hCG — human chorionic gonadotropin

Human Chorionic Gonadotropin (hCG) is a prescription medication containing chorionic gonadotropin obtained from a natural (human) origin. Chorionic gonadotropin is a polypeptide hormone normally found in the female body during the early months of pregnancy. It is synthesized in syncytiotrophoblast cells of the placenta, and is responsible for increasing the production of progesterone, a pregnancy-sustaining hormone. Chorionic gonadotropin is present in significant amounts only during pregnancy, and is used as an indicator of pregnancy by standard over-the-counter pregnancy test kits. Blood levels of chorionic gonadotropin become noticeable as early as seven days after ovulation, and rise evenly to a peak at approximately two to three months into gestation. After this point, the hormone level will drop gradually until the point of birth.

Although it possesses minor FSH-like (Follicle Stimulating Hormone) activity, the physiological actions of chorionic gonadotropin mainly mimic those of the gonadotropin luteinizing hormone (LH). As a clinical drug, hCG is used as an exogenous form of LH. It is typically applied to support ovulation and pregnancy in women, most specifically those suffering from infertility due to low concentrations of gonadotropins and an inability to ovulate. Due to the ability of LH to stimulate the Leydig’s cells in the testes to manufacture testosterone, hCG is also used with men to treat hypogonadotropic hypogonadism, a disorder characterized by low testosterone levels and insufficient LH output. The drug is also used in the treatment of prepubertal cryptochidism, a condition in which one or both of the testicles have failed to descend into the scrotum. HCG is used by male athletes for its ability to increase endogenous testosterone production, generally during, or at the conclusion of, a steroid cycle, when natural hormone production has been interrupted.

Brand name hCG, Human chorionic gonadotropin, Pregnyl, Pregnon

Human Chorionic Gonadotropin History

Chorionic gonadotropin was first discovered in 1920, and was identified as a pregnancy hormone approximately 8 years later. The first drug preparation containing chorionic gonadotropin came in the form of an animal pituitary extract, which was developed as a commercial product by Organon. Organon introduced the extract in 1931, under the trade name Pregnon. A trademark dispute forced the company to change the name Pregnyl, however, which reached market in 1932. Pregnyl is still sold by Organon to this day, although it no longer comes in the form of a pituitary extract. Manufacturing techniques were introduced in 1940 that allowed the hormone to be obtained by filtering and purifying the urine of pregnant women, and by the late 1960’s were adopted by all manufacturers formerly using animal extracts. Over the years the process and manufacturing protocols have been refined, but hCG is made in essentially the same way today as it was decades ago. While modern preparations are of biological origin, the risks of biological contaminants are said to be low (although cannot be completely excluded).

Early on, the indicated uses for chorionic gonadotropin preparations were much broader than they are presently. Product literature from the 1950’s and ’60’s recommended the use of these drugs for, among other things, the treatment of uterine bleeding and amenorrhea, Froehlich’s syndrome, cryptochidism, female sterility, obesity, depression, and male impotence. A good example of the wide uses of chorionic gonadotropin are illustrated in the preparation Glukor, which was described in 1958 as being, “Three times more effective than testosterone. For tired young men in male climacteric. For tired old men in male senility. Beneficial in impotence, angina and coronary heart disease, neuropsychosis, prostatitis, [and] myocarditis.“ Such recommendations, however, reflect an era less tightly regulated by government agency and less reliant on proven clinical trials. Today, FDA-approved indications for hCG are limited to the treatment of hypogonadotropic hypogonadism and cryptocridism in men, and anovulatory infertility in women.

HCG has no significant thyroid-stimulating activity. This is specifically pointed out because hCG was once widely used for the treatment of obesity. The trend seemed to have become popular in 1954, after a paper was published by Dr. A.T.W. Simeons claiming that chorionic gonadotropin was an effective adjunct to dieting. According to the study, patients were able to effectively stave off hunger with severely low-calorie diets provided they took the hormone injections. Dubbed the Simeons diet, people all across the country were soon subjecting themselves to severe calorie restriction (500 calories per day) and taking hCG injections. Soon after, the hormone itself became the main focus for fat loss. In fact, by 1957 it was said that hCG was the most commonly prescribed medication for weight loss. More recent and comprehensive investigations, however, refute that there is any anorexic or metabolic advantage to the use of hCG. In 1962, the Journal of the American Medical Association had already been warning consumers about the hCG-inclusive Simeons diet, stating the more basic fact that severe calorie restriction, which causes the body to sacrifice muscle and organ tissue to obtain necessary protein, was more hazardous than obesity itself. By 1974, the FDA had had enough of the hCG fat loss claims, and mandated the following statement to be included with all prescribing literature. “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 CALORIERESTRICTED DIETS.” This warning persists on all product sold in the U.S. today. In spite of this warning and evidence to the contrary, some clinics still promote the use of hCG for dieting purposes.

