The Dangers of HCG Injections

Shoot up, slim down: That’s the premise behind HCG injections, hormone-containing syringes that stick dieters to help them lose weight—and they’re becoming increasingly popular.

Proponents claim regular injection of human chorionic gonadotropin—a hormone that women produce during pregnancy and that is sometimes prescribed as a fertility treatment—speeds metabolism and breaks down the body’s stored fat, allowing dieters to get by on 500 calories a day without the hunger and health risks that accompany other starvation diets.

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False. Being on the HCG diet—just like any seriously low-cal diet—lowers your metabolism and results in serious muscle loss, says Pamela Peeke, M.D., M.P.H., senior science advisor at Elements Behavioral Health and author of The Hunger Fix. And while starving yourself for a week may yield short-term weight loss, over the long haul, you are more likely to gain weight from trying the HCG diet than anything.

The Food and Drug Administration states that HCG does not aid in weight loss, and a 1995 meta-analysis published in the British Journal of Clinical Pharmacology (yes, this is the fad diet that just keeps coming back!) concluded that “there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight loss or fat-redistribution, nor does it reduce hunger or induce a feeling of well-being.” Researchers believe that when dieters do happen to lose weight on the HCG diet, it’s most likely from a combination of calorie restriction and placebo effect.

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Whether HCG makes you lose or gain weight is one thing, but more concerning is what else it could do to your body. HCG is a hormone, and once you start manipulating your body’s delicate hormonal balance, wide-ranging effects can occur, says Peeke. “HCG injections have been associated with headaches, blood clots, leg cramps, temporary hair thinning, constipation, and breast tenderness.” The FDA has received at least one recent report of an HCG dieter developing a pulmonary embolism, a potentially fatal blood clot in the lung.

Think that’s bad? There’s more. When you get an HCG shot from anyone other than a licensed physician, you don’t know what you’re really being injected with. The FDA does not approve over-the-counter use of HCG, meaning that the ingredients are not regulated—and any shots or serums sold online are offered illegally. The FDA does allow physicians to administer HCG injections for off-label uses, but giving it to a patient definitely enters into an ethically murky area as FDA labeling for approved HCG products requires the following statement:

“HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity.   There is no substantial evidence that it 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-restricted diets.”

The bottom line: “Avoid falling for a fad, especially one that is expensive and fraught with side effects and serious health risks,” says Peeke. Our suggestion? Stick with these science-backed ways to lose weight.

RELATED: 8 Surprising Ways You’re Slowing Your Metabolism

Why You Should Avoid Using HCG for Weight Loss

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What is HCG?

HCG or human chorionic gonadotropin is a protein-based hormone that supports the normal development of an egg in a woman’s ovary, and stimulates the release of the egg during ovulation. HCG is used to cause ovulation and to treat infertility in women, and to increase sperm count in men. HCG is also used in young boys when their testicles have not dropped down into the scrotum normally. This can be caused by a pituitary gland disorder.

HCG With Regards to Weight Loss

Simply put—taking HCG in any form does not result in weight loss. The methods used alongside HCG are what might result in weight loss—such as a very-low-calorie-diet (VLCD).

HCG itself doesn’t result in weight loss…

It’s actually the diet that accompanies “prescriptions” of HCG that causes the weight loss. HCG has been in the news a lot recently as a weight loss “aid.” Ads claim it “targets the fat” and “reduces cravings.”

However, HCG providers prescribe a 500-calorie diet, too. A very-low-calorie-diet (defined as 800 cal/day or lower) alone would result in significant weight loss. However, there are risks associated with a VLCD, and medical monitoring is suggested as a standard of medical care. The American Society of Bariatric Physicians Position Statement on the use of VLCDs is an informative resource.

Why do people claim they are not hungry on HCG?

The decrease in hunger emphasized in HCG ads is likely attributed to the dietary emphasis on higher protein intake and/or carbohydrate restriction resulting in ketosis. These dietary regimens are associated with diminished hunger sensation. It is not the HCG itself that reduces hunger, but the accompanying prescribed diet.

Methods of Taking HCG

HCG is typically taken as drops, but also some are prescribed tablets or injections. Only one of these methods are actually a viable method of taking HCG, but the benefits are unfounded and the side effects dangerous.

What about HCG drops?

HCG is sold as drops to be absorbed “under the tongue” or sublingually. There is a “ceiling” with regard to the size of a molecule that can be absorbed orally—and that size is approximately 1500 daltons (a measure for molecular weight). HCG’s molecular weight is approximately 30,000 daltons—about six times larger than insulin, which measures in at 6,000 daltons.

