Background: The FDA does not regulate supplements, so safety is unknown.
National drug-event database (2004-2013), analyzed all ED visits for adverse events from dietary supplements.
n = 3667 cases
Estimate = 23000 ED visits annually in the US, 9% result in hospitalization
Children < 5 years = 22% of visits, young adults = 28%
Worst offenders: weight loss, energy and sexual enhancement supplements
Most common symptoms: cardiac (CP, palpitations, tachycardia), neurologic (HA, dizziness, pre-syncope).
Older patients 38% had swallowing problems, likely due to pill size
Conclusion: We should be discussing the dangers of supplements with our patients.
N Engl J Med 2015 Oct 15; 373:1531