 Can you, there we go, I think you're going to be, okay, there, now it's on, okay. And it's already synced so you don't have to do it. So now that we are recording, I will be introducing our presenter, Sarah Hunter. She's been studying and working in the field of alternative and complementary medicine since 1999. Her passion was lit with urban medicine which then naturally progressed into midwifery. She's certified by the North American Registry of Midwives. She's been working with pregnant families since 2004. Her view of illness and wellness is filtered through her understanding of traditional Chinese medicine. So we're also pursuers of a variety of related interests including managing two small businesses and volunteering as an online community manager for HANA. So you would prefer if you hold your questions until the end of the presentation and without further ado I will turn them over to Sarah. Hi guys, I'm super happy to be here again this year. I've really enjoyed this conference in the past. I love the international issues and I've just heard so many excellent presenters over the years and I really hope that I make it up to my own standards. So forgive me, usually I don't look like a nervous person but I am. So if I talk too fast, forgive me. If you can't understand, ask me to clarify and we'll do questions at the end. So a human placenta phagee. Let's start with primal needs. I originally thought the word primal came directly from the word primate but as it turns out both the word primal and primate come from the root primus meaning first. And to start off on a good foot here on the right is a primate placenta. It's a orangutan placenta from this lovely website that you should be able to click on and go and visit and I'll also have the resource at the end of the presentation as well. So of more than 4,000 terrestrial mammal species in the subclass eutharia which means placenta having only a handful of these including camelids and humans have been identified as a species that do not regularly engage in this behavior. However, I'm kind of here to dispel that. I do think humans have regularly consumed their placentas but we'll get to that in a second. So the researchers have come up with a bunch of ideas why mammals would eat their placentas. Some ones that get tossed around a lot are here on the slide to keep the nest airy sanitary to reduce orders that might attract predators to the birth site to replenish nutritional losses that occurred during pregnancy or delivery. This one stands out a lot for me to acquire hormones present in the after birth. We'll deal with that quite a bit to respond to a general hunger. After all, it's right there. Or my personal favorite is the express a tendency at partition towards temporary voracious carnivorousness. I don't know about you but I never felt temporarily voraciously carnivorous postpartum but it's not outside of the realm of possibility. So to me the question is not really why but rather why not. And I think the answer is our modern values. There are many taboos that surround placenta fagi. Different peoples decided that the placenta was taboo to eat at a certain point in history. And in modern times it's definitely considered gross. If you talk to a random person on the street or if you put it into Google like I did there and you see my screenshot you'll see that people think it's gross. It's disgusting, it's gross, it's cannibalism. I'm just going to check my notes here for a second. So the researchers are always saying that they can't find any evidence of human placenta fagi. I apologize for the formatting of this slide. Things go off when you put them into the Adobe meeting here. So taboos in and of themselves are generally formed against likely behaviors or those are recognized as possible. Not against behaviors that are exceedingly unlikely. So Mark Crystal is one of the big researchers of mammalian placenta fagi and that's his line from one of his studies. So it's recognized as yes there's a taboo for it because it has been done. For example there's no taboo against eating rocks. If you put eating rocks into Google you don't come up with the same kind of response. We do know even Mark Crystal knows in some cultures placenta has been saved for subsequent medicinal applications. We see a couple examples on this slide. And then we jump straight to blaming the hippies as usual. So this quote is from a couple of different sources but basically verified consumption of the placenta by the mother however has been sporadically reported from the 1970s to the present among a small number of clients of midwives and alternative health advocates in the US and Mexico I would add in here too, here in Canada as well and people claim therapeutic benefits and I guess that's why we're here today is to discuss what's happening now. I'm checking my notes. So let's discuss the earliest written accounts. The first, whoops, it's getting super small. My slides are super small on my side, I'm not sure why. The first written account of placenta used medicinally is from a book called the Ben Cow Gang Moo and I apologize if I'm pronouncing