Supplements that cause cardiac arrhythmias in young adults

  • Cardiologists tell Insider that people under the age of 30 experience heart problems from taking herbal supplements.
  • Common supplements like fish oil and bitter orange have been linked to heart problems.
  • Lax federal regulations mean that supplements may contain dangerous ingredients that are not listed.
  • Do you have health issues from supplements, or have patients with health issues? Email Senior Health Reporter Allana Akhtar:

Cardiologists are ringing alarm bells about herbal supplements that are causing heart problems in younger patients.

California cardiologist Dr. Danielle Belardo said the most common cause of arrhythmias or irregular heartbeats in her patients in her 20s stemmed from taking herbal supplements.

Belardo says her patients take herbs such as bitter orange and ephedra, both of which have been linked to arrhythmias in case studies and clinical studies.

Because Belardo’s patients often take multiple supplements, and supplement trends are rising faster than researchers can keep up, it’s not always straightforward to figure out which compound is to blame.

“This is on the cusp of using what we know about herbal supplements and cardiac arrhythmias,” Belardo told Insider. “Because the formulation, purity and efficacy of these herbs are poorly regulated, we don’t have any reliable literature that can tell us exactly what’s causing it.”

Belardo isn’t the only doctor raising the alarm

The US does not strictly regulate the $1.5 trillion health industry, which means supplement manufacturers are not legally required to provide proof of the safety or strength of their products.

However, the number of Americans taking dietary supplements has exploded since the start of the COVID-19 pandemic. In Southern California, Belardo said, she often sees patients with heart disease “turning toward alternative treatments, herbs, and supplements.”

Now, Belardo says, she’s started asking her patients about the over-the-counter medications they take — and she’s not alone.

back tweet Speaking to her 70,000 followers that she sees young people getting sick from supplements, she has other cardiologists, emergency room doctors and internists across the country saying they experience the same phenomenon.

Dr. Martha Gulati, a California-based cardiologist and president-elect of the American Academy of Preventive Cardiology, is one of them. Gulati told Insider she’s concerned that many falsley believe taking “natural” remedies means they’re safer than lab-made pills.

“I think it reflects more and more alternative medicine, essentially, pseudoscience in this field,” Bellardo said.

Emerging evidence links popular supplement to heart problems

As Belardo mentioned, trying to find evidence to support the benefits or risks of supplements can be tricky. There is little reliable research to refer to, so most of the evidence we have comes in the form of case studies—individual cases that doctors report in journals or articles.

Insider has reported on such cases: patients with serious health problems from taking vitamin, herbal, and hormone supplements come to the hospital.

Supplements linked to cardiac arrhythmias in published research include:

  • limeAccording to Belardo, also known as citris aurantium, it is associated with cardiac arrhythmias. The National Institutes of Health acknowledges that bitter orange may cause arrhythmias, but says more research is needed to show a direct link.
  • Ephedra and Ephedrine Alkaloids, the compound was banned in the United States in 2004 for causing cardiac arrhythmias, heart attacks, strokes and death. Despite the ban, the compound is still present in supplements: A 2021 case study of a 56-year-old with a cardiac arrhythmia showed that he took an herbal pill containing ephedrine alkaloids.
  • fish oilTaking doses of one gram or more per day may increase the risk of an irregular heart rhythm called atrial fibrillation, according to several clinical studies. Fish oil can also interact with blood thinners, leading to dangerous bleeding, Gulati said.

Other supplements have question marks, such as Ashwagandha, an evergreen shrub touted by celebrities for its stress-reducing properties. Belardo said the herb may have been associated with cardiac arrhythmias in some case studies, including a 2022 report suggesting the herb caused cardiac arrhythmias in a 73-year-old woman — when she stopped taking it Heart disease stops when ashwagandha. Researchers found no link between ashwagandha and heart problems in clinical studies.

Stop believing everything you hear on social media, says cardiologist

Belardo acknowledges the appeal of alternative medicine, especially for patients who may feel neglected by the healthcare system. But she has seen firsthand that people get health advice from social media, which is often not the case. While young people are generally at lower risk of developing cardiac arrhythmias, that doesn’t mean they’re immune.

“The truth is, when you sometimes look at the top health podcasts or the top health influencers, often they’re not recommending the kind of guideline-based, evidence-based medicine that all the major academic medical organizations recommend,” Belardo said. For evidence-based recommendations, she recommends looking at guidance from the American College of Cardiology and the American Heart Association.

Gulati agrees, warning that the current hype around natural supplements can be tempting and misleading.

“Be an informed consumer and don’t be influenced by social media,” Gulati said. “Be smart about what you put in your body and do some research on it. Just because it’s sold over-the-counter doesn’t mean it’s safe.”

Do you have health issues from supplements, or have patients with health issues? Email the author at aakhtar@insider.

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