2022 review in Advanced Science (Schwartz-Duval and Sokolov) describes chrysiasis as evidence that gold nanoparticles form inside the bodies of patients given gold salts. Light seems to matter: Fleming and colleagues (1996) reported chrysiasis after a relatively low gold dose in a woman exposed to intense Australian sunlight, and Q-switched lasers produce blue macules at the treatment site immediately in previously treated patients.

The claimed mechanism of the nanocrystal drug

Clene's investigators report that CNM-Au8 catalyzes the conversion of NADH to NAD+ in cultured neurons, raising ATP (Wang and colleagues, Small 2023). In REPAIR, brain NAD+/NADH ratio measured by 7-tesla phosphorus spectroscopy rose 10.4 percent after 12 or more weeks in the combined cohorts (p = 0.037), though neither the Parkinson's (p = 0.11) nor the multiple sclerosis cohort (p = 0.14) reached significance alone. These findings describe a manufactured drug, not supplement colloids, which Bute found behave differently from reference particles in cells.

Synergistic Supplements

None. No study has tested gold with any other supplement for added benefit, and no rationale supports one. The one documented combination effect runs the wrong way: gold plus cyanide, in the plating salt, is described by the 2024 forensic case authors as synergistically more cytotoxic than either component.

Interactions & What NOT to Take

ACE inhibitors with injectable gold

"Nitritoid" reactions (flushing, low blood pressure, dizziness or fainting shortly after an injection) were linked to ACE inhibitors in patients receiving gold sodium thiomalate in a 1989 New England Journal of Medicine letter (Healey and Backes), with later reports naming lisinopril (Ching and McClintock, 1997) and enalapril (Muravev and Tsapina, 2002). Injectable gold has largely left the market, but anyone still receiving it should have every blood pressure drug reviewed.

Q-switched lasers after systemic gold

A procedural interaction rather than a drug one. Cohen and Ross found that all five reviewed patients developed blue macules immediately at Q-switched treatment sites, as long as 26 years after gold therapy ended, and that long-pulsed laser treatment, in one case followed by fractional and carbon dioxide lasers, later cleared the color in two. Tell any laser clinic about past gold injections or gold-based skin treatments.

Other drugs

The Ridaura label requires laboratory review before each prescription because gold can depress blood counts and damage kidneys, so combining it with other drugs that do the same raises the stakes. For colloidal, monatomic or bhasma gold, no interaction study exists in either direction.

What not to take it with

Any Ayurvedic metal preparation of unknown testing status; any gold product while on a gold drug; any gold product before a cosmetic laser session; and anything stored near a plating or jewelry-making chemical.

Quality, Testing & Adulteration

No standard exists to test against

Third-party programs such as USP, NSF and ConsumerLab check a product against its label or an official specification. None of the regulators reviewed here has issued a specification for gold as a supplement ingredient, so a verified "10 ppm" would be verified against the label alone. EFSA asked that any E 175 specification state mean particle size, size distribution and the percentage of particles under 100 nanometers; no supplement label reviewed here gives all three.

What the published analyses found

• Bute's three Romanian colloids did contain metallic gold nanoparticles, but with no declared stabilizer and a broader, more aggregated size distribution than laboratory reference particles. Ingredient lists elsewhere name the chemistry used to make them: Source Naturals lists hydrogen tetrachloroaurate, a gold(III) salt, and EDTA, which leaves open how much gold remains unreduced. The label states no test.

• "Monatomic" products publish claims of 1000 ppm and "verified" purity without documents. Thalira's page cites Hudson's expired British patent and physics papers in place of a lot analysis.

• Swarna bhasma is variable by design. Bhaskaran's trial batch assayed at 93.52 percent gold. Beaudet and colleagues (Scientific Reports 2017) found roughly 60 nanometer crystallites clumped into aggregates averaging 4,711.7 nanometers. Biswas found two particle populations more than three orders of magnitude apart in size.

• Contamination is the documented adulteration problem for Ayurvedic metal products: Saper found lead, mercury or arsenic in 20.7 percent of 193 Ayurvedic medicines bought online, 95 percent of the metal-containing products sold by US websites, 75 percent claiming Good Manufacturing Practices, and every one exceeding at least one acceptable daily intake standard for a toxic metal.

What a meaningful certificate of analysis would report

Total gold by ICP-MS, with method and detection limit; number-based particle size distribution by electron microscopy, with the fraction under 100 nanometers; residual chloride or unreacted gold(III) for products made from chloroauric acid; any stabilizer or capping agent; lead, mercury, arsenic and cadmium at stated limits; and, for leaf, the silver and copper content of the alloy.

What a shopper can see for themselves

Small gold nanoparticles absorb green light, so a genuine colloid looks ruby red to purple; Bute measured absorbance peaks at 514 to 519 nanometers in the supplements. A label that calls its gold "monatomic," "crystalline" and "not colloidal" at once is describing chemistry that does not hang together. A label that lists a gold(III) salt among the ingredients is telling you what the product was made from.

Special Considerations

The medical gold that was discontinued, and why

On June 10, 2019, Sanofi wrote to UK prescribers that Myocrisin injection was being permanently discontinued "due to a shortage of Active Pharmaceutical Ingredient (API) and not due to any safety issue," that no new patient should start it, and that existing patients should be switched. Health Canada's shortage database records Myochrysine as discontinued in June 2019, with Sanofi stating it would stop all three strengths "globally." Injectable gold left the market over supply, not in a safety withdrawal. Auranofin remains FDA-approved, distributed as Ridaura by Sebela Pharmaceuticals under a label last revised in October 2017.

