Is human placenta a wonder drug, or is it just another Japanese health fad?

Is human placenta a wonder drug, or is it just another Japanese health fad?

Is human placenta a wonder drug, or is it just another Japanese health fad?

Health and medicine explained.
Dec. 30 2008 8:00 AM

The Tissue of Youth

Is human placenta a wonder drug, or is it just another Japanese health fad?

Embryo. Click image to expand.
An embryo

TOKYO—Call it the oxygen bar of the future, but with needles and nurses, vitamins, and a shot of human placenta.

Located in a tony complex—upstairs from L'Occitane and Armani, down the hall from Morgan Stanley—the clinic offers 10-minute intravenous drips to urbanites in need of a pick-me-up. (The place is called Tenteki 10, after the Japanese word for intravenous.) When I drop in, three women are on their way out, exuding relaxation, as if they've been to a spa. A technician tidies up the treatment room, where patients sit on elevated stools. IV bags release liquid into their veins as a flat-screen TV displays images of red leaves and water rushing over rocks. Many of the treatments include recognizable fare—vitamin C, biotin, and various amino acids—however questionable it may be to infuse unspecified doses of these "treatments" into healthy adults. But the kicker is the key ingredient in one of the cocktails: human placental extract.

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Placental extract has been available in Japan since at least the late 1950s. The country's National Health Insurance covers placental treatments for liver disease and symptoms of menopause, though patients pay out of pocket for its other alleged benefits, like fighting fatigue, treating insomnia, and combating aging, according to several Japanese doctors. The academic literature on it remains thin, however. And the complex soup of placental compounds—including, potentially, hormones, growth factors, and immune molecules—might mean that fountain-of-youth seekers could face some risks, like unwanted immune reactions or viruses. Is placental extract a clinical treasure trove? Or do these infusions amount to freaky magical thinking?

The staff at Tenteki 10 is confident about its popular "placenta pack," which costs about $30. The bubbly receptionist tells me it's her favorite drip at the clinic—she personally receives it at least once every other week. The morning after, she says, she wakes up refreshed, her skin noticeably smoother and younger. The clinic's medical director, Ryuji Yasumura, a physician who telegraphs calm paternalism, is also a fan. "Some young doctors don't know about placenta because it's old," he says, gesturing to his own salt-and-pepper mop, though it's not clear exactly how far back it dates as a folk remedy. But he argues that placenta ought to be better recognized and covered by insurance for more uses, particularly for fatigue, which many people in Japan's workaholic culture suffer from.

It's hard to deny the poetry of placenta. Placenta plays a crucial role in sustaining pregnancy by supplying the fetus with oxygen and nutrients, allowing it to dispose of wastes, and helping it build blood vessels and protect itself from disease. The possibility that it could also serve as a fountain of youth or health for mom and dad has circle-of-life allure. In some cultures, people bury the placenta and plant a tree in the soil. Many mammals—including cats, bats, goats, and, possibly, Tom Cruise—eat the placenta after birth. One Japanese company sells a placental "health drink" that reportedly tastes like peaches.

So, poetry gives way to commerce. At least two Japanese companies produce human placental extract, and numerous sites advertise online sales. The extract is also exported from Japan to Korea, where it is approved for liver disease and menopausal symptoms and widely used for fatigue and "skin whitening" as well. A doctor in Yunoyama, Japan, who runs a "health and rejuvenation tour" that offers injections of placental extract, in part for menopausal women, tells me that the extract is effective for treating disease and "safer than aspirin, I'm sure, 100 percent." Still, he concedes, "pure scientists say, 'show me the evidence.' "

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To date, at least, that evidence supporting placenta as a health treatment is scant. One small, randomized clinical trial from Korea published this spring suggests that injections of placental extract may help relieve symptoms of menopause and fatigue. The study followed roughly 80 women between ages 40 and 64. Those who received placental injections for eight weeks scored significantly lower on a scale of menopausal symptoms than those who received saline injections. They also seemed to experience decreased fatigue. The researchers speculate that immune molecules in placenta may act to reduce inflammation, which could have a positive effect on energy. The reduction in women's menopausal symptoms might be linked to estrogen, which is present in the extract. But estrogen may increase the risk of blood clots and strokes as well, as data from the landmark Women's Health Initiative suggested. Depending in part on the woman's age, it may also, together with progestins, increase the odds of a heart attack. The Korean group did not find an increase in cardiovascular risk factors. The researchers also note that their extract contained a relatively low dose of estrogen compared with hormone therapy. But they did not follow women for very long, and their sample was small, so it's hard to dismiss these worries out of hand.

As for liver and skin, some work suggests that placental extract may stimulate the regeneration of liver cells—in rats, at least. This may happen partly because placenta contains hepatocyte growth factor, which supports liver cell growth and tissue development. But without clinical trials, it's hard to know what the effects would be in people. The effects on skin are also fairly speculative. In theory, topical gels or creams containing placental extract might help chronic wounds to heal. That is plausible since placenta contains compounds that facilitate collagen formation and skin cell proliferation, says Michael Nelson of Washington University School of Medicine, who edits the scholarly journal Placenta. But this paper, at least, finds that the wound-healing effect is merely comparable to that associated with a common antiseptic. Nor did I turn up any clinical trials that demonstrate anti-aging effects on skin, at least in the peer-reviewed, medical literature. Perhaps the fountain-of-youth claims spring from a belief that  substances connected with childbirth or infants must hold some power to turn the clock back. (The same leap seems to fuel hype about fighting wrinkles using cells from babies' foreskins—though foreskins themselves seem rather wrinkly!)

Placenta contains hormones, growth factors, immune molecules, lipids, and nucleic acids—hundreds of different compounds. Specific placental molecules isolated from the mix could turn out to have particular clinical applications. But the richness of placenta also makes casual infusion risky. To make an extract, according to one academic description, manufacturers simply gather human placentas from women who have just given birth and place the tissue on ice. Then, they cut it into pieces, test it for viruses, perform chemical separation and purification steps, and sterilize and seal the product. Some proteins may be rendered inactive by sterilization. And some manufacturers may remove specific groups of molecules. (Yasumura says Tenteki 10's infusion does not contain hormones.)

But it's hard to know what exactly is present and what the accumulated effects will be. For instance, some cytokines found in the placenta act to increase inflammation while others act to decrease it; some, like interleukin 6, can do either, depending on what other molecules are present, according to Ted Golos, an expert on placenta at the University of Wisconsin-Madison. Rigorous clinical trials, using standardized extracts, would be crucial for sorting out what the actual effects might or might not be. And since extracts are made from human tissue, they could contain bacteria or viruses, some of which may not be tested for. As the staff at Tenteki 10 casually informs clients, those who receive placental infusions are no longer allowed to donate blood in Japan.

These dangers might seem important to wrestle with if placenta were shown to have genuine healing powers. But with little proven benefit, it seems questionable to turn to the extract, especially for conditions that have other available treatment options. For severe menopausal symptoms, for instance, it's hard to know whether placenta would prove better (or worse) than hormone therapy, unless more research, including head-to-head comparisons, were conducted. Meanwhile, claims that the extract aids both insomnia and fatigue are cause for some head-scratching.

Placental drips do not seem ready for prime time, even among the clinically adventurous. Nor are they likely to win approval in the United States anytime soon. Still, Tenteki 10 reports growing demand for all of its infusions, especially since the financial meltdown. When I drop by for a second visit, late in the afternoon, two businessmen are filling out intake forms in the reception area. Another is sprawled in the backroom VIP lounge, his eyes closed, his arm outstretched for the human cocktail. Regardless of the needle and drip, he seems, at least, to be getting a good nap.