Palpitations And Cardiac Events, KMUD, 15-03-2013

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Raymond Peat, Ph.D.

Palpitations and cardiac events

KMUD, 2013-03-15​

(transcribed and verified by Burtlancast)

HD: Andrew Murray
HD2: Sarah Johanneson Murray
RP: Ray Peat


HD: Good evening. The subject of this month’s show is: palpitations and related hormones, notably progesterone. We will also be talking about blood clots, myocardial infarcts and other cardiac events. There are many factors involved in palpitations, but we will only look at a couple in detail. As usual for the people who have never heard of you, Dr Peat, could you please give us an outline of your academic and professional career?

RP: I studied physiology at the University of Oregon for several years, 1968 to 1972. And the circulatory system wasn’t my main interest, but I ran across interesting work done in the 1940’s by one of my science heroes, Albert Szent-Györgyi, who happened to be studying the effects of estrogen and progesterone on the heart of animals and blood vessels. And his work exactly matched what I was doing in animal aging and the effects of those same hormones. So, I was interested in the circulatory system as it relates to the endocrine system especially.

HD: I know you’re main interests are anti-aging, stress, and the associated hormones. Many papers have been published showing the dangerous effects of estrogen, and the beneficial effects of progesterone, testosterone as well as thyroid hormone. What are we supposed to understand regarding the misleading advertizing surrounding estrogen’s supposed beneficial effects?

RP: It’s the standard thing that what gets into the news, or the science journals, or the universities is strongly influenced by the giant corporate interests. And estrogen happens to be a very profitable thing, multi billions of dollars per year. So they can control the public perception of the hormones in their interests. And part of the idea of selling estrogen as a beneficial thing was that women lived longer than men. And since they were selling estrogen as the female hormones, they said that it must be estrogen that accounts for why women live longer and have lower incidence of heart disease before menopause. So at one point, they actually did a trial of giving estrogen to men, and when they started having more heart attacks, they stopped the experiment. But that didn’t kill the idea that estrogen is heart protective. So for 50 years, they carried on, promoting the idea of giving estrogen to women to protect their heart, until the Women’s Health Initiative’s (WHI) results came out, with women having more heart attacks on the estrogen trial.

HD2: Why did they start with estrogen? Instead of progesterone?

RP: Because there’s only one substance that really has the effects of progesterone. And just about anything that is interfering with the use of oxygen has estrogenic effects. Several extracts of soot were demonstrated to be estrogenic. The polycyclic aromatic hydrocarbons are very estrogenic. Even cyanide has some estrogenic effects. Or putting a plastic bag over an animal’s head, or irradiating any part of the animal with X-rays or gamma rays is estrogenic. So the concept of estrogen is something very easily brought to market in a product [many different molecules have similar estrogenic effects]. Where progesterone is one single molecule that can’t be imitated exactly with any alteration [it can’t be modified, or it will lose its properties].

HD2: What about the cost differences in manufacturing estrogen vs progesterone?

RP: Yea. The fact that soot extracts are estrogenic means that you can produce it for less than 1 cent per dose if you want to. Where progesterone has to be exactly duplicated. For years, they were extracting it from the corpus luteum of [inaudible animal] ovaries. And it took tons of ovaries to produce a few grams of progesterone. So they found how to manufacture it from plants steroids: they were closely similar in structure.

HD2: Like wild yam, and other herbal products.

RP: Yea. With a few chemical operations, they can become exact copies of the progesterone molecule. But since no one can patent that one substance, they introduced small changes, making it no longer progesterone. And they said it was close enough to progesterone, [and claimed] it would be [even] better than progesterone (because they had a patent on it, and could advertise it). And they devised tests that had something in common with the real progesterone molecule (a certain change in cells of the uterus). But that led them call it a progestin, or progestogen, because that had something in common with progesterone. But they implied that it supported gestation. But in fact these were the chemicals that were the bases for the birth control pill, because they prevented gestation. So, really they should be called anti-progestins. *chuckles*

HD2: Indeed, it’s so much simpler to commercialize something like black soot from a fireplace than to synthesize progesterone at a cost. Which of these 2 hormones has a wider effect in the body?

RP: Progesterone affects every system, but in pretty much exactly the opposite way that estrogen does. Any tissue that’s injured will begin producing its own estrogen. So, the idea that a woman is estrogen deficient at menopause is just a complete fabrication. Someone was measuring the estrogen manufactured in a monkey’s ovary by measuring the change from the blood going in to the blood coming out of the ovary. And as a control, they measured the blood going into the arm, and the blood coming out of the arm of the same monkey, and found that the monkey’s arm was producing more estrogen than the ovary. And since women at menopause still have their arms and legs, there’s no way that they’re going to have a decrease in the basic estrogen.

