A reader sent me an interesting email that interested me greatly about her daughter. Some extracts
“confined to her bed or at least her house with CFS for 5 -7 years. We’ve been following your suggestions as best we can, given my goofiness about science, and we’ve had some modest success, but in the last three weeks she began to get stirrings of energy. Her doctor…has had great success with other non-CFS patients using HCG, which here … is fashionable, along with a diet, for weight loss. … He talked her into trying HCG 3 weeks ago (without the diet- she’s on a Mediterranean diet as you recommend), first on 2 doses of .4 of 125 iu a day, which seemed to achieve nothing, then 10 about days ago, he increased it to 2 doses of 150iu a day. Within 3 days of that, she unexpectedly got out of the house at 6AM to go the airport to welcome a friend home, then stayed up all day travelling (though not driving) 130 km by car and was still awake and bubbly at 9 pm. Only a little delayed exhaustion and rattiness the next day- usually after this she’d expect to be laid out for a week or more with slurred speech etc The next two days she was on the go…. A low energy three days followed – but today as I write she’s out and about finding out what the shops look like these days! She’s begun to think about what she’d like to do in the world!”
What do we know about hCG beyond this single report?
- Potential Therapy for Neisseria Gonorrhoeae Infections With Human Chorionic Gonadotropin.– has some antibiotic characteristics
- Human chorionic gonadotropin is an immune modulator and can prevent autoimmune diabetes in NOD mice .
- “Human chorionic gonadotropin (hCG) and the other human glycoprotein hormones (luteinizing hormone [hLH], follicle stimulating hormone [hFSH], and thyroid stimulating hormone [hTSH]) are biochemically very similar.. an hCG-like material was produced by a bacteria they called Progenitor cryptocides…. epitopes reacting with hCG polyclonal antibodies were present on several strains of bacteria including: Staphylococcus (ATCC 19433, 27848), Enterococci coli (ATCC 25922), and Pseudomonas maltophilia (ATCC 13637)….Pseudomonas maltophilia possessed an hCG/hLH binding site 
- SelfHacked reports impairment of working memory, increased cancer risk, and increased anxiety (with references)
- Unusual cause of profound weight loss in a young woman.– cause was high hCG
- “The human chorionic gonadotropin or “hCG diet” is such a diet, which after half a century still has no evidence to support its efficacy; …based on current data, these may do more harm than good.” 
- [Serious complications to a weight loss programme with HCG] .
- thrombosis and pregnant while on pill!
- “Recombinant human chorionic gonadotropin (hCG) is commonly misused as a weight reducing or performance enhancing agent but is associated with increased risk of thromboembolic events.” 
- First manic episode associated with use of human chorionic gonadotropin for obesity: a case report.
- “The HCG diet has very few efficacy studies and no significant safety studies associated with its use. Six relevant studies were identified for assessment of efficacy, and only 1 was associated with a significant weight reduction in the HCG diet study population. All of these studies evaluated the use of the HCG diet via injections of the hormone and significant calorie restriction, which is known as the Simeons method. Currently marketed HCG products include sublingual drops, lozenges, and pellets, but none of these methods has an evidence-based efficacy and safety standard.” 
- An unfortunate resurgence of human chorionic gonadotropin use for weight loss .
- “Reported acute adverse effects include mild hypotension, hypoglycemia, constipation, and fatigue . There is also a theoretical concern of increased thrombosis risk with IM injections of HCG . However, there has been a paucity of evidence for this dietary agent with multiple studies showing that weight loss was generally related to diet restriction as opposed to HCG injections [23, 25, 26].” 
The risk factors for continued use is high. I am pleased for this patient’s mother to see the change that occured, but there is too much risk and too little basis to even suggest it as an experiment for others. Some of the adverse effects (hypotension, hypoglycemia, constipation, fatigue) hints that it does cause alteration of the microbiome — but there are no studies on what the alterations are.
I would be inclined to discontinue use and see what the consequences are (it may have done the essential work and addition dosages may not have benefit — even for maintaining).
This is an education post to facilitate discussing this approach with your medical professionals. It is not medical advice for the treatment of any medical condition. Always consult with your medical professional before doing any changes of diet, supplements or activity. Some items cites may interfere with prescription medicines.