Human chorionic gonadotropin or (hCG) as it’s commonly known is a hormone that can be prescribed by a healthcare professional for specific medical purposes. The FDA approves it for female fertility and hormone therapy in men.
HCG is a hormone produced by the placenta in pregnancy and can help thicken the mother’s uterine lining to help support the growing embryo. It also tells the body to stop the menstrual cycle. For this reason, it’s often called the pregnancy hormone. Human chorionic gonadotropin is found in a female’s urine or bloodstream at approximately 10 to 11 days after the fertilization of the egg by sperm. The hCG levels are going to be highest by the end of the first trimester of pregnancy. Home pregnancy tests are actually looking for hCG in the urine to determine pregnancy, however this must be confirmed by an obstetrician.
HCG levels will rise after conception, with the placenta nearly doubling hCG levels every three days and continue to do so until about 2 1/2 months into pregnancy. For pregnant women, not only does hCG trigger the body to thicken the uterine lining, and stop menstruating, but it also helps to create more estrogen and progesterone to balance the woman’s hormone levels and support their pregnancy. HCG levels are measured in mIU/mL with a peak of anywhere between 25,700 to 288,000 mIU/mL in between weeks 9 to 12 during a pregnancy.
HCG is available in multiple forms, including injections, oral tablets, and there are even some homeopathic hCG sublingual drops that can be sold over the counter however, the FDA has warned about such products as only the injectable form is FDA approved.
HCG is currently FDA approved for the treatment of select cases of infertility in females, and for hormone treatment and men. FDA approved products are only available in injection form and require a prescription from a licensed medical professional.
There are no FDA approved hCG products for weight loss, even though the hCG diet has been famous for decades. Fortunately, hCG is available for men on testosterone replacement therapy still but will require a prescription from a licensed physician.
If you’re looking to obtain a prescription for hCG, you should follow the following steps
1. Schedule a consultation with a licensed healthcare professional. You’re going to first need to see a doctor or healthcare provider that can evaluate you for your specific medical condition that would make hCG a medical necessity. Most men on testosterone replacement therapy will complain about testicular atrophy. Which is something that HG can combat.
2. Get a prescription for hCG. Once you speak with healthcare provider, and they determine that hCG is a medical necessity, they will be able to provide you with a prescription for the medication. A doctor may hand you a written Rx or call one into a pharmacy that can dispense hCG.
3. Obtain hCG from a licensed pharmacy. Once you have the prescription in hand, you can take it to a pharmacy to have them fill the hCG for purchase. HCG is not typically covered through insurance, specifically for men on testosterone replacement therapy. If the pharmacy carries the product, they will be able to dispense hCG in the form and dose prescribed by your physician, which legally will be injectable. Many of the large commercial pharmacies do not necessarily maintain a supply of hCG, and it has become exceedingly difficult to find.
Some online clinics that prescribe hCG have partnerships with compounding pharmacies that may be able to distribute and dispense hCG to their patients so make sure you call ahead of time to find out if your hormone replacement therapy provider or clinic is able to help you obtain it. Many of these pharmacies will ship lyophilized (powdered), sterilized vials of the medication, which will be reconstituted (mixed) with bacteriostatic water and then will be ready for use. Once mixed, it will need to be kept refrigerated to help maintain its potency.
This is clearly the most convenient option as often patients have to search high and low to find pharmacies that carry human chorionic gonadotropin.
It’s vital to only use hCG as prescribed by your physician or healthcare provider as there may be side effects. It needs to be administered under direct medical supervision of the healthcare provider, so do not attempt to acquire it without a prescription or for unauthorized use. There are lots of online pharmacies, which may sell hCG without a prescription, and those clearly need to be avoided as they are violating the law, and it is uncertain as to what, if any, testing methods are being done to ensure product safety.
As of March 23rd, 2020, a change in the law impacted the compounding of certain products which included HCG. On that date biological products like hCG were transitioned to require licensing under the public health service act 503A and 503B of the FD&C act. Many of the local compounding pharmacies that had been able to manufacture and dispense hCG were no longer able to offer it as a product. This now requires the purchasing of hCG, directly from the large pharmaceutical Giants at a substantially higher price.
Because the availability is now lower, the demand for hCG has become greater and the price for the medication has skyrocketed.
Many doctors and clinics have started looking to utilize other forms of medication for a replacement of hCG, however, none come close in terms of its efficacy and efficiency. One such medication was a peptide called Kisspeptin-10 which had been used as an adjunct medication for men on TRT to help reverse testicular atrophy. However, the medication did not work, nearly as well as advertised or certainly nowhere close to as well as hCG.
On September 29th, 2023 the FDA sited safety risks associated with certain bulk drugs/substances and categorized kisspeptin as a category two substance under sections 503A and 503B and are no longer allowing compounding the product under its general enforcement policies.
Gonadorelin is a product that has been prescribed and dispensed to replace hCG by many pharmacies and healthcare providers, however, patients have discovered it to be ineffective and prefer hCG over it while on TRT. The test trials conducted that have shown any success with Gonadorelin have required an infusion pump to administer injections on an almost hourly basis, which makes it completely inconvenient for anyone to truly utilize whilst on hormone replacement therapy.
The use of compounded hCG is subject to strict regulatory oversight, and is limited to specific medical conditions and indications as well as situations where a compounded product is deemed necessary. The regulation regarding compounding pharmacies will very slightly from one state to the next however, it is essential to consult with a healthcare provider and pharmacy that are both knowledgeable and ethical, and adhere to all of the current regulations, so that they can provide a safe and effective product as well as guidance towards its safe utilization.
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