By Michael Gerber, MD, HMD

Is HCG Miraculous?

Of course human chorionic gonadotropin (hCG) is miraculous! None of us would be here without it. This placental hormone propels the pregnancy by elevating estradiol levels 100-fold and progesterone levels 40-fold via luteinizing hormone (LH) and thyroid stimulating hormone (TSH) during pregnancy. HCG levels can be as high as 1,000,000 to 1,800,000 IU by the 14th week of pregnancy. It has many other important clinical uses; however, there is a long-standing controversy over some of its other therapeutic applications, namely as an adjunct to weight loss.

Therapeutic Uses

Last week a 50-year-old fire department captain and body builder, with polycystic ovarian syndrome (PCOS) and rheumatoid arthritis, reported that she was completely pain free when injecting 125 IU of hCG per day. I have had several other PCOS patients report that their hirsutism improved during and after hCG injection therapy of 125 IU per day. Hypogonadism in boys and men responds very well to hCG therapy unless men are of advanced age and testosterone replacement is necessary. Infertility is another acknowledged use of hCG. Body builders after going on 6 week “stacks” of hyperphysiologic doses of testosterone and anabolic steroids experience a great drop of libido, mood, and energy when they stop. HCG revives their testosterone levels, increasing the LH drive to the testes by injecting 500 to 1000 IU per day three to five days per week for two weeks and then two or three times per week. This hCG therapy seems to be done quite safely.

In September 2004 in Buenos Aires, Argentina, the First International Workshop on hCG and Obesity was conducted under the auspices of the International Foundation for Chorionic Gonadotropin and Obesity Research (IFCOR). The conferences cite double-blind research studies supporting hCG and weight loss and importantly review the vast therapeutic potential of hCG beyond obesity including Kaposi’s sarcoma, asthma, athropathies, thalassemia, osteopenia, glaucoma, cancer, and benign prostatic hypertrophy. (See www.hcgobesity.org.)

HCG Therapy for Obesity

An interesting approach to the epidemic of obesity was created by Dr. A.T.W. Simeon. He outlined his use of hCG and diet in Pounds & Inches: A New Approach to Obesity (hcgdietinfo.com).

Dr. Simeons was born in London and graduated summa cum laude at the University of Heidelberg Medical School. Early in his career, he became engrossed in the study of tropical diseases and joined the School of Tropical Medicine in Hamburg. In 1931, he went to India, where he stayed for 18 years. He was awarded the Red Cross Order of Merit by the Queen of England for discovering the use of an injectable remedy for malaria, and a new method of staining malaria parasites, now known as the Simeons stain. During World War II, he held several important posts under the government of India, conducting extensive research on bubonic plague and leprosy control.

In 1949 he moved to Rome, treating patients at the Salvator Mundi International Hospital. During his career, he authored several medical books and contributed to many scientific publications. Dr. Simeons was regarded as one of the top research doctors in Europe. Traveling the world, he became fascinated with the unique and rare condition known as obesity. Until this time in history, the majority of obese people were the rich. (Please read his manuscript listed above and The Weight Loss Cure by Kevin Trudeau for the complete historical evolution of his search for the cause of obesity.)¹

After many false starts into the cause of obesity, including psychological and hormone issues, he stumbled across scientific papers which led him to believe that the source of problems for the obese patient, which defied all attempts at permanent weight loss, resided in the hypothalamus. He noted that the obesity of Froehlich’s syndrome, a rare childhood metabolic disease that results in obesity, was successfully treated with hCG. The hypothalamus resides deep in the brain and gives instructions to the pituitary gland on how to regulate all the body’s hormones: thyroid, adrenal, estrogen, progesterone, and testosterone. With Simeons’s hCG program, this regulation is achieved by injecting very small doses of hCG, 125 IU/day.

