5 supplements that kill

By Naveed Saleh, MD, MS, for MDLinx
Published March 11, 2020

Key Takeaways

Although many dietary supplements contain highly active compounds that can adversely affect underlying health conditions or the efficacy of other medications, they are regulated by the FDA as foods and not as drugs. This designation is cause for concern, given that some dietary supplements contain biologic compounds that can have fatal effects. Disconcertingly, less than 1% of serious adverse effects due to supplements, including death, are reported to the FDA. Thus, the full extent of health disturbances caused by supplements remains unknown.

Here are five supplements that can have potentially fatal consequences.


Aconite (Aconitum) goes by many names: helmet flower, monkshood, devil’s helmet, and wolfsbane. The plant is largely used as an herbal medicine for fever, pain, cough, asthma, and other health conditions. People consume it as a tincture, paste, herbal tea, or supplement. 

The leaves, flowers, stems, and roots of the aconite plant, however, are very toxic and can only be consumed after detoxification. Thus, poisoning can occur without proper processing or following consumption of large quantities. Adverse effects of aconite impact various organ systems and can lead to weakness and paralysis, palpitations, chest pain, hypotension, fibrillation, tachycardia, nausea, vomiting, and diarrhea. 

Specifically, aconite interferes with voltage-sensitive sodium channels, thus resulting in ventricular arrhythmias refractory to cardioversion. Symptoms are potentially deadly and can take only minutes to manifest.

Treatment for toxicity can include cardiopulmonary bypass or extracorporeal membrane oxygenation.

Kava kava

Kava kava (Piper methysticum) is a member of the pepper family endemic to the South Pacific. In the United States, kava kava-containing products and supplements are used to treat anxiety, insomnia, premenstrual symptoms, and stress. The active ingredients in kava kava are referred to kavalactones.

Since 1999, experts in the United States, Germany, and Switzerland have reported severe hepatotoxicity related to kava kava-containing products, with 11 patients requiring liver transplant secondary to liver failure.

Although the FDA warns against kava kava-containing products, no outright ban against this supplement exists. However, sale is restricted in other countries, including Germany, Switzerland, Canada, and Australia.


Lobelia (Lobelia inflata) is an annual herb with attractive, pale violet-blue flowers. Its leaves and seeds are used to make extracts, tinctures, capsules, and supplements. Historically, lobelia has been used to support smoking cessation and to treat nausea, vomiting, skin infections, and respiratory illnesses (eg, asthma, bronchitis, and cough).

For instance, Native Americans smoked lobelia, also called Indian tobacco, as a treatment for respiratory illnesses, namely asthma. In the 19th century, Americans used lobelia as an emetic to remove perceived toxins from the body, which is how it garnered its other moniker “puke weed.”  Today, it is sometimes used as an expectorant.

The active ingredient in lobelia may be similar to nicotine, which is why it was once used in anti-smoking products. In 1993, however, the FDA deemed that lobelia was not useful in the treatment of smoking cessation and banned its use in smoking-cessation products. Nowadays, experts believe that lobelia may act as a nicotine antagonist and decrease the effects of nicotine; however, more research needs to be done. Nevertheless, this herbal product may harbor some potential for use in addiction medicine.

In small amounts, lobelia is likely safe, but in moderate to large amounts it can lead to dry mouth, nausea, convulsions, and coma. Curiously, one early account from 1850 concluded that a woman from Northampton apparently died of lobelia overdose.


The herb celandine (Chelidonium majus) has a long history dating back to ancient Greece, where it was first described by Dioscorides and Pliny the Elder in the 1st century AD. It has long been used as folk medicine in central and eastern Europe, as well as in China, for the treatment of eye disease, jaundice, and pain. More recently, it has been hypothesized that celandine may have antimicrobial, antiviral, and anticancer properties. Of note, alkaloids—a class of nitrogenous organic compounds—are the active ingredients in celandine. Well-known alkaloids include morphine, quinine, and nicotine.

Because celandine is used to treat liver disorders, it’s ironic that hepatotoxicity can result from the use of this supplement. To date, more than 50 cases of hepatotoxicity have been documented in Europe (mostly Germany). And, as we know, hepatotoxicity can lead to death.


Supplements containing germanium,a nonessential trace element, are often promoted as preventatives and treatments for serious health conditions such as cancer and AIDS. To date, however, there are no new drug applications for germanium—investigational or otherwise—which suggests that this element harbors no legitimate health use.

In an import alert, the FDA warned that chronic use of germanium —even at “recommended” doses—could cause nephrotoxicity and death.

“Districts may detain all [g]ermanium products offered for entry, without physical examination, including unlabeled bulk entries, except for semiconductor use...If the product claims to be useful in the diagnosis, cure, mitigation, treatment, or prevention of disease, use the drug charge; otherwise use the ‘poisonous and deleterious’ charge,” wrote the FDA.

If consumers knew that germanium was used in semiconductors, it’s likely far less people would ingest it! Yikes!

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