High levels of lead detected in authenticated locks of Ludwig van Beethoven’s hair suggest that the composer had lead poisoning, which may have contributed to ailments he endured over the course of his life, including deafness, according to new research. In addition to hearing loss, the famed classical composer had recurring gastrointestinal complaints throughout his life, experienced two attacks of jaundice and faced severe liver disease. It is believed that Beethoven died from liver and kidney disease at age 56. But the process of understanding what caused his many health problems has been a much more complicated puzzle, one that even Beethoven himself hoped doctors could eventually solve. The composer expressed his wish that his ailments be studied and shared so “as far as possible at least the world will be reconciled to me after my death.” An international team of researchers set out nearly a decade ago to partially fulfill Beethoven’s wish by studying locks of his hair. Using DNA analysis, the team determined which ones truly belonged to the composer and which were fraudulent, and sequenced Beethoven’s genome by analyzing his authenticated locks. The findings, published in a March 2023 report, revealed that Beethoven had significant genetic risk factors for liver disease and a hepatitis B infection before his death. But the results didn’t provide any insights into the underlying causes of his deafness, which began in his 20s, or his gastrointestinal issues. Beethoven’s genome was made publicly available, inviting researchers around the world to investigate lingering questions about Beethoven’s health. Meanwhile, scientists continue to figuratively go over the authenticated locks of Beethoven’s hair with a fine-tooth comb, teasing out surprising insights. In addition to high concentrations of lead, the latest findings showed arsenic and mercury that remain trapped in the composer’s strands nearly 200 years after his death, according to a new letter published Monday in the journal Clinical Chemistry. And the insights could provide new windows not only into understanding Beethoven’s chronic health ailments, but the complicated nuances of his life as a composer. A tangled web reveals lead Christian Reiter, now the retired deputy director of the Center of Forensic Medicine at the Medical University of Vienna, had previously studied the Hiller Lock, a sample of hair long attributed to Beethoven. He authored and published a 2007 paper after determining there were high levels of lead in the hair, and suggested the lead may have contributed to the composer’s deafness, and potentially his death. In a twist, the 2023 genomic sequencing study uncovered that the Hiller Lock did not belong to Beethoven, and it was actually a hair sample from a woman. But at the time the researchers did not test Beethoven’s newly authenticated hair samples for lead. So the question remained: Did Beethoven have lead poisoning? A separate research team used two different methods to search for evidence of lead in two authenticated locks of Beethoven’s hair: the Bermann lock, estimated to have been cut between late 1820 and March 1827, and the Halm-Thayer lock, which Beethoven hand-delivered to pianist Anton Halm in April 1826. It was very common during Beethoven’s lifetime for people to collect and keep locks of hair from loved ones or famous people, said William Meredith, Beethoven scholar and study coauthor of the 2023 genomic analysis and the latest study. The newer research detected incredibly high levels of lead in both samples: 64 times the expected level in the Bermann Lock, and 95 times the expected level in the Halm-Thayer lock. “These levels are considered as lead poisoning,” said lead study author Nader Rifai, professor of pathology at Harvard Medical School and director of clinical chemistry at Boston Children’s Hospital. “If you walk into any emergency room in the United States with these levels, you will be admitted immediately and you will undergo chellation therapy.” A statue of Ludwig van Beethoven stands outside the opera house in Hannover, Germany on Monday, Aug. 31, 2009. (Joerg Sarbach / AP Photo, File) Diagnosing Beethoven Elevated lead levels such as those detected in Beethoven’s hair “are commonly associated with gastrointestinal and renal ailments and decreased hearing but are not considered high enough to be the sole cause of death,” the study authors wrote. Because the researchers don’t have hair samples from earlier in Beethoven’s life, it’s impossible to understand when the lead poisoning started, Meredith said. The study authors do not believe the lead poisoning was solely responsible for Beethoven’s death or deafness. But he experienced symptoms of lead poisoning throughout his life, including hearing loss, muscle cramps and