MARILYNN MARCHIONE, AP Chief Medical Writer

A new federal study estimates that dietary supplements send 23,000 Americans to hospital emergency rooms each year.

The riskiest ones are weight-loss and energy-boosting products, says the report, published in this week’s New England Journal of Medicine. Bodybuilding and sexual-enhancement products also led to cardiac symptoms in many seeking ER help.

Supplements do not have to have federal Food and Drug Administration approval before they are sold, nor do they get the kind of testing prescription drugs do.

Researchers at the Centers for Disease Control and Prevention and at the FDA studied emergency room records from 2004 through 2013 at 63 hospitals around the country to make their estimate.