Human chorionic gonadotropin (HCG) diet
- Abnormal fat, allergies, androgens, appetite, Dr. Simeons, estrogen, fat distribution, follicle-stimulating hormone. Froelich's syndrome, Frölich's syndrome, FSH, gonadotropin, gynecomastia, HCG, HCG diet, homeopathic HCG, human chorionic gonadotropin, hypogonadism, IM, infertility, intramuscular injection, kidney disease, LH, low fat, luteinizing hormone, normal fat, Novarel®, obesity, Orange Book, ovarian hyperstimulation, ovulation, pituitary, precocious puberty, Pregnyl®, progesterone, secondary sex characteristics, structural fat, sublingual HCG, testicular descent, testosterone, tumors, weight loss.
- Overview: Human chorionic gonadotropin (HCG) is a hormone produced in large amounts during pregnancy by the placenta. It is also produced in small amounts elsewhere, including in the pituitary, which is a small gland located in the brain.
- HCG production has also been associated with some tumors and cancers, the significance of which is currently a topic of research for the development of various related treatments and vaccines.
- HCG and two additional hormones produced by the pituitary, called luteinizing hormone (LH) and follicle-stimulating hormone (FSH), are important in the growth and development of the male testes (testicles) and the female ovaries. The testes and the ovaries are called gonads, and HCG, LH, and FSH are called gonadotropins.
- In males, the gonadotropins stimulate the testes to produce androgens, which are referred to as male sex hormones. Androgens are responsible for male secondary sex characteristics, such as deepening of the voice, growth of facial and body hair, and increased musculature.
- One particular androgen produced by the testes, called testosterone, stimulates the descent of the testes and promotes sperm production.
- In females, the gonadotropins stimulate the ovaries to produce progesterone and estrogens, which are female sex hormones. These hormones are responsible for female secondary sex characteristics, such as breast development, female body hair patterns, and widening of the hips. The gonadotropins also stimulate ovulation during the female monthly menstrual cycle.
- During pregnancy, large amounts of HCG are secreted by the placenta, thereby maintaining continued estrogen and progesterone production to support pregnancy and prevent menstruation.
- Safety concerns and approved uses: In late 2011, the U.S. Food and Drug Administration (FDA) issued a warning to consumers to stay away from HCG diet products. HCG weight-loss products are often marketed over-the-counter and are identified as "homeopathic." However, the FDA has only approved prescription HCG for female infertility and other medical conditions. HCG is not FDA-approved for weight loss. The FDA has noted that any weight loss achieved while taking HCG products is likely due to severe calorie restriction. The FDA advised any consumers in possession of HCG products to dispose of them immediately and to stop following the restrictive dietary guidelines associated with the diet until further research becomes available.
- The FDA has approved HCG for the following uses: undescended and underdeveloped testes in young males and ovulation induction in females.
- Testicular descent is in part stimulated by high amounts of local testosterone secreted by the testes. HCG is therefore used to stimulate testicular descent by stimulating the testes to produce testosterone.
- As with undescended testes, in male hypogonadism, HCG also stimulates testicular production of testosterone, thereby promoting growth and maturation of the testes. However, HCG is only used if the male hypogonadism is due to a pituitary problem, rather than a problem at the level of the testes.
- HCG is also used to stimulate ovulation in women. However, similar to male hypogonadism, if the problem stems from the ovaries themselves, HCG would most likely not be helpful.
- Weight loss effects: In 1901, A. T. Simeons, MD learned of a regimen involving HCG injections and dietary restriction for boys with hypogonadism and obesity. He also noted that the excess fat distribution in his young male patients with this condition resembled that of other patients with obesity.
- He therefore hypothesized that HCG injections and dietary restriction may be beneficial for these other patients as well. He theorized that the regimen would prevent the loss of what he called "normal fat," and instead encourage the loss of "abnormal fat," a term he used to refer to fat accumulation to the stomach, hips, thighs, and upper arms.
- Dr. Simeons also theorized that HCG injections would improve well-being during the diet and therefore help increase patient compliance.
