WHAT SHOULD HCG/PALEO USERS CONSIDER AS ADJUNCTS?

READERS SUMMARY:

ARE THE SUPPLEMENTS FOR THE LEPTIN RESET DIFFERENT FOR HCG USERS?
WHAT ARE THOSE SUPPLEMENTS?
WHAT DO THOSE SUPPLEMENTS DO?
WHAT SHOULD HCG USERS CONSIDER OVER A STANDARD PALEO/PRIMAL TEMPLATE?

I decided to add this post for the many readers I have that use HCG. To say that I have been inundated with emails about this topic would be an understatement. I think from my public comments at MDA and PaleoHacks about HCG, people have wanted to know a bit more about why HCG patients react differently than a regular paleo patient would. I think is best explained by the following example. Patients given coumadin by their doctors have to be treated differently for osteoporosis in my clinic. Most of you know I no longer use the bisphosphonate drugs as a first line treatment for this condition. So if a patient is on coumadin, I cannot offer them high dose Vitamin K2 therapy because coumadin depletes vitamin K as a side effect of its mode of action. This why so many people on long term coumdin treatment suffer from dystrophic calcification of their arteries in their aortic tree and coronary vessels while simultaneously having extreme osteopenia. So these patients need to be managed differently. HCG patients have to be handled differently than an obese patient as well for but different mechanism.

I have been very flattered by the many patients and readers of my blog that have posted their results in the monster MDA thread marrying a paleo/primal lifestyle with my Leptin Rx. One of my patients informed me there was also a big thread over at another web forum of people who use HCG with a paleo template. One of those people happens to be an author who is a friend of mine of FB. After reading the thread in total and seeing the many questions they had I decided last night to put something together for them as well. The HCG diet is very controversial in the medical profession and in the paleo world. This blog is not about to discuss whether or not the diet is “total WOO WOO” or not. As a practicing physician, my job is to take care of patients with what they bring to me as they walk through my clinic door. Many of my own patients in Nashville have confided to me that they too decided to give HCG a whirl before they came to see me. In fact , one of my family members, who is a healthcare practioner, now works with a group of physicians who use the HCG diet in their practice. I get many questions from that group of physicians as well. I get asked tons of questions by the lay public and my referral docs about the diet and what I think about it. Recently, I even spoke to a group of ICU nurses in a local hospital about the diet’s pro’s and con’s. My job as a physician is to listen to my patients and then treat them in the best fashion possible. When a person comes to me overweight or with a smoking history I do not ostracize them and refuse to treat them because they maybe impacting their health in a detrimental way. I look at HCG in the same light. People who opt for HCG have usually struggled with obesity and body composition issues for a long time. They want help and are ready to change. These characteristics make them favorite patients because they are ready for real change to occur.

Many of them have found when they come off HCG weight loss gains are tough to keep unless they do some very specific things. The things I have recommended to this group of patients is quite a bit different then I would recommend to a person who has no history of HCG use. Once one comes off the last round of treatment, it is critical that you adopt a paleo/primal template quickly and use the Leptin reset Rx that I outlined in the my blog post. Timing of meals is more critical for an HCG user than the food fuel source macronutrients ratios. Most people on HCG can use the “protein method” of controlling the incretin hormones from the gut like PYY, agouti, and gherlin, but I find that the addition of MCT to work best for them. This is why coconut oil is often added to the BAB outlined in the Leptin Rx blog, when cravings or hunger return. It completely obliterates them via the afferents from the vagus nerve that connect parts of the brainstem with the hypothalamus. So todays post is for my readers who have chosen a different path to conquer a disease that has taken something dear from them……..their health.

If I can answer any questions about these supplements please let me know. I blog to help people who want help. I don’t judge people who decide to take their health care decisions and make them their own. I am here to help guide you through the land mines of bad health to get back to optimal.

1. Pinolenic Acid: Recent research has shown its potential use in weight loss by curbing the appetite. Pinolenic acid causes the triggering of two hunger suppressants—cholecystokinin and glucagon-like peptide-1 (GLP-1). Pinolenic acid may have LDL-lowering properties by enhancing hepatic LDL uptake. Cholecystokinin is recognized to suppress appetite in humans. When a partially digested meal rich in fats or proteins leaves the stomach to enter the duodenum (the first portion of the small intestine), the duodenal mucosa cells secrete CCK. In turn, CCK stimulates the pancreas to secrete numerous enzymes to help digest food. CCK also acts on the gallbladder to stimulate the release of bile into the small intestine, which helps to emulsify and break down fats. Most important to appetite control, CCK acts to slow gastric emptying and to promote a feeling of fullness, thus suppressing further food intake. Glucagon-like peptide-1 is another hormone that is intimately connected with fullness and satiety. Produced in the small intestine in response to fat and carbohydrates, GLP-1 works in part by activating the “ileal brake” mechanism. This slows down the absorption of food in the gut, promoting feelings of fullness and satiety, and therefore limits the desire for further food intake. GLP-1 also helps to control the health of pancreatic beta cells, which serve the crucial function of manufacturing insulin in the body. Abnormal beta-cell function plays a key role in the development of insulin resistance due to intracellular Magnesium deficiency , and scientists believe that therapies that boost GLP-1 levels could help to favorably alter the course of diabetes.

CCK and GLP-1 are key hormones for appetite control and satiety, and scientific studies show that these two hormones exert effects in combination that are more powerful than either alone (synergistic effects). Studies of normal-weight and obese subjects have shown that GLP-1 and CCK reduce feelings of hunger and decrease voluntary food intake at meals.

2. Pycnogenol: inhibits key triggers of inflammation. In 2000, it was first discerned that Pycnogenol works on a genetic level by suppressing activation of a genetic master switch, called nuclear factor-kappa B, which regulates expression of more than 300 genes that promote an abnormal inflammatory response. In a 2006 study on seven healthy human volunteers, 200 milligrams a day exerted anti-inflammatory effects, apparently by inhibiting pro-inflammatory gene expression. It is a potent blocker of series two prostaglandins (excessive omega 6) that can cause leptin resistance to develop at the SOCS3 receptor site of leptin in the brain.

Pycnogenol boasts more than 220 published studies over the past 35 years. In 2008 alone there were three published studies in the peer-reviewed literature for osteoarthritis. In one, 100 milligrams per day of the ingredient decreased the use of anti-inflammatory drugs by 58 percent (which led to a 63 percent decrease in gastrointestinal irritation, versus no change in the placebo group), lowered levels of HS-CRP, cut patient pain and increased patient walking distance. This is a drug I use myself because of my knee injury.

On the cardio front, it specifically enhances circulation, reduces cholesterol, controls blood pressure and protects against heart infarction and stroke. In one study amongst people with borderline hypertension, eight weeks of taking Pycnogenol led to diastolic blood pressure dropping from 139.9 to 132.7.

3. Green Tea extract: Green tea extract boosts the “resting” metabolism by inhibiting an enzyme called catechol-O-methyl transferase (COMT) that breaks down norepinephrine, an adrenaline-like hormone that sustains energy production. This action helps to burn more calories for fat loss. HCG is a low calorie diet that uses hypothalamic modification to try to increase weight loss. In a large clinical trial, a patented green tea phytosome extract produced exceptional weight loss in obese individuals. Supplemented subjects lost almost 31 lbs over 3 months, while controls lost just 11 pounds! Both groups followed a low calorie diet. This study is particularly interesting for HCG patients. Green Tea is also loaded with ECCG a potent antioxidant that is also a potent aromatase inhibitor. This keeps the sex steroid hormones at a higher level supporting HDL levels in the liver to improve endotoxin clearance and decrease plasma oxidative potential (sdLDL). Green Tea also slows down the effect of the enzyme lipase in the gut. This helps slow the absorption of fats. I drink on average close to 1-1.5 liters of green/black tea daily with coconut oil melted in it.

4. Kelp: is potent inhibitor of amylase and another digestive enzyme called alpha-glucosidase. It also lowers BG and it helps thyroid function by increasing dietary Iodine levels.

5. CLA: is found in grass fed meats and raw dairy products. A study that showed a dose of 3.4 g CLA per day for 12 weeks seems to be sufficient to reduce body fat mass (BFM) significantly in overweight and obese humans

6. Curcumin: The active compounds in turmeric known as curcuminoids are potent phytonutrients that contain powerful antioxidant properties, showing activity as much as 300 times greater than that of vitamin E. The main curcuminoid, Curcumin helps to counteract the damaging effects of free radicals in the body, exerting extraordinary liver protection to aid in weight loss lowering IL6 and TNF alpha. I really like curcumin when it is mixed with raw black pepper in cooking because it increases its effectiveness by ten fold when taken in tandem. This powerfully lowers your HS CRP and serum ferritin levels. I use this in supplement form myself and use the spice turmeric on just about every meal I eat.

