Testosterone Deficiency

~30% of men aged aged 40-79 have testosterone (T) deficiency.  T deficiency not only causes low sex drive, erectile dysfunction and poor sexual performance, but is also associated with other health problems such as obesity, cardiovascular diseases, diabetes etc.  T repletion therapy may be helpful in improving not only the sexual health, but more importantly the overall health.

Manifestation of T deficiency:

  • Physical: Decreased bone marrow density, decreased muscle mass and strength, increase body fat or BMI, gynecomastia, anemia, frailty, fatigue;
  • Psychological: decreased mood, diminished energy/sense of vitality or well-being, impaired cognition and memory;
  • Sexual: diminished libido, erectile dysfunction, difficulty achieving orgasm, decreased morning erections, decreased performance.

Source: The American Journal of Medicine (2011) 124, 578-587

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Dr. Steve C, a heart surgeon, lost 17 lbs in 17 days on our Holistic hCG Plan.

It’s nice to see a physician colleague to trust in our services.  Dr. Steve C, a heart surgeon form out of state, started our Holistic hCG Plan recently and lost 17 lbs in 17 days (from 226 lbs to 209 lbs), or 7.5% of his original body weight), or 1 lb/day.  His waist line also went down ~ 5 in.  Dr. Steve is not the first physician to go on our hCG Plan.  We have many physicians (internal medicine, endocrinology, anesthesiology, orthopedics and cardiovascular surgery etc), nurses, and physician assistants, on our plans.

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Dietary instructions for hCG Plan: 1st Week.

Objectives of 2 weeks on protein bars

  • To show you that you can lose lots of weight, when you are put on an appropriate diet;
  • To boost your confidence that you can lost weight on this diet;
  • To establish a baseline weight loss amount.  We’ll use this baseline amount to measure future success.

First Week on hCG Diet

At the 1st day of your 1st week, weigh yourself and enter the weight into your account online (It’s ok if you weighed differently on your scale than on ours.  What we are looking for is the rate of weight loss.  Weigh in online again in the middle and the end of the 1st week.

  • Breakfast (~6-8 AM) : make sure you start your day with a breakfast.  Your breakfast should consist of a protein bar (ours only), a glass of water, or a cup of coffee or green tea.  Do not eat anything else.  Definitely do not eat (or drink) any bread, donuts, eggs, milk or dairy products, bacon, not even fruit.  Just one protein bar and lots of water.  You eat a protein bar not as food, but as medicine to prevent muscle loss.
  • Lunch: eat another protein bar, a green salad consisting of only green leafy vegetables (cabbage, lettuce, celery or spinach etc).  You may use vinegar, lemon juice or vinaigrette as salad dressing.  Do not put any croutons, bacon, cheese, eggs meats on salad.  Do not eat any rice, bread or pasta.  Drink lots of water, or green tea.  No more coffee. Other than water, you should be having anything else.  You shouldn’t be hungry.   If you really want to have some snack, you may snack on carrots, cucumber, or celery sticks (you may dip into soy sauce, but not rich creamy sauce such as Thousand Island or Ranch).
  • Dinner (supper): the same as for lunch.  Other than water, you should be having anything else.  You shouldn’t be hungry.  If you are hungry, report to us.  If you really want to have some snack, you may snack on carrots, cucumber, or celery sticks (you may dip into soy sauce, but not rich creamy sauce such as Thousand Island or Ranch).
  • Exercise: we encourage you to do exercise.  Any form of exercise is fine.  Do not push yourself when exercising.  If you feel a tired or uncomfortable, take a break.  During the first few days to a week after starting the program, your body is adjusting  to the new condition.  You may feel a bit easy to get tired, easy to get short of breath, esp. when climbing stairs.  That’s normal.  Take a break when that happens.
  • Do not smoke cigarettes.  This is actually the best time to quit smoking.  Our medications help to reduce your body’s reaction to dieting (to smoking too).  If you quit smoking now, you won’t feel as bad.  Talk to us about this.  We’ll add other cigarette quitting aids to your plan.
  • Do not drink any alcohol (beer, wine or liquor).
  • How to take medications:
    • Take 2 capsules of Green Coffee Extract twice daily (30 minutes before lunch and before supper).
    • Take 2 capsules of Garcinia twice daily.
    • Inject under the belly skin 1 ml of B12, once a week.
    • Inject under the belly skin 0.1 ml of hCG.  This can be done any time of the day.  Choose a convenient time for you.  It’s a good idea to stick to the same time, say, evening hours.
    • Take Herbal Diuretic or maxzide in the morning (we usually start with Herbal Diuretic, as Maxzide is stronger and may cause some side effects).  You should expect more urine output than usual.  If not, we need to switch to a stronger water pill;
    • Take Thyroid pills in the morning,
    • Take Trazadone 30 minutes before bed time, as this will make you sleepy; If we give you Fluoxetine, take it before bed time as well.
    • Take 2 capsules of 3 Ballerina before bed time.  Do not take 3 Ballerina in the morning.
    • Take  T-Gran or M-Vite multi-vitamin tablets at dinner (supper) time.  do not take it in the morning, as it tends to cause nausea.
  • Expected weight loss: average 7-15 lbs (with more weight loss for bigger people).  Your first week’s weight loss is greater than usual, as you may have known, due to water loss, and colon cleansing.
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I feel sluggish and tired, what should I do?