that badly, written in the 16th century. So there's a pretty good history, a really good written history in fact and again I apologize for the formatting of this. The British Medical Journal also has an article in 1917 which references both current usage at that time in different cultures as well as earlier publications of placenta. And then I found this lovely book here that you see on the bottom right it's a French book, it's called Remedies of the Past, How Our Fathers Healed Themselves. So it's a book about the remedies that had previously been used and it was written, itself was written in 1905 and it was written by Dr. Cabanes who speaks of heated, dried and pulverized placenta for various things including afterpains, hemorrhage, wound healing to establish lactation and for postpartum recovery. And as well as cat placenta used for fertility, for human fertility. So these usages come up over and over again. So specifically lactation, fertility, wound healing, postpartum hemorrhage. There's a lovely quote in there which I'll read to you in French and then translate. It means this usage is as old as the world, eating placentas. So this is totally not unheard of. Let's take a dip into Trudesan-Chinese medicine for a second. So in Trudesan-Chinese medicine it's called Zihachi and I'm sure I'm pronouncing that very badly as well. The pharmaceutical name being placenta hominus. The literal English translation of that would be purple river vehicle which is I guess a beautiful reference to the vessels. They speak of it entering the liver, lungs and kidneys as well as tonifying the liver and kidneys and augmenting the essence also known as the jing. Also tonifying the chi blood and the yang. The indications that are commonly still used today. In fact, you can get human placenta pills or something at least marked as human placenta pills in Chinatown where I live and probably where you live too. And they've used it for chronic weakness and ability which I think plays into anemia or maybe is just directly translated to western thought as anemia. Weasing due to deficient lungs is a common one that comes up again in traditional Chinese medicine. A lot of lung indications, deficient liver and kidneys, promotion of lactation which I'm going to bring up again so pay attention here. Lactation promotion as well as dermatological disorders including ulcerations and infertility as well as impotence. So modern values and modern preparations. So what is it that your placental lady does? What does your placental lady do? So most placental ladies and I apologize again for the formatting spend their time doing capsules. There's a lot of other things as many placental ladies are out there. There are different products you can make out of the placenta. People are pretty creative with it. But generally it looks like capsules, tinctures not unlike an herbal tincture salves for the skin. Smoothies, people do preparation of small pieces of placenta in a blender with fruit immediately post-bottom as well as prints which is like an art print and homeopathic remedies. There are generally speaking two categories of ways that placentas are prepared in modern day including the raw preparation method. The raw preparation method is of course because of the raw food movement that believe that raw foods have higher nutrient values than foods that have been cooked. And so people who subscribe to that as a general way of life or a more serious way of life also are more interested in having their placenta prepared that way. And then the other way is often called the TCM or traditional Chinese medicine preparation method where the placenta is cooked usually by steaming prior to dehydration. Herbs are often used in the steam water. Sometimes there's confusion that goes with this. Sometimes people misunderstand that their herbs put in the capsules with the placenta but that is usually not done. Of course modern placenta encapsulation is not exactly regulated so what one person does may not be what another placenta lady does. So let's look at what does placenta lady do. Most placenta ladies abide by strict infection control guidelines. Most of us are well thought out, have done research or have histories knowing about infection control. Most of us also subscribe to local food safety guidelines and people have food handler cards. A lot of thought goes into this. What does your placenta lady do? That much I can't really tell you. So does your placenta lady abide by the strict infection control guidelines? I don't know. So can you ensure safety if your clients are looking to eat their placentas via encapsulation that I can't really speak to your lady in particular? I think should you recommend encapsulation? That really depends on you and your personal feelings about it. However, I'm pretty sure that at least in this part of the world more and more women are wanting placenta encapsulation and it's definitely going to be something that comes up in your practice if it hasn't already. I think it's worth investigating or at least having a discussion with your local placenta lady or ladies about what their food safety