Regardless the type of dietary supplements—from vitamins, energy drinks, herbal medicines, homeopathic products, to some hormonal treatments—they usually come with big claims about boosting health and wellbeing. While those claims are questionable (and often unfounded), the products collectively do enhance one thing: the volume of calls to poison control centers.

Between 2005 and 2012, the rate of supplement-related calls to poison centers increased 49.3 percent , researchers reported Monday in the Journal of Medical Toxicology. In the final year of data, the centers were getting calls at a rate of nearly 10 adverse exposures per 100,000 people.

There didn’t seem to be a big jump in use of dietary supplements during that time. Self-reported use among adults has held steady, around 49 to 54 percent, the authors note. But, these supplements are not regulated by the Food and Drug Administration as are drugs—no FDA review or approval is required before supplements hit the market.

“Lack of federal oversight has led to inconsistencies in the quality of dietary supplements, product mislabeling, and contamination with other substances,” Henry Spiller, a co-author and director of the Central Ohio Poison Center at Nationwide Children’s, said in a statement.

Examining nearly 275,000 reports from the National Poison Data System between 2000 and 2012, Spiller and his colleagues came up with trends and details about dietary supplement poisoning calls. Of all the exposures, 70 percent were in kids six years old or younger and 82.9 percent were unintentional. But not all the kinds of supplements were of equal concern.

Of all the categories of products, homeopathic agents were the largest single cause of calls to poison control centers, accounting for 36 percent of calls. Between 2000 and 2010, the annual rate of exposures to homeopathic products jumped 227 percent and then fell by 18 percent between 2010 and 2012.

Following homeopathic products, botanicals were the second leading cause of calls and accounted for 31.9 percent. Hormonal products, such as androgen supplements, came in third, accounting for 15.1 percent.

But the most dangerous categories—those with the highest proportion of serious medical outcomes—included energy products, botanicals, and cultural medicines. Energy drinks can cause abnormal heart rhythms and breathing, as well as seizures. Two botanicals of note that seemed particularly dangerous were yohimbe, used for male sexual enhancement, and ma huang (aka ephedra), used for boosting energy, alertness, weight loss, and athletic performance. Yohimbe is linked to heart attacks, seizures, and kidney failure, while ma huang is linked to strokes, as well as heart attacks. In 2004, the FDA banned ma huang after it was linked to several deaths. The number of poisonings and deaths from ma huang plummeted after the ban.

The ban even seemed to influence overall supplement-related poison calls. The rate of calls was on the rise between 2000 and 2002, jumping 46.1 percent, then decreased 8.8 percent around the time of the ban between 2002 and 2005 before increasing again 49.3 percent from 2005 to 2012.

Though the data coming into poison centers may miss adult exposures and chronic, rather than acute, poisonings, the authors say it shows the FDA needs to do more. “Our results demonstrate the need for FDA regulation of yohimbe and energy products in the US as was done successfully with ma huang products in 2004,” the authors conclude.

Journal of Medical Toxicology, 2017. DOI: 10.1007/s13181-017-0623-7 (About DOIs).