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Posted by Dr. Allison Smith on Thursday, 28 December 2017

Evidence Shows Placentophagy (Placenta Encapsulation) Works

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The practice of placentophagy – a woman consuming her placenta after she gives birth – is a bit of a hot topic these days. For those of you not familiar with the practice, if you're imagining the Dothraki queen devouring the giant, bleeding heart of a horse with her bare hands, you're probably not alone. In reality, there's much less of a "yuck" factor associated with the process when consuming an encapsulated placenta, which entails heating, dehydrating, pulverizing and then placing the resulting placenta powder into capsules. The result looks more like a vitamin supplement than a bleeding heart.

Cultural and personal interpretations aside, what would inspire someone to consume their placenta after birth? What's in it and what’s the therapeutic potential for a mom who’s riding the hormone roller coaster after giving birth or to a new baby who's exclusively breastfed? All of this attention on the placenta has classically been based on anecdotal evidence that consumption of it in the postpartum period leads to improved mood, more energy, increased iron stores and more milk production. ZRT Lab has been involved in some fascinating research on postpartum human placenta consumption to help answer some of these questions. And now we're happy to say that there’s a small body of research to back up some of these claims.

Study Design

In the studies referenced herein, the placentas were all prepared in the same manner and dosed on the same schedule. The placentas were either frozen or refrigerated upon retrieval from birth, heated to 160oC, dehydrated, ground up in a food processor and then encapsulated in capsules that hold up to 550 mg of dehydrated placenta. The maximum daily dose studied was 3300 mg; (two 550-mg capsules taken 3 times daily) for the first 4 days after birth, then 2200 mg for the next 8 days, and finally 1100 mg for the final 9 days.  The studies assessed hormone, mineral and element content and maternal quality of life.  Women were either in the control group with encapsulated beef or in the study group with encapsulated dried placenta.  All the hormone testing for these studies was performed at ZRT Laboratory using mass spectrometry (LC-MS/MS).

What's in the Placenta?

Minerals

The first of this series of studies [1] found that the encapsulated placenta at the 3300 mg dose provided about 2.2 mg of a particularly absorbable form of iron called heme iron, roughly four times the amount provided in the same dose of encapsulated beef. 2.2 mg certainly isn’t a high enough dose to be considered an iron supplement alone for the anemic new mom; however, in the world of foods, it would be considered a good iron source. A less significant showing of copper, selenium and zinc and even smaller detections of manganese, molybdenum, strontium, and rubidium rounded out the trace mineral content. Still, in the follow-up study [2] that analyzed postpartum iron status, no measurable benefit to iron status markers in the new mom emerged by week 3 of placenta supplementation vs beef supplementation. So, just like beef, placenta acts to maintain iron status over a 3-week period, not boost it [2].

Below Threshold Toxic Elements

Concern that toxic elements like cadmium, lead, and mercury might concentrate in the placenta diminished, with surprisingly relatively small, insignificant levels reported in the 28 placentas analyzed. This study [1] looked at some of the more common toxic exposures but it is entirely possible that the placenta concentrates other environmental toxins not tested in this research. 

Elements found in modest amounts

Elements found only at low levels

Copper

Arsenic

Iron

Cadmium

Selenium

Lead

Zinc

Mercury

 

Uranium

Streptococcus agalactiae (Group B Strep)

A common finding in late pregnancy, vaginal group B Streptococcus (GBS) bacterial infection usually signals extra precautions to protect the baby from transmission during delivery. In these studies, one out of the 28 women studied was positive for GBS at delivery. Certainly, the presence of GBS wouldn't necessarily render the placenta positive, but the risk should certainly be considered higher. This is a real concern based on a case report of GBS sepsis in a twice-infected infant exclusively breastfed by a mom ingesting her GBS-positive placenta. It's not clear how the oral consumption of the GBS in the placenta capsules was making it to the baby but perhaps additional safety steps in delivery and preparation should be considered. To me, it’s much like consuming a meat product. If it's "tainted", mother and child could potentially be harmed.

Hormones!

If these hormones are getting into the circulation, are they at least in part responsible for the purported beneficial effects on mood and bonding – all the things so important when the baby arrives?