7. Resveratrol: increases mitochondrial biogenesis leading to increased exercise endurance and protection from diet induced obesity. Resveratrol increases SIRT 1 and has wide effects all over the our genome. It activates many epigenetic switches that control fat and protein metabolism favorable for weight loss. Resveratrol effects were shown to be mediated through the SIRT1 gene and mTor pathways and PGC-1a pathways. Many people who are LR complain of losing muscle mass while on the HCG diet. This is because they are profoundly LR and they are not stimulating the AMPk pathway because of how the diet is constructed. Resveratrol helps modulate this when calorie reduction is occurring. Anyone who is a neurosurgical patient of mine or a FB friend already knows how I feel about Resveratrol. I take large amounts this supplement myself because of the myriad of good things it does to our biology. In a recent study from the American Journal of Clinical Nutrition , resveratrol was shown to: inhibit preadipocyte proliferation inhibits preadipocytes’ maturation into mature adipocytes stimulates glucose uptake inhibits de novo lipogenesis cause a down regulation of the inflammatory cytokines IL-6, TNF-alpha, NF-kB, and IL-8 (IL-8 is proatherogenic- enhances CAD) Resveratrol increases production of rhBMP2 to increase bone mass which is important for leptin resistant patients with obesity, high cortisol levels or those with anorexia.

8. Pregnenolone: replacement to support poor steroid genesis that is common in HCG users. Pregnenolone falls dramatically in two states. Aging and in leptin resistance. The fall in LR is due to excessive sympathetic outflow from the the brain due to stress. This stress often translates to increase amounts of adrenal fatigue seen in these patients. If you remember my Hormone 101 blog I said there that LR leads to adrenal resistance given enough time. Pregnenolone converts into DHEA and progesterone. DHEA does not convert into progesterone, rather it converts into estrogen and testosterone. It can also convert to cortisol as well so this dose needs to be done with salivary levels and the care of your doctor. Without context you can make some errors in dosing.

9. Vitamin E: Is useful in preventing lipid peroxidation. Fats are very sensitive to oxidation and this is the antidote to this. Its major effects for weight loss are in being a powerful reducer of HS CRP which reduces many of the inflammatory cytokines associated with leptin resistance development. For those who have been on multiple rounds of HCG I also think adding high dose alpha lipoid acid is prudent to this regimen as well. I usually will have multi rounders use 600 mgs three times a day.

10. Chromium picolinate: works by increasing peripheral tissue to insulin. This allows for more AMPk pathway signaling that increases your body composition as you lose weight. Some claim it curbs appetite but I do not find this to be a major benefit. It also is very helpful in shredding weight when it is used with coconut oil and Vitamin K2. This is a method that body builders also use. If you are new to HCG then you can get away with 200 mcgs a day but if you are a frequent user of HCG I would use that dose three times a day. Chromium is synergistic when used with L-arabinose. It is a non absorbable sugar the blocks sucrase digestion and works quite well when paired with chromium to lower blood sugars and HbA1c.

********All HCG users should seriously consider high dose PQQ use while using HCG (not homeopathic HCG)

CITES:

Peng Q, et al. Pycnogenol inhibits tumor necrosis factor-alpha-induced nuclear factor kappa B activation and adhesion molecule expression in human vascular endothelial cells. Cell Mol Life Sci 2000 May;57(5):834-41.

Belcaro G, et al. Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects. Phytother Res. 2008 Apr;22(4):518-23

Stoffers DA. The development of beta-cell mass: recent progress and potential role of GLP-1. Horm Metab Res. 2004 Nov-Dec;36(11-12):811-21.

Paquot N, Tappy L. Adipocytokines: link between obesity, type 2 diabetes and atherosclerosis. Rev Med Liege. 2005 May;60(5-6):369-73.

Christophe J. Is there appetite after GLP-1 and PACAP? Ann NY Acad Sci. 1998 Dec 11;865:323-35.

Flint A, Raben A, Astrup A, Holst JJ. Glucagon-like peptide 1 promotes satiety and suppresses energy intake in humans. J Clin Invest. 1998 Feb 1;101(3):515-20.

Gutzwiller JP, Degen L, Matzinger D, Prestin S, Beglinger C. Interaction between GLP-1 and CCK-33 in inhibiting food intake and appetite in men. Am I Physiol Regul Integr Comp Physiol. 2004 Sep;287(3):R562-7.

Marx J. Cellular warriors at the battle of the bulge. Science. 2003 Feb 7;299(5608):846-9.

Brennan IM, Feltrin KL, Horowitz M, et al. Evaluation of interactions between CCK and GLP-1 in their effects on appetite, energy intake, and antropyloroduodenal motility in healthy men. Am I Physiol Regul Integr Comp Physiol. 2005 Jun;288(6):R1477-85.

Diepvens K, Westerterp K R, Westerterp-Plantenga MS. Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea. Am J Physiol Regul Integr Comp Physiol. 2007 Jan;292(1):R77-85.

Lipids. 2001 Aug;36(8):773-81.

Lee JW, Lee KW, Lee SW, Kim IH, Rhee C. (April 2004). “Selective increase in pinolenic acid (all-cis-5,9,12-18:3) in Korean pine nut oil by crystallization and its effect on LDL-receptor activity”. Lipids 39 (4): 383-7.

Comments

  1. Why does Pycnogenol have to be from a FRENCH pine tree? We have tons of pine trees in Florida … I could make a fortune! (not to mention getting the benefits free by just gnawing on local pine bark)

    But, seriously, THANK YOU, Dr. K for the information. It's kind of you to think of HCGers and ways to help us specifically.

  2. Also, I'm assuming these are in addition to your other top 10 … and if a person can't afford all 20 at one time, which 10 should we be looking at first?

  3. HI Jack, you've mentioned resveratrol many times in your articles, but there seems to be a controversy around it.

    Stephan Guyenet, for example, thinks that it has a hermetic effect. Is that a concern for you and why?

    http://wholehealthsource.blogspot.com/2011/02/pol

    The main point is that the body does not seem to "want" polyphenols in the circulation at any appreciable level, and therefore it gets rid of them pronto. Why? I think it's because the diversity and chemical structure of polyphenols makes them potentially bioactive– they have a high probability of altering signaling pathways and enzyme activity, in the same manner as pharmaceutical drugs. It would not be a very smart evolutionary strategy to let plants (that often don't want you eating them) take the reins on your enzyme activity and signaling pathways. Also, at high enough concentrations polyphenols can be pro-oxidants, promoting excess production of free radicals, although the biological relevance of that may be questionable due to the concentrations required.

    • @Anna I think SG comments must be taken in context. In my opinion, he never put them in a proper context. The best data on resveratrol is coming out of labs he never he mentions. (David Sinclair, Lenny Guarrente, and Mary Lisani.) I feel the same way over food reward. For a perfectly healthy person there is some data out of the Mary Lansari’s group that this could be the case but no one knows for sure. The one thing that is clear is that resveratrol has some amazing effects at the hypothalamic level in Sirt 1 pathways, mTor, and AMPk pathways to augment leptin’s biological function. That is why I recommend it. I treat people first and foremost. I don’t base my entire clinical moves on some papers alone. I see many so called paleo MD’s rush to support the latest blog post on someone opinion of a paper or a book. To me medicine is practiced in the crucible of the clinic. Can you help them now without hurting them. I think eventually people will realize that there is difference between those who practice what they preach and those who write about what they read. Patients will determine who is wrong or right……not a writer.

      All research has pro’s and con’s, both clinical and bench top. In the paleo blogosphere we constantly hear about the bad of clinical medical research but we rarely hear of the horrible academic research being done just so many can keep a job.

      Researcher’s work at a very detailed level and they tend to lose the big picture fast. Doctors work 180 degrees opposit this. We work from a bigger picture view down to their level. Mistake are made from both optics. This community tends to focus on just the pitfalls of medicine and not its own. Robb Wolf said it best. Paleo has no chance of a tipping point until clinical medicine buys in. Why? Its where the rubber hits the road and this pisses off the many in the community in my opinion. My focus from here on is to to stay on the clinical side.

      This is why I have criticized some in our community for making rec’s on issue when they dont treat people clinically. This may sound bad to some……but it is a critical distinction. Be critical but do something about it. We have MD’s in this community who know the science is behind us and they are playing armchair QB from the computer. I say do somethign to help people now. Patients are calling my office and emailing me like mad because I have been willing to go where they wont or cant. I think patients have to do their due diligence when they decide what to do. I have an open mind on all things. As a surgeon I always suggest another opinion. surgeons often disagree with other doctors but it seems in the paleo world that is looked at with a tainted view. I’m sorry. I call Bullshit on that. I will let patients decide if I am wrong. They are my customer. Not another doctor or a researcher. I love reading what others are thinking. But it does not mean I am buying everything they sell. I use my thoughts and my expertise to think about issues.

