When exploring the risk of the blood clots with the hCG diet we have to take into account many factors including, what hCG is FDA approved for, the dosing used in weight loss, dietary influences and predisposing health conditions. The answer as always is not a simple yes or no but requires more context to understand the actual risk vs. what may exist in theory.
The first and simplest issue, is that dehydration due to any cause makes the blood more viscous and therefore more likely to clot. The hCG diet, due to its ketogenic nature can commonly cause dehydration especially in the first few weeks. For patients not following the recommended fluid intake and also not taking electrolyte supplements, who are also restricting their sodium intake they can get dehydrated very quickly resulting in an increase risk for clots. This is unrelated to the hCG hormone, and entirely part of the metabolic changes associated with the ketogenic aspect of this diet. The same would apply to any ketogenic or low carb diet like Paleo, Atkins etc. This risk exists, but is not above nor beyond the same risk of dehydration related blood clots as any low carb diet.
The next potential risk would effect only women and is due to the hCG’s effect on the ovaries which is to increase progesterone primarily and estrogen secondarily. Here the context is important as it relates to the dosing. So, yes, hCG does increase progesterone and estrogen slightly at the weight loss dosing, but the increase is very low and unlikely enough to change the risk of clotting due to excess estrogen. Progesterone itself does not increase clotting risk and this is the hormone which is primarily stimulated. Estrogen does but is not increase much with hCG. This doesn’t create an obvious concern as its well below levels that would come from more common medications like oral birth control or hormone replacement therapies.
For further context, consider the pregnancy levels of hCG reaching 100’000 units vs. the weight loss range of 125-200 units. So while clotting risk goes up during pregnancy, the levels of hormone required to do so are significantly greater than what is used for weight management and are also maintained for much longer. hCG also has FDA approval for fertility treatments at significantly higher doses than are used for weight loss (almost 3 months of weight loss dosing in a single injection is about what is used in fertility). The approval at these high doses for fertility should add context to the relative risk at minute doses used in weight management.
The hCG hormone changes for men which is a slight increase in testosterone levels is subject to the same scrutiny as the increase in estrogen for women. While it is correct to say that an increase in testosterone can increase the risk for clots, the degree to which testosterone goes up from hCG is very slight and does not actually increase levels to where the risk of clots is a concern. Additional caution may need to be taken for men on testosterone replacement therapies who are maintaining an already elevated level of testosterone to begin with.
Some signs of blood clots to watch for include chest pain, shortness of breath, pain at the location of the clot with redness and swelling, skin discoloration, lightheadedness. Immediate emergency attention is required in the event of a blood clot.
Consideration is given to patients who want to use the hCG diet but have a history of a specific blood clotting disease, or a prior history of blood clots. The most common is Factor V Leiden and Prothrombin gene mutations. These patients are generally on anti coagulant medications, including Warfarin or Heparin which manage their increased risk of clots. Some patients manage hypercoagulable states resulting from other pre-existing health conditions by taking aspirin which can help prevent blood clots and this precaution is sometimes taken by patients with an increased risk.
In summary, the technical risk of blood clots is not absent with the hCG diet, but when taken into context is not much higher than would occur from simple dehydration or from other much more commonly used and FDA approved medications like oral birth control pills or testosterone replacement therapy.