Human Chorionic Gonadotropin is a widely popular drug preparation today, owing to the fact that it remains an indispensable part of ovulation therapy for many cases of female infertility. Popular preparations in the U.S. presently include Pregnyl (Organon), Profasi (Serono), and Novarel (Ferring), although many other trade names have been popular for chorionic gonadotropin preparations over the years. This drug is also sold widely outside of the United States, and can be found under many additional trade names, too numerous to list here. Owing to the fact that this drug is not controlled on a federal level, U.S. athletes and bodybuilders unable to find a local physician willing to prescribe the drug to treat steroidinduced hypogonadism often order the product from international pharmacy sources. Given that this drug is cheap and rarely counterfeited, most international sources are trusted. Although recombinant forms of chorionic gonadotropin have been introduced to market in recent years, the vast supply and low cost of biological hCG continues to make it a staple product for both labeled and off-label uses.

Human Chorionic Gonadotropin Structural Characteristics

Chorionic gonadotropin is an oligosaccharide glycoprotein composed of 244 amino acids. It has an alpha subunit that is 92 amino acids long and identical to that of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and thyroid-stimulating hormone (TSH). It has a beta subunit that is unique to hCG.

How is Human Chorionic Gonadotropin Supplied

Human Chorionic Gonadotropin is widely available in various human and veterinary drug markets. Composition and dosage may vary by country and manufacturer, but typically contain 1,000, 1,500, 2,500, 5,000, or 10,000 international units (IU) per dose. All forms are supplied as a lyophilized powder, requiring reconstitution with sterile diluent (water) before use.

Human Chorionic Gonadotropin Administration (General)

Human Chorionic Gonadotropin is generally given by intramuscular (IM) injection. The subcutaneous route is also used, and has been deemed to be roughly equivalent therapeutically to IM injections. Peak concentrations of chorionic gonadotropin occur approximately 6 hours after intramuscular injection, and 16 to 20 hours after subcutaneous injection.

Human Chorionic Gonadotropin Administration (Men)

When used to treat hypogonadotropin hypogonadism, current FDA-approved protocols recommend either a short 6-week program, or a long-term program lasting up to 1 year, depending on the individual needs of the patient. Prescribing guidelines for short-term use recommend that 500 to 1,000 units to be given 3 times a week for 3 weeks, followed by the same dose twice a week for 3 weeks. The long-term recommendations call for 4,000 units to be administered 3 times weekly for 6 to 9 months, after which point the dosage is reduced to 2,000 units 3 times weekly for an additional 3 months. Bodybuilders and athletes use hCG either on cycle, in an effort to maintain testicular integrity during steroid administration, or after a cycle, to help restore hormonal homeostasis more quickly. Both types of use are deemed effective when properly applied.

Post-Cycle

Human Chorionic gonadotropin is often used with other medications as part of an in-depth Post Cycle Therapy (PCT) program focused on restoring endogenous testosterone production more rapidly at the end of a steroid cycle. Restoring endogenous testosterone production is a special concern at the conclusion of each cycle, a time when subnormal androgen levels (due to steroid induced suppression) could be very costly to the physique.The main concern is the action of cortisol, which in many ways is balanced out by the effect of androgens. Cortisol sends the opposite message to the muscles than testosterone, or to breakdown protein in the cell. Left unchecked by a low level of testosterone, cortisol can quickly strip much of your new muscle mass away. Protocols for the post-cycle use of hCG generally call for the administration of 2000-3000 Units every 2nd or 3rd day, taken for no longer than 2 or 3 weeks. If used for too long or at too high a dose, the drug may actually function to desensitize the Leydig’s cells to luteinizing hormone, further hindering a return to homeostasis. For a more comprehensive view of hCG’s role in a proper hormonal- recovery program, please refer to the Post Cycle Therapy section of this book.