      I find that people tend to make better decisions when they have their own skin in the game. It tends to broaden their view of the situation. Medicine’s does not work like science and in the paleo world this distinction is blurred by some of it luminaries. It is an art meshed with the science we know. But there are no proof’s in medicine contrary to what some bloggers would have you believe. I think when patients come to a practitioner and see it live and how we think about things they can make a decision and go from there. Once a researcher makes that leap and treats somebody from start to finish…….I will be all ears. I am held to pretty strict standards in my own world. I think they seem to forget that. Patients who have come to see me have left many comments on my blog and elsewhere about how I go about things. Recently I have called a “quack”. When you have a differing opinion the CW mindset does that. I take all comers on my blog posts. I let patients ask me anything they want. I answer them all. Patients have started monster threads on other peoples sites and posted their results as well. PATIENTS WILL DECIDE WHOSE OPTIC IS REASONABLE WITHIN A GIVEN CONTEXT.

      I soon will have patients telling their stories on my blog. We will see how my quackery works in the clinic. you will hear from other MDs I have treated. You will hear about children who have become rockstars athletically. You will hear about mothers with 3 kids getting a six pack.

      Soon I am going to be posting very specific cases of what worked well in a clinical setting that is very at odds with much of the theories of researchers. I get paid to get people well……not to do it by the guides of some research paper done on a mouse micronutrient ratio. All that being said…….I use a ton of resveratrol and there is no good data to say what I am doing is wrong. My job is to do no harm first. My patients are the arbiter of this not a benchtop researcher or an arm chair MD.

  4. Cú Chul says:

    "I drink on average close to 1-1.5 liters of green/black tea daily with coconut oil melted in it."

    How do you feel about adding cloves, allspice, ginger etc. to tea?

  5. Doc, thanks for this list I`ve posted a link for other hcgers to see and benefit from your knowledge and willingness to help!

    personal question regarding the use of the curcumin. you indicate it drops hs crp and serum ferritin levels, my hs crp tested at 12.2 mg/L (Cdn lab range <5.0 mg/L) and serum ferritin was most lately tested at 220 ug/dl down from 283 ug/dl…however serrum iron is 13 umol/L UP from a previous draw of 7 umol/L (range 10-33 umol/L). the serum iron only rose after 8 month of eating beef 2x day and dropping Mg while on HCG (original serum iron draw was 8 umol/L and attempted regular supplementation with chelated iron just dropped my serum iron to the 7 and caused constipation)

    given the above would curcumin still be advisable?

  6. Doc, thank you for the great info. The Hcg diet requires 4 phases. I am in phase 2. Can I go straight to paleo from phase 2? Do I take the above suggested after the transfer or something different?

    Also, please comment on the good, bad and ugly of Astaxanthin.

    You are awesome! Thanks so much for your help!!!!

  7. Brian Kerley says:

    I have a friend that had a dog named Cú Chulainn. Thanks for making me smile remembering such a great dog.

  8. @Lynn you can exit it and go straight to paleo at any step. Remember it is not Unusual to gain weight at the exit but the reset will allow you to keep it off and kill all your cravings and hunger too while it is going on.

  9. How much green tea is in "1-1.5 litres". Assuming fresh crushed green tea leaves, how many tbsp would be optimal?

  10. "@Kaleein Nope. These are HCG's top ten……the only cross over is PQQ."

    What a relief! THANKS!

  11. Cú Chul says:

    sure, the hound of Cullan

    should also make you think of this, Brian–

    http://www.youtube.com/watch?v=TmzivRetelE

    Dr. Kruse, may I ask how you deal with keen hunger during leptin reset? Art DeVany says eat fruit when you are hungry, or BCAAs–coconut oil does not seem to satisfy my appetite like those do

    I guess a bigger breakfast is called for…

    • @Cu Chulainn I have never had hunger in 5.5 yrs using my protocol. I think there are enough patients now who have done this……I hope some post here and tell you what their experiences are. If you do this……hunger vanishes completely. It makes Ifing a natural way to live.

      For me personally, when I miss a meal because my job is not amenable to perfect hours, I keep a jar of coconut oil in my locker at work and the office and one in my trunk. If I miss I get a cup of coffee and put two or three massive table spoons in it and drink it up. I also use macadamia nuts as a third back up. Hunger is just not part of my life any longer.

  12. Who are the most powerful people in American medicine today?
    http://www.kevinmd.com/blog/2011/09/powerful-peop

    Of course, the American People are the most powerful.

    Almost everyone I know considers the American healthcare system to be a horrible mess, although some that are deeply into it are quite happy with it. It serves their interests well.

    Many do have big-time power.

    There are lots of candidates for the "most powerful" title.

    How about Regina Benjamin, the Surgeon General of the United States Public Health Service?

    Maybe Kathleen Sebelius, the Secretary of Health and Human Services?

    Consider Howard Koh, the Assistant Secretary of HHS for Health.

    Many would name Donald Berwick, who heads CMS, thus running Medicare.

    Could it be Walter Herger, the chair of the Subcommittee on Health of the Ways and Means Committee of the U.S. House of Representatives, or maybe Max Baucus, the chairman of the U.S. Senate Finance Committee?

    Or perhaps President Obama himself?

    Consider Francis Collins who runs the NIH, or Margaret Hamburg who directs the FDA, or Tom Frieden who is in charge of CDC.

    Outside government, how about Harvey Fineberg, President of the Institute of Medicine of the National Academy of Sciences?

    Or George Halvorson, the CEO of Kaiser Permanente?

    Or maybe the presidents or CEOs of the American Medical Association, the American Hospital Association, the Joint Commission, or perhaps United Healthcare or Anthem Blue Cross Blue Shield?

    Consider the dean of Harvard Medical School, or the editor of the NEJM or the JAMA, or the highly visible Dr. Mehmet Oz, or the New York Times' Gina Kolata, CNN's Sanjay Gupta, or Quackwatch's Steve Barrett?

    A pretty impressive list of candidates, I do believe. Which one or ones are the most powerful?

    Impressive though their individual and collective clout is, it is none of these powerhouses.

    The most powerful people in American medicine are every patient, empowered by the dominant ethic of patient autonomy; the authority to say Yes, or No, to anything.

    And it is every American physician, empowered by the dominant ethic of physician autonomy; the authority to say Yes, or No, to anything.

    When working effectively together in the professional relationship, the patient and physician must and can continue to be supremely powerful.

  13. Jack, well I don't know – green tea, litres is just the measure of the water, how much actual tea leaves goes into those litres?

  14. @Greg honestly I dont count I just have my wife make it and I drink it.

  15. Tina Leese says:

    Thank you Dr. Kruse. What is considered a high dose of PQQ?

  16. @Dex great link and it also is nice to see there are other MDs who get this.

    To change the profession we have to change the mindset.

    Other docs will not be able to change other docs because their ego's get in the way.

    I think patients are the change agents because they ultimately will select out who gets it and who does not

  17. “@maile Yes and in high doses“

    thanks doc, it`s added to the routine

  18. @ Dr. Patel I really deeply appreciate your email. The comments of quackery really did not hurt because I know where they came from. I hit a nerve and I got the expected response. We need more from those MD's who get the science but dont push the clinically on the follow thru. Dietary advice is often not enough. Right now I am afraid the impact from a blog is rather flat. When you treat and lay hands on people they get. No one really cares how much you know until they know how much you care.

    I am glad to hear that my writings are helping your patients. The best thing a physician can do is add value to others lives every day. It is the best form of compensation I know of.

  19. @Mary I am ecstatic to hear how you have done on the HCG/Leptin Reset protocol. Keep it up and make sure you post the results to the Leptin Rx blog. 3.5 months and 54 lbs is amazing.

  20. @Marj I am quite glad to hear that some neurobiolgist are following the blog! To answer your email in detail here goes…..Sirt1 regulates food intake through the central melanocortin signaling. It has also been shown that fasting (CRON) increases hypothalamic Sirt1 expression and decreases FoxO1 (Forkhead transcription factor) acetylation suggesting that Sirt1 regulates the central melanocortin system in a FoxO1 dependent manner. I also have another theory on this that will be coming out in the next big leptin blog down the road.

