Human Chorionic Gonadotropin

I have been getting many questions about the “hCG diet” and wanted to formalize my thoughts. So here goes. The known function of this hormone is to promote the maintenance of the corpus luteum during early pregnancy. It is the corpus luteum that allows the early developing fetus to implant, develop a placenta and continue the pregnancy until the placenta can take over. Failure of the placenta to take over this function leads to early loss of a pregnancy (i.e. miscarriage). It is chemically similar to Leutenizing Hormone and can be used clinically to cause ovulation in the ovaries as well as testosterone production in the testes. hCG is used also as a clinical marker for some cancers such as germ cell tumors, hydatidiform mole formation, and testicular cancer.

The original diet regimen was published by Dr. Simeons in 1954 in the journal Lancet. He described use of a highly structured 500 calorie diet and intramuscular injections of 125 units of hCG 6 days per week. He claimed that hCG suppresses appetite and improves mood so that patients better comply with dietary recommendations. Dietary recommendations include: Breakfast: coffee or tea, Lunch: 100 gm of veal, chicken breast, fresh white fish, lobster, crab or shrimp. Meat must be boiled or grilled. Salmon, eel, tuna, herring, dried or pickled fish are not allowed. One vegetable of the following group: spinach, chard, chicory, beet-greens, green salad, tomatoes, celery, fennel, onions, red radishes, cucumbers, asparagus, or cabbage. One breadstick or one Melba toast. An apple, orange, or a handful of strawberries or one-half grapefruit. Dinner is the same choices as lunch. Other notes include: the juice of one lemon is allowed daily. Spices are allowed. Water, tea, coffee, or mineral water at 2 liters per day. The fruit of the breadstick may be eaten between meals instead of with lunch or dinner, but not more than 4 items listed for lunch or dinner may be eaten per meal. NO medicines or cosmetics other than lipstick, eyebrow pencil and powder may be used without special permission. No oils or lotions may be applied to the skin. (People think I am strict!)

The first study using accepted study design (prospective, randomized, double-blind study) was done by Asher and Harper and published in The American Journal of Clinical Nutrition in 1973. Quite a bit of controversy ensued including re-analysis of the statistical work and reports by the Food and Drug Administration asserting that hCG has not been demonstrated to be an effective adjunctive therapy in weight reduction programs.

hCG has also been used in the world of performance enhancement. It is combined with various anabolic androgenic steroid cycles. As a result, hCG is included in some sports’ illegal drug lists. In male patients using anabolic steroids, hCG is used during and after steroid cycles to maintain and restore testicular size as well as normal testosterone production. If used too long or at too high a dose, the resulting rise in natural testosterone will eventually inhibit its own production via negative feedback.

In the weight loss world, use of hCG is still considered controversial. Stein, et al, published their findings in AJCN in 1976 after studying 51 obese women comparing the hCG with diet alone and placebo injections. They were attempting to reproduce the work done by Asher and Harper. They even used the original protocol. They report, “no statistically significant difference in the means of the two groups in number of injections received, weight loss, percent of weight loss, hip and waist circumference, weight loss per injection, or in hunger ratings. hCG does not appear to enhance the effectiveness of rigidly imposed regimen for weight reduction.”

It has been over 30 years and still the controversy continues. For me, this dietary plan is not something that I endorse nor recommend. I actively recommend against it. Why inject something and risk potential problems when weight loss can be effectively achieved with the protein-sparing modified fast? It is my job to first do no harm and I think the potential for harm exists with the use of hCG and dieting.

Sources: Stein, MR, et al Am j Clin Nutr. 29:940-948, 1976.
http://hcgdietinfo.com
http://en.wikipedia.org