and infection control guidelines are. Anyone who has put enough thought into it is going to be more than happy to discuss it with you so you can make a decision about whether or not you want to recommend someone specifically or at least not recommend against it. Of course we can talk about that more in detail during the question period. An interesting comparison would be to a tattoo artist or a piercer. If somebody sees that you have a piercing or a tattoo would you recommend them to go see yours or just go see some random tattoo artist around the corner. I think most people would feel more comfortable having had a discussion and looked at the autoclave the tattoo artist is using. Back in the day, those people weren't regulated either and now they're self-regulated and placenta ladies are kind of going in that direction as well. I'm just flipping through my notes. Modern medical use. I'm using the word modern and medical together. I just mean medicine in a broad sense and modern meaning today. Sorry, I'm grabbing some water here. So this is a thing that comes up fairly regularly in midwifery circles depending on where your circles are I imagine. It comes up in my circles anyway is people speaking about using placenta to stop postpartum hemorrhage in the immediate postpartum. I believe the only reference I could find to it was from Robin Lim's 2010 book and that's also in the references later. She speaks of five cases where her first line oxytocin did not work and she successfully stopped postpartum hemorrhage with a piece of placenta coated in honey. As we saw there is some historical usage of placenta for uterine hemorrhage. Currently human placental extracts are also used for burns, chronic ulcers and other skin defects in mainstream medicine and even more mainstream is the amniotic membrane usage as a transplant in ophthalmology and this in fact if you look around for it is quite common. It seems to be well accepted relatively speaking. So in 2013 I can't see if my slide actually shows the number 2013 but yes this is the pie chart and the slide is all based on a 2013 study at UNLV. Excuse me. It's women's self-reported experiences with placenta encapsulation or just general ingestion, placenta phagy in general. And so they were asked among other things why do you want to ingest your placenta? As you see here most women came back with to improve mood. There's a lot of talk of placenta encapsulation, placenta phagy being used as a preventative method for postpartum depression. The next up is unspecified benefits followed by it was recommended by somebody else. And then I'll let you read the rest of it yourself. And recovery from birth, improved lactation. People also came up with things like to increase their iron. It's a natural behavior. Of course encapsulation of itself is a natural behavior. The feeding of the placenta however is. Other people spoke of weight loss and they're just playing curiosity. The non-human studies about placenta phagy have come up with some interesting things. They've noted that placenta phagy offers pain-believing properties in rats via an active substance called placental opioid enhancing factor. And that again is Mark Crystal in 2011. They also noticed the most interesting thing here for me is the increase of the interaction between the mother and infant and the animals that ate their placentas versus the animals that did not eat their placentas. I don't know if that would potentially cross over to the explanation for prevention of postpartum depression. But there it is. So here we go again with the placental opioid enhancing factor. It creates the pregnancy mediated analgesia and delivering mother as well as suppressing postpartum pseudo-pregnancy, which I haven't really noticed happening in humans. I don't know if that's the thing or if it's never come up in my book. And I see a question here and I am not aware if the placental opioid enhancing factor has been found in humans. I have no idea. There's not really a huge amount of research that goes along with modern-day placenta phagy, but there's definitely a lot of interesting things coming up and we'll get to that in a bit too. So reported and suspected benefits. Again, this is from the self-reported benefits study at UNLV in 2013. You'll see in the pie chart that the 40% say that it improved their mood, followed by increased energy, 26% improved lactation at 15%, 7% say it alleviated bleeding, and the 12% is other kind of unspecified benefits. Why? Some hypothesize that placenta phagy offers health and nutritional benefits by replenishing depleted bodily stores, including both vitamin B6 and bioavailable iron, both of which are associated with depression when they are deficient hormone content. That lovely molecule you see there is estradiol. So this was a fun study that I came across the first four points on this slide where they actually measured the hormone content in cooked dried placenta, which is exactly what we do. And what they came up with were these four hormones, estradiol, progesterone, testosterone, and growth hormone. And the quantities are there. These are very, very