On-Cycle

Bodybuilders and athletes may also administer Human Chorionic Gonadotropin throughout a steroid cycle, in an effort to avoid testicular atrophy and the resulting reduced ability to respond to LH stimulus. In effect, this practice is used to avoid the problem of testicular atrophy, instead of trying to correct it later on when the cycle is over. It is important to remember that the dosage needs to be carefully monitored with this type of use, as high levels of hCG may cause increased testicular aromatase expression (raising estrogen levels), and also desensitize the testes to LH. As such, the drug may actually induce primary hypogonadism when misused, greatly prolonging, not improving, the recovery window. Current protocols for the use of hCG in this manner involve administering 250 IU subcutaneously every 3rd or 4th day throughout the length of the steroid cycle. Higher doses may be necessary for some individuals, but st no point should exceed 500 IU per injection.

These on-cycle hCG protocols were developed by Dr. John Crisler, a well-known figure in the anti-aging and hormone-replacement field, for use with his testosterone replacement therapy (TRT) patients. Although TRT is often administered on a long-term basis, testicular atrophy is a common cosmetic complaint of patients irrespective of the maintenance of normal androgen levels. Dr. Crisler’s hCG program is designed to alleviate this concern in a manner that is acceptable for longer-term use. For those interested in precisely timing their hCG shots in relation to a prescribed testosterone replacement program, Dr. Crisler recommends the following in his paper,“An Update to the Crisler hCG Protocol,” “…my test cyp TRT patients now take their hCG at 250IU two days before, as well as the day immediately previous to, their IM shot. All administer their hCG subcutaneously,and dosage may be adjusted as necessary (I have yet to see more than 350IU per dose required)… Those TRT patients who prefer a transdermal testosterone, or even testosterone pellets (although I am not in favor of same), take their hCG every third day.”

Human Chorionic Gonadotropin Administration (Women)

When used to induce ovulation and pregnancy in anovulatory infertile woman, a dose of 5,000 to 10,000 units is administered one day following the last dose of menotropins.The timing is specific so that the hormone is given precisely at the right moment in the ovulation cycle. Human Chorionic Gonadotropin is not used by women for physique- or performanceenhancing purposes.

Human Chorionic Gonadotropin Availability

When we find hCG, we see it is always packaged in 2 different vials/ampules (one with a powder and the other with a sterile solvent). These need to be mixed before injecting, and any leftover drug should be refrigerated for later use. Make sure your product matches this description. Human Chorionic Gonadotropin is widely manufactured, and easily obtained on the black market.To date, counterfeits have not been much of a concern, although a couple of oddities have popped up (all in multi-dose vials).

Bodybuilders reference

HCG is used medically to positively influence ovulation in women, and to help produce estrogen. It is also utilized in fertility medicine to aid in ovulation.

Male bodybuilders used HCG for another important reason. HCG is almost exactly the same amino acid sequence as Luteinizing Hormone (LH). LH is normally produced in the pituitary gland which is then circulated to the testes where it contacts the Leydig cells. The Leydig cells then produce androgens such as testosterone. Obviously this means so-called natural bodybuilders reported use of HCG to increase endogenous (natural) testosterone levels. According to some clinical studies this works so well that an injection of 1500-2000 i.u. of HCG has increased plasma testosterone levels 200-300% over normal levels. For those males who utilized high aromatizing AAS, HCG was a "partial" cure for restarting natural testosterone production either mid or post-cycles.

When administering exogenous (occurring outside the body) androgens, such as AAS, the body's endocrine system shuts down (partially of completely) natural androgen production in an attempt to maintain homeostasis. This is simply because the hypothalamus senses the excess estrogens from AAS aromatization (and to a lesser degree elevated androgen levels) and signals the pituitary (hypophysis) to partially or completely stop producing LH and FSH (follicle stimulating hormone). Since the Leydig cells in the testes do not receive the signal from LH, they partially or completely shut down testosterone production. Sperm production is also reduced as a result of FSH downregulation. Because the testes are not producing androgens and/or sperm at their normal level, the testes shrink. This often causes a drop in libido too. Many heavy AAS users reported sexual dysfunction for a brief (Brief?) period post-cycle.

