How Dietary Supplement Complications Present in the Emergency Department

By Joe Elia

Edited by Susan Sadoughi, MD

Dietary supplements — herbals, vitamins, and minerals — account for some 23,000 emergency visits annually in the U.S., according to an analysis in the New England Journal of Medicine.

CDC and FDA epidemiologists used a nationally representative sample of emergency visits to build a rough portrait of which supplements cause the most problems in various age groups.

The 10-year sample found that micronutrient supplements (iron, calcium, and potassium) were most often at fault in older people, causing allergic reactions or swallowing problems. In young adults, weight-loss and energy-related products predominated, often causing cardiovascular symptoms such as palpitations and tachycardia (energy drinks were excluded from the analysis).

Children, of course, are liable to ingest anything within reach.

Ali Raja, associate editor of NEJM Journal Watch Emergency Medicine, comments: "We do not often ask patients about their dietary supplement intake, despite the fact that almost half of U.S. adults report using supplements. Given the potential adverse events, we should be discussing their use and potential adverse events with our patients — especially those with unexplained cardiac or neurologic symptoms."