Why are we talking about insulin? Insulin can’t be taken orally—it has to be injected. Therefore, since HCG’s molecular weight is six times that of insulin, which can’t be absorbed orally, neither can HCG be absorbed orally.

What if I swallow HCG?

Even if drop formulations actually contained HCG, the protein molecule would pass into the stomach where it would be broken down into small peptides and amino acids by gastric acid—just like your dinner portion of chicken—again, no potential for biological action!

What about HCG injections?

HCG can be given by injection by a licensed physician under “off-label” use. However, doing so is not risk free. This medicine can increase chances of a multiple pregnancy. Some women using this medicine have developed a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment cycle. You should NOT use this medicine if you are at risk for a hormone-related cancer such as tumor of the breast, ovary, uterus, prostate, hypothalamus, or pituitary gland.

What about homeopathic or chiroHCG sold by chiropractors?

Homeopathy is based the belief that disease symptoms can be cured by small doses of substances which produce similar symptoms in healthy people. All HCG drop formulations are inert, or having no pharmacological action, due to their high molecular weight. Moreover, it is the specific shape and structure of a molecule on which the hormone’s action depends.

In other words, it has to fit like a “key into a lock” or nothing happens. Therefore, it would be impossible to “take a small dose” or “a segment” of a hormone and expect to cause any kind of biological action.

What do the experts have to say about HCG?

The Food and Drug Administration, The Federal Trade Commission, and The American Society for Metabolic & Bariatric Surgery all share the same stance: HCG does not result in weight loss. See each of their statements below.

What is the FDA’s stance on HCG?

Since 1975, The Food and Drug Administration has considered the use of HCG for weight loss to be fraudulent and requires labels for HCG to state:

HCG has no known effect on fat mobilization, appetite or sense of hunter, or body fat distribution. HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it cases a more attractive or “normal” distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.

Has the FTC taken action?

In 1976, The Federal Trade Commission ordered the Simeon Management Corporation, Simeon Weight Clinics Foundation, Bariatrics Management Corporation, C.M. Norcal, Inc., and HCG Weight Clinics Foundation and their officers to stop claiming that their HCG-based programs were safe, effective, and/or approved by the FDA for weight-control. Although the order did not stop the clinics from using HCG, it required that patients who contract for the treatment be informed in writing that:

These weight reduction treatments include the injection of HCG, 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-restricted diets.

What is the opinion of physicians trained in obesity management?

In 2009, The American Society of Bariatric Physicians issued a position statement which stated:

Numerous clinical trials have shown HCG to be ineffectual in producing weight loss. HCG injections can induce a slight increase in muscle mass in androgen-deficient males. The diet used in the Simeons method provides a lower protein intake than is advisable in view of current knowledge and practice. There are few medical literature reports favorable to the Simeons method; the overwhelming majority of medical reports are critical of it. Physicians employing either the HCG or the diet recommended by Simeons may expose themselves to criticism from other physicians, from insurers, or from government bodies.

What have the studies on HCG revealed?

A meta-analysis of eight controlled and 16 uncontrolled trials that measured the effect of HCG in the treatment of obesity shows no benefit to using HCG. It was concluded that there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight-loss of fat-redistribution, nor does it reduce hunger or induce a feeling of well-being.

Lijesen GK et al. The effect of human chorionic gonadotrophin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. British Journal of Clinical Pharmacology 49:237–243, 1995.

HCG injection. Pregnancy after an injection of hCG

Unfortunately, many couples of reproductive age face the problem of infertility these days. As you know, infertility is a consequence of any disease that is currently present in the body or was previously. Therefore, in order to eliminate infertility, a couple must undergo a series of examinations to help identify the cause of this condition. Based on the results of the examination, the attending physician will prescribe measures to eliminate infertility, which include stimulation of ovulation with an injection of hCG.

When ovulation stimulation is indicated

Ovulation stimulation is one of the methods to eliminate infertility. It can be shown with regular anovulatory cycles, as well as when performing assisted reproductive technologies.

Ovulation stimulation can be performed for conception in a natural way, with artificial insemination, as well as during in vitro fertilization.
Before ovulation stimulation, a couple must be prescribed examinations to identify the causes of infertility. Since problems with the reproductive system can affect both women and men, both partners are examined. During the diagnosis, the causes of anovulatory cycles can be identified, which are sufficient to eliminate to restore natural ovulation (endocrine system disorders, inflammatory or infectious diseases, etc.). It is also important to check the “capacity” of male germ cells. Sometimes pregnancy may not occur not only because of anovulatory cycles, but also due to impaired spermatogenesis.

