Increase in Dietary Supplement Exposures Over the Past Decade
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The rate of dietary supplement exposures reported to the National Poison Data System was analyzed from 2000 through 2012. The rate of dietary supplement exposures per 100,000 population increased by 46.1% during the first 2 years. There was then an 8.8% decrease from 2002 through 2005 attributed to an FDA ban on ma huang products. The rate then increased by 49.3% from 2005 through to the end of the study period. Miscellaneous dietary supplements accounted for almost half the exposures, and the majority occurred in children aged <6 years as acute, unintentional exposures. Serious medical outcomes were seen in 4.5% of cases; the substances with the greatest toxicity were ma huang products, yohimbe, and energy products.
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Overall, there was a significant increase in dietary supplement exposures from 2000 through 2012, with considerable toxicity seen with yohimbe and energy products. The success of the FDA ban on ma huang products suggests that regulation of yohimbe and energy products may be beneficial.
abstract
This abstract is available on the publisher's site.
Access this abstract nowINTRODUCTION
The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA.
METHODS
A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012.
RESULTS
There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000-2002, decreased 8.8% during 2002-2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity.
CONCLUSIONS
There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.
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Additional Info
An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers
J Med Toxicol 2017 Jul 24;[EPub Ahead of Print], N Rao, HA Spiller, NL Hodges, T Chounthirath, MJ Casavant, AK Kamboj, GA SmithFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.