Cited by 502Complementary and Alternative Medicine StudiesPharmacovigilance and Adverse Drug ReactionsNutrition and Health Studies

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Emergency Department Visits for Adverse Events Related to Dietary Supplements

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Geller, Andrew I., Shehab, Nadine, Weidle, Nina J., Lovegrove, Maribeth C., Wolpert, Beverly J., Timbo, Babgaleh B., Mozersky, Robert P., Budnitz, Daniel S.·2015·New England Journal of Medicine

DOI 10.1056/nejmsa1504267PMC PMC6196363

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Abstract

BACKGROUND: Dietary supplements, such as herbal or complementary nutritional products and micronutrients (vitamins and minerals), are commonly used in the United States, yet national data on adverse effects are limited. METHODS: We used nationally representative surveillance data from 63 emergency departments obtained from 2004 through 2013 to describe visits to U.S. emergency departments because of adverse events related to dietary supplements. RESULTS: On the basis of 3667 cases, we estimated that 23,005 (95% confidence interval [CI], 18,611 to 27,398) emergency department visits per year were attributed to adverse events related to dietary supplements. These visits resulted in an estimated 2154 hospitalizations (95% CI, 1342 to 2967) annually. Such visits frequently involved young adults between the ages of 20 and 34 years (28.0% of visits; 95% CI, 25.1 to 30.8) and unsupervised children (21.2% of visits; 95% CI, 18.4 to 24.0). After the exclusion of unsupervised ingestion of dietary supplements by children, 65.9% (95% CI, 63.2 to 68.5) of emergency department visits for single-supplement-related adverse events involved herbal or complementary nutritional products; 31.8% (95% CI, 29.2 to 34.3) involved micronutrients. Herbal or complementary nutritional products for weight loss (25.5%; 95% CI, 23.1 to 27.9) and increased energy (10.0%; 95% CI, 8.0 to 11.9) were commonly implicated. Weight-loss or energy products caused 71.8% (95% CI, 67.6 to 76.1) of supplement-related adverse events involving palpitations, chest pain, or tachycardia, and 58.0% (95% CI, 52.2 to 63.7) involved persons 20 to 34 years of age. Among adults 65 years of age or older, choking or pill-induced dysphagia or globus caused 37.6% (95% CI, 29.1 to 46.2) of all emergency department visits for supplement-related adverse events; micronutrients were implicated in 83.1% (95% CI, 73.3 to 92.9) of these visits. CONCLUSIONS: An estimated 23,000 emergency department visits in the United States every year are attributed to adverse events related to dietary supplements. Such visits commonly involve cardiovascular manifestations from weight-loss or energy products among young adults and swallowing problems, often associated with micronutrients, among older adults. (Funded by the Department of Health and Human Services.).

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Authors: Geller, A. I., Shehab, N., Weidle, N. J., Lovegrove, M. C., Wolpert, B. J., Timbo, B. B., Mozersky, R. P., & Budnitz, D. S.
Affiliations: Center for Food Safety and Applied Nutrition (US)
Centers for Disease Control and Prevention (US)
United States Food and Drug Administration (US)
ORCID: Geller, Andrew I.
Shehab, Nadine
Lovegrove, Maribeth C.
Wolpert, Beverly J.
Budnitz, Daniel S.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2015-10-15
Volume: 373
Issue: 16
Pages: 1531-1540
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmsa1504267
PMC: PMC6196363
OpenAlex: W2330664058
Cited by: 502
References: 22
Citations by year: 2026: 35 · 2025: 44 · 2024: 41 · 2023: 46 · 2022: 50 · 2021: 45 · 2020: 58 · 2019: 40 · 2018: 47 · 2017: 48 · 2016: 43 · 2015: 5
FWCI: 93.54
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: U.S. Department of Health and Human Services
U.S. Consumer Product Safety Commission
National Institutes of Health (CC999999)
Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
Keywords: dietary supplements, emergency department visits, micronutrients, weight loss supplements, energy supplements, hospitalization, choking, dysphagia, tachycardia, emergency department surveillance, young adults, older adults, supplement safety
MeSH terms: Adolescent, Adult, Aged, Complementary Therapies, Calcium, Child, Child, Preschool, Emergency Service, Hospital, Female, Hospitalization, Humans, Iron, Phytotherapy, Middle Aged, Population Surveillance, Potassium, United States, Age Distribution, Micronutrients, Dietary Supplements, Young Adult

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