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Dietary supplements send at least 23,000 Americans a year to the emergency room and cause at least 2,000 to be hospitalized, according to a study published online Wednesday.

The true number of ER visits caused by dietary supplements – which include vitamins, minerals, herbs and other products – could be much larger than the study’s estimates because many patients don’t mention their supplement use when visiting the doctor, according to the study, published in The New England Journal of Medicine.

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