A 52-year-old man reported to an integrative medical center for chronic low back pain in August 2010. The patient reported a 20-year history of chronic, episodic low back pain. The pain was described as a dull ache across the small of the back without radiation. Sitting for prolonged periods of time, lifting, and running increased the pain, whereas rest and nonsteroidal anti-inflammatory drugs decreased the pain. The patient had been to a chiropractor previously on an as-needed basis during acute episodes. He would discontinue treatment once the pain was “tolerable.” He stated that the lumbar pain was constant and rated it as a 47 on a quadruple numerical pain rating scale (QNPRS).13
He also rated it as a 43% disability rating on a functional rating index (FRI).14
The patient had a positive medical history for gout and a surgical history of an appendectomy at age 30 years. He also reported being in an automobile accident approximately 25 years ago. Because of the lack of resolution to spinal manipulative therapy, a radiographic examination was performed of the lumbar spine. The radiographs were essentially normal, with minor degenerative disk changes at L4 and L5.
The patient's vital signs were as follows: 6' 1" tall, 281 lb, BMI of 37, blood pressure of 125/79 mm Hg, temperature of 98.2°F, and waist circumference of 44". Given these vitals, combined with a history of constant pain despite intervention and gout, laboratory analysis was recommended. The patient related that he had just had laboratory tests performed by his primary care physician and thus released copies to the author (MWM) for review. shows an outline of the patient's initial laboratory results before our intervention. The more notable values included total cholesterol, 259; triglycerides, 217; LDL, 178; glucose, 109; and uric acid, 9.8. Patient was currently taking red yeast rice 600 mg daily for his cholesterol, as well as vitamin C and a proprietary product called Flex Protect for gout episodes.
Patient's laboratory results before and after intervention
Given the cardiovascular risk factors present, the chronic episodic low back pain, combined with the fact that a BMI greater than 30 may likely significantly contribute to his chronic low back pain,15
the author (MWM) recommended a weight loss program using a homeopathic HcG product. The patient agreed and also gave his HIPAA-approved written consent to publish his results. The program was designed in a manner similar to the original plan by Simeons.8
The main difference was the use of an over-the-counter combination homeopathic HcG product (Homeopathic HcG; Deseret Biologicals, Inc, Sandy, UT) instead of the prescription injectable HcG. However, the dietary intake outlined by Simeons8
The patient was instructed to take 10 drops of the HcG under the tongue 5 times daily. He was limited to a total daily energy (calorie) intake of 500 cal for the first 30 days of the program while on the HcG. After the first 30 days, he reported back in for follow-up to perform laboratory testing, as well as to measure his weight and calculate his BMI. During this follow-up visit, his weight had decreased to 250 lb (BMI 33); and his waist circumference dropped from 44" to 42". His cardiovascular risk factors improved as follows: glucose, 79 (109); triglycerides, 106 (217); cholesterol, 162 (259); and LDL, 108 (171). Of note, his high-density lipoprotein also dropped to 33 from 45 initially. His disability rating improved to 10%, whereas his pain score was reduced to 23 on the quadruple numerical pain rating scale. No manipulation was administered during the entire duration of this weight loss program.
After the first 30 days of the program, his caloric intake was increased to 1000 cal/d; and his only limitation was to avoid simple sugars and starch. He did not take the homeopathic HcG during this time. Over this interim 30-day period, he lost an additional 10 lb (BMI 32); and his blood pressure decreased to 107/61 mm Hg.
The third 30-day period was a repeat of the first 30-day period: 500 cal/d, adhering to the Simeons8
dietary guideline. Finally, the last 30-day period consisted of increased calorie intake to 1000 cal/d; and he could not eat any sugar or starch. At the end of this protocol, his laboratory studies were repeated, as well as his QNPRS and FRI, to evaluate any changes.
At the conclusion of the diet, the patient's QNPRS remained at a 23, whereas his FRI improved to an 18% disability rating (7/40 score). His laboratory values continued to improve. His LDL, glucose, and total cholesterol were maintained, whereas his triglycerides dropped further to 95 (106). His weight had also further dropped to 210 lb (240), for a total weight loss of 71 lb in 4 months. This final weight dropped his BMI to 28 (32).