The Medicines Control Council (MCC) is not aware of the presence of any diet pills in South Africa containing a highly toxic "fat burning" substance known as 2,4-dinitrophenol (DNP) that can cause fatal hyperthermia, with body temperature rising as high as 44°C before death.
DNP is popular among people wanting to lose weight and those with eating disorders. Bodybuilders also use it to reduce their body fat percentage. It is not registered in South Africa as a clinical medicine, making it illegal to manufacture, promote, sell or use it.
No DNP in South Africa
"The MCC has to date not registered any medicine containing the active pharmaceutical ingredient 2,4 Dinitrophenol," MCC head of inspection and law enforcement Dr Joey Gouws told Health24.
She added that the regulatory body is also not aware of the sale of any product with the trade name eDNP within the legal distribution chain in South Africa.
Interpol put out a worldwide urgent notice to law enforcement in all 190 member countries, of which South Africa is one, after a sample of the drug, usually sold in yellow powder or capsule form, seized in Australia, was tested at a World Anti-Doping Agency laboratory.
The international police organisation said in a statement that DNP, which is used in pesticides, herbicides and as a raw material for explosives, has claimed the life of a 21 year-old woman in England in April and left a man in France in a serious condition last year.
DNP was used in France during the World War I to help to manufacture explosives. It was then found to generate body heat and thus burn fat causing weight loss among those working in the armament factories. However, Interpol said after being used as a weight-loss stimulant it was banned because of several deaths.
Concern over illegal manufacturing
Interpol pointed out that the risks associated with the use of DNP are worsened by illegal manufacturing conditions.
"In addition to being produced in clandestine laboratories with no hygiene regulations, without specialist manufacturing knowledge, the producers also expose consumers to an increased chance of overdose,” the organisation said.
Dr Gouws encouraged the public to buy medicine from the legal distribution chain. "Avoid looking for treatment of various ailments online and from purchasing these products online," she advised.
While online shopping has certainly made access easier for tablets, capsules, powders and liquids containing this deadly ingredient, Dr Gouws emphasised that the MCC and the Department of Health warned numerous times against the purchasing of medicines online.
"The quality, safety and efficacy of medicine imported via online sales offices or so-called pharmacies cannot be supported placing the user at risk of being exposed to substandard, illegal, dangerous products," she said.
Don't put your health at risk
Dr Eric Decloedt, clinical pharmacologist at Stellenbosch University, told Health24 if a regulatory authority such as the MCC bans a product, it is to protect the consumer. "By using an unregistered product or medicine such as 2,4 DNP, you put your health at risk."
He said apart from 2,4 DNP having a profile where the risk of using it outweighs the benefit, the product quality and concentration is unregulated. "This increases the risk of unintentional overdose and toxicity," warned Dr Decloedt.
What happens when DNP is consumed?
DNP is dangerous because the mechanism by which it helps to facilitate weight loss is also the mechanism by which it causes toxicity, said Dr Decloedt. "There is a small margin between the dose that gives you weight loss and the dose that causes toxicity, including death."
He explained that 2,4 DNP prevents cells from producing efficient energy by inhibiting ATP, which is an intracellular coenzyme responsible for energy transport.
"The cellular energy therefore escapes the cells as heat, instead of following normal energy transport processes. The heat production leads to increased fat metabolism."
Dr Decloedt said the danger is that it overwhelms normal temperature control mechanisms in the body and leads to hyperthermia.
Individuals who use DNP also expose themselves to cancer, Dr Gerhard Verdoorn, director at the Griffon Poison Information Centre, told Health24.
He pointed out that DNP from unscrupulous sources, which could then be advertised and sold via internet or even imported without being found by customs, may also contain impurities that may be extremely dangerous.
"It is from my perspective as a toxicologist an extremely dangerous compound to use," said Dr Verdoorn.
According to the Food Standards Agency (FDA) in the UK, DNP is also known as Dinosan, Dnoc, Solfo Black, Nitrophen, Aldifen and Chemox.