Dietary Supplement Adverse Event Report Data From the FDA Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS), 2004-2013
Abstract
Background: The Food and Drug Administration (FDA)’s Center for Food Safety and Applied Nutrition (CFSAN) oversees the safety of the nation’s foods, dietary supplements, and cosmetic products. Objective: To present a descriptive analysis of the 2004-2013 dietary supplement adverse event report (AER) data from CAERS and evaluate the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act as pertaining to dietary supplements adverse events reporting. Methods: We queried CAERS for data from the 2004-2013 AERs specifying at least 1 suspected dietary supplement product. We extracted the product name(s), the symptom(s) reported, age, sex, and serious adverse event outcomes. We examined time trends for mandatory and voluntary reporting and performed analysis using SAS v9.4 and R v3.3.0 software. Results: Of the total AERs (n = 15 430) received from January 1, 2004, through December 31, 2013, indicating at least 1 suspected dietary supplement product, 66.9% were mandatory, 32.2% were voluntary, and 0.9% were both mandatory and voluntary. Reported serious outcomes included death, life-threatening conditions, hospitalizations, congenital anomalies/birth defects and events requiring interventions to prevent permanent impairments (5.1%). The dietary supplement adverse event reporting rate in the United States was estimated at ~2% based on CAERS data. Conclusions: This study characterizes CAERS dietary supplement adverse event data for the 2004-2013 period and estimates a reporting rate of 2% for dietary supplement adverse events based on CAERS data. The findings show that the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act had a substantial impact on the reporting of adverse events.
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The adverse event report databases were searched for creatine in dietary supplements or products following accepted protocols.
“These databases were searched for “creatine’ in dietary supplements or products following accepted protocols [61,62].”
From Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports (2025) · cites this paper as [61]
Cites
Emergency Department Visits for Adverse Events Related to Dietary Supplements
Geller, A. I., Shehab, N., Weidle, N. J., Lovegrove, M. C., Wolpert, B. J., Timbo, B. B., Mozersky, R. P., & Budnitz, D. S. (2015) · New England Journal of Medicine · doi:10.1056/nejmsa1504267 · Cited by 502 · see citing works
Self-citationMillen, A. E., Dodd, K. W., & Subar, A. F. (2004) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2004.03.022 · Cited by 217 · see citing works
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Kreider, R. B., Gonzalez, D. E., Hines, K., Gil, A., & Bonilla, D. A. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2488937 · Cited by 29 · see citing works
Bukic, J., Rusic, D., Bozic, J., Zekan, L., Leskur, D., Seselja Perisin, A., & Modun, D. (2018) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2018.09.005 · Cited by 23 · see citing works
- Authors
- Timbo, B. B., Chirtel, S. J., Ihrie, J., Oladipo, T., Velez-Suarez, L., Brewer, V., & Mozersky, R.
- Affiliations
- Center for Food Safety and Applied Nutrition (US)
- Corresponding author
- Timbo, Babgaleh B.
- Venue
- Annals of Pharmacotherapy
- Publisher
- SAGE Publications
- Published
- 2017-11-24
- Volume
- 52
- Issue
- 5
- Pages
- 431-438
- ISSN
- 0012-6578 (ISSN-L)
- 1060-0280
- 1542-6270
- OpenAlex
- W2769146407
- Cited by
- 49
- References
- 2
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 1
- FWCI
- 6.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- 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 › Pharmaceutical Quality and Counterfeiting
- Keywords
- dietary supplements, adverse event reporting, mandatory reporting, voluntary reporting, serious adverse events, reporting rates, supplement safety, FDA regulation
- MeSH terms
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Male, Middle Aged, United States, United States Food and Drug Administration, Adverse Drug Reaction Reporting Systems, Dietary Supplements, Young Adult
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