To detect anovulation, a woman will be assigned the following tests over several cycles:

• measurement of basal body temperature;
• ultrasound examinations;
• blood tests for hormone levels.

Without normalization of the level of prolactin, thyroid hormones, and male sex hormones, ovulation stimulation is not carried out.

Stimulation of ovulation with an injection of hCG

Stimulation of ovulation begins with nonsteroidal antiestrogen or gonadotropic drugs. The choice of drug will depend on the method of eliminating infertility, during which stimulation occurs. On average, drugs are prescribed for up to 12 days. This will depend on the response of the ovaries to the ongoing therapy.
During the period of ovulation stimulation, to control the growth of follicles, a woman will undergo ultrasound every 3-4 days until the follicles reach the required size of 18-20 mm.

Next, the patient is given an injection of hCG. HCG completes the process of maturation of follicles and “turns on” the mechanisms of ovulation. HCG also prevents the regression of follicles and the appearance of follicular cysts, which can be formed due to non-disclosure of a mature follicle.

After an injection of hCG, ovulation occurs within 24-36 hours. Next, the patient is assigned a schedule of sexual intercourse (in the case of natural fertilization), insemination or the date of ovarian puncture (during IVF).

Artificial insemination

Artificial insemination is the intrauterine introduction of partner or donor spermatozoa to effect a pregnancy. Artificial insemination, in most cases, is carried out for women with immunological infertility, when antisperm antibodies that destroy spermatozoa are present in the secret of the cervical canal. Also, artificial insemination can be performed on women without a husband or partner who decide to have a child.
The artificial insemination procedure can be carried out with ovulation stimulation and in the natural cycle.

In vitro fertilization

During in vitro fertilization, ovulation is stimulated to obtain the maximum number of mature eggs. This process is called superovulation. There are several methods (protocols) for IVF. However, any of them use gonadotropic drugs that stimulate the growth of follicles and eggs, as well as an injection of hCG. Methods for IVF will differ in duration and dosage of drugs. The choice of the necessary IVF protocol is carried out by the attending physician based on the patient’s health status.

A long IVF protocol begins with the introduction of pituitary blockers – gonadotropin-releasing hormone preparations. This is necessary to control the natural hormonal background of a woman.

From the 3rd-5th day of the menstrual cycle, gonadotropic drugs are prescribed to stimulate the growth of follicles. These drugs will contain synthetic analogues of follicle-stimulating hormone, which is normally produced by the pituitary gland. Additionally, luteinizing hormone may be prescribed, which is necessary to prevent premature ovulation.

When the follicles are mature (determined by ultrasound), the woman is given an injection of hCG. After an injection of hCG, an ovarian puncture is performed approximately 36 hours later (more precise terms are determined by the attending physician in each individual case). Ovarian puncture is a minimally invasive procedure that collects eggs. During IVF, it is important to obtain eggs before they are directly released into the abdominal cavity, otherwise it is almost impossible to collect them in the future and stimulation will need to be repeated again.
The procedure is carried out under general anesthesia, so you can’t eat (6-8 hours before) and drink (2 hours before). During the puncture, a special needle is inserted into the ovaries through the vagina under the control of ultrasound. When the needle reaches the mature follicle, the eggs are taken with the follicular fluid. The manipulation is repeated with each mature follicle.

For further IVF, a man must provide sperm that was obtained on the day of the puncture. If donor sperm is used, it must be ready for use on the same day.

Selected oocytes and specially processed ejaculate are placed on the medium in a petri dish for fertilization. The environment in the Petri dish is as close as possible in composition to the natural environment of the fallopian tubes, where conception should take place. After fertilization, the highest quality zygotes continue to be cultured until they reach the blastocyst stage. Cultivation lasts 3-5 days.
Next, the embryos are transplanted into the woman’s uterus for further implantation and development. Usually 1-2 embryos are transplanted, which increases the likelihood of a positive outcome of IVF.

In Kaliningrad, IVF and other methods of reproductive technology can be done at the IVF Center clinic, whose specialists successfully eliminate infertility of any etiology.

Pregnancy after hCG injection

In order to check whether pregnancy has occurred, after the hCG injection, appropriate tests are prescribed after a certain time:

• 2-3 weeks from ovulation – with natural fertilization;
• 2 weeks from sperm injection – with artificial insemination;
• 14 days – after embryo transfer after IVF.

You can find out if pregnancy has occurred with the help of a “home” cavity test, which reacts to an increase in the content of hCG in the urine. However, the most informative is the analysis of the level of hCG in the blood, which is monitored over time. With the help of a blood test for the level of hCG, you can determine the quality of the course of pregnancy, its fertility, and also identify the threat of ectopic pregnancy or miscarriage.

