Table 2. Naranjo algorithm for adverse drug events.

Assessment	Score
1. Are there previous conclusive reports on this reaction? No previous clinical case reports.	Yes (+1); No (0); Do not know or not done (0) → 0
2. Did the adverse event appear after the suspected drug was given? Event reported approximately 10 days after initiating Hydroxycut® Gummies TM.	Yes (+2); No (-1); Do not know or not done (0) → +2
3. Did the adverse reaction improve when the drug was discontinued or a specific antagonist was given? Reduction in ventricular tachycardia burden after discontinuation of supplement.	Yes (+1); No (0); Do not know or not done (0) → +1
4. Did the adverse reaction appear when the drug was readministered? Not attempted.	Yes (+2); No (-2); Do not know or not done (0) → 0
5. Are there alternative causes that could have caused the reaction? Other alternative causes ruled out.	Yes (-1); No (+2); Do not know or not done (0) → +2
6. Did the reaction reappear when a placebo was given? Not attempted.	Yes (-1) No (+1) Do not know or not done (0) → 0
7. Was the drug detected in any body fluid in toxic concentrations? Not attempted.	Yes (+1); No (0); Do not know or not done (0) → 0
8. Was the reaction more severe when the dose was increased, or less severe when the dose was decreased? Medication was discontinued, and the patient did not adjust the dose.	Yes (+1); No (0); Do not know or not done (0) → 0
9. Did the patient have a similar reaction to the same or similar drugs in any previous exposure? No, first exposure.	Yes (+1); No (0); Do not know or not done (0) → 0
10. Was the adverse event confirmed by any objective evidence? Patient presented with electrocardiogram consistent with ventricular tachycardia.	Yes (+1); No (0); Do not know or not done (0) → +1
Total score	6 → probable adverse drug reaction (ADR)

Note: Naranjo scale: ≥9 = definite ADR; 5-8 = probable ADR; 1-4 = possible ADR; 0 = doubtful ADR.