HD2: So here’s another medical myth that at menopause, women suffer from a lack of estrogen. When in fact, they suffer from a lack of progesterone.

RP: Yea. That has been demonstrated and published, but in books, rather than journals. The journals are so controlled by the industry that you get real science in a lot of books but never in the medical indexes, or journals.

HD2: One might add to that list the medical schools, were students aren’t taught what the research is showing.

RP: Yea. Medical schools teach what the medical journals publish. And that’s always at least a generation behind the science journals.

HD2: They are more about 50 years behind.

RP: Yea. I’ve compared the biological abstracts publications, or the chemical abstracts on topics related to medicine, to the Index Medicus (which was the print forerunner of Pubmed), and i’ve found that, typically, even the most important things took 20 years before they were mentioned in Index Medicus after they were already in the generally accepted scientific existence. And the first mention in the medical literature was generally: « but it was not a valid medical concept ». Like vitamin E: medical journals, for several decades, were saying that it was a very dangerous substance and shouldn’t be taken.

HD: Gosh. It’s a good job it’s coming around, albeit slowly. You’ve mentioned that research has shown estrogen precipitates arrhythmia/palpitations, while progesterone has an inhibiting effect. Could you explain the physiological interactions taking place during muscle contractions?

RP: One of the very recent articles on that topic concluded that estrogen causes sudden cardiac death, and progesterone prevents it. And what they were talking about was the arrhythmia caused by prolonging the excited phase of the heart action. The electrocardiogram has several phases; the last phase is called the repolarization wave (the T wave). And when that has repolarized, the cell is ready for a good, strong, next beat. But if it’s delayed by staying in the excited state too long, the atrium [atrium = first chamber receiving venous blood and containing the specialized natural pacemaker cells of the heart] might send a signal for a new beat. And if it superimposes on that excited state, the cell can’t recover enough to have a proper full beat. So it will have a slight premature convulsive movement. But not an effective pumping stroke, unless it’s fully repolarized. And estrogen is the basic thing that tends to extend the excited state. It’s similar to what happens in epilepsy during periods of greatly excessive estrogen; the brain cells can’t get out of the excited state, and there’s an epileptic seizure. Progesterone prevents that by quickly accelerating the restoration of the readiness state, or the relaxed state of the nerve. The same thing in the heart muscle or the skeletal muscle; any kind of cell that’s excited is quickly restored by either progesterone or thyroid: both of them have the energy-restoring effect, but in slightly different ways: the thyroid increases the energy production needed to relax the nerve or muscle, while progesterone stabilizes the relaxed state, so that it can hang on to the energy produced by thyroid. Wherever estrogen interferes with both of these processes, “slowing the action potential” (electrical term; its what they call the excited state).

HD: So, thyroid hormone is also able to allow muscles to relax.

RP: When the cell is in its excited state, besides the electrical changes that are being measured, many other of its properties are changed. For example, one of the immediate obvious effects of estrogen excess is that cells take up more water, or release water more slowly. So, in this one second (or fraction of a second) state of excitation of nerves or muscles, the cell momentarily takes up a little bit of water, swells up a little bit, and then as it relaxes, it squeezes the water out. And so, if you are having the premature contraction, and not letting it relax fully, this cell is actually getting a little waterlogged with each of these false beats. And that’s an effect that estrogen has on every place that it acts [upon], whether its pituitary, uterus, breast tissue, or heart, or nerve. Its causing a slight water logging and swelling of that cell.

HD2: Is this why so many women had heart attacks during the HRT (Hormone Replacement Therapy) trial? Because the estrogen taken was suppressing their thyroid and causing the water logging, and blocking the progesterone, causing a further elevation in estrogen?

RP: Yea. One of the differences between heart failure in women and in men is that the diastolic (or relaxation) phase is more often defective, or obviously defective, in women. And under that poor diastolic relaxation, the cells become progressively more waterlogged and unable to relax. And in that over-hydrated state, they also can’t get rid of the calcium that comes in when the water enters. And so, it ultimately can lead to actual calcification of the heart. There was a picture published by a Mexican heart institute of a very old women’s calcified heart: it looked somewhat like a bone. And there was a famous 19th century story about someone who was cremated and he had a limestone heart that… I think the idea for the story came because people actually do get such highly calcified hearts. But it’s really the end stage of that chronic over-hydration, over excited inability to relax.

HD: OK. The other thing I wanted to bring up is the oral contraceptives use in women over 37, which if they were smoking, was associated with a much higher incidence of stroke and heart attacks.