  21. @Herb I did read his blog when it came out. I always read it because he is a great thinker. Regarding his comment, "Reward, hedonic and homeostatic systems are in a tightly coupled CNS circuit, suggesting that they may reciprocally influence one another."

    This is total utter nonsense because there is not one paper in the world that shows any reciprocity. I said this specifically in my central leptin series and I maintain it. Moreover, if he were correct, considering how many craniopharyngioma's (or gliomas) there are in the world there should be some case reports of an tumor growing into the reward tracts showing unrelenting morbid obesity……..there is not one case report I know of. But there are hundreds of reports of morbid obesity of hypothalamic gliomas etc in the hypocretin neuron regions.

  22. @Phu Thanks for your email on resveratrol and Zinc. Zn directly participates in catalysis of histone deacetylase (HDAC) Classes I, II, IV enzymes while its role in HDAC Class III activity is not well established in the literature yet. The effects of Zn on the deacetylase activity of sirtuin 1 reveals the endogenous Zn, at the zinc-finger motif of SIRT1 is essential for the structural integrity and the deacetylase activity of SIRT1 is required but it appears that exogenous Zn actually has the opposite effect. This is why I did not list Zn in the top ten of this list. I am a big Zinc fan in the right context but I dont recommend it for HCG or eating disorders at all.

  23. First, thank you so much for taking hcg seriously and not simply dismissing it out of hand as "snake oil."

    I know you advocate the injectible form, but I've used the homeopathic form successfully. Starting this past January, I lost 35 pounds in just over 3 months, with nary any hunger at all. I did as well (if not better) than a lot of the folks who opted for the prescription injections. I hit my LDW (low dosing weight)on April 12, and have been able to stay within 5 pounds of that weight (up and down) since that time by eating Paleo. (I've been paleo for the most part since around 1998.) I would still like to lose around 15 more pounds of fat, and am on the homeopathic form of hcg now.

    So, I was very interested to see your recommendations for supplements. You did not, however, include dosing amounts for pinolenic acid, kelp, curcumin, reservatrol, or pregnenolone. (Or did I miss it?)

    Please clarify, if you would.

  24. @Bawdy Pinolenic acid is 2-4 grams a day in divided doses based upon level of cravings and hunger. Kelp is 250 -500 mcgs a day, Trans Resveratrol base dose is 500mgs but honestly of you can afford more you take more. Curcumin is 900 mgs twice a day, and pregnenolone has to be set by testing done with your doc. If you do it by yourself without testing one might consider 25 mgs a day if you are a women and 50 mgs a day if you are a male. And these supplements should only be taken when you are on the HCG dosing. Once you stop I think you can move to the regular paleo supplement list.

    Resveratrol and Green Tea really work because they are aromatase inhibitors and have major effects on mitochondrial function making us better fat burners.

  25. Great information. I have done HCG with the drops twice, then a round without the drops (never felt they helped anything), and maintained fairly well eating paleo in between. My problem was that I simply felt too ill on the 500 calorie diet.

    This past September I decided to create my own "Cavegirl In a Corset" plan where I combined the rules of HCG but ate 6 oz of protein per meal and whatever fruits and veggies I wanted. I did eventually get weak and tired (stopped today) but I managed to lose 17.2 pounds in 38 days. I read about your Leptin Rx today on lowcarbfriends.com and plan to use it to stabilize my weight losses. I've lost 85 pounds so far but still have another 30-35 to go.

  26. Thanks for clarifying the dosages for the supplements. I have to say, that's a LOT of supplements. I priced it all out, and it will cost about $200 for a one-month supply. Granted, I could probably find some things cheaper, but that's still a lot of money.

    I know it's best to do the entire regimen, but if you simply can't afford that much, is there maybe a Plan B? Maybe do just the first 3 to 5 supplements mentioned?

    I hate to be the one to say this, but some others are probably thinking the same thing.

    • @Bawdy you can do some or all. I think it depends upon your goals. IF you got 120 lbs to lose you best do it all to maximize your possibilities. If you are only doing this for maintance you might not need any.

  27. Pycnogenol: would you recommend this for atopic derm eczema suffers?

    How much coconut oil do you consume a day if you are using it in your gallons of tea?

    Thanks,

    • @Steve it is a reasonable thing to consider. Eliminating all grains and PUFAs have a much greater effect. If you do use it make sure you optimize your Vit D 3 and K2 as well. As for my use of coconut oil, it matters little because my context is different than yours. I go through close to a gallon in my household a month.

  28. Dr. Kruse, you are a breath of fresh air, indeed!

    Since I'm so close to goal, I think I might just opt for your list of the top 10 supplements rather than these. I take many from the top 10 list already, so will just be upping my game a bit.

    THANK YOU!!!

  29. Jack, thanks for answering resveratol question, I hope I didn't offend you, I just wanted to know your opinion about it. thank you again for answering.

  30. And I wish we had more practicing MDs doing what you do.

  31. @Cindy Take a look here. This should answer it.

    http://paleohacks.com/questions/43211/paleo-after

  32. Cú Chulainn, I've been doing the leptin reset for 11 weeks now. For the first week or so, I ate huge meals but unbelievably was still hungry in between. Then that stopped, and I was not hungry at all in between. So give it some time.

  33. Jack Kruse is the Paleo Jack Bauer

  34. Cú Chul says:

    thanks, Owl

  35. There is another group of HCG users.

    Hypogonadal males.

    Hypogonadal male, when treated with testosterone only, will have his testes athrophy (depressed LH & FSH).

    To prevent testicular athrophy HCG injections are used.

    Depending on a protocol

    from two 500iu injections weekly to 700iu/EOD

    so 1000 – 2500iu/week

    this is life long protocol.

    Indeed poor steroid genesis is common, not sure if resulting only due to HCG use.

    Dr K, are you considering discussing Lipid and Steroid Hormone Panels in aging men and women?

    ….

    Note

    other than natural HCG there is also

    recombinant human chorionic gonadotropin (r-hCG)

    available under name Ovidrel.

    • @JanSz Im well aware of these males and yes I have several in my own practice. They have HPA issues related to trauma, tumors and in most cases due to propecia and avodart. Some others are related to exogenous steroid use as well.

  36. I had used HCG as part of my HRT treatment. For many years I had low HDL and low total CHOL (<110). Eventually pregnenolone, DHEA-S, and Progesterone bottomed out.

    Now that I've stopped HCG usage my HDL and Total CHOL has normalized. I'm waiting to see what happens with my adrenal hormones.

    Dr. Kruse, does it make sense that chronic HCG usage could lower total CHOL, resulting in a lack of raw material for steroid hormone production? Essentially, HCG usage could cause a Preg Steal?

    And why would this happen in some but not others?

    Thanks

    • @Dru The fate of cholesterol on the current version of the HCG diet is unknown because I dont believe it has been studied well. To gain some insight we can look at pregnency where HCG is high. One of the consequences of high HCG production in pregnant women is higher levels of free cholesterol in circulation. We know that LDL cholesterol is the substrate for all steroid hormone construction but it depends upon T3 levels and vitamin A levels. So if one has a lot of backround cellular inflammation that excess LDL cholesterol may not be fully utilized. I think a big problem with HCG is that many do not supplement to lower their inflammatory profiles to help this issue. I think many stalls and plateaus occur because of this. I do not prescribe HCG, but the docs who do rarely talk to the patients I see about this issue. I am not sure why either.

  37. Steve it is a reasonable thing to consider. Eliminating all grains and PUFAs have a much greater effect.

    I have not eaten grains for years,except once a week white rice intake in last year or so. Skin health no different before or after the rice eating time period. I take D3 and K2, but need to check D3level which was last around 50. Only PUFA intake via fish,olive oil,avocado, and some white meat turkey breast or chicken. Only starch i eat is in the form of potatoes, and other non veggie carbs via some berries. Eczema is very weather dependent for me; the less humidity the worse it gets.

    • @Steve You may eat well and think they are all good things but if you have a persistent problem then maybe testing gets to the bottom of it. I would look into the O6/3 ratios.

  38. Thanks Doc for posting this blog… it will be VERY useful.

  39. Christine says:

    Thank you Dr. K!

    For those of us battling massive hair loss while on HCG, what do you recommend? First round I had fantastic hair, nothing in the drain. Then in P3 and now 3 weeks into my second round nothing seems to be helping. I am taking:

    – iron

    – silica

    – MSM

    – biotin

    – regenemax: with choline and silicon

    what is really scary is the history of female hair loss in my family.

  40. Hi Dr. Kruse.

    Thank you for a fantastic article on HCG and Paleo. I've just come off of HCG right into paleo and I am certain that it is Paleo that made the transition into the VLC portion of HCG seamless.

