Many supplements and combinations of ingredients in dietary supplements can cause adverse effects. Adverse effects may occur due to excessive intake, allergic reactions, poor product quality control or contamination, interactions with medications, or even the adulteration with drugs or other compounds not listed on labels.
Supplements most likely to cause adverse effects
Supplement usage is popular among military service members (upwards of 70%). In a recent survey of over 26,000 service members from the United States Air Force, Army, Marine Corps, and Navy, individuals self-reported any adverse effects believed to result from dietary supplement use (Kapnik, Food Chem Toxicol 2022). Adverse effects ranged from cardiovascular symptoms such as palpitations or racing heart to abdominal pain, nausea, vomiting, diarrhea, muscle cramps and weakness, sleep disturbances such as insomnia, dizziness, tingling or numb extremities, and seizures, tremors, or convulsions.
It should be noted that these results were based on self-reports and do not prove the supplements directly caused symptoms. Other limitations of the survey were that severity of the reported side effects were not noted, nor was whether users discontinued use after experiencing adverse effects or if they were taken along with other supplements or drugs.
As shown in the table below, supplements most likely to be associated with adverse effects were "combination products" such as weight loss supplements, pre- and post-workout supplements, and body building supplements, as well as prohormones, followed by complete body cleanse products and herbal products. Among specific brand name supplements, the most likely to be associated with adverse effects were Libido Max, Hydroxycut Hardcore, and OxyElite.
Supplements Most Often Associated with Adverse Effects
|Supplement||% of Users Reporting Adverse Effects|
|Complete Body Cleanse||19.0%|
|Multivitamins and Multiminerals||12%|
|By Specific Product:|
|Growth Factor 9||30%|
|Xenadrine Xtreme Thermogenic||27%|
|C4 Original Pre-Workout||25.3%|
|Dr Jekyll/Mr Hyde||24.2%|
|Test 3X SX7||17.6%|
|Women's Ultra Mega MVM||11.5%|
Source: Kapnik, Food Chem Toxicol 2022