New England Journal of Medicine analyzes ER visits in United States linked to dietary supplements.

• A significant percentage of the U.S. population consumes dietary supplements — a product category that encompasses a wide variety of products such as vitamins, minerals, herbs and botanicals, and amino acids.
• An article published in the New England Journal of Medicine analyzed a data set to estimate that approximately 23,000 ER visits per year (and over 2,000 hospitalizations) were attributable to adverse events related to dietary supplements, with “herbal or complementary nutritional products for weight loss…and increased energy” commonly implicated.  The analysis is based on statistics from 63 emergency departments during the 2004 to 2013 time frame, and not on FDA’s Serious Adverse Event Reporting database for dietary supplements.
• The broader implications of this analysis are questionable.  First, a CDC estimate suggests that there are 136.3 million ER visits per year; thus, an estimated 23,000 visits related to supplements represent an insignificant fraction of that total.  Further, industry stakeholders cite critically the researchers’ failure to assess the severity of the adverse events that triggered ER visits and the incorrect classification of products as dietary supplements (e.g., ear drops, eye drops, OTC products).  This report suggests continued scientific and journalistic interest in the general safety of dietary supplements, but its utility may be quite limited due to the host of variables and factors that were not considered or explained in the overall assessment.