- The diet is discussed in Dr. Simeons' 1967 book entitled Pounds and Inches: A New Approach to Obesity. However, the FDA, the American Bariatric Association, and the American Medical Association have issued statements that the use of HCG as a dietary aid has not been demonstrated to be effective for the treatment of obesity.
- Despite this lack of evidence, HCG diets continue to be popularly marketed on the Internet, and by stores and weight loss clinics. Recently, the infomercial marketer Kevin Trudeau promoted the diet in his 2007 book entitled The Weight Loss Cure "They" Don't Want You to Know About. However, the Federal Trade Commission (FTC) has since charged Trudeau with making misleading statements about the ease with which the diet could be followed.
Theory / Evidence
- Theory: After treating young male patients with hypogonadism and obesity with injectable human chorionic gonadotropin (HCG) and a restricted diet, A. T. Simeons, MD observed reduced appetite and fat redistribution.
- He therefore theorized that there were three types of fat: structural fat, which provides essential padding; normal fat, which provides fuel when insufficient calories are consumed; and abnormal fat, which is only found in overweight patients.
- He further described abnormal fat as excessive fat distribution to the stomach, hips, thighs, and upper arms. He theorized that HCG injections would cause the abnormal fat to redistribute and that in the process of moving, the abnormal fat would be used as fuel as a result of a severely restricted diet.
- However, he emphasized that while abnormal fat could serve as a fuel reserve, in order for it to do so, the regimen had to be followed exactly. If it were not, he theorized that the normal and structural fats might be used as fuel first, while the abnormal fat would remain.
- He also noted that failure to follow the regimen exactly might cause patients to become fatigued and hungry, which would place them at risk for quitting the diet.
- Dr. Simeons used the regimen in other patients with obesity and reported appetite reduction and fat redistribution similar to that found in his young male patients.
- Evidence: There is currently a lack of evidence that HCG helps promote weight loss or fat redistribution, reduced feelings of hunger, or improved feelings of well-being.
- This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
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- Lijesen GK, Theeuwen I, Assendelft WJ, et al. 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 Sep;40(3):237-43.
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- Natural Standard: The Authority on Integrative Medicine.
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- General: Excessive restriction of calories or consumption of fluids in this diet, including certain types of fluids such as coffee, may be unsafe. A qualified healthcare provider should be consulted before making decisions about therapies or health conditions, including the use of restrictive diets.
- Diet details: In his 1967 book Pounds and Inches, A. T. Simeons, MD described a 23-day regimen consisting of daily human chorionic gonadotropin (HCG) intramuscular (IM) injections of 125 international units.
- According to Dr. Simeons, if a patient had more than 15 pounds to lose, treatment could be extended to daily injections for 40 days but with breaks of several weeks between additional courses if they were needed.
- Dr. Simeons then described a concurrent 500-calorie, low-fat diet to extend three days beyond the initial 23 days of injections. The diet then becomes fairly unrestricted for the next three weeks, with the exception of sugars and starches.
- The diet includes the daily consumption of two liters of fluids, including coffee, tea, or water. It also excludes the use of oil-containing lotions or cosmetics, since Dr. Simeons believed that oils applied to the skin could be absorbed just as if they had been eaten.
- Patients are required to schedule daily clinic visits for the injections along with weight checks and general check-ups.
- Currently, due to a lack of scientific evidence for the diet, agreement or standardization is lacking as to exactly what the HCG diet is or what it should be. Several different types of HCG diets and products have been promoted in secondary sources; however, these products lack approval from the U.S. Food and Drug Administration (FDA).
- HCG availability: FDA-approved HCG is in an injectable form and available by prescription only. Practitioners' authority to prescribe HCG can be checked by contacting the appropriate state licensing board.
- Over-the-counter forms of HCG are also available and can be found on the Internet or in stores as homeopathic formulations, sublingual (under-the-tongue) drops, creams, and pills. Injectable HCG can also be obtained without a prescription. However, because HCG is categorized by the FDA as a prescription-only drug, none of the nonprescription formulations are approved or regulated for consumer safety as required.
Copyright © 2011 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.