renal abnormalities, Rifai said. Both locks also contained increased levels of arsenic and mercury, about 13 to 14 times the expected amount, according to the study. Study coauthor Paul Jannetto, associate professor in the department of laboratory medicine and pathology and laboratory director at the Mayo Clinic, carried out the analysis of the samples and said he’d never seen such high lead levels. But Rifai said he saw comparable lead levels when he conducted research in two villages in Ecuador where the main trade is to glaze tiles with lead from batteries. The villagers experienced mental delays, hearing loss and hematological abnormalities, which are common in liver disease, he said. Lead exposure in Beethoven’s lifetime Currently, there is no understanding of the average amount of lead in the bodies of people like Beethoven who were living in Vienna during the 19th century, Rifai said. He said he hopes to access old locks of hair people have from their families to determine the baseline level of the population at the time since there is no documentation. But how did Beethoven end up with so much lead, as well as arsenic and mercury, in his body? The substances likely accumulated over decades of the composer’s life through food and drink, Rifai said. Beethoven was known to favor wine, sometimes drinking a bottle a day, and he drank plumbed wine. A common practice dating back at least 2,000 years, the creation of plumbed wine involves adding lead acetate as a sweetener and preservative, Rifai said. At the time, lead was also used in glassmaking to give glassware a more clear and appealing appearance. Beethoven also loved to eat fish, and at the time, the Danube River was a great source of industry, meaning waste ended up in the same river that was a source of fish caught for consumption — and that fish likely contained arsenic and mercury, Rifai said. The report marks the first time lead levels have been established for Beethoven and points to another possible cause for Beethoven’s kidney failure in the months before his death and the liver failure he experienced at the end of his life, Meredith said. Lead poisoning appears to be the fourth factor that contributed to his liver failure, apart from genes that predisposed Beethoven toward liver disease, his hepatitis B infection and his penchant for drinking alcohol, Meredith said. Linking Beethoven’s health and music The composer wrote a letter to his brothers in 1802 asking that his doctor, Johann Adam Schmidt, determine and share the nature of his “illness” once Beethoven died. The letter is known as the Heiligenstadt Testament. But the documents kept by Beethoven’s favorite doctor, who died 18 years before his patient, have been lost. In the 1802 letter to his brothers, Beethoven admitted how hopeless he felt as a music composer struggling with hearing loss, but his work kept him from taking his own life. He said he didn’t want to leave “before I had produced all the works that I felt the urge to compose.” “People say, ‘the music is the music, why do we need to know about any of this stuff?’ But in Beethoven’s life, there is a connection between his suffering and the music,” Meredith said. May 7 marked the 200th anniversary of the first performance of Beethoven’s famed Ninth Symphony, largely regarded as his greatest work and his final symphony. Completely deaf at the time, Beethoven was onstage as one of the conductors, but the orchestra was instructed to follow the conducting of Beethoven’s friend, who was also onstage. The concert marked one of the most triumphant moments in Beethoven’s life, and the female singers turned him to face the crowd as they clapped and waved their handkerchiefs at the beloved musician, Meredith said. But at the end of the night, Beethoven gathered with three of his friends who helped him organize the concert. What first seemed like a dinner to reward his friends actually resulted in Beethoven yelling and accusing them of cheating him out of money. The outburst was ironic, considering that Beethoven had been inspired as he worked on the Ninth Symphony in part by Friedrich Schiller’s poem “Ode to Joy,” and the concluding themes of the symphony include living in peace and harmony with one another, Meredith said. But above one sketch Beethoven did for the Ninth Symphony, he included the French word for despair. “When you look back at his life, it’s a life that is so full of despair. He went deaf. He never found a woman that he could settle down to love. He had terrible abdominal problems ever since he was a child. He really had a hard time sustaining relationships with people,” Meredith said. “If you understand how much pain he was in and the paranoia he experienced from the deafness, it makes that whole story of the Ninth Symphony much more complex.”