By Gary Pepper, M.D.
In the first article in this series, The HCG-Cancer Connection, I explained how HCG is made by some types of cancer and can serve as a marker for cancer activity. Now I want to explore another effect of HCG, the stimulation of male hormone (testosterone) production.
Just to review, there is no evidence that HCG will cause cancer although conceivably certain cancer responsive tumors may grow faster due to its effect to increase estrogen and testosterone. Every woman who has had a normal pregnancy has been exposed to high HCG levels for many months so if it did cause cancer that effect would be very obvious.
What concerns me is how HCG can influence the normal ovary and its hormone metabolism. HCG is a promiscuous hormone. It will hook up with different hormone “receptors” and masquerade as these other hormones. In the previous article I explained how at very high levels HCG can stimulate the thyroid to make thyroid hormone resulting in hyperthyroidism. Another hormone effect of HCG is to mimic LH (leutinizing hormone) which turns on the production of the sex hormones by the testicle in men and ovary in woman. Surprisingly the normal ovary makes testosterone which it then converts to estrogen. FSH (follicle stimulating hormone) from the pituitary helps the ovary change testosterone to estrogen. What happens when the ovary gets a lot of LH but not FSH? This is the situation when a woman gets HCG. Testosterone levels will rise more than estrogen levels. Research shows that after a single HCG injection a rise of 20% in testosterone levels occurs in normal women, confirming this theory. During pregnancy with HCG pumping in the blood from the placenta, testosterone levels can double, resulting in acne, oily skin and (in some women) an increase in sex drive. The situation would be far worse for a pregnant woman if the placenta wasn’t also pumping out 100 times the normal amount of estrogen to counteract all the male hormones.
So why should women care if HCG makes their testosterone levels go up? Acne, oily skin and horniness are one thing but there are other effects which might be less acceptable. Testosterone is a mischievous hormone. While it causes hair growth where you don’t want it, it causes hair loss in places you want to keep it. Testosterone stimulates hair growth on the face, chest, back and abdomen. At the same time it causes hair loss from the scalp particularly at the temples and crown. This is referred to as male pattern baldness. Other effects of testosterone in women are the growth of the clitoris, known as clitoromegaly. A clitoris the size of a man’s thumb has been described in a woman due to excess testosterone exposure. Generally this degree of clitoromegaly is seen only in more extreme cases. So you may want to think twice before starting an HCG diet unless looking like Bruce Willis is your thing.
In the final installment on the hazards of HCG I will focus on other possible nasty hormone effects of HCG such as fibroids, infertility and bulging muscles.
The editors of the latest research on the controversial subject of combination therapy (t4 plus t3) for treating hypothyroidism have missed the point again.
A recent article published in the Annals of Internal Medicine (March 15, 2005) attempted to answer the question about whether combining t3 (Cytomel) with t4 (Synthroid, Levoxyl, Levothroid) for treating under active thyroid (hypothyroidism) produces a better outcome than using t4 alone.
Although the latest studies of this controversy lump all hypothyroid patients together, the most recent one showed an impressive preference for combination therapy by 18 of the 28 patients who got t3 added to their conventional t4. And this happened without adjustment of t3 dosing which is often required for the best results.
I was excited and impressed with these results. But guess how the editors who published this study interpreted these results? With a dry and simple statement that dismissed these findings as showing “no difference” between combination treatment and treatment with t4 alone. They concluded by stating that treatment with t4 alone is “sufficient”, leaving one to conclude that adding t3 produces no benefits. I have to scratch my head in wonder.
What could explain the resistance of these experts to see combination t3 and t4 as an exciting improvement in treatment of hypothyroidism? Perhaps it is the old bias against combination t3 and t3 products. These products which include names like Proloid were withdrawn from the market decades ago. How can we physicians rationalize our abandonment of combination hormone treatment leaving our patients to struggle on their own with their symptoms? By denying that in many cases combination treatment can be superior we can avoid having to deal with this failure of our accepted teachings.
For now each hypothyroid patient must decide with their own physician whether combination therapy is right for them. Keep an eye on metabolism.com for more updates on the latest in this debate.