small quantities of hormones, but they are there, as well as human placental lactogen and a bunch of other things such as oxytocin, and then relaxin, inhibidinactive, and endorphin, and beta-lipotrophin, on to nutrients. A lot of nutrients have been found in placenta, trace elements, you can see there, and their quantities in micrograms per gram based on the wet weight, so not cooked. And researchers in ITA3 discuss the B-vitamin in placenta, including ribophyte and thymine and peroxidine, and some others found really small amounts of essential fatty acids. Negative effects. So again, these are the self-reported negative effects of placenta-phagy from the 2013 UNLV study, unpleasant taste or smell, including unpleasant belching. So if the vast majority of people reported there were no negative effects, I think if unpleasant taste or smell is your worst effect, then we're doing pretty good. And more importantly for me is 4% of people reported headache. So that's a real little side effect. If people are taking placenta capsules and they're having problems with headaches, it might be time to stop at least temporarily or diminish the quantity they're taking in a day. Other negative effects are at the bottom here, difficulty remembering to take capsules, increased eutering, cramping, increased vaginal bleeding, a limited supply of capsules, and digestive difficulties. Oops, went too fast. Contraindications. This is by no means complete. We, like I said, there's not a whole huge amount of research that's available. There's historical references to a lot of things. And what we know is very little compared to what we could know. And from a TCM point of view, deficient YIN is a definite contraindication, which includes having an active infection like a mastitis or something. From a TCM perspective, it kind of goes without saying that a full gang would also be a contraindication. Bansky-Gamalong-Cabchuk, that's a TCM text, also talk about prolonged usage, although they don't describe what they mean by prolonged, although that's interesting considering what we are doing these days with placenta encapsulation being taken over longer periods of time. Corioamnionitis is well accepted as a reason to not encapsulate the placenta for obvious reasons. And then if the placenta has been stored improperly, stored improperly before transformation is possible, excuse me, that's a definite contraindication. This is from like a food safety standards point of view. The last line is dot, dot, dot because it's definitely unfinished. There are probably many more contraindications and we don't really know about them. Yet, I'm sure they will reveal themselves. Questions and controversies, I'm going to jump right into kind of a big one. This slide is about the rumor going around the placenta encapsulation forums about Jack Newman not being a provonet for placenta veggie. So I went ahead and asked him how he felt about it and because of this, I figured it would be something that came up today during the presentation and for a quote and this is what he sent me. He says, I don't think we are 100% against the taking of placental capsules, but the notion does not make sense to me. If the placenta capsules contain the hormones of pregnancy, they are likely going to interfere with the milk supply as do birth control pills. If they do not contain hormones, what is the reason for taking the capsules? No one has ever been able to give me a logical reason. So I think that's a logical question from Jack Newman. I'll deal with the hormones again on the next slide, and we've covered them very briefly in the past. I also hope at this point in my presentation people understand at least what the reason is for people to want to ingest their placenta. On the next slide I'll deal with that. Edith Kurnerman is an IBCLC who works with Jack. She also wrote me back and has a very interesting concern as well. She says, quote, my concern is that women are taking these capsules at the wrong time. If they are attempting to mirror what happens with some mammals, certainly not all, then placenta should be consumed immediately after birth. And then the desired hormonal effects might make sense before the onset of lactogenesis too. But to draw this out for days or weeks, I believe is problematic, especially if they do have the intended hormonal impact. My worry is that these hormones will then affect the milk supply. I'm getting my throat again. I think this is definitely an avenue for the research that needs to be done. It's a very valid question. What we have is the historical usage is that placenta has been used for insufficient lactation. If it's been used for insufficient lactation, it's at the point where we already know that lactation is insufficient, which is to say after secondary lactogenesis. So historically, that hasn't been an issue. In fact, the opposite has been true. So with regards to the hormones, we know progesterone is not absorbed via the digestive tract. In birth control pills, they use a synthetic form, or it's absorbed via the skin for other treatments. The estradiol content was found to be, again, 9.35 