Nausea in Pregnancy: Do We Know What Causes It?

It never ceases to surprise me how little we know about very common health and disease scenarios, so it’s nice when we get a peek into some of the more problematic ones.

Nausea is a pretty well accepted thing with pregnancy. No one actually looks forward to it, but most women manage to get through it. Personally, I have always felt that it somehow relates to hypoglycemia (after all, that little developing nugget in the womb is using so much glucose you can almost hear the sucking sound…). This is why it is more common in the morning and why B6 and more frequent eating seems to help in some cases.

But when the nausea gets so severe that the mere thought of food leads to projectile vomiting, nausea of pregnancy gets its own name: Hyperemesis gravidarum.

Even the name is scary. The danger in this condition is nutrient (both macro and micro) deficieny to a degree that can harm the growth of the developing baby.

The only answer that we have had for this condition is anti-emetic drugs like Compazine, Phenergan or Zofran. In same cases steroids may be used. Steroid use during pregnancy has some concerns and Zofran is ridiculously expensive.

But what if we could begin to identify factors that increased the risk of sufferering from hyperemesis gravidarum? This particular study does just that.

In it, researchers looked at what diagnostic factors may be associated with the presence of HG. Here’s what they found:

• There was no relationship between ketonuria (ketones in the urine—a sign of malnutrition) and presence or severity of HG.
• HCG, thyroid hormones, leptin, estradiol, progesterone and white blood count were not consistently related to HG.
• However, those who had HG were 320% more likely to have markers for H Pylori (the “ulcer” bacteria).

For years, I have contended that H. pylori is not the problem. Rather, H. pylori is an opportunistic pathogen that rises to the top and creates problems like ulcers only when conditions are ideal. Probably one of the most important factors I can think of is probiotics.

I know—you’re thinking, “UGH!! Not again!”

Don’t shoot me—I’m just the messenger. And yes, it is entirely possibly that probiotics early on in pregnancy (or even before) could potentially lower the chance of developing HG. I have never recommended probiotics for HG, although after this study it is definitely now going to be on the list of recommendations.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.