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Hyperemesis Gravidarum

What is it?

Hyperemesis Gravidarum is a more severe form of morning sickness. Women usually experience severe nausea, vomiting, and fatigue, which may lead to dehydration and a depletion in electrolytes. Hospitalization for fluid and electrolyte replacement is often the case when dehydration occurs. Other symptoms may include inability to keep food or fluids down, urinating less, fainting, headaches, dizziness, and/or lightheadedness. HG (hyperemesis gravidarum) affects approximately 0.3-2.3% of pregnancies. 

 

What causes hyperemesis gravidarum?

    HG is said to be caused by being pregnant with multiples, a history of migraines, a family history of HG, the increase of HCG, previous pregnancies with HG, lack of magnesium and/or zinc, and the hormone GDF15, which is released by the placenta. 

    Hormones double, triple, etc. when pregnant with multiples. This raises the chance of HG because of the increase in HCG and GDF15. 

    GDF15 is a protein hormone that acts as a stress response and survival factor in the body. It regulates appetite, body weight, and immune response. GDF15 binds to receptors in the brainstem AP (area postrema) and NTS (nucleus tractus solitarius). The area postrema acts as a chemoreceptor trigger zone for vomiting. When the receptor detects toxins, it activates and leads to symptoms like nausea, vomiting, taste aversions, and decreased food intake. NTS also activates vomiting when its receptor is triggered. 

    Migraines and HG share a genetic predisposition related to hormone changes during pregnancy. Both are triggered by hormone fluctuations of HCG and estrogen. This is why a history of migraines may increase your chances of having HG during pregnancy. 

 

Things that can help decrease HG?

    Although there has not been any cure for HG, here are some things you can try to help decrease the symptoms of HG. 

    1. Avoid food that may increase GDF15, like food that contains linolenic acid (soybean oil, sunflower oil, corn oil), oleic acid (olive oil, hazelnuts), whole milk, cheese, cream from whole milk, brown algae, processed foods, and foods with added sugars. 

    2. Foods that can help lower GDF15 are fruits and vegetables rich in polyphenols, such as organic berries, apples, seeded grapes, onions, spinach, broccoli, etc.; virgin olive oil; and nuts.

    3. A Mediterranean diet that consist of fruits, vegetables,whole grains, legumes,nuts etc.

    4. Increase magnesium and zinc intake. Zinc levels that are low cam cause dysgeusia. Zinc replacement could help reduce some symptoms. Like with morning sickness, low magnesium can cause worsening nausea and vomiting. Replacing magnesium may help alleviate some of the symptoms. 

 

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