So what did the men do about “the boy’s”? HCG injections act as a replacement for the LH normally produced by the pituitary gland which normally stimulates androgen and sperm production by the testes. When 2000-5000 i.u. of HCG was injected every 5th day for 2-3 weeks, mid or post-cycle, the testes began to function again. Also an increase in total testosterone was realized and athletes often made some of their best gains at this point. It also helped to keep the "significant other" significantly happy! When HCG was administered beginning the last week of an AAS cycle and for an additional 1-2 weeks post-cycle, testes function normalized again and much of the common post- AAS cycle muscle mass and strength loss was avoided. However, our athletes were not out of the woods (with acceptable wood) quite yet. Earlier, I mentioned that HCG has been a utilized as a "partial cure" for the shut-down of the hypothalamus-pituitary-testes-axis (HPTA). HCG only "replaces" natural LH. The pituitary and hypothalamus part of the HPTA still sense no reason to produce gonadotropins and restore normal LH/FSH production. So ending HCG administration sometimes only brought on another crash. But staying on HCG for more than 3 weeks without at least a month off between HCG cycles could cause permanent gonadal dysfunction and/or a desensitizing of Leydig Cells. Male bodybuilders commonly used Clomid or Cyclofenil with HCG (*See Clomid for more info). Available literature shows that Clomid stimulates the pituitary to release more gonadotropin so a quicker and elevated level of LH and FSH are realized. By following an AAS cycle with 2000-5000 i.u. HCG every 5th day for 2-3 weeks and ingesting Clomid for the last 10-15 days of HCG administration many athletes noted that muscle mass and strength losses post AAS cycle were significantly avoided. Many athletes also used Clenbuterol at this point. (*See Clenbuterol for more info)

*It should be noted that administration of HCG will increase plasma testosterone levels 200-300% or more. Therefore all of the negative side effects of testosterone injections can apply to a lesser degree.

There are several other HCG brands including veterinary. HCG always comes in two vials: one contains a packed powder and the other contains sterile water. Once the product is mixed (swirled not shaken) it must be refrigerated. HCG was often what bogus Growth Hormone (GH) vials contained. A simple test for real GH was to buy a pregnancy test kit and drop a few drops into the test. If your test read pregnant, you are also screwed. This is because most test kits test for elevated gonadotropins and HCG will test as such, but GH will not.

Anabolic Steroid Guide reference

HCG, is not an anabolic/an-drogenic steroid but a natural protein hormone which develops in the placenta of a pregnant woman. HCG is manufac-tured from the urine of pregnant women since it is excreted in un-changed form from the blood via the woman's urine, passing through the kidneys. The commercially available HCG is sold as a dry substance and can be used both in men and women. in women injectable HCG allows for ovulation since it influences the last stages of the development of the ovum, thus stimulating ovulation. In a man HCG stimulates pro-duction of androgenic hormones (testosterone). For this reason athletes use injectable HCG to increase the testosterone produc-tion. HCG is often used in combination with anabolic/androgenic steroids during or after treatment. Since the body usually needs a certain amount of time to get its testoster-one production going again, the athlete, after discontinuing ste-roid compounds, experiences a difficult transition phase which often goes hand in hand with a considerable loss in both strength and muscle mass. Administering HCG directly after steroid treat-ment helps to reduce this condition because HCG increases the testosterone production in the testes very quickly and reliably. In the event of testicular atrophy caused by mega doses and very long periods of usage, HCG also helps to quickly bring the testes back to their original condition (size). Since occasional injections of HCG during steroid intake can avoid a testicular atrophy, many athletes use HCG for two to three weeks in the middle of their steroid treatment. It is often observed that during this time the athlete makes his best progress with respect to gains in both strength and muscle mass. Those who are on the juice all year round, who might suffer psychological consequences or who would perhaps risk the breakup of a relationship because of this should consider this drawback when taking HCG in regular in-tervals. A reduced libido and spermatogenesis due to steroids, in most cases, can be successfully cured by treatment with HCG.