There are several causes why you may feel tired or sluggish.

  • Slow metabolism.  You may use B12, T-Gram or M-Vite, or increasing thyroid dose.
  • Imbalanced nutrition:  imbalance in water (dehydration), minerals and vitamins may result in fatigue.
  • Insomnia or constipation.
  • Medication side effects: SSRI such as fluoxetine and trazadone may make you feel tired or sluggish during the day.  Make sure to take them before bed time.  If this still doesn’t help, contact us.  We may need to reduce the dosage.
  • Increase your exercise.  This definitely will help you to feel better and give you more energy.  Over a period of time, exercise will also increase your metabolism as well.

 

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Dietary instructions for hCG Plan: 2nd Week.

Objectives of 2 weeks on protein bars

  • To show you that you can lose lots of weight, when you are put on an appropriate diet;
  • To boost your confidence that you can lost weight on this diet;
  • To establish a baseline weight loss amount.  We’ll use this baseline amount to measure future success.

2nd Week on hCG Diet

At the 1st day of your 2nd week, weigh yourself and enter the weight into your account online.  Weigh in online again in the middle and the end of the 2nd week.

By 2nd week, you are most likely adjusted to the new lifestyle.  You shouldn’t have any more side effects or difficulties.  The food intake is the same as the first week.  There is some minor change to medications.

  • Breakfast (~6-8 AM) : make sure you start your day with a breakfast.  Your breakfast should consist of a protein bar (ours only), a glass of water, or a cup of coffee or green tea.  Do not eat anything else.  Definitely do not eat (or drink) any bread, donuts, eggs, milk or dairy products, bacon, not even fruit.  Just one protein bar and lots of water.  You eat a protein bar not as food, but as medicine to prevent muscle loss.
  • Lunch: eat another protein bar, a green salad consisting of only green leafy vegetables (cabbage, lettuce, celery or spinach etc).  You may use vinegar, lemon juice or vinaigrette as salad dressing.  Do not put any croutons, bacon, cheese, eggs meats on salad.  Do not eat any rice, bread or pasta.  Drink lots of water, or green tea.  No more coffee. Other than water, you should be having anything else.  You shouldn’t be hungry.   If you really want to have some snack, you may snack on carrots, cucumber, or celery sticks (you may dip into soy sauce, but not rich creamy sauce such as Thousand Island or Ranch).
  • Dinner (supper): the same as for lunch.  Other than water, you should be having anything else.  You shouldn’t be hungry.  If you are hungry, report to us.  If you really want to have some snack, you may snack on carrots, cucumber, or celery sticks (you may dip into soy sauce, but not rich creamy sauce such as Thousand Island or Ranch).
  • Exercise: we encourage you to do exercise.  Any form of exercise is fine.  Do not push yourself when exercising.  If you feel a tired or uncomfortable, take a break.  During the first few days to a week after starting the program, your body is adjusting  to the new condition.  You may feel a bit easy to get tired, easy to get short of breath, esp. when climbing stairs.  That’s normal.  Take a break when that happens.
  • Do not smoke cigarettes.  This is actually the best time to quit smoking.  Our medications help to reduce your body’s reaction to dieting (to smoking too).  If you quit smoking now, you won’t feel as bad.  Talk to us about this.  We’ll add other cigarette quitting aids to your plan.
  • Do not drink any alcohol (beer, wine or liquor).
  • Medications. Take all medications the same as the 1st week.
  • Expected weight loss: average 4-7 lbs.  The easy weight is already lost.  This 4-7 lbs weight loss is your net weight loss (mostly should be excess fat and sugar which is stored in the muscles and the liver).  This amount of weight loss is your baseline weight loss.  We’ll use this amount of weight loss to gauge your future success.  In other words, in the future, if you achieve this amount of weight loss, we need to figure out why and how to improve.

 

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Dietary instructions for hCG Plan: 3rd Week.

The 3rd week is the transition week to your regular food.  Breakfast and lunch remain the same.  Dinner will be different.