RP: Yea. There have been a lot of theories about that. I suspect that the fact that estrogen increases the carbon monoxide in tissue probably overlaps with the high chronic exposure to carbon monoxide in smokers. The air pollution’s carbon monoxide is highly associated with increased heart events and hospitalizations for heart attacks.

HD: I see. How to suppress palpitations and restore normal contractions?

RP: There are a lot of other factors besides the electrical properties of the heart, or the hydration. The blood volume is one of those. For example, high estrogen women are susceptible to varicose veins, ultimately (or initially, just swelling or distention of the veins). For example, putting your hand straight down: sometimes, the veins on the back of the hand swell up. And the legs tend to do that in the high estrogen phase of the menstrual cycle. And when the veins in the legs are distended, much of the body’s blood supply is in the legs. And so, it isn’t coming back to the heart at the normal speed. And this means that in that condition, if the woman stands up and her blood tends to fall into her legs, there will suddenly be a small return to the heart, so the heart doesn’t have very much blood to beat. So, it has fast, little strokes, because the blood simply isn’t being returned. So, this “situational” arrhythmia, or tachycardia, isn’t necessarily connected to the electrical instability, but simply to the way the blood isn’t getting sent back to the heart.

HD2: But that again is linked to high estrogen causing the veins to distend and to swell up.

RP: Yea. Progesterone increases the smooth muscle tone in the wall of the veins. And so, if your progesterone is deficient, the veins bulge, [during any] slight pressure on them. If you hold your hand at your waist, you won’t [normally] see your veins if your progesterone, and other things, are right. But if you’re low on progesterone, or under stress, even at waist level you’re likely to see bulgy veins.

HD2: So there you go, women. Here’s a good way to see if you’re aging or under stress: if your veins on the back of your hands are bulgy at waist level.

Caller: On a physiological level, what happens when we take Sensa crystals ( product designed for weight loss)?

RP: I’ve never heard of it. Sorry.

Caller: Did you mention that estrogen is linked to epilepsy seizures?

RP: Yea. I’ve got an article on my website about that in detail. But it’s been known for around 70 years that there’s a pre menstrual type of epilepsy. And that eventually led to animal experiments in which they showed that the ratio between estrogen and progesterone, mainly, is what governs the stability of nerve cells - as much as any [other] cell-. But when the ratio is too high, just a slight stimulation can set off an uncontrollable volley of activity, leading to seizures of different types. And it’s very easily correctable by metabolically lowering that ratio, increasing progesterone and excreting estrogen faster.

HD2: And one can figure out this ratio by asking your doctor to do a blood test for estradiol and progesterone, and looking at the ratio between the 2.

HD: Regarding myocardial infarct, I’ve read an article saying progesterone relieves the vasoconstriction caused by prostaglandins (inflammatory mediator) both in angina and myocardial infarct. Does it make sense to take progesterone as early as possible during these situations in order to reverse them?

RP: It’s very much like cortisol, [which acts] as an anti-inflammatory, inhibiting many different kinds of inflammation-promoting things. And prostaglandins are probably the most important ones for people who eat quite a bit of unsaturated fat. But [progsterone] doesn’t have the harmful side effects of taking cortisol, or the synthetic glucocorticoids, [taken] as anti inflammatory [drugs].

HD2: Do aspirin and progesterone work the same way in blocking prostaglandins when taken a short moment after a heart attack?

RP: Yea. They both stop the inflammatory process which leads to tissue damage. And the brain is more sensitive in many ways than the heart. And there has been research going on now for several years showing that if you can get a big dose of progesterone to someone who has had a potentially fatal head injury, they will have a high survival and recovery rate, because the progesterone stops the progression of brain damage. It does the same thing to any tissue that’s injured: stops the progression by reducing inflammation.

HD: Right. So, for traumatic head injuries, or myocardial ischemia, or any other event like that, it’s a pretty restorative compound.

Caller: [enquires about possible relation between fake progesterone contained in birth control pills and heart palpitations]

RP: Some of the synthetic progestins used in birth control, or others ones, actually have some protective effects. There’s one called drospirenone that is probably the closest [in function] to natural progesterone that they’ve come up with. And it’s been used to treat heart failure, for example. Where natural progesterone would be the best overall treatment. But this is a patented drug that is now being accepted because it opposes the pro-inflammatory effects of aldosterone, the salt-regulating steroid hormone, which progesterone is the natural antagonist of that. But this synthetic is a relatively safe drug for protecting the heart against failure, and fibrosis, and inflammation.

HD2: Do you know if they used that progestogen in the birth control pill?

RP: I think there is either that, or a very similar one in the European birth control pill.

