23 February 2010

The slimming pill saga continues

Since the MCC banned sales of the Simply Slim diet pill in SA, DietDoc has been inundated with queries about other over-the-counter slimming pills. Read her comments here.


Thankfully, the Medicines Control Council of South Africa recalled the Simply Slim range of slimming products from the market on 5 February 2010 (SAPA, 2010). This was in reaction to the flood of adverse side-effects reported by slimmers and their doctors, and the fact that the Simply Slim products were found to contain nearly double the dose of sibutramine that is permitted by the Council.

Tests showed that Simply Slim contained 27mg sibutramine per tablet, while the permitted dose is 15mg sibutramine per tablet in Schedule 5 slimming pills. The latter pills must be prescribed by a medical doctor, who is required to examine the patient before prescribing sibutramine and to also monitor the patient’s progress and health while using such products.

Lurking dangers

Despite the recall, regulatory authorities fear that versions of this product may still be doing the rounds (Pienaar 2010), and that some members of the public are sharing their supplies of Simply Slim with friends and relatives.

If you purchased Simply Slim before the recall, please be responsible and do NOT give it to other people to use. This could be very harmful to them and you will not be doing your friends a favour if they take the tablets and develop heart problems, strokes or high blood pressure. Take any unused Simply Slim products to your nearest pharmacy for safe disposal.


Some of my readers who have stopped taking Simply Slim are still suffering from side-effects like insomnia, palpitations, mood swings and headaches. These readers want to know what they should do and how long these negative side-effects will continue.

It is practically impossible to predict how long such side-effects will last, but in view of the seriousness of some of the side-effects, the sensible thing is to have a medical checkup to determine if you have developed any health conditions such as high blood pressure or heart arrhythmias. If you have, then your medical doctor will have to treat you for these conditions.

Other slimming pills

Alerted by the Simply Slim saga, I now receive endless questions about the safety of other over-the-counter slimming pills and products. Some of my readers have provided me with the list of ingredients of the specific slimming pills they are using to ask if these ingredients can be potentially harmful. Two such products are Maxislim and Slimming Solution Plus.


According to one of my readers, Maxislim contains: Cordifolia Extract 300mg, Guarana 400mg, Korean Ginseng 50mg, Siberian Ginseng 50mg, and Ginger root 30mg. The capsule is encased in gelatine and the maximum dosage is 4 capsules per day.

The ingredients in Maxislim can cause the following side-effects:

  • Cordifolia is listed as a herbal product that contains epinephrine. Epinephrine is an appetite suppressant, but can cause many negative side‑effects such as nausea, vomiting, dry mouth, problems with urination, high blood pressure, rapid and irregular heart beat, heart arrhythmias, angina pain, palpitations, and even heart arrest, fear, anxiety, restlessness, insomnia, dizziness, faintness, flushing, tremor, muscle weakness, headache, irritability, psychotic states and most serious of all, addiction.

    Products that contain synephrine or epinephrine should not be used during pregnancy, breastfeeding, in patients with high blood pressure, hyperthyroidism, diabetes, heart disease, prostate enlargement, children or teenagers. The appetite suppressant effect wears off with time, requiring larger doses and increasing the risk of addiction. 
  • Guarana contains double the amount of caffeine found in coffee beans, so the capsules can cause symptoms of excess caffeine intake (tremors, sleeplessness, dry mouth, irritability, and so on).
  • Ginseng, although regarded as relatively harmless, can also cause nausea, diarrhoea, headaches, high blood pressure and mania when used together with antidepressants. 
  • Ginger root should not be used by anyone suffering from gallstones, ulcers, gastritis, inflammatory bowel disease or patients taking anticoagulants.  

Slimming Solution Plus

Another concerned reader sent me the ingredients of Slimming Solution Plus, which are:

Citrus aurantium, L-phenylalanine, Hoodia, Guarana, Chromium Picolinate, Fructus Senna, Green Tea, Bioperine, Iodine, Vitamin A, Vitamin B1 (Thiamine), Vitamin B2 (Riboflavin), Vitamin B3 (Nicotinamide), Vitamin B5 (Pantothenic Acid), Vitamin B6 (Pyridoxine), Vitamin B12 (Cyanocobalamin), Vitamin C, Vitamin D3, Vitamin E, and Folic Acid.

These ingredients can cause the following side-effects:

  • Citrus aurantium or Bitter Orange Extract contains a compound called synephrine. Synephrine is similar to epinephrine (see above for the long list of side-effects associated with epinephrine)
  • Hoodia may or may not work as an appetite suppressant, but we don't yet know what side‑effects hoodia can cause because no well controlled research studies have been conducted with this compound.
  • Guarana (see above for caffeine side-effects) 
  • Chromium picolinate should not be taken in doses exceeding 200 microgram per day because chromium is a heavy metal. Research conducted in the UK has also shown that chromium picolinate is not as safe as chromium polynicotate. In 2004, the Food Standards Authority in the UK issued a safety alert regarding the potential for chromium picolinate to cause cancer (FSA, 2004)
  • Fructus Senna is a powerful laxative that if used in excess can cause dehydration and loss of normal bowel function 
  • Green tea is probably the only herbal ingredient that is not harmful and will assist weightloss 
  • Bioperine or extract of black pepper may act as a stimulant, but should not be used by anyone suffering from gastritis or ulcers because of its potential to irritate the lining of the gastrointestinal tract 
  • L-phenylalanine, an amino acid, is probably harmless, but is contraindicated in individuals with phenylketonuria. Patients with phenylketonuria are not able to metabolise this amino acid and should avoid foods or products that contain phenylalanine. 
  • Although the vitamins that have been added to this product all occur in normal foods, manufacturers of slimming and sports products often add them in very large quantities, which are potentially harmful (i.e. more than 100% of the RDA per day). It is necessary to check if the daily dosage does not provide multiples of the RDA per day because overdosing on certain vitamins, especially vitamin A, can be harmful.

I would, therefore, not recommend the use of any slimming product that contains epinephrine or synephrine, guarana or any of the above mentioned compounds.

The sensible approach to weight loss is to reduce your energy intake with a balanced diet and to increase your energy output with daily, aerobic exercise, not to take all these diet pills and potions that can cause serious harm to your health.

(References: FSA (2004). FSA issues warning over the use of chromium picolinate. InsideOut, Vol 1, No1, April to June 2004; Pienaar A (2010). As jy Simply Slim gebruik, doen jy dit op eie risiko. Die Burger, 11 Feb 2010; SAPA (2010). Simply Slim diet pill recalled. News24, 5 Feb 2010)

(Dr IV van Heerden, DietDoc, February 2010)

Any questions? Ask DietDoc

Read more:

Simply Slim in the firing line

Another diet scam exposed

The dodgy ingredients of diet pills 


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