weight loss "tools"

As I was thinking about what to write for the month, I had a patient spark an interest for me. Several members of their office staff are working on weight loss. My patient is utilizing a protein-sparing modified fast for weight loss with the use of meal replacements. Another member of their staff is utilizing a diet plan that adds injections of Human Growth Hormone (HGH). Apparently this person using HGH has lost a large amount of weight in a short period of time and my patient asked about this as a weight loss “tool.” This got me thinking and doing some research into other options that can be instead of or in addition to diet modification and exercise.

Human Growth Hormone
HGH levels are known to decline as people age starting in the 4th decade of life. It has also been shown that lower levels are found in people with obesity. HGH is naturally made in the pituitary gland in the brain. There has been suggestion that it is the “Fountain of Youth,” as the drop in HGH may be responsible for frailty in elders. Synthetic hormone is a prescription drug that has to be injected.

The benefits of HGH can include: 1) Increase in bone density, 2) increase in muscle mass, 3) decrease in body fat, 4) increase heart contractility, 5) improve mood and motivation, 6) increase exercise capacity. Studies related to this are limited and while they seem to support decrease in body fat and increase in muscle mass, however no more than strength training at the gym.

The FDA has approved HGH for use in 1)Children with short stature, 2) Children with kidney failure, 3) Children with Prader-Willi syndrome, 4) Children with Turner's syndrome, 5) Muscle wasting associated with AIDS and HIV.

Like all medications there can be side effects associated with HGH use. These can include: Swelling in the arms and legs, arthritis-like symptoms, carpal tunnel symptoms, headaches, bloating, muscle pain, diabetes, abnormal growth of bones and internal organs (ie Gigantism or Acromegaly), hardening of the arteries, and high blood pressure.

Vitamin B12 injections
This water soluble vitamin is also called cobalamin. It is stored in the liver and its food sources include, “eggs, meat, poultry, shellfish, milk, and milk products.” Deficiency of B12 can occur when a person doesn't take in sufficient amounts: such as strict vegan diets. People who don't absorb B12 include those with stomach and/or intestinal surgery. Symptoms of deficiency include, “anemia,numbness or tingling in the arms and legs, weakness, and loss of balance.”
Unless a patient is previously deficient due to insufficient intake or inability to absorb, there is no reason to take B12 injections. The upside of supplementation is that whatever the body doesn't need for B12, the body will eliminate it in the urine.

HCG hormone injection therapy
This hormone injection coupled with a very low calorie diet was developed in the 1950's by a British physician living in Italy. He (Dr. A. T. W. Simeons) observed that with the low calorie diet and hCG injections, the patients lost more fat from their fat tissue stores. The websites discuss how it is common for people to feel some hunger for the first few days but this abates and patients are reported to be hunger free, less irritable, and without headaches. This same effect has been observed in patients utilizing a protein-sparing modified fast diet without the use of hCG.

What is not clear to me is why Dr. Simeons coupled these two things together in the first place. Human Chorionic Gonadotropin (hCG) is a hormone that naturally is produced by the placenta of a pregnant woman. It can also be made by abnormal tissue such as a molar pregnancy or uterus cancer or testicular cancer.

Thyroid hormone (=Synthroid or Armour Thyroid)
Patients who have an abnormal weight gain will often undergo lab testing for low thyroid hormone levels (hypothyroidism). The thyroid gland (located on the front of the voice box in the neck) is the “body thermostat,” and without thyroid hormone a person can gain weight, feel sluggish, have constipation, low heart rate, and many other symptoms. Replacement of thyroid hormone with synthetic (Synthroid, Levo-thyroxine, Levothroid, etc.) or natural (Armour thyroid) preparations can reverse these symptoms. Too much thyroid (hyperthyroidism) can have the opposite effect in patients and hence the potential benefit in weight loss. With prolonged levels of too much thyroid hormone a patient can develop rapid and irregular heartbeat, brittle bones, anxiety attacks, tremor, irregular menstrual periods, muscle weakness and insomnia.

Sources:
http://www.mayoclinic.com
http://www.nlm.nih.gov/medineplus/ency/article/002403.htm
http://www.hcgdietinfo.com
http://www.webmd.com/baby/human-chorionic-gonadotropin-hcg