This is a continuation of the hCG Phase 2 threads here:
Part I
http://forum.lowcarber.org/showthread.php?t=420922
Part II
http://forum.lowcarber.org/showthread.php?t=427175
Link to the stabilization and maintenance thread (P3, P4):
http://forum.lowcarber.org/showthread.php?t=422160
I thought a good way to begin the new thread would be with a summary of what hCG is, how it works, and the Dr. Simeon's protocol.
1. hCG is Human Chorionic Gonadotropin. It’s a hormone produced in great abundance by pregnant women. It is the hormone tested for by home pregnancy kits.
2. The purpose of hCG is to increase metabolism and fat-burning, in order to provide a growing human embryo a steady supply of rich nutrition in the early stages of the pregnancy, when heart, brain, nervous system, etc is forming (mother may not even know she's pregnant, let alone be eating nutritiously). HCG accomplishes this by accessing the abnormal fat stores in the body, and releasing this fat.
3. The FDA approved use of hCG is as a fertility treatment in females, and select hormonal treatment in males. It is not approved as a weight loss drug, but US doctors can prescribe it "off-label".
3. The use of hCG as a diet aid was first discussed in a report (Pounds & Inches) that Dr. A.T.W. Simeons published in 1954, who discovered that his patients could drastically reduce their caloric intake without experiencing hunger or weakness while taking it. Over 16 years of research, he developed the hCG diet protocol.
4. Taking hCG in and by itself will not cause weight loss. A drastic decrease in calories must accompany the hCG. Users are prescribed a 500 calorie a day diet. Without hCG, this would be a starvation diet, and mess up metabolism. As much muscle tissue as fat would be lost. Hunger would make the diet non-sustainable. Any weight lost would quickly return as soon as normal levels of calories were consumed.
WITH hCG, up to 2000 calories a day worth of FAT is released from abnormal fat stores. The body is well-fed off this fat; muscle tissue loss does not occur. Slowing of metabolism does not occur. Appetite is naturally suppressed and hunger is not felt. Weight does not return when the diet is ended.
5. Average rate of weight loss is about 1 pound a day for men, .5 - .75 pound a day for women.
6. Since hCG accesses abnormal fat deposits, a loss in girth and reshaping of body contour is quickly noticeable.
7. Dr. Simeons wrote that he believed hCG works on the hypothalamus to cause a change in set point and metabolism, thus resulting in a "cure" for obesity. The details of this mechanism are found in "Pounds and Inches", readily available to download from the internet.
8. Naysayers say sure, anyone can expect to lose a pound a day while eating 500 calories, the hCG isn't doing anything. A number of double-blind placebo studies comparing hCG + a 500 calorie diet to placebo + a 500 calorie diet have been performed, and there was no difference in weight loss. The naysayers are missing the point. See #4 and 7 above.
9. Dr Simeons said that a minimum of 23 injections is needed, even if the patient reaches his/her normal weight before that (weight loss is self-limiting, as only abnormal fat stores are lost, normal and structural fat stores are spared) because it seems that in cases of obesity, where the hypothalamus has been exhausted by long periods of overuse, about three weeks rest is needed for it to regain normal function. This "reset" is the key to maintaining the weight loss.
10. The reason for limiting a course to 40 injections is that by then some patients may begin to show signs of HCG immunity. Some may show signs before that, so skipping one day out of 7 may be used to help avoid immunity and prolong the weight loss period.
11. After 40 daily injections it takes about six weeks before the immunity is lost and HCG again becomes fully effective.
12. After the last injection, hCG will still be in circulation in the body for about 3 days. The 500 calorie diet must continue during these 3 days, as increasing calories while the hCG is still in the system could lead to rapid weight regain.
13. The first 2 days of injections are called "load days" and the patient is instructed to eat to capacity of all the high-caloric fattening food they can choke down. "One cannot keep a patient comfortably on 500 Calories unless his normal fat reserves are reasonably well stocked. It is a fundamental mistake to put a patient on 500 Calories as soon as the injections are started, as it seems to take about three injections before abnormally deposited fat begins to circulate and thus become available."
14. So, the normal course of treatment is as follows:
HCG 125 - 175iu daily injection for 23 to 40 injections. Skipping one day in 7 is optional but advised.
Phase 1: First 2 injection days, forced feeding.
Phase 2: After 3rd injection, 500 calorie diet of specific allowed foods to be continued until 72 hours after the last injection. 1 to 2 gallons of water a day must also be drank.
Phase 3: For the following 3 weeks, all foods allowed except carbohydrate, starch and sugar in any form. Slowly and gradually increase calories, introducing 1 new food a day, until you are eating at your calorie limit (Your weight, or desired weight, x 10 (women) or x 11 (men)).
Phase 4: After 3 weeks, very gradually add carbs in small quantities, always controlled by morning weighing. If ever a 2 pound gain is seen, immediately do a correction day: See “Pounds & Inches”.
FOOD PLAN
BREAKFAST (is basically skipped): Tea or coffee in any quantity without cream or sugar.
LUNCH:
100 grams (3.5 ounces) of veal, beef, chicken breast, fresh white fish, lobster, crab, or shrimp. All visible fat must be carefully removed before cooking, and the meat must be weighed raw. It must be boiled or grilled without additional fat. Salmon, eel, tuna, herring, dried or pickled fish are not allowed. The chicken breast must be removed from the bird.
One type of vegetable only to be chosen from the following: spinach, beet greens, fennel, chard, lettuce, tomatoes, celery, onions, radishes, cucumbers, asparagus, cabbage.
One grissino breadstick or one Melba toast.
A small apple, orange, 6 strawberries or one-half grapefruit.
DINNER : The same four choices as lunch.
The juice of one lemon daily is allowed for all purposes. Salt, pepper, vinegar, mustard powder, garlic, sweet basil, parsley, thyme, marjoram, etc., may be used for seasoning, but no oil, butter or dressing.
Tea, coffee, plain water, or mineral water are the only drinks allowed, but they may be taken in any quantity and at all times. Only one tablespoonful of milk allowed in 24 hours. Saccharin or Stevia may be used. It is important to drink about 2 liters of these fluids per day.
The fruit or the breadstick may be eaten between meals instead of with lunch or dinner, but not more than four items listed for lunch and dinner may be eaten at one meal. Allowed substitution for meat (no more than once per day) 1 egg + 3 egg whites, or ˝ c of skim (fat free) cottage cheese. No other cheeses allowed.
Link to Dr Simeon's original manuscript, "Pounds & Inches":
http://endthefat.net/simeonspi.pdf
Taking it a step beyond "pounds & Inches", an excellent blog and book,
Weight-Loss Apocalypse, with some more up-to-date theories on how and why hcg works:
http://weightlossapocalypse.blogspot.com/