"There they go again"--hCG and weight loss

Dr. Albrink's review of information available in 1969 did not allow her to determine a physiologic basis for the use of hCG or any proof of immediate or long term benefit. Subsequent discoveries and clinical studies only support her impressions. Despite these facts, this form of therapy has achieved a resurgence in popularity. The difference today is that patients no longer have to rely on health care providers to prescribe their medications since internet sites allow them to obtain medications "on line". This has potential adverse ramifications when we consider that the initial use of gonadotropins derived from the human pituitary was discontinued due to the iatrogenic transmission of Creutzfeld-Jakob disease. It is thought that the disease is transmitted by an abnormal protein called prion protein. Subclinical forms of the disease exist and the prions could potentially be transmitted in urine. No cases or transmission via urine have been reported and reputable sources of hCG would appear to be safe, but products from countries with greater risk have the potential for contamination. The increased demand for hCG from reputable sources has led to shortages and increased expense for the legitimate uses of hCG in treatment of endocrine disorders and infertility. Obesity and the adverse impact on health has become a priority in public health policies for the state of West Virginia and for our nation as a whole. The benefit of longevity in the practice of medicine is that one is given the opportunity to observe attempts to "reinvent the wheel" where medical practices that have been previously disproven are reintroduced. Fineberg and Hiatt state this more eloquently when they said: "What is unacceptable is to persist in demonstrably ineffective practices either because we fail to collect systematic information about the effects of our actions or because we establish and respond to inappropriate incentives." Systematic information has been obtained and has shown lack of evidence for the benefit of this therapy. The alternative explanation for the persistence and promotion of this treatment is unacceptable.