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Tough to swallow: Are multivitamins a choking risk?

A variety of pills in wooden spoons.

Sept. 24, 2019—Some dietary supplements may pose a choking hazard to seniors, suggests a new study in the Annals of Internal Medicine. Of particular concern: larger pills, like multivitamins.

The study found that between 2006 and 2015, close to 4,000 people reported trouble swallowing supplements to the U.S. Food and Drug Administration (FDA). Not all the reports tracked age, but most of those that did involved adults 65 and older.

Choking was by far the most commonly reported problem. It accounted for 86% of all the complaints. Three people even died from swallowing-related problems.

The supplement loophole

FDA advises that generic drugs not exceed 17 mm in length. But it doesn't have similar guidelines for supplements.

The 10 supplements most often reported to FDA—including multivitamins and calcium pills—had an average length of 19.3 mm.

By some estimates, more than 1 in 3 older adults now takes multivitamins. And nearly 1 in 4 takes calcium pills.

The study underscores the need for manufacturers to take steps to help protect the many older adults who take supplements from choking, researchers said. Possible safeguards include making supplements available in smaller doses or adding coatings that make swallowing easier.

What you can do

The risk of swallowing problems rises with age. That can be because of changes that happen over time inside the mouth and throat. Or it can be the result of a health condition.

If you have trouble swallowing supplements, tell your doctor, FDA advises. Treating the underlying problem may help. Or your doctor may share tips that can help you swallow better.

There may also be a liquid or chewable version of your supplement that works just as well. Or you might be able to crush the supplement. But don't crush, break or chew any pill without your doctor's OK.

A good question to ask

Should you be taking a multivitamin at all? Learn more about who needs them—and who doesn't.

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