When I was a geneticist Malena Fesso When she became pregnant for the first time, she, like most people, suffered from nausea and vomiting. Approximately 70% — The proportion of pregnant people is. In most cases, symptoms are manageable and often disappear by the end of the first trimester. However, Phezo’s illness was serious. Although she lost 15 pounds and went to the emergency room twice, she was never officially diagnosed with hyperemesis gravidarum, severe nausea and vomiting during pregnancy.
The study published in the same journal found that there is no scientific consensus on what constitutes “severe” nausea and vomiting in humans, and that the estimated number of pregnant women affected by nausea and vomiting ranges from 0.3% to 10.8%. It is said that there is. frontiers of medicine.
It is a “diagnosis of exclusion”. Dr. Emmanuel Baghdasarianan obstetrician-gynecologist at Good Samaritan Medical Center in Palm Beach, Florida, told HuffPost. “Hyperemesis is constant vomiting with no other identified cause, accompanied by weight loss and intolerance to oral fluids and food,” she says.
This disease is the leading cause of hospitalization during early pregnancy and can cause unimaginable suffering.Both the Duchess of Cambridge and comedian Amy Schumer were hospitalized with the disease while pregnant, and historical records show that British writer charlotte bronte‘s His death in 1855 is likely due to this disease.
After giving birth to her first child, Fezo became pregnant for the second time.
“I didn’t think it could get any worse, but it was so much worse,” she told HuffPost. “I couldn’t eat, drink or move without violently vomiting. It was really torture for weeks. I just had to lie completely still in bed.”
In addition to standard IV fluids for dehydration, she was treated with a feeding tube and seven different medications, none of which provided relief. Her symptoms continued until she miscarried at 15 weeks.
Although she was on an IV, she was completely bedridden and required regular bedpan changes and other care throughout the day. But the most shocking part of the ordeal was the gaslighting from the medical establishment.
She recalled being told that she was just looking for attention from her husband and family, and said, “It seemed like she really enjoyed asking my dad to change the toilet bowl.”
As Fejzo discovered, throughout human history pregnant people have struggled with nausea and vomiting; male-dominated Medical professionals ignore their suffering.
For decades, researchers have virtually ignored hyperemesis gravidarum. But after his own experience, Fezo set out to change that. She knew that her illness had a biological cause.
In 2018, Fejzo, who has a PhD in genetics, and his colleagues published the following paper: paper This indicates that two genes, GDF15 and IGFBP7, are involved in hyperemesis gravidarum. Finally, there is scientific evidence that this condition is not psychological.
Last week, Fejzo and his co-authors published the following paper: another paperThis explains the mechanism by which the hormone produced by the GDF15 gene (also known as GDF15) causes nausea and vomiting.
Although this finding reveals a potential path to more effective treatments, there is more to learn about the relationship between GDF15 and nausea and vomiting. But for now, here’s what you need to know.
What is GDF15?
Both the gene and the hormone it produces are called GDF15. Fejzo explained that our genes can be thought of as “recipes” and the GDF15 gene provides the instructions for making her GDF15 hormone. This hormone is produced by what Fezzo called “the fetal part of the placenta.” However, pregnancy is not the only time that hormones are present in the body. For example, cancer patients who suffer from cachexia, which causes weight loss and loss of appetite, are due to increased levels of the GDF15 hormone.
“Symptoms like this occur when you have a disease that’s caused by unhealthy tissue, such as a viral or bacterial infection,” she says. “Levels increase when there is kidney or liver damage. This hormone is produced when the body’s organs and cells are exposed to some type of physical stress.”
The theory is that humans evolved this gene to prevent them from going hungry or searching for food while their bodies are weakened, since they are more likely to be killed by predators while they are sick. That means he let it happen.
It is important to note that GDF15 and human chorionic gonadotropin are two different hormones. HCG is a hormone that is only produced during pregnancy, so it is detected by pregnancy tests. For infertile patients, levels of this hormone can be tested throughout early pregnancy, as low HCG levels may predict miscarriage. However, there is no evidence that HCG causes nausea or vomiting.
How does GDF15 cause hyperemesis gravidarum?
What Fejzo and colleagues found is that people with low levels of the GDF15 hormone before pregnancy were more likely to experience nausea and vomiting. This is due to mutations in the GDF15 gene. As if her tolerance to GDF15 is low and the placenta produces more of her GDF15 during pregnancy, she is more likely to develop symptoms.
“Everyone has GDF15 during pregnancy, and it’s produced in the fetal part of the placenta. But people who tend to have low levels of this before they get pregnant will be more sensitive to it,” Fezzo said. .
Researchers also found that people with hyperemesis gravidarum had higher levels of GDF15.
People who are most likely to suffer severe symptoms like those endured by Fezo are those whose “levels tend to decline even before pregnancy,” she says.
What are some potential ways to treat hyperemesis gravidarum in the future?
One possible treatment could involve building up tolerance to GDF15 before pregnancy in people who are genetically predisposed to hyperemesis gravidarum, similar to how allergy shots build tolerance to allergens. Fejzo said the strategy has been successfully tested in mice.
Fejzo and his co-authors also studied women with a genetic disorder called beta-talesymia, which causes elevated levels of GDF15. Researchers found that these women were much less likely to experience nausea and vomiting during pregnancy, with only about 5% reporting these symptoms. This is further evidence that high tolerance is protective.
There are also drugs to treat cancer cachexia and wasting syndrome. Currently undergoing clinical trialsthese may be effective in hyperemesis gravidarum patients.
What should I do if I am sick now?
If you’re pregnant and suffering from nausea and vomiting, it’s important to understand that your illness is real, Fazzo says. Find a health care provider who will listen to you and take your symptoms seriously.of HER FoundationFejzo serves as a board member and research advisor and helps find providers and volunteers to provide support.
It is important to seek medical attention if you are unable to eat or drink normally, are losing weight, or are dehydrated. IV fluids may be required. In addition to that, you may need to take a vitamin called thiamine (vitamin B1). Deficiency of this vitamin can lead to a serious neuropsychiatric disorder known as . wernicke encephalopathy, But for hyperemesis gravidarum patients, this is completely preventable. If you cannot take vitamins because of vomiting, thiamine can be given intravenously.
Baghdasarian said there are several levels of treatment, starting with ginger and avoiding fatty foods that are difficult to digest. The next step is vitamin B6 and doxylamine (a sleep aid also known as Unisom).
“If that doesn’t work, we move on to antiemetics like Zofran or Reglan.” “Treatments are effective,” she said, but added, “The goal is to control the symptoms.”often completely treats symptoms
It’s not realistic. ”
Dr. Baghdasarian also said that with hyperemesis gravidarum, “there are usually no adverse events for the fetus. Low birth weight is common, but that’s usually the only complication.”
However, don’t put off getting care. Baghdasarian said hyperemesis could be a sign that you’re carrying multiple fetuses or have other complications.