Most athletes, however, use HCG at the end of a treatment in order to avoid a "crash," that is, to achieve the best possible transition into "natural training." A precondition, however, is that the steroid intake or dosage be reduced slowly and evenly before taking HCG. Although HCG causes a quick and significant increase of the endogenic plasma- testosterone level, unfortunately it is not a perfect remedy to prevent the loss of strength and mass at the end of a steroid treatment. Although HCG does stimulate endogenous testosterone production, it does not help in re-estab-lishing the normal hypothalamic/pituitary testicular axis. The hypothalamus and pituitary are still in a refractory state after prolonged steroid usage, and remain this way while HCG is being used, because the endogenous testosterone produced as a-result of the exogenous HCG represses the endogenous LH production. Once the HCG is discontinued, the athlete must still go through a re-adjustment period. This is merely delayed by the HCG use." For this reason experienced athletes often take Clomid and Clenbuterol following HCG intake or they immediately begin an-other steroid treatment. Some take HCG merely to get off the "steroids" for at least two to three weeks. HCG package insert states clearly that HCG "has no known effect of fat mobilization, appetite or sense of hunger, or body fat distribution." It further states, "HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity, it does not increase fat losses beyond that resulting from caloric restriction. 6000 I.U. of HCG in a single injection resulted in elevated testosterone levels for six days after the injection. At a dosage of 1500 I.U. the pharmatestosterone level increases by 250-300% (2.5-3fold) com-pared to the initial value. The athlete should inject one HCG ampule every 5 days. Since the testosterone level remains considerably elevated for several days, it is unnecessary to inject HCG more than once every 5 days. The effective dosage for ath-letes is usually 2000-5000 I.U. per injection and should-as al-ready mentioned-be injected every 5 days. HCG should only be taken for a few weeks. If HCG is taken by male athletes over many weeks and in high dosages, it is possible that the testes will respond poorly to a later HCG intake and a release of the body's own LH. This could result in a permanent inadequate gonadal function.

HCG can in part cause side effects similar to those of injectable testosterone. A higher testosterone production also goes hand in hand with an elevated estrogen level which could result in gynecomastia. This could manifest itself in a temporary growth of breasts or reinforce already existing breast growth in men. Farsighted athletes thus combine HCG with an antiestrogen. Male athletes also report more frequent erections and an increased sexual desire. In high doses it can cause acne vulgaris and the storing of minerals and water. The last point must especially be observed since the water retention which is possible through the use of HCG could give the muscle system a puffy and watery appearance. Athletes who have already increased their endogenous test-osterone level by taking Clomid and intend subsequently to take HCG could experience considerable water retention and distinct feminization symptoms (gynecomastia, tendency toward fat de-posits on the hips). This is due to the fact that high testosterone leads to a high conversion rate to estrogens. In very young ath-letes HCG, like anabolic steroids, can cause an early stunting of growth since it prematurely closes the epiphysial growth plates. Mood swings and high blood pressure can also be attributed to the intake of HCG.

HCG's form of administration is also unusual. The substance choriongonadotropin is a white powdery freeze-dried substance which is usually used as a compress. Each package, for each HCG ampule, includes another ampule with an injection solution containing isotonic sodium chloride. This liq-uid, after both ampules have been opened in a sterile manner, is injected into the HCG ampule and mixed with the dried substance. The solution is then ready for use and should be injected intra-muscularly. If only part of the substance is injected the residual solution should be stored in the refrigerator. It is not necessary to store the unmixed HCG in the refrigerator; however, it should be kept out of light and below a temperature of 25* C.

HCG is a relatively expensive compound. It costs approx. $36 -45 for 3 ampules of 5000 I.U.

Newbies Research Guide reference

HCG, or Human chorionic gonadotropin , which is derived from the urine of pregnant women, is an injectable drug available commercially in the United States as well as many other countries. Pregnyl, made by Organon, and Profasi, made by Serono, are FDA approved for the treatment of undescended testicles in very young boys, hypogonadism (underproduction of testosterone) and as a fertility drug used to aid in inducing ovulation in women. Among athletes, HCG is used to stimulate natural testosterone production during or after a steroid cycle which has caused natural levels to be reduced. Stopping a steroid cycle abruptly,especially when endogenous androgens are absent, can cause a rapid loss in the athlete’s newly acquired muscle. When HCG is used to stimulate natural production, a notably pronounced crash may be avoided. Although fakes are not very common, they do exist and should be avoided. More than one athlete has reported unpleasant side effects (fever, aches) due to an un-sterile fake so take caution. HCG is always packaged in 2 different vials, one with a powder and the other with a sterile solvent. These vials need to be mixed before injecting, and refrigerated should any be left for later use.

References

Wlliam Llewellyn (2011) - Anabolics
L. Rea (2002) - Chemical Muscle Enhancement Bodybuilders Desk Reference
Anabolic Steroid Guide
Newbies Research Guide

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