Adverse events associated with dietary supplements: an observational study

Palmer, M. Elizabeth; Haller, Christine; McKinney, Patrick E.; Klein‐Schwartz, Wendy; Tschirgi, Anne; Smolinske, Susan C.; Woolf, Alan D.; Sprague, Bruce M.; Ko, Richard; Everson, Gary W.; Nelson, Lewis S.; Dodd-Butera, Teresa; Bartlett, Wade; Landzberg, Brian R.

doi:10.1016/s0140-6736(03)12227-1

Cited by 225 publications

(150 citation statements)

References 15 publications

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“…For instance, patients need to know that for some vitamins, effectiveness is only established when taken in fruit and vegetables but not as supplements (Moertel et al, 1985) or that effectiveness of supplements may be confined to specifically selected populations (Blot et al, 1993;Russell, 2000). They also need to know that supplements may be associated with adverse events including bleeding and liver failure (Palmer et al, 2003) or fail to work, for example, high dose vitamin C (Creagan et al, 1979). Only recently, the UK Food Standards Agency has reduced the safe upper limit for many supplements (Food Standards Agency, 2003).…”

Section: Discussionmentioning

confidence: 99%

Potential health risks of complementary alternative medicines in cancer patients

et al. 2004

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Many cancer patients use complementary alternative medicines (CAMs) but may not be aware of the potential risks. There are no studies quantifying such risks, but there is some evidence of patient risk from case reports in the literature. A cross-sectional survey of patients attending the outpatient department at a specialist cancer centre was carried out to establish a pattern of herbal remedy or supplement use and to identify potential adverse side effects or drug interactions with conventional medicines. If potential risks were identified, a health warning was issued by a pharmacist. A total of 318 patients participated in the study. Of these, 164 (51.6%) took CAMs, and 133 different combinations were recorded. Of these, 10.4% only took herbal remedies, 42.1% only supplements and 47.6% a combination of both. In all, 18 (11.0%) reported supplements in higher than recommended doses. Health warnings were issued to 20 (12.2%) patients. Most warnings concerned echinacea in patients with lymphoma. Further warnings were issued for cod liver/fish oil, evening primrose oil, gingko, garlic, ginseng, kava kava and beta-carotene. In conclusion, medical practitioners need to be able to identify the potential risks of CAMs. Equally, patients should be encouraged to disclose their use. Also, more research is needed to quantify the actual health risks.

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Section: Discussionmentioning

confidence: 99%

Potential health risks of complementary alternative medicines in cancer patients

et al. 2004

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“…The occurrence of some severe incidents after the intake of PFS (Palmer, 2003;Vassilev, 2009;Vitalone, 2011), demonstrated the need for additional studies on PFS-related adverse effects. For these reasons, the European Community's Seventh Framework Programme funded PlantLIBRA project (www.plantlibra.eu) also comprised research on the adverse effects profile of PFS and plants consumed as food (Bucchini, 2011).…”

Section: Introductionmentioning

confidence: 99%

Adverse Effects of Plant Food Supplements and Plants Consumed as Food: Results from the Poisons Centres-Based PlantLIBRA Study

et al. 2016

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Plant food supplements (PFS) are products of increasing popularity and wide-spread distribution. Nevertheless, information about their risks is limited. To fill this gap, a poisons centres-based study was performed as part of the EU project PlantLIBRA. Multicentre retrospective review of data from selected European and Brazilian poisons centres, involving human cases of adverse effects due to plants consumed as food or as ingredients of food supplements recorded between 2006 and 2010. Ten poisons centres provided a total of 75 cases. In 57 cases (76%) a PFS was involved; in 18 (24%) a plant was ingested as food. The 10 most frequently reported plants were Valeriana officinalis, Camellia sinensis, Paullinia cupana, Melissa officinalis, Passiflora incarnata, Mentha piperita, Glycyrrhiza glabra, Ilex paraguariensis, Panax ginseng, and Citrus aurantium. The most frequently observed clinical effects were neurotoxicity and gastro-intestinal symptoms. Most cases showed a benign clinical course; however, five cases were severe. PFS-related adverse effects seem to be relatively infrequent issues for poisons centres. Most cases showed mild symptoms. Nevertheless, the occurrence of some severe adverse effects and the increasing popularity of PFS require continuous active surveillance, and further research is warranted. Most cases showed a benign clinical course; however, five cases were severe. Conclusions:PFS-related adverse effects seem to be relatively infrequent issues for poisons centres. Most cases showed mild symptoms. Nevertheless, the occurrence of some severe adverse effects and the increasing popularity of PFS require continuous active surveillance, and further research is warranted.

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“…Adolescents are at risk of significant adverse effects, as some of the nutritional supplements they use have been associated with cancer, gastrointestinal and cardiovascular problems (17)(18)(19) . The fact that some vitamins/ minerals, the most frequently consumed supplements by the adolescent population, are toxic in adults, if consumed in excess (17,20) , is raising concern.…”

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confidence: 99%

Nutritional supplement use among Slovenian adolescents

Grm

Ars

Besednjak-Kocijančič

et al. 2011

Public Health Nutr.

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AbstractsObjective: Little is known about the prevalence of nutritional supplement use in European adolescents. We conducted the present study to analyse the prevalence of nutritional supplement use and factors associated with this use among Slovenian adolescents. Design: The nutritional supplementation practices of 818 adolescents were studied using an anonymous questionnaire. Information was sought on the type of supplements used, frequency of use and sources of information. Setting: The region of north-west Slovenia. Subjects: Schoolchildren from twenty primary schools and twelve secondary schools. Results: Some 19?3% of all adolescents reported using at least one nutritional supplement and the prevalence of use was significantly higher in adolescents who were members of sports clubs. Multivitamins were the most common nutritional supplement. Older adolescents were significantly more likely to be supplementing with iron, protein and minerals. Less than 16 % of supplement users in our study sought information from health-care professionals. Nearly 62 % obtained information from parents and coaches, and many adolescents appear to decide on nutritional supplementation themselves, without advice. Older adolescents were significantly more likely to combine supplements than younger adolescents. Conclusions: One-fifth of Slovenian adolescents use nutritional supplements. There are clear differences in supplement use between younger (age 12 years) and older (age 17 years) adolescents. Multiple use of supplements, coupled with self-managed supplementation in older adolescents, is concerning. Hence, there is an urgent need to provide accurate information regarding nutritional supplements, which will help adolescents, their parents and coaches to make informed choices about their use.

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Adverse events associated with dietary supplements: an observational study

Cited by 225 publications

References 15 publications

Potential health risks of complementary alternative medicines in cancer patients

Potential health risks of complementary alternative medicines in cancer patients

Adverse Effects of Plant Food Supplements and Plants Consumed as Food: Results from the Poisons Centres-Based PlantLIBRA Study

Nutritional supplement use among Slovenian adolescents

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