At the 1st day of your third week, weigh yourself and enter the weight into your account online.  Weigh in online again in the middle and the end of the 3rd week.

  • Breakfast (~6-8 AM) : make sure you start your day with a breakfast.  Your breakfast should consist of a protein bar (ours only), a glass of water, or a cup of coffee or green tea.  Do not eat anything else.  Definitely do not eat (or drink) any bread, donuts, eggs, milk or dairy products, bacon, not even fruit.  Just one protein bar and lots of water.  You eat a protein bar not as food, but as medicine to prevent muscle loss.
  • Lunch: eat another protein bar, a green salad consisting of only green leafy vegetables (cabbage, lettuce, celery or spinach etc).  You may use vinegar, lemon juice or vinaigrette as salad dressing.  Do not put any croutons, bacon, cheese, eggs meats on salad.  Do not eat any rice, bread or pasta.  Drink lots of water, or green tea.  No more coffee. Other than water, you should be having anything else.  You shouldn’t be hungry.   If you really want to have some snack, you may snack on carrots, cucumber, or celery sticks (you may dip into soy sauce, but not rich creamy sauce such as Thousand Island or Ranch).
  • Dinner: do not eat protein bar.  Eat 4-5 oz (raw weight) of high protein food.  High protein food includes fish (including shell fish and shrimp), chicken or turkey breasts or drumsticks with skin and fat removed, pork chop with skin and fat removed.  Do not eat beef, bacon, sausage, etc.  You may steam, grill, bake, barbecue them.  Do not use oil (no olive oil either), butter or margarine, honey, sugar etc in cooking.  You don’t want to introduce any unnecessary (bad) calories to your diet.  What you need is protein, but carb or fat.  You should also eat a green salad (the same as before).
  • Expected result: you should see lose similar amount of weight during the 3rd week compared to the 2nd week, or >4 lbs/week.
    • If you lost similar amount of weight in the 2nd and 3rd week or great than 4 bls/week, then you may continue to read Dietary Instructions for Weeks Beyond 3rd Week.
    • If your weight loss is significantly less than the 2nd week (or less than 4 lbs), you probably didn’t follow our dietary instructions or you may have other issues (for more info click here).
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What causes obesity? Overeating or lack of activity?

While we all know both play a role in our obesity, it’s obvious to me that overeating is a lot more significant than lack of exercise.  The following is an email that I sent to a well known research scientist here in Columbia.

***************

Dear Dr. —–

I saw an article on the State about your research into the cause of obesity.  I highly respect your world wide reputation on this topic.  But as a medical practitioner who has seen and treated close to 8000 obese patients, I thought the answer was pretty straightforward: I have never seen an individual who can lose weight by increasing exercise without dietary control.  But I have seen plenty of patients who go on a diet without added exercise and lose lots of weight.
I felt the US academic on obesity research has been missing the key point.  One other topic that receives lots of research is the genetic contribution to obesity.  I don’t think genetics plays any significant role in American obesity.  The reasons are clear:
  1. The obesity rate among the Americans is ~30% and that of the Europeans, 10-12%.
  2. Most, if not all, American caucasians immigrated to the US within the last 500 years.
  3. 500 years, in genetic evolution, like a drop of water in a bucket, are too short to cause a genetic mutation to spread to a significant proportion of a population.
  4. Moreover, if a genetic mutation(s) caused our obesity, why does it happen only the the Americans?
The conclusion from the above public domain info is clear: genetics doesn’t play much of a role in our obesity.
The causes of American obesity are well known and are multiple: overeating, slowed metabolism, lack of physical activity and imbalance of homeostasis.  The treatment should also be of a multi pronged approach.  That’s the approach that I have taken for the last couple of years and that’s why it’s EASY for me to help my patients to lose 20 lbs in a month and 50 lbs in 3 months (see a few examples here:http://www.drwlc.com/blog/?cat=14).  In my opinion, obesity treatment or the lack thereof, highlights the urgency why modern medicine needs to change how we think about disease and how we treat them.  Modern medicine has been quite successful in dealing with simple and single factor diseases such as infections.  But when it comes to multi-factor conditions such as obesity, hypertension, or diabetes, modern medicine has not made much advance in the past couple of decades.  Why?  The answer, in my view, is our approach is wrong.
For acadmic curiosity, I’d like to meet with you to exchange our experiences in this field.

***************

 

 

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Dietary Instructions for Weeks Beyond 3rd Week.

If you have done well in the first 3 weeks of hCG plan, you should have lost at least 15 lbs by now.

Again, weigh in at the beginning, the middle and the end of the week (basically weigh in twice a week).