    I noticed near the end of your article you make this statement: "All HCG users should seriously consider high dose PQQ use while using HCG (not homeopathic HCG)" Why "not homeopathic HCG"? That is the form of HCG I've been using with great success and have been interested in PQQ ever since you wrote about it. Is it a problem for homeopathic HCG users?

    Thanks!

    Lila

    • @Lila Homeopathic HCG does not do much to the hypothalamus so its not mandatory. Personally I think PQQ and Vitamin K2 will be the next big things in the world of evolutionary medicine.

  41. Cú Chul says:
    • @Cu Chulainn I think this line in the article says it all, "And it is difficult to control for all other factors, like general physical health, that might have influenced the findings." If you cant control for this you can't reach that conclusion. Very bad study design that will only confuse people. I will still take my supplements without worry.

  42. @Kaleein: Here's more than you wanted to know about the tree:

    Pycnogenol is derived from French pine trees only because the scientist that discovered it was French himself and was likely sourcing the bark from the local trees. "Jacques Masquelier (aka Jack Masquelier, born in 1922 in Paris, died 24 February 2009) is a French scientist. He is the discoverer of oligomeric proanthocyanidins or OPCs. It was Masquelier who first developed techniques for the extraction of proanthocyanidins from certain plant species." http://en.wikipedia.org/wiki/Jacques_Masquelier

    "Pinus pinaster, the Maritime Pine, is a pine native to the western and southwestern Mediterranean region. The range extends from Portugal and Spain north to southern and western France, east to western Italy, and south to northern Morocco, with small outlying populations in Algeria and Malta (possibly introduced by man). It generally occurs at low to moderate altitudes, mostly from sea level to 600 m, but up to 2000 m in the south of its range in Morocco.

    Pinus pinaster is widely planted for timber in its native area, being one of the most important trees in forestry in France, Spain and Portugal. Landes forest in southwest France is the largest man-made maritime pine forest in Europe. It has become naturalised in parts of southern England, South Africa and Australia. It is a serious pest in parts of South Africa, where it is called the cluster pine." http://en.wikipedia.org/wiki/Pinus_pinaster

    However, the pinolenic acid that is the base material used in the production of the patented extract Pycnogenol is a fatty acid that's also found in the Korean Pine nut and the seeds of other conifers of the genus Taxaceae. The **highest** percentage of pinolenic acid is found in Siberian pine nuts and oils, not the French pine.

    Also, "proanthocyanidins (from which Pycnogenol is derived) can be found in **many** plants, most notably apples, maritime pine bark, cinnamon, aronia fruit, cocoa beans, grape seed, grape skin (procyanidins and prodelphinidins),[2] and red wines of Vitis vinifera (the common grape). However, bilberry, cranberry, black currant, green tea, black tea, and other plants also contain these flavonoids. Cocoa beans contain the highest concentrations.[3] Proanthocyanidins can also be isolated from Quercus petraea and Q. robur heartwood (wine barrel oaks).[4] Açaí oil, obtained from the fruit of the açaí palm (Euterpe oleracea), is rich in numerous procyanidin oligomers.[5]

    **Apples contain on average per serving about eight times the amount of proanthocyanidin found in wine, with some of the highest amounts found in the Red Delicious and Granny Smith varieties.[6]

    However, "the patented extract of maritime pine bark called Pycnogenol bears 65-75 percent proanthocyanidins (procyanidins).[7] Thus a 100 mg serving would contain 65 to 75 mg…." http://en.wikipedia.org/wiki/Proanthocyanidin

    So much for your ideas about fortunes, apparently the stuff is fairly common, even just by eating an apple.

  43. Dr. Kruse,

    Yes, none of my prescribing docs educated me in regards to proper supplementation to control inflammation. As such, I am currently trying to dig myself out of a hole.

    My cholesterol numbers have normalized since discontinuing HCG. Vitamin A was low but has now been brought up to decent levels with 60,000 IU's of supplemental Vitamin A (retinyl palmitate).

    T3 seems to be my sticking point. I cannot convert Synthroid and I cannot tolerate Cytomel.

  44. @dru. There are other options outside of cytomel. Talk to your doc about different formulations, natrualthyroid, mexican T3 sources you might tolerate, compounding pharmacies, or even glandulars. Dont give up. Keep your resolve strong. The best news i can tell you is that when most become LS their thyroid hormonrs generally slide back into balance. Only hashimotos patientsntend not to fit thst bill. This is a generalization of course but you should keep doing what you can.

    Natural dessicated thyroid to titrate with your thyroid symptoms or high reverse T3 is also a consideration. Ask your doc about these options.

  45. Thanks for the encouragement, Dr. Kruse.

    I've tried the natural thyroid combos with no success. I'm thinking it's an autoimmune situation and that's something I'm currently looking into with my doc. Rest assured I'll keep plugging away and researching as much as I can…your blog and Q&A is a tremendous resource. Thanks.

  46. Doc, any interactions between any of these supplements and grapefruit? I ask, because one of the fruits you can have on the HCG diet is grapefruit, and I know that it can slow down how some substances are metabolized by the liver.

  47. Dr K,

    I am one of those lucky guys who took propecia and got hammered. I have been on HCG in the past but am now on clomiphine. Any idea if clomiphine users should follow the same protocal as HCG users?

  48. John Mitchell says:

    When I get your RSS feeds to my mail box, they are in CAPITAL LETTERS.

    Can you change that? It means you are YELLING!!!

    All due respect,

    Dr. John

  49. Excellent!

  50. I don't even think this question belongs here but I've gotta ask because tomorrow I start the process of reversing all the crap I've done to myself. Q: If I had my gallbladder out and find that coconut oil causes problems for me (running to the restroom with 30 minutes), but bile salts and probiotics solvce the problem…would it be okay to take the two upon awaking and then start my cooking to get in 50 grams of protein with eggs cooked in coconut oil and bacon? (silly question but I worry the two supplements might somehow "mess" with me getting in the required protein). Thanks in advance.

  51. This is super helpful, Doc! I so appreciate you taking the time to help us. On the pregnenolone steal, I really think hcg did something to fix my issue. That was the only thing I did differently and not it's not getting stolen anymore.

  52. Hey, Doc. I was doing some reading about Astaxanthin, and it looks like even a low does reduces some marker of oxidative stress and reduces CRP concentrations after 8 weeks, but according to their chart the higher dose greatly increased cytokine concentrations of IL-6, which as we know plays a role in the pathogenesis of various diseases. They interpreted this as improved immune function, and they may well be right, but I wanted to know your take on it. I know it's simplistic to say that "IL-6 is bad", especially when CRP dropped and IL-6 was elevated, so I'm confused.

    Here's the paper and the chart

    http://www.ncbi.nlm.nih.gov/pubmed/20205737

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC28455

    • @Stabby IL-6 is not always a bad actor. There are times the body uses it for repair mechanisms in the correct context. When folks talk about IL6 most often they are speaking in terms of its negative connotations when it activates cytosolic NF kappa beta to translocate into the nucleus and cause all kinds of havoc. But let me give you an example of a good side of IL6. It would be in a patient who has sustained a massive head injury or suffering from sepsis. This patient would be unable to eat due to the injury. IL6 in this case like a number of pro-inflammatory cytokines, inhibits food intake (for review see Plata-Salaman, 1995). This allows for better autophagic repair to occur so the body can heal while it simultaneously upregulates the immune system to carry out the repair. IL-6 is mainly produced by macrophages, T lymphocytes and adipocytes. It exerts its inhibitory feedback on the body fat mass via hypothalamic leptin receptors. It also appears that IL 6 is critical in down regulating the thyroid function as a protective mechanism in injury as well. So as you can see……context is critical.

      In chronic disease states like Obesity there are also other hormone responses with chronic elevated IL 6 that push the metabolic machinery to disease. For example, in obesity chronic cortisol elevation is the rule and it is usually seen with higher insulin levels and high IL6. In this context IL 6 will kill you. This is why obesity is tied to neolithic disease generation like heart disease, diabetes, and cancer. When you think about human physiology you must consider multiple hormonal and signals that are acting in unison to get the desired result. Rarely is one hormone the causal link. Unless of course you are talking leptin.

  53. Aha, I get it now. Yeah I assumed that it was a context thing, and that makes sense since the immune system is responsible for healing. Thanks for the timely reply.

