--- title: Supplements Cause More Than 23,000 ER Visits a Year description: Many Americans are going to the emergency department after taking supplements, according to a study in the New England Journal of Medicine canonical: https://time.com/4072487/supplements-cause-more-than-23000-er-visits-a-year/ author: Alexandra Sifferlin article:opinion: false article:content_tier: free article:published_time: 2015-10-14T21:00:34.000Z article:modified_time: 2026-08-04T07:57:29.407Z article:section: Health og:title: Supplements Cause More Than 23,000 ER Visits a Year og:description: Many Americans are going to the emergency department after taking supplements, according to a study in the New England Journal of Medicine og:url: https://time.com/4072487/supplements-cause-more-than-23000-er-visits-a-year/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt390aadd1359ccf0b/698778978e060173ca45993d/health-pills-5.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2560 og:image:height: 1440 og:image:alt: TIME.com stock photos Health Pills og:type: article twitter:card: summary_large_image twitter:title: Supplements Cause More Than 23,000 ER Visits a Year twitter:description: Many Americans are going to the emergency department after taking supplements, according to a study in the New England Journal of Medicine twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt390aadd1359ccf0b/698778978e060173ca45993d/health-pills-5.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # Supplements Cause More Than 23,000 ER Visits a Year > Sponsored content. 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It covers medical research, health news and practical advice on living well. #### Where can I get reliable health news by email? Health Matters is TIME's daily health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free daily newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ## Video: Why Do I Need a Flu Shot? TIME Explains [Watch (HLS stream): Why Do I Need a Flu Shot? TIME Explains](https://cdn.jwplayer.com/manifests/jxdi6F8H.m3u8) (2:20)  _Published 2013-11-04. If you think it's one and done like a measles vaccine, think again. The flu virus is ever-changing and mutating. So this year health experts created new vaccines that can protect you from upto 4 of the latest strains._ by [Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/) ## Alexandra Sifferlin Oct 14, 2015 9:00 PM UTC  Elizabeth Renstrom for TIME by [Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/) ## Alexandra Sifferlin Oct 14, 2015 9:00 PM UTC More Americans are taking dietary supplements, and many are going to the emergency department as a result, according to a [new study](http://www.nejm.org/doi/full/10.1056/NEJMsa1504267) published by federal health experts. Supplement makers are asked to voluntarily report adverse events associated with their product, but in a new study published Wednesday in the _New England Journal of Medicine_, researchers from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) say “a limited regulatory framework makes it challenging to accurately monitor the safety of supplements.” By using ten years of data from 63 U.S. hospitals—from 2004-2013—the researchers estimated the number of emergency department visits across the U.S. based on population and determined how often Americans are going to the emergency room due to supplement use. Each year, 23,005 emergency department visits stem from supplement-use problems, the researchers estimate. Of those visits, an average of 2,154 result in hospitalizations every year. The researchers defined each case as an emergency department visit where a clinician who treated the patient explicitly attributed the patient’s complication to dietary supplement usage. More than half of emergency department visits due to supplements involved female patients, and weight loss and energy products were responsible in more than half the visits for patients 5-34 years old. (The researchers did not look at energy drinks, which they said are typically considered food or drinks, not supplements.) The most common symptoms linked to weight-loss and energy products were heart symptoms, including palpitations and chest pain. Cardiac symptoms were also common among emergency visits linked to bodybuilding and sexual-enhancement products. The most common health problems associated with micronutrients, like vitamins and minerals, were allergic reactions or trouble swallowing. “Like anything that we do at CDC, we are trying to identify opportunities for reducing harm,” says study author Dr. Andrew Geller, a medical officer in CDC’s Division of Healthcare Quality Promotion. “People may not realize \[supplements\] can cause adverse effects.” Dietary supplements in the United States require no safety testing or FDA approval before being sold and marketed. Providing reasons for the use of the ingredients—citing historical use, for instance—is considered enough. If supplements are found to be unsafe, the FDA can remove them from market. Despite the fact that supplements cannot legally be marketed for the treatment or prevention of disease, Americans often take them for that purpose, or to maintain and improve their health. Estimates suggest that the number of supplement products in the U.S. increased from 4,000 in 1994 to more than 55,000 in 2012. The researchers say in their study that the number of emergency department visits and hospitalizations were less than 5% of the numbers reported for drug products, but add that supplements are marketed “under the presumption of safety. “Unlike over-the-counter or prescription medications, there are no requirements to identify adverse effects on dietary-supplement packaging,” the study authors write. They also say that their numbers are possibly underestimates, given that patients often underreport their supplement use, and doctors don’t identify them as the cause of adverse health events as often as they do for medications. In response to the report, the supplement trade organization Council for Responsible Nutrition (CRN) released a statement, writing: “The results of this study reinforce that dietary supplements are safe products, particularly when put into context with the number of people—over 150 million Americans—who take dietary supplements every year…However, we do appreciate the elements of this study that present reasonable takeaways for the industry, and are pleased to confirm that companies are already responding to many of these suggestions made by the study authors.” “\[Supplement use\] is continuing to be an interest of ours,” says CDC’s Geller. “Patients should always tell their doctors if they are taking supplements.” ## Transcript It's time for your annual flu shot. But will the vaccine protect you? Here's what you need to know. It's flu season which means it's time for your annual flu shot. So, the question always is: Why do we need to get a shot every year? Why isn't the influenza vaccine more like measles or rubella or polio, where it's one undone and you're protected for years if not for life? Well, you can blame the influenza virus for that. It has gotten so good at mutating to bypass the effects of the vaccine that we have to get rearmed against whatever circulating that season each year. So, every spring, officials at the World Health Organization convene influenza experts and they decide which strains of the virus should be included in the upcoming season's vaccine. They do their best to look at which strains are emerging in people who are starting to get sick with flu but it's a guess. It's and educating yes, but it's still a guess. So, why did they make this decision so early? Nearly nine months before the first sneezes and cough start? Influenza viruses are grown on chicken eggs and in order to grow enough virus to fill those vaccines, it takes several months. This year, when you go to the doctor, you'll have far more choices than you've had before. You could still get the traditional flu shot which contains three different influenza strains and kids who are afraid of needles can get the nasal spray. And for adults who are needle- phobic, there's also a micro needle version, which contains a smaller needle that gives a little less painful job. And for the first time this year, there's also an influenza vaccine that protects against four different flu strains. So, it gives you a little more protection once the season starts. And the elderly can also get a little extra dose from a high dose vaccine that protects their weaker immune systems and gives them a little bit of a boost. For those who are allergic to eggs, there's also a cell- based flu vaccine that allows them to get vaccinated against influenza for the first time. So, given all this choice, there should be something for everyone. 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