His program features a very strict 500-calorie-per-day diet that Simeons claims is easily tolerated without hunger due to the hCG injections and can usually result in a 1 pound per day weight loss, slightly more in men than in women. One hundred grams of animal protein are consumed for lunch and dinner. Thirteen vegetables are allowed, one per meal in unlimited quantity. One apple and one lemon are allowed per day with two breadsticks. Organic foods are recommended, and the diet must be studied extensively before undertaking the hCG program, with food intake being very strictly controlled during the program’s duration. Simeons found that hCG helps many health issues and is particularly helpful in removing areas of stubborn, deep fat without depleting protein or protective joint or organ-supportive fat, and doesn’t cause anemia or nutritional deficiencies.

Modern authors such as Trudeau suggest a period of detoxification prior to the program for a more successful outcome. His four-phase program begins by taking patients off sugar, soda, fast foods, and dairy and should include a period of far-infrared saunas, colon therapy, coffee enemas, liver gallbladder flushes, and other detox methods so that when the fat breaks down releasing environmental toxic accumulations people don’t feel toxic, tired, and achy.

This program should definitely be supervised by a physician experienced with the protocol.

Does Everybody Love HCG for Weight Loss?

In 1976 the FDA mandated that the following disclaimer be placed in all hCG products and advertisement:

HCG is a drug which has not been approved by the food and drug administration as safe and effective in the treatment of obesity or weight control. There is no substantial evidence that HCG increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or “normal” distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restrictive diets.

In 1995 the American Society of Bariatric Physicians opined the following: there is no scientific evidence that hCG is effective in the treatment of obesity. The meta-analysis found insufficient evidence supporting the claims that hCG is effective in altering fat distribution, reducing hunger, or inducing a feeling of well-being. The authors stated “… the use of HCG should be regarded as an inappropriate therapy for weight reduction …” In their opinion, “Pharmacists and physicians should be alert on the use of HCG for Simeon’s therapy. The results of this meta-analysis support a firm standpoint against this improper indication. Restraints on physicians practicing this therapy can be based on our findings.”²

In November 2011 the FDA banned the OTC sale of oral, homeopathic hCG preparations from the marketplace.

Contrary to most studies, Harold W. Harper, our beloved friend and mentor, founding father of AAMPS, the American Academy of Medical Preventics, now ACAM, the chelating doctors, published a positive study in the American Journal of Clinical Nutrition in 1973. He and coauthor W. L. Asher found that the hCG and the 500 calorie per day diet resulted in greater weight loss than diet alone.³

Many other studies report negative findings.^4,5

Why Do People Like HCG?

There are hundreds of happy, online supporters of hCG who agree with Dr. Simeon’s protocol and results. When examining the data of the negative papers on hCG at face value they only control calories and not the type of food. They could have used bacon and ice cream. There are a great many restrictions on the diet not only in calories but also the types of foods are strictly proscribed and this was not done in these studies. The diet is very low in fat and carbohydrates. The program also controls cosmetics, shampoos, soaps, and methods for cutting the protein using exam gloves so as not to get oils and fat on the skin. No edible oils on the body except for coconut oil and MCT. Gorging, although counterintuitive, must be done on the first two days of injections, especially fatty foods such as whipped cream and cheese to make entry into the diet go smoothly. It may be that the body is tricked into thinking it is having a fat baby priming the pump to burn 3500 to 4000 calories per day, which is 1 pound. I have had patients who have done the diet and lost 100 pounds in a year. Many say they want to be on the diet for life because they have never felt better. They do seem to be sculptured, losing weight from difficult body parts, abdominal, thigh and buttocks fat as well as facial and neck adiposity. Some women reported losing deep breast fat volume, which is welcomed by some but not all. Women who jumped into the diet without some initial detoxification and told their doctors that they had to lose 30 pounds for a wedding in a month occasionally had fatigue, depression, weakness, and cravings and failed to stick with the diet.

Is It Safe?