Caller: Can the presence of an IUD releasing synthetic progesterone cause an increase in estrogen and trigger palpitations? Or irritate the whole organism?

RP: You had an IUD (intra-uterine device), did you say? Just the presence of an irritant in the uterus will lower your natural progesterone. And so, even if it’s releasing a progestin, I think it’s likely that the effect is by reducing your ovary’s natural production.

Caller: And over time, my body will resume producing natural progesterone again, right?

RP: Yea. As soon as the irritation stops. And if your diet and everything else are good, it will recover quickly.

Caller: Will progesterone rubbed on the skin be absorbed properly?

RP: Progesterone is very absorbable. If you stick your finger in it, and if you’re familiar with the taste of progesterone, in about a minute you can taste the progesterone. [Its] the same [phenomenon] as putting DMSO on your skin; the progesterone just goes right through, so that you can get the systemic effects pretty quickly through your skin.

HD2: I’ve rubbed on the arm of a lady who had had heart failure, first olive oil, then a teaspoon of progesterone (who had 10% progesterone and 90% Vit E), and within half an hour, the veins on the back of her hand were completely flattened. And to start with, they were very elevated. So it definitely gets absorbed through the skin pretty quickly.

HD: On another subject, you’re saying that aldosterone is a bad compound we’re naturally exposed to as part of the kidney-brain-angiotensin system.

RP: Yea. There’s several things that will start that process towards hypertension, and inflammation, and degeneration. Low blood sugar is enough to start the process, signaling your kidneys to send out renin, and starting the process to produce aldosterone. Not eating enough salt is another thing that raises the aldosterone. If your blood vessels leak for any reason, if something makes them permeable, such as hyperventilating: you [will] lose a little blood volume. And anything that lowers [either] your blood volume, or [your] sugar, or [your] sodium, will cause your kidneys to activate the process that ends up increasing aldosterone. And the aldosterone has the central function of slowing down the rate at which you lose your sodium. Keeping the sodium inside your bloodstream helps the blood absorb water, so that it doesn’t go form edema: it stays in the circulatory system, nourishing the tissues. But the side effects of that essential regulatory aldosterone is that, instead of losing sodium, you lose potassium and magnesium. And the loss of potassium and magnesium are very important in causing the heart rhythm problem. The reploarizing, restorative process of the heart muscle means that the muscle cell can retain magnesium and potassium, and excrete the excitatory sodium and calcium. And so, if you’re restricting salt, or having hypoglycemia, or losing blood volume for any reason, your aldosterone is going to tend to make you lose the stabilizing magnesium and potassium, and all of your cells will tend to become unstable electrically and functionally.

HD2: Is this why premenstrual women tend to swell, because the drop in progesterone and the rise in aldosterone?

RP: Yea. Protein deficiency is another thing that will start the swelling process.

HD2: And salt deficiency.

RP: Protein, salt, sugar.

HD: Yea. You’ve mentioned many times on our show how important sugar and salt are, contrary to popular belief.

Caller: I have Lupus, and have grand mal seizures once a month, in association with my menstrual cycle. Typically, it comes the night before my period started (the rest is inaudible).

RP: Behind the balance of aldosterone, estrogen and progesterone, is the thyroid function. Low thyroid is the main cause of that inappropriate loss of sodium. The hospitals don’t seem to realize how important that sodium loss problem is, especially in older people. But under the influence of estrogen it happens too.

Caller: I’m a 50 year old male with rope-like veins on my legs; should I use topical progesterone to treat it?

RP: Although some men do use progesterone very successfully often for varicose veins, I think that the best thing is to start with pregnenolone, using it orally, because that will normalize…it can produce testosterone, DHA, as well as progesterone. And so it will tend to keep your hormones more in balance than applying big doses of progesterone.

Caller: How much sodium should a 155 pounds, 42 year old male ingest?

RP: Your taste and craving would be the best way to judge. Because everything affects it: if your thyroid function is a little bit low, you need lots more sodium in your food. If your thyroid function is good, you can get along with a very low sodium intake and not have any problem. The reason women tend to have salt cravings around their ovulation, or premenstrually, or in pregnancy, is because the excess of estrogen and low thyroid, or low progesterone, causes them to lose sodium. But if your thyroid and hormones are good, you don’t have to worry at all about adding salt to your food.

HD2: Also, if you have a comprehensive metabolic panel done, you’ll see the sodium level somewhere: it can be a good indication sometimes if you need to supplement more sodium.

RP: And on that same test, the albumin works with the sodium and thyroid to regulate the volume of your blood.

HD: Ok. Thanks you so much for your time, Dr Peat.

RP: Ok.