Just before delivery, hormones like estrogens and progesterone were very high, as expected. Within a few days after birth, hormone levels dropped steeply to help adjust the body to the new baby and to urge the system into the lactation period. With this rapid drop in estrogens and progesterone, some women experience the "baby blues".  Researchers took an interest in studying placentophagy because human placentas amass a rich concentration of different steroid hormones, which when reintroduced after birth could help attenuate postpartum symptoms. When dosed as a supplement (taken in small pieces), the typical maximum daily dose of placenta was found to yield varying amounts of 17 different hormones tested [3], the ones in highest concentration being those typically used in hormone replacement therapy - about 2.5 µg of estriol, 0.3 µg of estradiol, 1.1 µg of estrone, 37.3 µg of progesterone (and of interest for postpartum depression, a 0.37 µg dose of allopregnanolone) which raised the question: do the hormones taken orally in capsules have any chance of making their way into circulation and from there to the brain, where they can influence behavior and prevent postpartum depression?

Researchers sought to find out [4] and the short answer is yes, but…! Yes, this study actually found a small increase in absolute levels of the hormones tested in moms’ saliva in the placenta consuming group compared to no change in the beef group, but that’s not the end of the story. In further analysis, they uncovered a significant increase in the volume of distribution (Vd) of the hormones present in the placenta group, not the beef group. Vd is a measure of how much hormone was expected to have made it into the body tissues (the higher the Vd, the higher the distribution to all tissues). These findings hold the key to future clinical research to develop new treatments for postpartum problems. Amazingly, the natural concentrations of the different hormones in the human placenta as shown in this study [4] lends itself to use during breastfeeding with higher levels of progesterone and allopregnanolone and lower levels of androgens, all the while softening that rapid postpartum drop in estrogens and progestogens – which may be how this all works. So, if these hormones are getting into the circulation, are they at least in part responsible for the purported beneficial effects on mood and bonding – all the things so important when the baby arrives?    

How Did Moms Feel?

Improvement in Mood and Fatigue in the Placenta Group

To try to answer that question, pilot study number 2 [5] assessed the effect of placenta consumption on mood, bonding and fatigue with the same group of participants.  Using that same decreasing dosage schedule from 3300 mg daily to 1100 mg daily, they found decreasing benefits from the high dose days to the low dose days. So, again, perhaps the dose matters. Depression scores (mood) improved significantly in the placenta group over the beef group only when they were taking the higher doses (3300 mg and 2200 mg) but dropped to match their beef counterparts by the end of the study after taking 9 days of the lowest dose (1100 mg). Overall, fatigue scores improved in the placenta group over the beef group from beginning to end of study. Suffice it to say, I was surprised to read the actual study and find that the negative news headlines about these results were rather misleading.

Further Study?

I, for one, am thrilled to see more work being done in this area of study.  In 2014, when I was contemplating having my placenta prepared for consumption after the birth of my third child, I did a PubMed search on human placentophagy to investigate some of these beliefs about the benefits, and at that time there were only a few articles.  Most of them covered cultural factors leading to the practice and one or two that presented clinician and patient "perspectives" on the practice. So, anecdotal evidence (or REALLY old research) was as good as it got in 2014. Given the research available to us now, I'm still not sure I’d be overwhelmingly swayed one way or the other. As it goes for most pilot studies, they just lack the power – if we could look at a thousand women in the treatment arm and as many in the placebo arm with a look at safety over a longer period of time, we’d all be a little more confident on both sides of this conversation. So, while placentophagy can’t yet be officially recommended by obstetricians until more research develops, women must rely on that "woman's intuition" as we always have. It truly is a personal choice. It's good to know there are researchers out there who are curious about how this disposable organ may be of help to some of us while shedding light on the scientific basis for all our collective, historical experiences with the practice. 

Related Resources

References

[1]  Young SM, et al. Human placenta processed for encapsulation contains modest concentrations of 14 trace minerals and elements. Nutrition Research 2016;36(8): 872-8.

[2] Gryder LK, et al. Effects of human maternal placentophagy on maternal postpartum iron status: A randomized, double-blind, placebo controlled pilot study. Journal of Midwifery and Women’s Health 2017;62:68-79.

[3] Young SM, et al. Presence and concentration of 17 hormones in human placenta processed for encapsulation and consumption. Placenta 2016;43: 86-9.

[4] Young SM, et al. Effects of placentophagy on maternal salivary hormones: A pilot trial, part 1.  Women Birth 2017; Nov 23 [in press].

[5] Young SM, et al. Placentophagy’s effects on mood, bonding, and fatigue: A pilot trial, part 2.  Women Birth 2017; Nov 23 [in press]

Tagged in: Elements Testing Fertility Progesterone Estrogen