Ester S Mark MD, Anti-Aging Physician, Laguna Hills, CA, Scientific Advisor to Natural Clinician LLC

There is a major renaissance interest in the use of intermittent HCG injections with very low calorie diets for weight control (1). Some debate has ensued on the disadvantages and limitations of HCG interventions which include arguments about efficacy, difficulty with dietary compliance and dose-related side effects of HCG, in some individuals. The proponents of HCG therapy believe strongly in the ability of this hormone to act on the diencephalon or hypothalamus and fats stores to promote weight loss by a variety of mechanisms, some of which remain unclear. Integrative Medicine has accepted the concept of a comprehensive, synergistic approach to weight control which involves calorie control diets, behavior modification, aerobic exercise and adjunctive techniques, such as drugs or nutraceuticals. In open-label clinical studies, HCG injections with very low calorie diets have been found to be effective in weight control, but compliance with punitive dieting is a clinical challenge. A number of patients describe muscle weakness after prolonged courses of HCG, but muscle mass is alleged to be retained. In order to overcome these therapeutic disadvantages HCG has been combined with a number of adjunctive weight loss approaches. The most effective approach has been to apply thermogenic agents which complement the actions of HCG by acting on alternative pathways for weight control. Several thermogenic agents have been explored as part of a companion protocol for HCG treatments e.g. acai, caffeine, fucoxanthin, but these agents do not match the power of selected amines of natural sources. While ephedra was the most popular amine used in weight control, it was withdrawn from supplement use in 2004 because of adverse side effects. While few people questioned the effectiveness of ephedra in weight control, its risk benefit ratio was found to be unacceptable. The combination of HCG injections with the thermogenic agent Advantra Z has resulted in excellent accelerated outcome of weight control. Advantra Z is a patented product that is standardized for its p-synephrine content and it has many of the advantages of Ephedra, without the same propensity to cause cardiovascular hyperstimulation and adverse central nervous system effects (2, 3). The thermogenic effects of Advantra Z appear to be more powerful in females compared with males (2). Several studies have indicated that Advantra Z does not provoke excessive raises in blood pressure or heart rate and it has not been directly associated with cardiac arrhythmias in otherwise healthy people (3). Advantra Z possesses the putative advantages of ergogenesis with lypolysis and demonstrable thermogenesis in controlled clinical studies (4). In addition, Advantra Z may have effects on improvement of mood, reduction of appetite; and it increases the uptake of amino acids in muscle tissue, as a consequence of its more selective actions on beta-3 adrenergic receptors. The use of thermogenesis alongside HCG injections presents part of a viable protocol for the adjunctive management of obesity in individuals who do not have established cardiovascular or stroke risk. Within open-label experiences, our group has defined the need for multivitamin intake with severe dietary restriction in the form of powder mixtures that contain phytochemical co-factors from greens, berries, fruit and vegetables. Protein malnutrition should be avoided. In addition, it has been important to select individuals with Metabolic Syndrome X for specific adjunctive nutritional interventions that are primarily aimed at overcoming insulin resistance.


  1. Simeons ATW. The action of chorionic gonadotrophin in the obese. Lancet 2:946-947, 1954
  2. Gougeon R, Harrigan K, Tremblay JF, et al. Increase in the thermic effect of food in women by adrenergic amines extracted from citrus aurantium. Obesity Res 2005; 13:1187-1194
  3. Preuss HG, DiFernando D, Bagchi M, Bagchi D. Citrus aurantium as a thermogenic, weight-reduction replacement for ephedra: an overview. J Med 2002;33 (1-4):247-64.
  4. Holt S, Peel off the Weight, HIOM, Little Falls, NJ 2009

With Best Wishes.
Stephen Holt, MD, PhD, DSc, LLD(Hon.) DNM, ChB, FRCP (C), MRCP (UK), FACP, FACG, FACN, FACAM, KSJ, Distinguished Professor of Medicine (Emerite)

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