Study finds more poison center calls tied to dietary supplements

25 Juillet, 2017, 22:56 | Author: Cyril Hebras
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It is a particularly hard problem to try to solve: Dietary supplements are not regulated by the U.S. Food and Drug Administration as drugs, so they're not subject to the same scrutiny and oversight.

The study, published online in the Journal of Medical Toxicology, found the rate of calls regarding dietary supplement exposures increased (46.1%) during 2000 to 2002, decreased (8.8%) during 2002 to 2005, and increased again (49.3%) from 2005 to 2012. Poison control centers receive phone calls through the Poison Help Line and document information about the product, route of exposure, individual exposed, exposure scenario, and other data.

Seventy percent of the calls involved children younger than 6 years old. Ninety-seven percent of the time, the children swallowed the supplements while at home, the study found.

Overall, only about 4.5 percent of the cases in the study had serious medical outcomes.

Dr. Gary Smith, of Nationwide Children's Hospital and senior author of the study, says consumers mistakenly believe dietary supplements are similar to over-the-counter medication.

"Dietary supplements are not considered drugs, thus they are not required to undergo clinical trials or obtain approval from the FDA prior to sale, unless the product is labeled as intended for therapeutic use", Smith points out.

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In nearly half of the cases, miscellaneous substances found in commonly used dietary supplements accounted for the calls. Hormonal products, such as androgen supplements, came in third, accounting for 15.1 percent.

But the most risky categories-those with the highest proportion of serious medical outcomes-included energy products, botanicals, and cultural medicines. In the category of botanical medicines (a medical system based on the use of plants or plant extracts that may be eaten or applied to the skin), yohimbe accounted for the largest proportion of serious medical outcomes (28.2 percent). The botanical, which is often used as an aphrodisiac, can cause heart beat rhythm changes, kidney failure, seizures, heart attack, and death.

Almost 30 percent of yohimbe exposures resulted in moderate or major side effects.

In that case, the doctor who treated the child only had to deal with a very exhausted 3-year-old, but it might have been a far more serious scenario if a different dietary supplement, such as the energy product ephedra or the male enhancement herb yohimbe, had been swallowed.

During the 13 years of the study, Spiller's team also found an increase from 2000 to 2002, when the rates of calls to USA poison control centers involving supplements rose 46 percent each year. "Our results demonstrate the need for FDA regulation of yohimbe and energy products in the U.S. as was done successfully with ma huang products in 2004", the authors conclude.

"Lack of federal oversight has led to inconsistencies in the quality of dietary supplements, product mislabeling and contamination with other substances", said Henry Spiller, a co-author of the study and director of the Central Ohio Poison Center at Nationwide Children's.


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