Dietary supplements send an average of 23,000 Americans to hospital emergency rooms each year, according to a new study by the federal government.

The problems include heart-related issues such as chest pain and an irregular or rapid heartbeat.

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“People may not realize that dietary supplements can cause any adverse events, but every year thousands of Americans are treated in emergency rooms for symptoms attributed to dietary supplements,” says Dr. Andrew Geller, medical officer at the Centers for Disease Control and Prevention who led the study, which was published in the New England Journal of Medicine.

More than half of ER visits due to supplements involved female patients. Young adults between the ages of 20 and 34 were most at risk. The study found that supplements for weight loss and energy caused the most problems.

Other problems include children accidentally taking supplements and older people choking on the pills.

Due to a 1994 change in federal law, supplements no longer must be approved by the U.S. Food and Drug Administration (FDA) before they are allowed to be sold. Now supplement manufacturers, not the FDA, are responsible for safety, reports Medscape. If supplements are found to be unsafe, the FDA can take them off the market.

More Americans are certainly taking dietary supplements. According to the new study, the number of supplements sold in the U.S. rose from 4,000 in 1994 to more than 55,000 in 2012. About half of Americans adults take at least one dietary supplement per month.

For the study, researchers analyzed 10 years of data, from 2004 to 2013, from 63 hospitals. Based on the 3,667 cases they found, the researchers estimated that dietary supplements landed an estimated 23,005 Americans in the ER each year and 2,154 were serious enough to require hospitalization.

In response to the study, the supplement trade organization Council for Responsible Nutrition, issued a statement: "The results of this study reinforce that dietary supplements are safe products, particularly when put into context with the number of people — over 150 million Americans — who take dietary supplements every year ... However, we do appreciate the elements of this study that present reasonable takeaways for the industry, and are pleased to confirm that companies are already responding to many of these suggestions made by the study authors."

In the statement, Duffy MacKay, a naturopathic doctor and senior vice president for scientific and regulatory affairs at CRN, points out that, "far less than one tenth of one percent of dietary supplement users experience an emergency room visit annually."

Mary Jo DiLonardo Mary Jo writes about everything from health to parenting — and anything that helps explain why her dog does what he does.