If one were administering hCG it is advisable to require a complete history and physical examination along with comprehensive lab panels and thyroid testing including free T3 and free T4. If someone is overtly, chronically ill, this is not the time to dump all the body’s fat toxins on an already compromised system. Build the patient up for a few months first with bioidentical hormones, nutrients, avoidance of sugar and fast foods, and so on. To ensure safety, it would be wise to do weekly weights and measures in the office with staff trained to watch for problems along with an initial and weekly bioimpedance analysis (BIA), electrodes attached to the foot and hand, to measure intracellular and extracellular water percentages to determine if the patient is too toxic to do the diet and lean muscle mass and fat mass percentages. Too much extracellular water means a toxic system, above 50%. If too much lean muscle mass is being lost, the diet should be reassessed. The diet mandates that all supplements and hormones be restricted during the course of 23 or 41 days of the shots with the possible exception of thyroid hormone support. Some programs suggest supplementing with antioxidants, such as a green drink with açai berries, and noni berries with supplements to support phase I and II liver detoxification pathways and extra minerals and homeopathic drops which support weight loss, not homeopathic hCG, Calcarea carbonica, and so on. It would be a good idea to check daily ketone levels in the urine. If the ketones were low and the weight loss was slowing, it would be advisable to add in MCTs (medium-chain triglycerides) derived from coconut oil, which help to mobilize fat. Patients who have followed this type of regimen have rarely reported ill effects. Some physicians increase the dose of hCG to 150, 175, or 200 IU if weight loss slows down, the appetite-suppressive effect is not working, or the person is very large. One 78-year-old woman had her gallbladder, which was chronically inflamed, removed one month after the diet; and two young women with not much weight to lose had mild abdominal pain that resolved on its own after the diet. There are many guidebooks and recipe books available to assist the patient through the hCG journey. Simeons advises patients to take a 6-week break between the first and second set of injections, 9 weeks after the second and 12 weeks after the third round.

Weight loss is a $40 billion industry annually in the US. Is it any wonder that a nonpatentable, safe, inexpensive, and perhaps miraculous therapy is overlooked?

What About Bariatric Surgery?

It is interesting that some of the negative papers about hCG and weight loss emanate from bariatric associations. Death rates from bariatric surgery for Pennsylvania residents from 1995 to 2004, when relatively few were done early in that era, were about 2.6%, ranging from 1% to 6% from 1 to 5 years postoperatively.⁶ The total number was 16,683 surgeries, and overall there were 440 deaths with an unusual increase in the frequency of suicide, pulmonary embolism, coronary artery disease, and sepsis. Mortality rates increased with age and were more frequent in males than females, 3 to 1. Gastric bypass surgery and lap-band surgery have many side effects including development of gallstones in one-third of patients and kidney stones. Other frequent side effects include nutrient deficiencies of vitamins D and B12 and iron, with increased incidence of diabetes, ulcers, hernias, hair loss, weakness, sweating, rapid heart rate, intolerance to cold, abdominal cramps, incision problems, blood clots, dumping syndrome with nausea, vomiting, and diarrhea, and, because of maldigestion, odiferous flatulence. (There is a company, Flat-D Innovations, that specializes in odor control after bariatric surgery and offers its Flatulence Deodorizer, an activated charcoal cloth pad placed in the underwear next to the buttocks). In 2008 there were 220,000 bariatric surgeries in the US costing between $17,000 and $35,000 each depending on locale.⁷ Some studies, especially from Sweden, note a decreased death rate after bariatric surgery because of improved health parameters. The use of stimulants such as phendimetrazine is also fraught with many serious side effects, especially in the unhealthy person.

Notes

1. Trudeau K. The Weight Loss Cure. Alliance Publishing Group; 2007.

2. Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. Br J Clin Pharmacol. 1995 September; 40(3): 237–243.

3. A study by Drs. W. L. Asher and Harold W. Harper in the American Journal of Clinical Nutrition in 1973 concluded that using hCG along with a 500-calorie diet resulted in greater weight loss than dieting alone.

4. Stein MR, Julis RE, Peck CC, Hinshaw W, Sawicki JE. Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study. Am J Clin Nutr. September 1976; 29:940–948.

5. Nelson JK. Does the HCG diet work – and is it safe? [online article] MayoClinic.com.

6. Omalu BI, Ives DG, Buhari AM, et al. Death rates and causes of death after bariatric surgery for pennsylvania residents, 1995-2004. Arch Surg. 2007;142:923–928.

7. American Society for Bariatric Surgeons.