nanograms per gram, which compared to a low-dose birth control pill, and if we compare apples to apples, we're comparing 20,000 nanograms versus 9. Even if a person is taking 10 grams of placenta a day, which most aren't, most are taking significantly less, more like three or five, it's still far too low to affect breastfeeding. Placenta also contains human placenta lactogen, which mimits the action of prolactin. And of course, it is the biological norm, and the DPA from that would be having the question be put in the other direction. That happens when we don't eat our placentas. Another big question and controversy that comes up is re-intoxication. People ask me this all the time when they're not asking me to actually encapsulate their placenta. They're asking me, won't it just re-intoxicate me? Isn't the placenta the organ that prevents the baby from getting toxins and do they all stick in the placenta and then you consume it? So what I did is I compared a study that, as the quantities of cadmium, mercury, and lead, and I believe these are, yes, wet weights of placenta versus Health Canada standards. I used Health Canada because I'm in Canada. Of course, you can do your own comparison if you feel like it for your own country. This last link that you see in this beautiful aqua color is clickable. The others are not. Government websites in my experience tend to change the URLs for all their information about every two weeks, but they are searchable on the Health Canada website. So in the case of cadmium, Health Canada set the maximum acceptable concentration for cadmium in drinking water at five parts per billion. The researchers found in different placentas the average was from one to six part per billion. So if you were consuming as much placenta in a day as you do water, it's possible you're drinking too much cadmium. Although it's not possible. There's not as much. A placenta in and of itself is probably in the neighborhood of 500 grams, not a couple of liters. They also came up with an acceptable daily intake, which came to 57,000 to 7100 nanograms per day. As far as mercury goes, the maximum limit for mercury content of fish is 0.5 parts per million or 500 parts per billion in retail fish as compared to what the researchers found in the placenta, which was 2 to 13 parts per billion. And then lead, what Health Canada found is that most people are consuming about 100 nanograms of lead per kilo of their body weight. So if you weigh a nice 70 kilos, you're looking at 7,000 nanograms per day. And the placenta contains 5 to 60 per gram. So re-intoxication from a heavy metal perspective is not an issue. From my perspective, questions. This is my question. And we'll get to your questions in just a second. There are a lot of questions go around. There are a lot of things we don't know about modern placenta, some of them come up over and over again. Is it okay to encapsulate your placenta or eat your placenta when there is medication used during pregnancy? We don't have the answers to this. I usually do a quick math and think if this much got through and is still in your placenta and then you divide it by, say, the 200 capsules and you take three days, it doesn't end up being a whole lot per dose. But again, we always go back to risk versus benefit. Is the risk too large? Is the benefit not good enough? Are there interactions between placenta and medications that are currently being used? We don't know. This is not something we have any idea about. We can only guess. And again, risk versus benefit. One that comes up that's a little more thought up is placenta-phagy appropriate with hormonally mediated cancers or other illnesses. We've seen that the hormone content in cook placenta is pretty low. However, will it play an effect? What if you have a hormonally mediated cancer? Is it worth the risk? That's up to you and your own opinion. Hormonally mediated illnesses such as the people who get headaches with their menstrual cycle, is placenta-phagy appropriate for people like that? Are they more likely to get headaches as a side effect with placenta-phagy? Maybe. It's something we need to look at. I have two pages of references that I'm just going to leave up for a bit. And in the transfer, they lost their italicized words. Sorry about that. And then I have one more slide after this one. And then we'll take questions. So the first link here on this slide is Jack Newman's site, because I figure talk about him might as well pump up his clinic. It seems to be a good place where a lot of people get a lot of help. Placentation.ucst.edu is where I got the pictures and permissions to use them. This guy collected mammalian placenta information as well as pictures. And then there's my contact information. And over to the right, just to leave things loose. Loose and happy. Placenta, baby's first roommate. These are lapel pins you can wear. And they're at iHercut.com. So that's pretty much it for me. I'm ready to take any questions if there are any. I see there are. Okay. Well, it looks like, thank you very much. That was a very interesting presentation. And it looks like we've got