Supervised doses, kept out of Recommended Dosages

Auranofin's labeled adult dose is 6 mg a day, with 9 mg a day allowed after six months if response is inadequate, prescribed only by physicians experienced in gold therapy, with laboratory review before each prescription. Gold sodium thiomalate was given as weekly 50 mg intramuscular injections. CNM-Au8 was given at 30 or 60 mg a day by mouth to trial participants with ALS. These are prescription and investigational regimens with monitoring, and they say nothing about what a supplement user could swallow.

The pending gold drug

Clene announced on October 19, 2026 that it had submitted a New Drug Application earlier that month seeking accelerated approval of CNM-Au8 for ALS, based on neurofilament light chain biomarker data and clinical outcomes, while preparing a confirmatory phase 3 trial, RESTORE-ALS. The release did not state that FDA had accepted the filing. If approved, CNM-Au8 will be a prescription drug for one disease, and its approval would not validate any colloidal gold supplement, whose particles, surfaces and manufacturing differ.

Edible gold and lasers

AlHargan and colleagues (Lasers in Medical Science 2019) gave Q-switched laser spot tests to 10 adults in Riyadh who had eaten edible gold, mostly on chocolate, 3 weeks to 3 months earlier; none developed chrysiasis. That reassures about occasional decorative gold, in a very small sample, and says nothing about months of daily colloid.

Research Status & Evidence Quality

Tier 1, human randomized trials

Injectable gold for rheumatoid arthritis: effective short-term with high toxicity withdrawal (Cochrane, 4 trials, 415 patients). Auranofin: small effect in one Cochrane review, no significant superiority over placebo in the EULAR review. CNM-Au8: no benefit on the primary outcome of HEALEY ALS (161 randomized within its regimen) or RESCUE-ALS (45). Gold-coated stents: worse restenosis and five-year outcomes in 731 patients. Swarna bhasma in 102 infants: no between-group difference on its primary IgG outcome.

Tier 2, uncontrolled or pilot human studies

REPAIR imaging (24 evaluable people), the Nano Swarna Bhasma pilot, the nanoshell device study (16 men), the edible-gold laser study (10 adults) and the unindexed colloidal gold pilots.

Tier 3, case reports and series

Chrysiasis and laser-induced chrysiasis; gold nephropathy (21 patients followed for up to 130 months); gold lung disease (140 cases); gold-liqueur dermatitis; colloidal gold and silver cardiomyopathy (one case); potassium gold cyanide poisonings. For safety, this tier carries most of the information.

Tier 4, animal and cell studies

E 175 in mice for 90 days; swarna bhasma in rats for 90 days; Romanian colloids in human cell lines; nanocrystal catalysis in neurons.

Research Limitations

• No randomized trial has tested a retail colloidal, monatomic or ORMUS gold supplement in people for any outcome, in any of the databases searched for this issue.

• The human safety data come almost entirely from drug users whose exposures (grams over years by injection) bear no simple relation to supplement use.

• Patch-test prevalence studies sample patients referred for dermatitis, not the general population.

• RESCUE-ALS was "substantially funded" by the charity FightMND with additional funding from Clene, and several of its authors are Clene employees.

• Supplement particle size, purity and gold content are known only for the few products independent groups have analyzed.

Summary & Key Takeaways

Bottom Line

Gold is two substances for a buyer's purposes. Prescription gold salts treated rheumatoid arthritis for most of the twentieth century, worked modestly, and left a detailed record of rashes, kidney injury, blood disorders, lung disease and permanent skin pigment before Sanofi stopped making the injections in 2019 for lack of raw material. Supplement gold, sold as colloidal, monatomic, ORMUS or Ayurvedic ash, has no demonstrated benefit, almost no human data, no nutrient status anywhere, and no authorization as a supplement mineral in the EU. The one engineered gold nanoparticle drug taken by mouth in placebo-controlled trials that this issue found, the investigational CNM-Au8, missed its primary outcomes in ALS.

Key Safety Points

• Gold allergy appears in roughly one in seven dermatitis patients who are patch tested, and swallowed gold from flake liqueurs has caused lichenoid rashes. A known gold allergy rules out every oral gold product.

• Anyone who ever had gold injections should tell a laser clinic: Q-switched lasers have provoked blue pigment up to 26 years later.

• Potassium gold cyanide, a goldsmith's white powder, has killed a man who mistook it for a supplement. Store it apart from anything edible.

• Ayurvedic metal preparations carry a documented risk of lead, mercury and arsenic.

• No reproductive safety data exist for any supplement gold, and auranofin harmed rabbit pregnancies.

• Prescription gold is still dispensed rarely as auranofin, under laboratory monitoring, and its doses do not translate to supplement use.

Special Note

Medicine spent nearly ninety years documenting what gold does inside people, and the documentation is mostly a list of harms. A supplement label borrows gold's prestige and leaves that record behind. On a colloidal gold label the most informative line is the ingredient list; on a monatomic gold page it is the missing certificate of analysis.

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Researched and drafted with AI assistance. Every claim verified against primary sources and human-reviewed before publication. Last reviewed: October 26, 2026. Corrections: reply to any issue.

This issue is educational and is not medical advice. If you take auranofin or any other prescription drug, have kidney disease, a known metal allergy or a diagnosed condition, or are pregnant, talk to a clinician before taking any gold product or changing a treatment.