During pregnancy, hCG levels will continually increase tens of thousands of times, reaching a maximum peak of approximately 200,000 mIU/mL by the 12th week. Further, hCG will gradually subside, while its level will still be high compared to the norms for a non-pregnant woman (0-25 mIU / ml). A sharp decrease in the level of hCG in the first trimester may signal a threat of miscarriage, ectopic pregnancy, or pregnancy fading.

In a multiple pregnancy, the level of hCG will increase depending on the number of fetuses: two times for twins, three times for triplets, etc.

HCG injections during pregnancy

In some cases, with a history of threatened miscarriage or after IVF, hCG tablets or injections are prescribed to support pregnancy directly during pregnancy (in the first trimester). Chorionic gonadotropin maintains the life of the corpus luteum, which produces progesterone, which is necessary for the development of the child. That is why hCG increases so intensively in the first trimester: until the placenta can synthesize progesterone in the required amount on its own, which occurs by the 12th week.

Dosage and duration of administration of maintenance drugs will differ in each individual case.

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Human chorionic gonadotropin (hCG, β-hCG, beta-hCG, Human Chorionic Gonadotropin): indications for the appointment, rules for preparing for the test, interpretation of the results and normal indicators.

Chorionic gonadotropin is a hormone produced by the outer shell of the embryo, and is normally determined in the blood and urine of a woman only when pregnancy occurs.

Human chorionic gonadotropin (hCG, beta-hCG, b-hCG, Human Chorionic)

Synonyms: Beta-hCG generic.

Human Chorionic Gonadotropin; hCG; Pregnancy Quantitative hCG; Beta hCG; Total beta hCG.

Brief description of the analyte Human Chorionic Gonadotropin…

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Chorionic gonadotropin consists of two subunits – alpha and beta. The beta subunit (β-hCG) used for the immunometric determination of the hormone is unique. To monitor the course of pregnancy, the determination of the beta subunit of hCG is used. The level of beta-hCG in the blood as early as 6-8 days after conception makes it possible to diagnose pregnancy (the concentration of β-hCG in the urine reaches the diagnostic level 1-2 days later than in the blood serum).

HCG has a multifaceted effect on the body of a pregnant woman: it affects the development of the embryo and fetus, stimulates the synthesis of estrogens and androgens by ovarian cells, promotes the functional activity of the chorion and placenta, and ensures the successful course of pregnancy.

The introduction of hCG into the body of non-pregnant women stimulates ovulation and the synthesis of sex hormones necessary for conception. In men, this hormone enhances the formation of seminal fluid, activates the production of gonadosteroids.

In early pregnancy and up to the 2nd trimester, β-hCG supports the production of hormones necessary to maintain pregnancy, and in male fetuses it stimulates cells responsible for the formation and development of the male reproductive system.

Indications for determining the level of hCG in women

1. Absence of menstruation (amenorrhea).
2. Exclusion/confirmation of pregnancy, including ectopic (ectopic).
3. Diagnosis of the state of the fetus at different stages of pregnancy.
4. Assessment of the state of the placenta at different stages of pregnancy.
5. Dynamic monitoring of fetal development during pregnancy, including in the diagnosis of malformations.
6. Suspicion of the presence of neoplastic diseases of the reproductive system, such as hydatidiform mole (a rare pathology of the fetal egg, in which instead of developing the embryo, chorionic villi grow), chorionepithelioma (a malignant tumor that develops from the epithelium of the villi of the fetal egg).
7. Performing artificial termination of pregnancy.

Indications for determining the level of hCG in men:

The presence of suspicion of tumors of the testicles.

Completion date for this study is 1 working day, excluding the day of taking the biomaterial.

Rules for preparing for a blood test to determine the level of hCG

non-specific: it is enough to refrain from smoking and drinking alcohol on the eve of the procedure, limit stress and intense physical activity for a week; blood donation is carried out on an empty stomach.

The determination of hCG in the blood is possible already on the 6-8th day after conception. The use of urinary test systems (rapid pregnancy tests) will be informative starting from the 7th day after the fertilization of the egg. To confirm the result, it is recommended to re-determine the level of the hormone a few days after the first analysis.

You can take a blood test for hCG (thyroid stimulating hormone, thyrotropin, Thyroid StimulatingHormone, TSH) at the nearest INVITRO medical office. The list of offices where biomaterial is accepted for laboratory testing is presented in the “Addresses” section.

