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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
By Category:
Prohormones 35%
Weight Loss 33%
Pre/Post Workout 26%
Complete Body Cleanse 19.0%
Androstenedione 18.2%
Herbal Products 14%
Caffeine Products 13.7%
Multivitamins and Multiminerals 12%
Protein/Amino Acids 11%
By Specific Product:
Libido Max 35%
Hydroxycut Hardcore 33%
OxyElite 33%
Roxylean 31%
Growth Factor 9 30%
Super HD 29%
Hydroxycut Advanced 29%
Lipo 6 28%
The Ripper 27%
Test Booster 27%
Xenadrine Xtreme Thermogenic 27%
C4 Extreme 26.2%
C4 Original Pre-Workout 25.3%
Dr Jekyll/Mr Hyde 24.2%
Ripped Fuel 23.6%
N.O.-Xplode 23.6%
ENGN Shred 23.3%
C4 Ripped 23.1%
Assault Black 23.0%
Vapor XS 22.0%
ENGN 20.3%
Thermo Detonator 20.0%
Lit 19.1%
Lean Mode 19.0%
Transform 18.2%
Iridium 17.8%
Test 3X SX7 17.6%
Shred Jym 17.0%
Neurocore 16.7%
Nitraflex 15.3%
1 M.R. 15.1%
B-Nox Androrush 14.9%
Prime-T 13.8%
ION 13.3%
Test X180 12.7%
Pre JYM 12.6%
P6 12.5%
NO3 Chrome 12.5%
Hoodia Gordonia 11.8%
Women's Ultra Mega MVM 11.5%
Essential AmiN.O. 11.4%
Synepheine/Bitter Orange 11.1%
IN-Kaged 10.5%
Super-T 10.5%
True Mass 10.5%
ISO 9:2:2 10.2%
Animal Whey 10.1%
Yohimbe 10.1%
EVL Test 10.0%




Source: Kapnik, Food Chem Toxicol 2022

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