Regardless of the type of dietary supplements-from vitamins, energy drinks, herbal medicines, homeopathic products, to some hormone treatments-they usually come with great claims about promoting health and wellness. While those claims are questionable (and often unfounded), the markets as a whole increase one thing: the volume of calls to poison control centers.
Between 2005 and 2012, the rate of calls related to poison centers increased to 49.3 percentresearchers reported Monday in the Journal of Medical Toxicology. In the last year of data, companies receive calls at a rate of approximately 10 adverse events per 100,000 people.
It doesn’t seem like a big jump in using nutritional supplements during that time. Self-reported use among adults has remained steady, at around 49 to 54 percent, the authors note. But, these supplements are not regulated by the Food and Drug Administration like drugs—no FDA review or approval is required before the supplements hit the market.
“The lack of federal oversight has led to inconsistencies in the quality of dietary supplements, counterfeit products, and contamination among other things,” said Henry Spiller, co-author and director of the Central Ohio Poison Center at Children’s Nation. , said in a statement.
Analyzing 275,000 reports from the National Poison Data System between 2000 and 2012, Spiller and his colleagues came up with trends and details about additional food poisoning calls. Of all exposures, 70 percent were in children six years of age or younger and 82.9 percent were unknown. But not all types of supplements are of equal concern.
Of all categories of products, homeopathic agents are the single largest cause of calls to poison control centers, accounting for 36 percent of calls. Between 2000 and 2010, the number of annual exposures to homeopathic products jumped 227 percent and then fell by 18 percent between 2010 and 2012.
Following homeopathic products, botanicals are the second leading cause of calls and account for 31.9 per cent. Hormonal products, such as androgen supplements, came in third, accounting for 15.1 percent.
But the most dangerous categories—those with the highest percentage of serious medical consequences—include energy products, plant materials, and traditional medicines. Energy drinks can cause abnormal heart rhythms and breathing, as well as seizures. Two botanicals of note that seemed particularly dangerous were yohimbe, used for male sexual function, and ma huang (aka ephedra), used for boosting energy, alertness, weight loss, and athletic performance. Yohimbe has been linked to heart attacks, strokes, and kidney failure, while ma huang has been linked to strokes, and heart attacks. In 2004, FDA bans ma huang after being linked to many deaths. The number of poisonings and deaths from ma huang fell after the ban.
Prohibition also seems to influence supplement-related toxicity calls. The number of calls rose between 2000 and 2002, jumping 46.1 percent, then decreased 8.8 percent around the time of entry between 2002 and 2005 before increasing to 49.3 percent from 2005 to 2012.
Although the data coming into the poison centers may miss older and chronic exposures, rather than acute, poisoning, the authors say it shows that the FDA needs to do more. “Our results demonstrate the need for FDA regulation of yohimbe and energy products in the US as was done successfully with ma huang products in 2004,” the authors concluded.
Journal of Medical Toxicology2017. DOI: 10.1007/s13181-017-0623-7 (About DOIs).