The objective of this study was to provide an epidemiological description of dietary supplement exposures reported to Poison control center (PCC) in the United States (US) over a 13-year period.

Unlike prior studies that focused on specific dietary supplements, included small sample sizes, or were conducted more than 10 years ago, the current study uses the NPDS database to investigate all dietary supplement exposures resulting in calls to PCCs in the US from 2000 through 2012

A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. 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.

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.

The study 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.