Think “all natural” means “perfectly safe”? That’s not always the case, at least when it comes to vitamins and supplements. Thousands of people in the United States go to the emergency room each year due to problems related to supplements. Many even require a hospital stay.
About three-quarters of U.S. adults take dietary supplements, according to the Council for Responsible Nutrition. While the number of people needing medical treatment is small compared to the total number using these products, some supplements can pose health hazards. Learning more about them, including the best ways to purchase quality products, can help you prevent medical mishaps.
“There’s a lot of misinformation” surrounding supplements, says Keith Roach, MD, associate professor in clinical medicine in the division of general medicine at Weill Cornell Medical College and New York Presbyterian Hospital. “A lot of people think if it’s natural it can’t hurt you, and that’s just not true.”
Weight-loss and energy-boosting supplements account for a significant portion of ER trips. Heart-related symptoms are common complaints for many people who visit.
“Weight-loss and energy supplements have the potential to be scary,” says Dr. Roach. “With too much [of them], you’re going to start getting these kinds of toxicities.”
Taking supplements responsibly can start with a helpful change in mindset.
“Consumers need to think of supplements as drugs,” Roach says. “If you’re starting to have symptoms that look like the side effects of drugs, it could be the supplements. If it’s severe, go to the emergency room. If it’s not as severe, stop taking them and call your doctor.”
How to prevent problems
Supplements aren’t regulated by the U.S. Food and Drug Administration (FDA) in the way over-the-counter and prescription drugs are, so there’s comparatively little oversight. This means their safety and efficacy don’t have to be proven before they hit the market. It also means the actual content of any given supplement can differ greatly from what’s printed on the label.
“Because supplements are not regulated, most don’t have quality control, and you don’t know what you’re getting,” says Roach. That’s changing, he says, as more brands have their supplements independently tested and verified.
If you decide to take supplements, follow these guidelines to optimize your use and reduce the risk of health problems:
- Look for supplements certified by organizations like NSF International, U.S. Pharmacopeia (USP), and ConsumerLab.com, which test and verify supplement content.
- Buy products from reputable manufacturers or a good local store rather than an unfamiliar online vendor.
- Speak with your healthcare provider (HCP) about potential drug interactions, since some supplements can affect how your prescriptions work. St. John’s wort may interfere with oral contraceptives or certain heart medications, for instance.
- Read labels carefully and look for duplicate ingredients. For example, if you take a multivitamin in addition to a supplement with collagen plus B vitamins, you might be getting a lot more B vitamins than you intended.
- Don’t take more than the recommended dose. Some products may be dangerous if you take too much or take them for too long.
- Keep in mind that supplements are not intended to replace a nutritious, well-rounded diet or prescription medicine. Speak with an HCP about your health concerns.
Most of all, Roach says, remember that supplements are often unnecessary. Some might help people who can’t or won’t take over-the-counter or prescription drugs with certain medical conditions. They may also benefit people with a diagnosed vitamin deficiency.
But, he explains, “there is little to no value in taking supplements for a healthy person with a healthy diet. For most people, you’re wasting your money.”
Sources: Li W, Wertheimer A. Narrative Review: Th... + 7
- Li W, Wertheimer A. Narrative Review: The FDA's Perfunctory Approach of Dietary Supplement Regulations Giving Rise to Copious Reports of Adverse Events. Innov Pharm. 2023 Oct 10;14(1):10.24926/iip.v14i1.4989.
- Cohen PA. Emergency department visits and hospitalisations for adverse events related to dietary supplements are common. Evid Based Med. 2016 Apr;21(2):79.
- Geller AI, Shehab N, et al. Emergency Department Visits for Adverse Events Related to Dietary Supplements. N Engl J Med. 2015 Oct 15;373(16):1531-40.
- Council for Responsible Nutrition. Three Quarters of Americans Take Dietary Supplements; Most Users Agree They Are Essential. October 5, 2023.
- U.S. Food and Drug Administration. FDA 101: Dietary Supplements. June 2, 2022.
- Consumer Reports. How to Choose Supplements Wisely. October 30, 2019.
- National Center for Complementary and Integrative Health. Herb–Drug Interactions. December 2024.
- National Science Foundation. Dietary Supplements Claims, Labels and Regulations. Accessed March 20, 2026.
