A elderly man looks at nutritional supplements in a store.
Nutritional supplements aren’t always the answer. Get the facts before you buy into the sales pitch. (For Spectrum Health Beat)

Those supplements that promise to make you skinny or boost your energy may come with a price—and not just the one you pay in the store.

Dietary supplements send more than 23,000 people to the ER every year, according to a study by the Centers for Disease Control and Prevention.

That’s just one more reason to proceed with caution before downing a supplement, suggested Jessica Corwin, MPH, RDN, a dietitian and community nutrition educator with Spectrum Health Healthier Communities.

Nearly 72 percent of these emergency department visits involved weight-loss and energy products. Complications included chest pain and fast or irregular heart rates, according to the study led by Dr. Andrew Geller, of the CDC.

The sale of dietary supplements—including herbal products, vitamins and minerals—is a booming business in the United States, with more than 55,000 products on the market.

Consumers should bear in mind that supplements aren’t required to undergo the testing mandated for prescription medications, Corwin said.

And they are coming under increasing scrutiny. The Department of Justice announced in December 2016 that, after its investigation into GNC, the biggest retailer of dietary supplements, the company agreed to pay $2.25 million and to take steps to improve the quality and purity of its products.

Even though products are marketed as “natural,” that does not mean they are safe for everyone, Corwin said.


3 steps for deciding whether to take a supplement:

1. Talk to your dietitian or physician

Ask how the product works with your health conditions or medications. Make sure it won’t cause a harmful drug or nutrient interaction.

Even when taking vitamins, calcium supplements or fish oil, ask about a recommended dose. The products on store shelves vary dramatically.

And when taking a new supplement, it’s a good idea to go back to your doctor after six weeks, and possibly get blood levels checked.

2. Look for reputable sources

Ask health care providers about trusted brands and look online to see which products go through testing. The American Pregnancy Association, for example, evaluates omega-3 fish oil supplements.

3. Listen to your body

Pay attention to the way you feel while taking a supplement.

“If you feel strange—your tummy is upset, or you feel dizzy or anxious, that’s probably a red flag,” Corwin said.

“There’s a lot of hype,” she said. “People assume if they go to a health food store and see a product on the shelf, it must be effective and safe.”

But a supplement may contain ingredients that could complicate medical conditions or interact badly with a patient’s prescription medications.

“A lot of weight-loss pills are loaded with caffeine,” she said.

A sudden, big jolt of caffeine could cause heart rate palpitations or send blood pressure skyrocketing.

Ephedra, an ingredient in weight-loss supplements that was banned in the U.S. in 2004, can cause vomiting, nausea, seizures and even death, according to the National Institutes of Health.

Bitter orange may cause you to burn more calories and reduce appetite a little, the NIH notes on its website. But it also can cause chest pain, anxiety, a fast heart rate and higher blood pressure.

Energy products often are loaded with ingredients that contain caffeine—guarana, kola nut, green tea and yerba mate.

There also are potential allergy triggers, Corwin said. Some supplements contain milk, soy, red food dye or an ingredient derived from shellfish.

For those with questions about specific ingredients, she suggested the NIH’s Office of Dietary Supplements as a good resource for information. It provides details on the claims made, evidence of effectiveness and possible complications.

Other good sources of information include:

  • Supplement 411, the site developed by the U.S. Anti-Doping Agency, the national organization supporting the U.S. Olympic team.
  • Get the Scoop on Supplements, an educational effort and app launched in November to provide information for members of the military.

The study on supplements, published in the New England Journal of Medicine, examined 3,667 emergency cases involving supplements at 63 U.S. hospitals from 2004 to 2013.

Based on that data, researchers estimate an average of 23,000 “adverse events” a year sent people to the ER with nearly 2,300 people having to be hospitalized.

About 20 percent of the ER visits involved unsupervised children who ingested supplements.

More than a quarter of those who sought treatment fell between age 20 and 34. Women were far more likely to report problems with weight-loss products, whereas men reported issues with bodybuilding or sexual enhancement products.

In general, Corwin advises a healthy dose of skepticism about supplements.

“If weight-loss pills worked, doctors would be prescribing them,” she said. “And we wouldn’t have an obesity epidemic.”

She advises people to look for a more comprehensive approach to health issues, rather than just a quick fix.

“We need to figure out our own issues,” she added. “If we are overeating, we have to figure out what’s going on with ourselves, versus taking a pill and not changing anything else within our lifestyle.”