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14 Articles in Volume 12, Issue #2
Chronic Pain in the Elderly: Special Challenges
Chronic Pain School
Diagnosis and Management Of Myofascial Pain Syndrome
ECG Screening Prior to Initiating Methadone: Is it Really Necessary?
HCG and Testosterone
How to Manage Unmotivated Pain Patients
March 2012 Pain Research Updates
Methadone for Pain Management
PPM Editorial Board Discusses Methadone Prescription Safety Measures
PPM Launches Online Opioid Calculator
Spontaneous Low Back Pain, Radiculopathy, And Weakness in a 28-Year-Old
Tapering a Patient Off Opioids
The Comorbidity of Chronic Pain and Mental Health Disorders: How to Manage Both
What Are Best Safety Practices For Use of Methadone In the Treatment Of Pain?

HCG and Testosterone

Letters to the Editor from March 2012

Dear Dr. Tennant,
I’d like to thank you for your excellent work over the years. It has been very helpful to both my patients and me.

I was wondering if you could answer a few questions for me. I recently saw your March 2011 abstract on human chorionic gonadotropin (HCG) for pain1 and that you had also written on this in 2009.2 We see in fibromyalgia that testosterone levels are often suboptimal in both men and women, and that low-dose bioidentical testosterone replacement helps (as was seen also in a small study by Hillary White, PhD, in female fibromyalgia patients).
The questions are:

  1. Are the benefits of HCG solely from stimulating testosterone production?
  2. Did HCG help any patients whose testosterone was already supplemented before the HCG was given?
  3. Has HCG helped any patients not on opioid medications? (I’m wondering if it is largely simply reversing a testosterone inhibition caused by the opioids.)
  4. Are you continuing to see benefit and any side effects from long-term use of HCG, besides acne? Do you continue to recommend it?

I appreciate your guidance.

Jacob Teitelbaum, MD
Fibromyalgia and Fatigue Centers
Kailua-Kona, Hawaii

Dear Dr. Teitelbaum,
Your questions on HCG are most pertinent and on target. First, I not only recommend it, but also now believe that every patient with central pain should be given a therapeutic trial of HCG. Central pain is a much more catastrophic and serious condition than formerly recognized. It is fundamentally a focus of neuroinflammation that produces progressive cellular damage and loss of tissue.3-5 At this point in time, therapeutic agents with anabolic nerve regeneration potential should be given every attempt to control central pain and its neurodestructive complications.

First, the ability of HCG to raise testosterone levels in men and women is clearly a primary, if not a major, beneficial role. I have now used it on patients who have normal testosterone serum levels and some who are on testosterone replacement. Both groups claim additional benefits from HCG. I have three patients who adamantly wanted to stay off opioids and have been able to do so with HCG. I now have patients who have taken HCG for up to two years without any side effects. In central pain patients, long-term HCG has had the effects of lowering but not eliminating opioid daily dosage, and HCG often obviates the need for testosterone replacement.

It is my belief that HCG not only has testosterone-raising ability, but a neurogenic and anabolic effect on its own. HCG has two sub-units; one the same as that in luteinizing hormone, follicle stimulating hormone, and thyroid stimulating hormone while the other unit is anabolic in that it produces neurogenic growth.

As I write this note I’m surveying our long-term (more than 6 months) HCG patients to present as a poster at the American Academy of Pain Medicine annual meeting in February. I hope to have some updated information on dosages, side effects, and outcomes. I’ll keep everyone posted.

Best wishes,
Forest Tennant, MD, DrPH




Last updated on: March 13, 2012
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