about, you know, seven or eight minutes here for questions. And a couple of things came up in the chat room. I don't know, Denise, if we really have the time to cover the relationship between beta endorphins and placental opioids. Sarah, do you feel like commenting on that at all? Yeah, it's, there's not a lot we have on what is, what has been researched with Ruraisa placenta that's already cooked and or encapsulated dried. There's almost no information. I basically found one study study and then historical references. So from a historical references point of view, I see this question about what's left in the final form. And no, we're not, we're not certain of everything. We're just, we are certain that people have been doing this forever. And that it has medicinal usage. Okay. So the information that you did have in terms of the mercury and lead. That was wet, wet weight. So it was. Was it on the hydrogen placenta or was it on unprocessed placenta? The mercury, cadmium and lead, it was unprocessed. Okay. And then what about the estradiol and the other hormones, placental lactogen? Was that also raw or was that processed? The first half of that slide with estradiol, progesterone, testosterone and human growth hormone, I believe it was processed placenta. Yep. And so already cooked and dehydrated. So it is still there in small quantities, but it's still there. Okay. So Claudia Boca was asking if you can put up, I guess the reference slide again. The resource ones are still up, but Claudia, were you interested in the references? Yeah. So there's two pages of references here. Okay. Maybe I can point something out more specifically, non-human mammals. You'll see two more crystal. He has some interesting stuff, placenta and human and non-human mammals. And then I'll back up one to the other page of references. So I'm really sorry if anybody has the same last name. I'm about to butcher it. It starts with an IY. Ion garb. There's two studies. Human placenta is dual biomarker for moderating fetal and maternal environment with special reference to potentially toxic trace elements. There's a part two and a part three that I used for this. So the toxic trace elements as well as minor trace and non-essential elements in human placenta. Those were called a wet weight. They were not processed. So to know Ipra also includes frozen. Sorry? The Denise and once-known Ipra ingestion includes frozen pieces. Some people do use frozen pieces. Yeah, some people like there's so many different things you can do and there's so many different things that placenta ladies do. A lot of people will cut up the placenta into small pieces and then freeze it to use in smoothies. People are really creative. Okay, so Melissa is commenting that for an area for research comparing raw versus cooking and dehydrated placenta. And then also, Marna is also looking at studies on composition of dehydrated. But I think that's been addressed. You talked about, you know, the values in dehydration. An interesting thing is coming up, people are asking you about studies and as Ariane states here, there are a long list of studies that everyone wants to do. There's not a lot of money behind it. However, the UNLV is in the middle of a double-blind study about placenta encapsulation. And they're saying they're going to have results as early as next year. Okay, we'll stay tuned then. And then Stephanie wanted to know more about cultural associations. Has there been a specific culture that was the norm to engage in placenta? You know, the thing is, it's suspiciously absent. One of these studies is called a suspicious absence, or at least discusses it. At some point in our history, we pretended like this never happened. A lot of this information has been lost, at least on a paper kind of, from a paperwork viewpoint. Traditional Chinese medicine is the one that does have written accounts of using placenta since kind of forever. It was written since the 1600s. Presumably it was written because they've been doing it for a while, if not forever, as well as the French text, which discusses it as if it goes without saying that we've done this forever. But as far as written accounts, that's what we have. Okay, well that's a pretty broad spectrum from European to Chinese. So I think that just the less you've done a good job at looking at the breadth of the evidence. Any final questions before we wrap up the presentation? Well, I see this one about memories. Memories to heal family old cares, okay? A lot of people do a lot of things. That's definitely within the scope of possibility. I didn't even deal with anything cosmetic. A lot of cosmetic usage to human placental extracts is the word they use in a study I have here somewhere about general laceration repair where they lacerated people and then used human placental extracts and found that they caused healing to happen faster. So membranes or even a piece of placenta itself is not outside of the possibility of something to do. I'm sure people have done it. Great, well thank you so much for contributing this information to the conference. Some people encapsulate the membranes too, yes.