Dietary supplements encompass a wide spectrum of products, including
vitamins and minerals, such as folate and calcium; herbal therapies and botanical
agents, such as ephedra and ginkgo biloba; and enzymes or extracts from organs
or glands, such as some "hormone" preparations.1 Dietary
supplements are readily available in pharmacies, grocery stores, and health
food stores, as well as by mail and via the Internet. These products are widely
promoted, often with unsubstantiated claims of benefit and rarely with any
mention of potential hazards. In the United States, dietary supplements are
used by millions of people every day and account for billions of dollars in
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