by Gary Pepper, M.D.
Last week Helen, a friend of the family, called to brag she had lost 12 pounds in 4 weeks and also to ask if she had given herself cancer in the process. What was the connection between her supposed miracle metabolism and cancer? Helen was taking HCG injections and just read this hormone was somehow related to cancer. I reassured her that I didn’t think she was giving herself cancer by taking HCG but I did let her know that very soon she was likely to resume her normal metabolism and regain the weight she lost. Unfortunately her wallet was never going to recover what it lost in this process. Many services prescribing HCG treatment for weight loss are charging $400 or more for a course of treatment.
Now what about the cancer-HCG connection?
HCG is a hormone normally produced by the fertilized egg in the earliest stages of fetal development and then later by the placenta itself. Since rising HCG level is one of the earliest hormone changes during pregnancy, measuring this hormone is the basis for the everyday pregnancy test. HCG also causes the ovary to make progesterone which is essential for preparing the uterus to become a nesting ground for the developing embryo. HCG may also suppress immune function so that the fetus is not rejected by the mother’s immune system.
The placenta forms at the onset of pregnancy to support the developing embryo and later the fetus. If a sperm fertilizes an empty egg at the onset of pregnancy a Hyditidiform mole can arise in conjunction with or instead of the normal placenta. This is also referred to as a molar pregnancy. HCG levels can rise to extreme levels in the presence of the Hyditidiform mole particularly if it goes on to become an invasive cancer known as a choriocarcinoma. Body chemistry gets a little weird at this stage. HCG is slightly similar in structure to TSH, the pituitary hormone that stimulates the thyroid. The result is that when HCG levels are extremely high as with a molar pregnancy, the thyroid can be stimulated to make excess thyroid hormone resulting in hyperthyroidism in the mother. Typical symptoms of hyperthyroidism can occur including feeling hot, shaky, sweatiness, palpitations, vomiting (which can be severe) and diarrhea. Curing the cancer will cure the hyperthyroidism as well.
Other cancers of the reproductive system can make HCG as well. Certain testicular cancers can make HCG. Since HCG is the hormone responsible for a positive pregnancy test, testicular cancer can sometimes be diagnosed in men by a positive pregnancy test. For tumors making HCG, measuring levels of this hormone during cancer treatment can aid doctors in determining whether therapy is working or not.
Certain cancers are termed â€œhormone responsiveâ€. That means the cancer will grow more aggressively in the presence of a particular hormone. Tumors that grow faster in the presence of estrogen include receptor positive breast cancer and endometrial cancer. A tumor that grows faster in the presence of testosterone is prostate cancer. Since HCG is likely to increase these hormones, it is conceivable that should a hormone responsive tumor already exist in the body it could grow faster during HCG treatment.
So Helen, I don’t think HCG is going to give you cancer, but it may cause you to grow a beard. Why is that? I’ll be explaining my theory in the next article, “HCG is a Hairy Hormone”. Visit metabolism.com for more on this, in the very near future.
Hey everyone. Itâ€™s been a while since i checked back w/you guys so hereâ€™s an update- it will be 11 months on the 25th of July for me. I have continued to gain in spite of my efforts -cutting calories, upping activity, working on my stress levels etc â€¦ I have gained 22 lbs back of the 30 I had lost before I quit. I have gone to the doctor and gotten checked out and it may actually be a thyroid problem [my TSH is deficient ..?..] Evidently smoking not only assaults the lungs but also other thingsâ€¦ You guys may want to talk to your doctors even if itâ€™s just to rule out anything. Iâ€™m hoping that sheâ€™ll put me on meds to tell the truth. If itâ€™s low but not enough to do anythingâ€¦ I really donâ€™t think I can handle the thought of that right nowâ€¦ Anyway, Iâ€™ll let you all know what happens-cross your fingers n send me some good vibes Good luck everyone
Beth wondered about her lack of response to thyroid hormone treatment. Leslie offers these comments:
Beth â€“ perhaps you are under-medicated. The numbers donâ€™t really mean much â€“ you must convince your doctor to pay attention to how you feel, rather than your labs! Remind him/her: prior to 1973 there was not measure for TSH. Doctors would give their Hypo patients Armour, and increase the dose until the patient felt â€œrightâ€ again â€“ and considered that to be successful treatment! I consider that to be successful treatment too! Weâ€™ll see what my doc says next week â€“ Iâ€™m feeling great after an increase in meds (in spite of a TSH of 1.9), and Iâ€™m sure my TSH has gone WAY low â€“ but it i hard to argue with success! I have absolutely NO Hyper symptoms. I think it is time to throw out TSH testing altogether, and treat patients instead!
In a suprise announcement a prominent leader in the field of thyroid disease, Dr. Leonard Wartofsky, suggested that a new lower level of TSH be utilized when attempting to evaluate and treat hypothyroidism.
When diagnosing hypothyroidism (low thyroid function) most physicians are trained to obtain a TSH measurement. TSH (thyroid stimulating hormone) is produced by the pituitary gland not the thyroid. The pituitary’s job is to act like a thermostat regulating the amount of thyroid hormone in the blood. When the pituitary senses thyroid hormone deficiency this “master gland” releases TSH into the blood to stimulate the thyroid to make more thyroid hormone. TSH therefore increases when thyroid hormone levels are low.
According to good medical training, it is appropriate to diagnose hypothyroidism and give thyroid hormone replacement only if the TSH level is above normal. The normal TSH level is generally recognized to be between 0.4 up to 4 or 5 (microIU/ml) depending on the lab where the assay is done.
I have found that relying strictly on the normal TSH range may fail to render a correct diagnosis of hypothyroidism. Take the situation in which an individual’s TSH level a year ago was 1.0 but this year is 2.8. Both of these TSH levels are within the normal range. Hasn’t something changed, however? Why is the pituitary releasing more TSH this year? My thought is in this situation the pituitary is sensing thyroid hormone deficiency and is trying to compensate by releasing more TSH. In such a case it may be appropriate to try thyroid hormone supplementation if there are also complaints compatible with low thyroid function.
The major flaw in the TSH measurement stategy is to fail to recognize how much variation in thyroid function can be hidden within the TSH normal range. To explain this I like to use the analogy of shoe sizes (you heard it here first!). It is common knowledge that although most people have normal foot size, only one shoe size is appropriate for each person. Similarly with TSH, for each individual there is very likely to be a particular level that is the “best fit”. Recall the normal TSH range is between 0.4 and 4.5. This is equivalent to a normal range of shoe size from 4 to 45! How difficult is it then to find the “best fit”?
For years, endocrinologists have debated what level of TSH is appropriate for the diagnosis of hypothyroidism. In a suprise announcement Dr. Wartofsky from Washington Hospital Center suggested lowering the upper limit of TSH to 2.5 (microIU/ml). This was after an analysis showed that 97% of the population had TSH levels below 2.5. In comparison the official American Association of Clinical Endocrinologists (AACE) statement recognizes the upper normal limit as 5.0, although dissenting members of this organization have been using 3.0 as the upper limit. By recognizing that a TSH level of 2.5 may signify thyroid hormone deficiency, Dr. Wartofsky and his colleagues legitimatize treatment with thyroid hormone replacement for a much broader range of patients then ever before. Public action groups have for years been seeking this reform in the medical community’s method for diagnosing and treating thyroid hormone deficiency.
My comments are intended as informational only, not to diagnose and treat medical conditions. Consult your own physician for individual advice on diagnosis and treatment of medical conditions.
Gary Pepper, M.D. Editor-in-Chief, metabolism.com