Okay, I just wrote a huge post below and I know all this information could be overwhelming. I'm also very aware, just from your handful of posts, of how hard this pregnancy has been for you and I don't want to add to your distress! I also don't expect you to change anything you're doing based on my say so, I'm not your doctor and I'm not you, only you and your doc can evaluate the information for *you* and your values and your comfort level with the benefit - risk analysis. What I do want to give you, though, is more information, since I believe (and remember I'm no doc) that you are making decisions based on minimal information, and more information might give you better informed consent.
The "can't hurt, might help" perspective is one we usually do better refuting, sorry! To be fair, my bias comes down much more on the side of don't do *anything* until the research is really clear, because time and time again I see the research change and I see women's stories here. It's true that negative effects are often rare, but anything you take in pregnancy is a risk / benefit analysis that we always want your doc to weigh in on and have you evaluate with as much information as possible. And when the research isn't quite there, you can't have full informed consent, so you're essentially experimenting on yourself and your baby.
I absolutely understand the desire to do something, anything, and I supplemented and changed my diet and did just about anything available to me in my own second pregnancy. My blood pressure was wonkier in my third pregnancy when I did nothing so I ended up with a lot more monitoring, but I delivered at exactly the same time - 37 weeks - as the pregnancy when I did "everything", but both immediately post-partum and longer term, my "nothing" baby is healthier by far than my "everything" baby. But correlation doesn't equal causation - doing "nothing" probably had nothing to do with my wonkier bp, just like doing "everything" probably had nothing to do with my other baby's health issues, but... I will always wonder.
Still, my experience is also just anecdotal, what is most important is what the research says.
Aspirin is now pretty standard, especially in Europe, but our docs are less than impressed with the research and some interpretations of the data show risks of placental abruption as about equal to the PE reduction benefits.
A high protein diet can be really hard on already stressed kidneys - and high blood pressure alone can stress kidneys. A high protein diet can also be hard on your body in general. I had blood in my stool (TMI, I know) for almost a year after my protein-diet pregnancy any time I had a carbohydrate-heavy meal (lots of rice, pasta, etc) that my doctor attributed to my body not knowing how to process carbohydrates any more.
And... high-protein low-carb diets have been shown to affect offspring:http://www.preeclampsia.org/forum/viewtopic.php?t=23462http://www.preeclampsia.org/forum/viewtopic.php?t=24698
For the less-researched supplements like fish oil and l-arganine, I have two main concerns, that may or may not ring accurate to you. You wrote "If low-dose aspirin and fish oil can help prevent micro-clots, logic tells me that will give the placenta a better chance at continuing to provide maximum nutrients to my baby, for a longer length of time."
- the problem I see there, and remember I'm not a doc, just a woman who has been there, is that I haven't seen any studies that say lda or fish oil prevent micro-clots. I think the latest understanding is actually that lda's effects - if any - may be due to anti-inflammatory effects. A quick google search tells me fish oil can also have anti-inflammatory effects - but fish oil has even less encouraging research than lda.
Here's an older thread where we discuss fish oilhttp://www.preeclampsia.org/forum/viewt ... 17&t=33025
*I know you didn't include Vitamin C
and E in your list of supplements, I'm including this information because it's the best example I have to explain my position against "can't hurt, might help".*
The biggest reason I personally am against supplementation without strong research is because of Vitamin C
and E. For years the docs and researchers had good evidence that antioxidants like Vit C
and E might help prevent preeclampsia from developing. Early studies, even moderately large ones, were promising. A few studies even seemed to confirm the "can't hurt, might help" possibility. Then they did more research and found that for most people vit c
and e didn't hurt, but they didn't decrease the risk of PE at all and made some women sicker and their babies smaller. http://www.ncbi.nlm.nih.gov/pubmed/19843004http://www.ncbi.nlm.nih.gov/pubmed/16616557http://www.ncbi.nlm.nih.gov/pubmed/18937704http://journals.lww.com/greenjournal/Ab ... _A.17.aspxhttp://www.medpagetoday.com/OBGYN/Pregnancy/2957http://www.preeclampsia.org/forum/viewt ... ker#p35318
I am generalizing the Vitamin C
and E to other supplements and interventions because any intervention that has the possibility of doing something good also has the possibility to do something we don't want. So again, risk-benefit according to your values and comfort level.
I'll also add yet another reason why working with your doctor is so important - even something that is benign or even helpful in the vast majority of people can be damaging for a rare individual. Our founder, Anne Garrett, has Sarcoidosis, so even though calcium supplementation is generally accepted as helpful in low-calcium intake populations, giving *her* calcium can be very damaging, and possibly contributed to her dangerous PE in her fourth pregnancy.http://www.preeclampsia.org/forum/viewt ... ium#p41012
Just like the rare possiblity of IUGR from bp drugs concerns you, I would like you to consider than any intervention or supplement you try could have risks, known or unknown, and have a much less chance of being helpful than the research supporting bp meds to reduce the risk of stroke and organ damage for you (though bp meds have not been shown to have success in decreasing progression to PE).
(And adding to what Alexis said, hypertensive pregnancies in general are known to produce either small or large babies - I think it's called "bimodal" - but very few "average" size babes. So yes, it's my understanding that the risk of IUGR from uncontrolled hypertension is much higher than the risk of IUGR from the mild bp meds like methyldopa.)
Whew, if you've read this far, I hope it's helpful and not too overwhelming and scary. Again, you and your doc need to work together to find the best risk-benefit combination for *you*. For *me*, supplementing in my second pregnancy, even knowing a lot of these risks, was something I did anyway because I felt like I had to try *something*. As long as you're aware that the things you're trying to prevent PE have risks that include "*could make PE worse or affect my child*".
Caryn says it better in this post.http://www.preeclampsia.org/forum/viewt ... er#p332945