  54. @Maria Your email about Gallbladder disease and supplements and hormones is excellent. Here is your answer. One of the more serious side effects of this birth control is gallbladder disease. Why you ask? Because hormonal birth control increases the amount of cholesterol in the blood, nearly every hormonal contraceptive on the market carries with it some increased risk of gallbladder disease. Not only that but all hormones are cleared via the liver and are detoxed into the bile. The gallbladder collects bile and concentrates it by removing water. This increases the emulsifying power of the bile but it also concentrates the cholesterol and phospolipids with in it. If either of these things occur chronically, IE BCP's or a low fat diet, you will eventually get gallstones and likely have a general surgeon wanting to take out your gallbladder. The best way to avoid gallstones is to eat a diet high in fat and lower in carbs and try to not take exogenous synthetic hormones. This is why so many overweight women who are fertile get their gallbladders excised by the time they are forty! This is where that acronym came from! Basically, the excess concentrated cholesterol with lecithin cause stone formation. If you have your gall bladder out you can no longer emulsify the high fat diet well and you bloat and have gas. Then you must take bile salts replacements the rest of your life to eat the optimal diet that will keep you healthy. Anytime I hear a patient has had a gallbladder out I know they have eaten a lifetime diet that was low fat and high carb. This is the major cause of gallbladder disease in the USA. When combined with the fact that many types of birth control pills are detoxed via the bile, removing your gallbladder is the last thing you want to do. Change your diet to a very high fat paleo version and a very low carb version to reverse the effects in 6-12 months. I also recommend dumping all BCP's for this reason and buy some condoms. They wont hurt you like the lack of a gallbladder will on your quest to optimal. Great Question!

  55. @Beth The reason for Green Tea extract in HCG users are most of them have a damaged hypothalamus or leptin receptors at their adipocytes. The reason HCG may not have worked on you is your pituitary adenoma likely affected your dopamine levels in the brain.

    This in turn affects the amount of dopamine in their brains. We actually have a way to measure the dopamine loss clinically in something called a "blink test." People with pituitary tumors usually have something called a stalk effect due to a dopamine issue that affects the anterior pituitary releasing hormones. Patients with alot of blinking feel great and have high dopamine levels and those with tumors feel like shit and dont blink a lot.

    Green Tea has ECCG and it has a central effect of limiting COMT in the brainstem. This down regulation of COMT increases dopamine and increase the number of times we blink. It is a clinical marker we neurosurgeons use at times. Normal leptin function is required to make a normal amount of dopamine. So in obesity seen in HCG users I use this test quite often.

    Now the ECCG in green tea also is an aromatase inhibitor. Aromatase is the enzyme that converts testosterone into estradiol and androstenedione into estrone. Green Tea is a 5 alpha aromatase inhibitor. This decreases the conversion of testosterone to DHT and E2. If you read my Leptin FAQ blog it talks about have good nails, and skin when you pedicure…..Why? because this blocking effect improves skin tremendously by modulating the hormones in the skin (lowering DHT and E2 are good for skin and hair growth). Resveratrol and Quercetin do the same thing too.

  56. Julie Borchers says:

    Hi Dr. Kruse,

    Love what you are doing! This has been a tremendous help for quite a few folks. Currently have about 20 people @UH doing HCG protocol and many trying to follow your Leptin RX. Question for you, do your advise taking all HCG supplements while using HCG (Phase 2)?I was the OR RN Sup @CHNO while you were in your residency and remember you so well. If you are ever in NOLA and have some free time, the old crew would love to see you. Thanks for giving your time, energy, and ideas to the "hungry." Julie

  57. Dr. Kruse, I know you've discussed "Hcg uncouples Leptin" as a reason fat is released by the cells and folks do lose weight while dosing. There's still some confusion concerning what you mean by this. Let me see if I get this straight:

    1) Leptin in a healthy, Leptin Sensitive individual signals the brain when a person has eaten enough fuel and needs to burn whatever is an "overage" in the body. This happens automatically in a Leptin Sensitive person and they lose excess "fuel" literally overnight while they sleep.

    2) When one becomes Leptin Resistant, for whatever biochemical reason, those signals can't get to the receptors in the brain, they are "blocked" and a person begins to store fat in excess to its normal reserves rather than automatically burn them off. No amount of "diet and exercise" will remove the excess until they become Leptin Sensitive again.

    3) When a fat person doses with HCG (if they don't have pituitary damage as discussed above) that dosing in the specifically right amount (as we've discovered in Dr. Simeon's protocol) breaks that blockage up between the Leptin circulating and the receptors in the hypothalmus. The brain then actually receives the signal to stop storing and start burning the excess fuel (stored as fat).

    4) People who take the HCG often cannot maintain the weight loss. This is because once the dosing stops, the Leptin Resistance again kicks in to "block" transmission to the receptors in the brain and the body returns to storing rather than burning the excess fuel (fat).

    5) #4 will happen UNLESS a person will eat in a way that actually restores Leptin Sensitivity to the hypothalmus.

    Am I on the right track?

    A group of us doing the reset are trying to figure out how to discuss this intelligently with other HCG folks coming off their dosing and wanting to maintain their losses. We are encouraging the Leptin Reset to do this, but need to come up with a good answer as to WHY HCG would work if we are all Leptin Resistant (seen by our fat build up) when we begin HCG. ie: What actually happened to let HCG work when the old CICO "diet and exercise" didn't? Inquiring minds want to know.

    Some are under the impression they were NOT Leptin Sensitive and HCG messed them up. Others are sure the HCG helped them start the progress toward Leptin Sensitivy and the Leptin Prescription is putting the finishing touches on it. Still others lose well on HCG and can maintain perfectly without the Reset, and we aren't needing to even discuss this with them.

    Whatever camp they are in, we'd like to tell them in a nut shell how it all happened. Are my 1-5 points on track?

    • @Kaleein good question. The protocol outlined by Dr. S is designed as a short term weight loss to trick the hypothalamus into thinking energy status has changed and fat needs to be burned and mobilized. It dramatically changes the appetite so that one can sustain eating only 500 calories without hunger/cravings. It only works for a short period because leptin forces the issue eventually and all calories consumed after the protocol are kept for fat storage and not able to be burned. The real bad news for HCG folks is that this method, unless it is repeated and sustained, will ruin your body composition because it encourages fat storage and muscle wasting during the weight loss on protocol and off of it. The reason one needs to transition to a Leptin Rx is because it is designed to make leptin work with you and not against you by destroying you appetite by stimulating CCK while simultaneously supporting protein synthesis and increasing your fat burning slowly all the while as your cortisol is dropping. All these things occur simultaneously to allow your hypothalamus to undergo neuro-plastic enhancement to re-yoke you back to normal circadian cycles and not rely on the broken leptin receptor. Again leptin levels are useless. Many people do not seem to understand this. Once this is established and you have met most of the signs outlined in the leptin Rx then you can move to a new phase…….called the Leptin post-Rx. That post is coming in the future. It tells you precisely how to (slowly but effectively) optimal and change your body composition in a big way.

  58. MastadonBob says:

    Resveratrol got a rave writeup on ABC News this week for helping treat obesity. http://is.gd/01kujH

    In a rare moment of clarity, ABC emphasized that Resveratrol was not a substitute for exercise, but rather a supplement that assisted in weight loss.

  59. hmmmm … I'm not sure how HCG "encourages fat storage …" and also tricks the brain into fat mobilazation and burning. Fat mobilization we definitely see dramatically during and immediately following dosing! My rear disappeared like it has on NO other diet ever! Some lose that "hump" behind the neck that Dr. Simeon described. That said, I'm reshaping wonderously on the reset as well, btw, so I've now found

    And as for muscle wasting, many don't see that happen, actually. Once they stop dosing and begin eating a healthy diet they resume regular exercise. Many even keep going to the gym even during the dosing period and find no muscle wasting as measured on bod pods and such.

    Also, there have been thousands (per Colleen) who have done the HCG protocol and NOT had a problem stabilizing solidly afterwards and they resumed a normal, healthy life, so far as they know and can tell. Are they not as healthy, perhaps, as they think? Or, did losing the weight and eating the way they did during dosing and immediately after actually help their metabolism to get balanced and Leptin Sensitive within the 40 day dosing cycle plus 21 days of careful maintenance on a basically Paleo diet? Would that explain their positive outcomes if they had no other hormonal issues to resolve?

  60. "so now I've found" … a second miracle in my body's journey to optimal … The reset is reshaping me although I've lost very few pounds in relationship to the inches I've lost on the Reset. So thanks!

    Still need a "nutshell" or "elevator speach" if you will on how HCG worked but the reset is needed now. …

    • @Kaleein keep doing it and I promise you will get there. I just cant say how long without know a lot more variables. I was a train wreck and I did it so I know anyone can if they are willing to think differently about how to do so.

