1. Introduction

Since May 2011, four Soldiers who died following physical exercise were found to have traces of dimethylamylamine in their blood analyses.  One Soldier died in the Pacific region and was found to have severe coronary disease on autopsy, but the other three were in the Southwestern United States and died of complications from rhabdomyolysis and severe metabolic acidosis. Two of these three Soldiers were reported to have had sickle trait.  In a precautionary move in December 2011, the Army and Air Force Exchange System pulled all DMAA containing products off of its Exchange and concession shelves pending the results of a safety review.  In December 2011, the Under Secretary of Defense for Personnel and Readiness, with the concurrence of the Assistant Secretary of Defense for Health Affairs, directed the removal of all products containing DMAA from Military Exchanges and concession stores on DoD installations pending further review of the product safety (Annex D: ALFOODACT 034-2011 and ALFOODACT 044-2011).

DMAA or methylhexanamine (MHA) has been an active ingredient in several performance enhancing dietary supplements (see Table 1). These products are commonly used to promote weight loss, bodybuilding and performance enhancement (OTSG, 2012).  Because DMAA-containing products have been considered dietary supplements and not drugs, they are not subject to rigorous pharmaceutical trials that have oversight by the FDA.  As a consequence, there is limited information available regarding their safety (FDA, 2012).


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