The use of dietary supplements causes thousands of Americans to go the emergency room each year, according to a new study.

Researchers from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) say an average of 23,000 ER visits occur annually as a result of people taking diet supplements. Common symptoms include heart problems such as palpitations and chest pain; allergic reactions; or trouble swallowing.

The findings, published in the New England Journal of Medicine, relied on a decade’s worth of data from 63 hospitals from 2004 to 2013.

More than 2,000 people wound up being hospitalized every year on average from taking supplements. Of the 23,000 ER visits, more than 50% were made by women. Weight loss and energy products were responsible for more than half the ER trips among all patients aged 5 to 34.

Supplements, which number more than 50,000 in the U.S., are not required to undergo safety testing or receive approval from the FDA before being sold, but the agency has the authority to remove them from the market if they are found to be unsafe.

“What we’re seeing from this study is that the system has failed,” Dr. Pieter Cohen, an assistant professor at Harvard Medical School, told The New York Times. “It’s failing to protect consumers from very serious harms.”

The researchers did not consider energy drinks in their study because those products are usually treated as food, not supplements.

-Noel Brinkerhoff

To Learn More:

Supplements Cause More Than 23,000 ER Visits a Year (by Alexandra Sifferlin, Time)

Dietary Supplements Lead to 20,000 ER Visits Yearly, Study Finds (by Anahad O’Connor, New York Times)

Dietary Supplements Send Thousands to ERs Yearly (by Rob Stein, National Public Radio)

Emergency Department Visits for Adverse Events Related to Dietary Supplements (by Andrew I. Geller, M.D., Nadine Shehab, Pharm.D., M.P.H., Nina J. Weidle, Pharm.D., Maribeth C. Lovegrove, M.P.H., Beverly J. Wolpert, Ph.D., Babgaleh B. Timbo, M.D., Dr.P.H., Robert P. Mozersky, D.O., and Daniel S. Budnitz, M.D., M.P.H., New England Journal of Medicine)

Is Revolving Door between FDA and Supplements Industry Keeping Dangerous Dietary Aids on the Market? (by Noel Brinkerhoff and Steve Straehley, AllGov)

Many Herbal Supplements Don’t Contain the Ingredients They Claim (by Noel Brinkerhoff and Danny Biederman, AllGov)