  61. … so "in a nutshell" I guess we could tell our folks …

    … "HCG tricks the brain into thinking our metabolism is 'normal' and once off HCG it will take careful eating for a while in order to regain Leptin Sensitivity so that we make 'normal' a true fact in our lives. Dr. Kruse's Leptin Prescription is one of the quickest formulas toward 'normal metabolism' after HCG dosing many of us have found."

    ???? ????

    • @Kaleein Its more complicated than that. Im trying to make it simple. What HCG does is temporarily cease cravings while allowing you to become a short term fat burner but it does not last. This is why you need to transition to a fat burning method and retrain your hypothalamus how to do it permanently.

  62. Dr. Kruse, Thank you so much for sharing your expertise with us! I feel like I'm a complete mess with adrenal problems, prior HCG user and about 20lbs overweight. I'm feel so uncertain as to where exactly I should start. I've spent hours reading your blog and while I'm totally excited I'm very hesitant of doing something wrong. Do you offer phone consultations or recommend Dr's in other areas?

  63. Dr Kruse, thank you for your great website, I'm totally addicted..

    Q: I am looking after my dear-dear friend who is 97, he had a CVA on his right in 2006 – he survived and even managed to walk a year or so, was pumped up with all sorts of meds incl statins and now he is bed bound of course .

    He was diagnosed with vascular dementia, he is blind (wet and dry MD) and also has enlarged prostate gland. He never drank alcohol, smoked and never been overweight, more like underweight boy. Which vitamins and supplements should he take to improve his life as doctors don't pay any attention whatsoever but he hasn't given up and I would really like to help him as much as possible. We have gone organic and I introduced coconut oil.

  64. I'm confused with the following:

    Kelp: is potent inhibitor of amylase and another digestive enzyme called alpha-glucosidase. Is amylase bad? I have Digestive enzymes supplement with amylase, protease, lipase and cellulase.

    • @Mart Is amylase bad? Nope The Leptin Rx purpose to move you from a sugar burner to a efficient fat burner. Limiting amylase by improving your diet is what i call allostatic reversion to the mean.

  65. Hi there

    I have adrenal faitgue, thyroid issues, gut issues and high mercury. I am treating all of these with bioidentical hormones, detoxing and probiotics, digestive enzymes and fibre. My diet is an elimination diet. No gluten or dairy. I am about 15lb overweight and I want to try the HCG or the leptin reset. What would you reccomend I do? HCG and then Leptin RX, or just straight out Leptin Rx? Would love your thoughts!! Thanks for all the info

  66. Here is a link to a hypothesis I've written (to the best of my ability) that might explain why eat such a small amount while on the hCG protocol improves metabolic rates and why symptoms of starvation do not occur. Since you are a real expert (I am not, just motivated). I would love your opinion. http://www.weightlossapocalypse.blogspot.com/2012

  67. Dr. Jack,I have done several rounds of HCG [ successfully] and am going for the Leptin reset. Which supplement set do you recommend, the HCG list or your other list. My last HCG was 5 months ago and I am within 10 pounds of my goal. thank you and AM delighted to have found you! [ and some of my HCG friends from years ago!]

  68. Are there other ways to stimulate CCK and GLP-1 in addition to following the Leptin Reset and taking Pinolenic Acid?

  69. Dr. Kruse, thank you for answering my post. The other issue is that I have a history of eating disorders, excess exercise, bulimia. I am staying the same weight but can't lose no matter what I do. With this information do you still recommend the Leptin postscript or should I do the Leptin rx. Thanks so much. Also really looking forward to the book!

    • @julia post Rx and I think you should have GI tract and blood accessed for toxins if you think you have them. It could be at the root of the gut issue. Most with an eating disorder have a leptin circadian incretin yoking issue…….

  70. Just to refresh you memory I am the one with the mercury, thyroid, adrenals and gut issues that is about 15lb overweight. I would alos be interesting in your take on toxicity. I believe I have a lot of this from not eating well. Can this block the cell receptors and damage the cells?

  71. wow thanks for the quick reply!

    I will do the post rx then :)

    I have a tendancy to overtrain from a past of being a professional sports person. With the fatigue I dont mind pushing through it.

    Would it be ok to do 3x lifting and 2x sprints per week with these issues?

    I appreciate your time. Thanks!

  72. also just to be clear, the post rx will fix the leptin circadian incretin yoking issue? I am trying to get my head around this

  73. great! any thoughts on the training?

  74. dr. kruse – firstly thank you for all of this. I have been resding and reading. My story is similiar to Julia in that I have a history of eating disorders – not eating enough, overexercise and some bulimia. I am not too much overweight probably about 15lb. I really watch what i eat to stay at this weight, eating primal and low carb, moderate protein and fat.

    My rev t3 was very high and I am on t3 hormone replacement. My CRP is low and consistently is. My cortisol test high in the morning and at night, despite apparently having adrenal fatigue (naturipath said this).

    I am wondering whether I should do the leptin rx or the post rx. What would you recommend?

    Looking forward to your thoughts!

    Thanks for all of your information.

  75. Is there any truth to the fact hcg causes the body to make more fat cells? It was suggested, this is the reason it's so easy to gain weight after doing a round of hcg.

  76. So, Dr.K I have been doing the reset for a while and need to lose more pounds so I am going to do a round of HCG and then move right into the LRX. My question is- Should I be taking these supplements during and post HCG or just post?

    I want to do this right this time. I have about 40 pounds to lose to be healthy and I am planning on continuing the Paleo style forever- no going back. I was 223 pounds before Hcg… I just can't stabilize. Well, that is until I found the LRX and then I did- but no losses.

    Thanks!!

  77. Ok, so I take that to mean that if I follow the Dr.S protocol (500 cal, specified foods and no fats) to a T except throw out the dairy and the grissini then I don't need the supplements while I am taking RX HCG.

    Then when I end RX HCG if I follow a strict Paleo (LRX style) eating plan to a T then I also don't need the HCG supplements at that time either, I would instead take the other top 10 list of supplements?

    OR are you saying that if my current diet- prior to HCG- is strict Paleo then I could not take them?

    I want to make sure that I have this right so that I can be successful and pass correct info along too.

    Peace and Blessings!

    April

  78. Hi Dr. Kruse! I am a big confused with the supplements. Do we take them during the hCG diet or right after while doing the Leptin Rx? If I am at goal, do you suggest doing the Leptin Rx or the post leptin Rx? Thanks so much!

  79. And when I say at goal, I mean right after the hCG protocol. Do I need to "fix" my leptin right after the diet first?

  80. Thanks! Do I take the supplements while on the diet or right after during the reset? Sorry if I missed this somewhere!

  81. I'm quite hormonal 53 y/o, taking DHEA cream, progesterone cream, Iodoral plus many of the supplements you've suggested. Used coconut oil for over a year. Just finished 5th round of Homeopathic HCG in September 2011 after losing 80 pounds over 18 months. I have stayed within 5 pounds of my LDW, but- this past few weeks have been very volatile. Where should I start with the Leptin plan? I so don't want to gain my weight back. I would like to lose another 15 but if I only stayed at 170 I would be pleased.

    Thank you for your guidance. I'm just learning about this Leptin.

  82. I have serious problems taking coconut oil. I've tried hiding it in smoothies, tea/coffee, etc, but somehow it doesn't grow on me. I've tried for quite a while. I need the extra fat, do you have any ideas on how to take it, dr. Kruse? Can I take MCT oil instead? I also take 2-3 tbl. spoons of Udo's choice 3-6-9 every morning, is this ok? Should I take more/less?

    Thank you for your informative blog!

  83. I've been doing HCG for the past 5 weeks and have lost 24 lbs. I just came off the diet and started Leptin Rx this morning. Within 30 minutes of getting up, I made my coffee and added 1 egg, coconut oil and coconut milk to it. I made paleo Scotch eggs and couldn't eat more than one egg/sausage. There was no way I could get in 50 grams of protein! I don't know how else to get in the protein. I felt kind of funny for about an hour after eating–my legs felt weak and I was exhausted. Is this from the sudden food intake? Or from starving for 5 weeks? I don't know. Can I ease into the Leptin Rx?

  84. Thanks for your response. I'll try different sources of protein to get the optimal amount in. I need to lose about 20 more pounds to be at an ideal weight. Being I've just come off the HCG, should I stay with the Leptin reset or just go right into the post leptin Rx? And, thanks for sharing all this amazing information!!

  85. Jack, I have been eating the Leptix RX for months, but I want to add more muscle. My bodyfat levels are about 12% What would you recommend post workout? Could I eat some starches, glucose? Whey protein/dairy seem to cause acne for me. I eat about a pound of grass fed beef a day. I am on HCG and TRT protocol and over 50 years old and feel great. Just want to add more muscle and become leaner. Follow all of your supplements protocol.