Reasons leading to high levels of β-hCG

1. Multiple pregnancy.

2. Incorrect timing of pregnancy.

1. Pathological pregnancy: the appearance of edema, increased blood pressure, loss of protein in the urine (preeclampsia), convulsions (eclampsia), toxicosis.
2. The presence of a pregnant woman with chronic diseases (for example, diabetes mellitus).
3. Multiple fetal malformations (in such a situation, the determination of the level of β-hCG is used together with other indicators, the so-called “triple test”. This study is used as a screening, and not for diagnosis.).

Reasons for fixing a decrease in the level of β-hCG

1. Incorrectly established terms of pregnancy.
2. Ectopic pregnancy.
3. Frozen pregnancy.
4. Threatened miscarriage.
5. Fetal or placental disorders (including placental insufficiency).
6. Intrauterine fetal death (in this case, it is informative to determine the level of the hormone in the first and second trimesters).

During abortions, the level of β-hCG is also monitored, the dynamics of growth / fall of which can be used to judge the completeness of the manipulation.

Determining the level of hCG, in addition to establishing the fact of pregnancy in the early stages, is part of the screening examination of pregnant women in the first trimester, along with ultrasound.

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Screening ultrasound 1st trimester of pregnancy (11-13 weeks 6 days)

Examination necessary to monitor the growth and development of the fetus in the first trimester of pregnancy.

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In gynecological practice, human chorionic gonadotropin is used to treat infertility, stimulate ovulation, and synthesize sex steroids. In urology, it is used in the treatment of cryptorchidism (undescended testicles) and infertility associated with impaired spermatogenesis.

Quantitatively, β-hCG is determined in the blood, for a qualitative determination, special test systems (pregnancy tests) are used, and in this case, urine serves as a biomaterial.

Quantitative determination of the level of hCG allows you to monitor the course of pregnancy in dynamics. To do this, obstetrician-gynecologists have developed tables for increasing the level of hCG, depending on the duration of pregnancy in weeks. The sensitivity of the determination is in the range of 1.2-1125000 mU/ml.

Reference values ​​of hCG levels in dynamics by gestational age

Values ​​ranging from 5 to 25 mU / ml do not allow unambiguous confirmation or denial of pregnancy, therefore, a second study is required after two days.

Since the hormone is produced by the placenta, during normal pregnancy, with placental pathology (for example, with fetoplacental insufficiency – a violation of the development of the fetus and placenta), with multiple pregnancies, the values ​​of β-hCG will differ. With a normal pregnancy until the fifth week, the level of the hormone rises exponentially: every two days its concentration doubles, reaching a peak by the 11th week of gestation. Accordingly, in a multiple pregnancy, the level of β-hCG will be even higher than in a single pregnancy.

If the indicator deviates from the norm, additional ultrasound of the pelvic organs (uterus, appendages) is required.

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However, with a normal hCG value, additional examinations may also be needed:

1. Ultrasound diagnosis of pregnancy (required to confirm pregnancy, clarify the term).

Ultrasound diagnosis of pregnancy

Examination to confirm pregnancy and determine the place of attachment of the ovum (to exclude ectopic pregnancy).

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2. Screening ultrasound of the 1st trimester of pregnancy (11-13 weeks 6 days) – to assess the characteristics and confirm the normal development of the fetus.

Screening ultrasound 1st trimester of pregnancy (11-13 weeks 6 days)

Examination necessary to monitor the growth and development of the fetus in the first trimester of pregnancy.

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3. Screening ultrasound of the 1st trimester of multiple pregnancy (11-13 weeks 6 days) – to confirm the presence of several fetuses, determine their characteristics; It is necessary for planning the subsequent actions of the doctor and the management of pregnancy.

Screening ultrasound of the 1st trimester of multiple pregnancy (11-13 weeks 6 days)

A study that allows you to evaluate the growth and development of fetuses, their position in the uterus, and make a plan for further pregnancy management.

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4. Fetal ultrasound according to indications (before the 20th week) – performed if an ectopic pregnancy is suspected.

Fetal ultrasound according to indications (before the 20th week)

Additional ultrasound, which is prescribed in the presence of concomitant pathologies to monitor the condition of the fetus.

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5. Lab tests to be performed in the first trimester are collected in the Pregnancy: 1st trimester (1-13 weeks) profile.

For professional assistance in interpreting the results, contact

obstetrician-gynecologist

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Sources:

1. www.invitro.ru
2. Clinical guidelines “Ectopic (ectopic) pregnancy”. Developed by: Russian Society of Obstetricians-Gynecologists, Association of Obstetric Anesthesiologists-Resuscitators. – 2021.
3. Clinical guidelines “Premature birth”. Developed by: Russian Society of Obstetricians-Gynecologists, Association of Obstetric Anesthesiologists-Resuscitators. – 2020.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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