If you did well in the 3rd week, that means you read and followed the dietary instruction on how to eat your foods.  Congratulations!  Now you don’t have to eat protein bars all the day.  You can eat your own food now.  Most people, however, still eat a protein bar for breakfast and a protein bar for lunch.  They cost ~1$/meal only.   Where can you find a 1$/meal these days?

  • Breakfast: you may choose any one (but only one) of the follow selections.
    • A protein bar (ours are recommended), or
    • 3 boiled egg whites, or
    • 4 oz of lunch meats (chicken or turkey),
    • a serving of Greek Chobani yogurt.
    • Do not eat: bread, cereal, bacon, sausage,  whole eggs, muffin or donuts.
    • Drink a glass of water, or green tea, or a cup of coffee.  Do not add sugar to your drinks.  In general, we recommend NOT to use sweetener. Because we are trying to wean you off of the sweet cravings.
  • Lunch: you may choose any one (but only one) of the follow selections.
    • A protein bar (ours are recommended), or
    • 3 boiled egg whites, or
    • 4 oz of lunch meats (chicken or turkey), a serving of Greek Chobani yogurt, or
    • 4 oz (raw) of pork chop, chicken/turkey breast, white fish (or other sea food).  Do not add oil or anything that has calories.  You may add spice, herbs in cooking.
    • A green salad: same as before, with lemon juice or vinegar or at most vinaigrette as salad dressing.
    • Do not eat: bread, cereal, bacon, sausage,  whole eggs, muffin or donuts.
    • Drink a glass of water, or green tea, or a cup of coffee.  Do not add sugar to your drinks.  In general, we recommend NOT to use sweetener, because we are trying to wean you off of the sweet cravings.
  • Dinner: you may choose any one (but only one) of the follow selections.
    • A protein bar (ours are recommended), or
    • 3 boiled egg whites, or
    • 4 oz of lunch meats (chicken or turkey), a serving of Greek Chobani yogurt, or
    • 4 oz (raw) of pork chop, chicken/turkey breast, white fish (or other sea food).  Do not add oil or anything that has calories.  You may add spice, herbs in cooking.
    • A green salad: same as before, with lemon juice or vinegar or at most vinaigrette as salad dressing.
    • Do not eat: bread, cereal, bacon, sausage,  whole eggs, muffin or donuts.Drink a glass of water, or green tea, or a cup of coffee.  Do not add sugar to your drinks.
    • Do not drink any alcohol beverages.  Alcohols are carbs.
  • Expected result: you should be able to expect similar weight (>4 lbs) as of your 2nd or 3rd week.  If you didn’t lose that much weight, here is your guideline.
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Dr. Cheng’s 1:10/500/5 Rules

The 1:10/500/5 Rule of Dr. Cheng’s Diet

  1. The 1:10 Rule: Anything you put in your mouth should meet this 1:10 Rule. The 1:10 Rule is: for every gram of protein, the total calorie amount should be 10 or less. Most of food packages come with nutrition label. For example, Chobani yogurt label reads the total protein is 14 grams and the total calorie is 140 calories per container.  The protein: calorie is 14 : 140 = 1:10. So this is a good food to eat.  This 1:10 rule implies that for every 100 calories, 4o calories are from protein.  The remaining 6o calories are from carb and fat.
  2. The 500 Rule: the total daily calorie allowed is 500.
  3. The 5 lb/wk Rule: You should expect to lose ~5 pounds per week. If you didn’t lose 5 lbs or more, you didn’t follow Rules 1 and 2. You need to ask yourself why you couldn’t follow.
  4. But it may also be that you are hungry or you are craving or you have side effects. If you didn’t follow the Rules 1 and 2, then stick to these rules.

 

 

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What if you don’t like injection?

There are several forms of hCG available on the market, i.e., injection, sublingual, nasal and transdermal.  However, we prefer and recommend the injection form for the following reasons:

  1. First and foremost, the injection form is the most reliable.  Once injected, it’s in your body 100%.  Whereas the other forms can never achieve 100% absorption.  Worse, the absorption rate varies depending on the many factors, e.g., the oral temperature, the time you hold the sublingual solution under tongue.
  2. All forms other than injection form are more expensive than the injection form.
  3. Injection form is actually pretty easy and painless, once you are trained.  The injection form uses the same technique and needles as the diabetics patients use for their insulin injection.  Think about it.  Millions and millions of diabetic patients have no choice but to inject themselves several times a day of insulin.  How can they tolerate it, if it really hurts them?
  4. If you really don’t like injection, you can rent or buy an automatic injector to help you with the injection.  With the automatic injector, you won’t feel a thing. Even with buying or renting an auto-injector, it’s still cheaper than the other forms of hCG.
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