    • @Aspen Arginine/ornathine post workout with a lot of unprocessed grass fed whey……and then I would tell you show me your free T and total T, DHEA and IGF-1 levels……..and cold ice baths post work too!

  86. My total was 390, free was 8.6 with range of 7.2 to 8.6. pre trt. last week results were 590 for total and 16.2 free, dhea was 306ug/l with range of 60-266. I hve not had IGF-1 levels checked yet. I will order some grass fed whey. How much would you recommend? at 170lbs? Thanks, I will let you know the results. You rock, Jack.

  87. it should have read 7.2 to 24 range on free T. sorry.

  88. Pre TRT Total was 390 NG/DL range of 292 to 867NG/DL

    Pre Free Total was 8.6 pg/ml range of 7.2 to 24 pg/ml

    Dhea was 306 UG/DL with range of 60 to 266 UG/DL

    I was taking DHEA supplements too.

    I have no IGF tests to report at this time.

    Post TRT

    Total went to 585 NG/DL same range as above

    Free T went to 16.2 PG/ML

    • @Aspen you need some doctoring…….got to push up the T protocol. Bi weekly dosing and you must not be afraid. You treat avg you get avg. Get on your doc…….and get an IGF-1 too.

  89. Thanks Jack again, after 5 weeks Doc put me on Bi weekly dosing to get me to the top. I will make sure I get IGF-1 tested. They wanted to, I just put it off.

  90. Jack I am trying to read as much as I can so I can learn to do the Leptin reset correctly . I have done way too much harm to my body in the past. A little about me.

    At 15 did a apple day diet to stay thin…my first mistake

    Yo Yo dieter all my adult life. I could lose the weight when I put my mind to it but as soon as I started to eat sugar I would loose control and felt like I couldn't stop. You know the drill I am sure. Get depressed …eat…get fat…eat..etc. Get fed up lose the weight then do it again !!! Started the HCG diet 2 years ago and did two rounds the first to lose the weight and the second was to do a reshaping round…small frame and body but big thighs mainly by knees….hate them. I have kept most of my weight off but struggling lately. My LIW 116 have kept my weight at 120 for a long time but after the first of the year started gaining. I think too many correction days. When I eat something that isn't protein and clean veggies. I will retain fluid like crazy. I started eating Paleo in the last week and a half. I am feeling much better and my weight is almost to my 2 lb over my LIW (Got up to 125) Just a few more things I am 47 and work out 5 days a week. Lift and interval training….Jari Love workouts.

    Have I detoxed my body so much that when I even have the smallest amount of something I normally don't eat I start to blow up with fluid retention.

    I was wondering if you could tell me why when I eat coconut oil or coconut cream I retain fluid. I really want to incorporate it into my eating. Is there a supplement I need to take with it? Someone told me that she thought she couldn't eat it but she just needed more of it. It was her body detoxing?

    Could this be my problem? Or do you think I should just stay away from it. I can only find good things about it not bad?

    I want to be able to use it during the reset if I can….but don't want to gain weight back. Another question …I have seen some people say they gain weight on the reset. Is there a reason they do? Can't find an answer to this yet.

    Thanks so much for your help…looking forward to finely getting to my optimum health!!

  91. I am also currently on the HCG diet and have the same issues as Marqueax. I thought I was doing good for my health and now after reading this I am unsure. I have lost 110 lbs. in 17 months and have done aqua detoxing throughout the entire process. I know I am insulin resistent or is it really LR? When I finish this round do I start the Leptin reset when I begin the phase 3 and if I do will this cause weight gain because we need to stay within 2 lbs. of our last injection weight? After all the reading, this paleo diet seams to really make sense. Also, what does PQQQ stand for? Thank you

  92. I'm not sure I understand. Are you suggesting that I use the cold thermogenesis protocol while I am on the HCG or immediately after? As I said before, I thought I was getting healthier on this diet by losing weight and I am feeling better but after reading through these blogs I am getting the feeling that I am harming myself?! All the supplements you are refering to, do we take during the 500 cal? What is the PQQ? Thank you for this blog and all the help you provide.

  93. I am really anxious to get the leptin reset started….but I gain weight every time I eat coconut oil. Should I stay away from it now and just use plam oil? or is there something else you would suggest?

    Or does the good out weigh the bad?

  94. It’s been asked a few times but the answer is still unclear so I’ll ask again.
    The blog makes it sound like these supplements are for POST HCGers, but your comments below make it sound like they are for CURRENT HCGers.

    I’m going to be doing an experimental round of HCG and I want to include supplements and CT (if I can stand it).

    During or after HCG, which are you suggesting here?
    Thanks!

  95. Jennifer says:

    Interesting post. I am post Homeopathic HCG for about 2 months now and doing your Leptin Reset. I only have about 5 pounds to lose but have been having a terrible time with low blood sugar symptoms since doing Hcg. I gather from reading this blog and the Oprah blog that it is some combo of my adrenals being maxed out, Leptin Resistance at the liver and muscles (I get the whole muscles feel like cement thing and it more pronounced when I have low blood sugar symptoms), and my circadian rhythm being off?? Which would make sense because on week three of Leptin Reset here I am SO TIRED. I am going to bed at 9pm and forcing myself up at 5:30 (to get ready for work). Curiously for me, green tea always makes my blood sugar bottom out to the point I think I’ll murder someone if I can’t eat.
    When I read over these supplements, I noticed that they are ones I recognize from doing some research on Hashimoto’s and Dr. Datis Kharrazian work on balancing Th1 and Th2 immune systems. For example, he lists Green Tea, Pycnogenol, Pine Bark extract and Grape seed extract as Th2 stimulants. Where as, Th1 stimulants are Astragalus, Echinacea, Beta glucan mushrooms, Maitake mushrooms, Glycyrrhiza, etc. Is there some correlation between Hcg and the Th2 branch? And is this why I can’t drink green tea?

  96. Jennifer says:

    Andrea, read comment 32 –
    And these supplements should only be taken when you are on the HCG dosing. Once you stop I think you can move to the regular paleo supplement list.

  97. Do you drink your tea/coconut oil only at meal times? Or throughout the day? I have been strictly drinking water in between meals, I was under the understanding that anything else would screw up my bodies Insulin releases. Basically, what I’m asking would consuming tea/coconut oil in between meals be considered “snacking?”

  98. Also, I cannot find the link to order your cookbook, can you point me in the right direction?

  99. Dr. Kruse, thank you so much for providing all of this valuable information. Unfortunately, I think that doing too many rounds of hcg diet has caused me some extensive issues. I know that it is something that has worked for me in the past, but the few times that I have tried it again, I have had great difficulty in achieving the same success.

    Not only that, I have developed early stages of Hashimot’s and am experiencing adrenal fatigue after the stress of the death of someone very close to me.

    Previously, I was very athletic in life (and I served in the military) but have experienced great decline in health after having children. One child has multiple food allergies, which I realize is probably due to my health during the pregnancy.

    I am currently on day 5 of another round of hcg diet. What would you advise (I want to at least lose 30 pounds)…would it be best to stop immediately and begin the program referenced here?

    Also, the leptin resistance really makes sense to me. No matter what I have done, how little I have eaten, how long I continue to “diet”, I cannot lose the weight. It’s so frustrating. My body retains water if I eat anything salty, and one day I became very nauseaus and ill after eating movie theater popcorn (iodized salt?). If I stay away from salt, I am much better (but I do use sea salt).

    Also, I work in a building that has a mold issue, so I don’t know how much that could play into me not seeing any success on this round of hcg, but it’s quite frustrating.

    I have a very athletic build, so when fat develops on top of that, it’s difficult to feel like I even have a chance to get back to where I want to be.

    Here are the things that I have shown on my blood tests recently: VitD: extremely low, VitB: just reached the low normal range (after 3 years), Ferratin: extremely low, high estrogen, low progesterone

    Can hormones recover by following the paleo method of eating or is hormonal supplementation needed? I have a progesterone oil (it is combined with coconut oil) and wonder if that should be used or not?

    I know these are a lot of questions, but I also wonder about exercise in my case? (Do you recommend Crossfit)

    Again, thank you so much for sharing your knowledge and your story with the rest of us. It is very encouraging and inspiring, and hopefully lifechanging.

    • @Sarah with out knowing about your specific details there is no way to know if your hormones or exercise is the correct things for you now. Some people do need hormone help and some do not. I’d tell you to get tested to find out what category you fall into.

  100. Sarah Stout says:

    Thank you for your response. I was trying to find information about your clinic – since I am local, do you recommend someone specific to see regarding these issues? Thank you.

  101. Sarah Stout says:

    Thank you so much!

  102. hcg information says:

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