Nausea During Pregnancy

Carolyn Mercer, B.Sc., N.D. Educator 15 Jun 2021

How to Treat Nausea during Pregnancy Safely: Using Vitamin B6 and Folate

Long term, this can lead to dehydration, loss of energy and weight loss during pregnancy. It can make it extremely difficult to go through your daily activities.
There is no known cause according to most medical research, and many treatments and medications have also been found to be ineffective.¹ 

In more recent years, potential allergies to hormones have been investigated as a potential cause of hyperemesis gravidarum.  There have also been increased incidence of nausea associated with increased oxidative stress and inflammation.²

It is well known that Vitamin B6 has been shown to reduce nausea during pregnancy.  
In one study 15 of 31 Vitamin B6-treated patients had vomiting before the study and at the completion of only 3 days of therapy, only 8 of 31 patients in the Vitamin B6 group had any vomiting.³

Vitamin B6 has been shown to be effective in preventing nausea in divided doses between 30-75 mg and up to 100 mg.  If 50 mg of Vitamin B6 is taken 2-3x/day this has been found to reduce the side effects of nausea and can be taken safely during pregnancy.⁴ Especially if slow release formulations are used.

As mentioned above, oxidative stress is being discussed as a potential contributor to hyperemesis gravidarum. 
Oxidative stress is caused by exposure to poor foods, pesticides, radiation, and pollution.  In one study⁵ pregnant women with hyperemesis gravidarum were found to have more oxidative stress than those who were pregnant and did not experience hyperemesis gravidarum. 
Antioxidants help reduce the effects of oxidative stress. 

As a result, there has been a lot of research around glutathione production since it is a powerful antioxidant and can aid in reducing the symptoms of nausea and vomiting during pregnancy.⁵ 

A lot of attention has been placed on the production of glutathione and the methylation cycle. This is because the methylation cycle is directly joined with the trans-sulfuration pathway. Trans-sulfuration is how we make glutathione. 
Increased glutathione levels are associated with less oxidative stress.⁶  (See Figure 1)

In short, some of the homocysteine that is made from methylation reactions is used to make cysteine, which then combines to form glutathione.  It is significant to address that any glutathione promotion should involve the use of Vitamin B6.⁶

Also, if a gene mutation, such as an MTHFR abnormality, is present, it can prevent folic acid from being converted into the active form, L-5-Methyltetrahydrofolate, which will in turn affect the methylation cycle, which will then indirectly affect glutathione production.⁶ (See Figure 1)

Improving glutathione production will help reduce oxidative stress in the body.  Women who experience hyperemesis gravidarum should consider using active forms of B vitamins which will help reduce oxidative stress and help relieve nausea/vomiting during pregnancy. 

B Vitamins such as the active forms of Vitamin B6 (P5P) and B9, Folate (5-Methyltetrahydrofolate) are considered a safe intervention during pregnancy, especially if they come in slow release form.

Figure 1

Reference List

1. Grow by Web MD. https://www.webmd.com/baby/what-is-hyperemesis-gravidarum#1 (accessed May 21, 2021).
2. Apple Podcasts Preview. 2014. “Why Methylation Matters and how you can Improve it.” Apple Podcast file. https://podcasts.apple.com/us/podcast/why-methylation-matters-and-how-you-can-improve-it/id921659583?i=1000334381885 (accesed May 20, 2021).
3. Sahakian, V, 1991. “Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study.” 78 (1). Abstract in Obstetrics and Gynecology 33-6.
4. Sheehan, Penny, “Hyperemesis gravidarum,” Australian Family Physician, September 2007, under https://www.racgp.org.au/afp/200709/200709sheenan.pdf (accesed May 20, 2021).
5. Fait, V, 2002. “Hyperemesis Gravidarum is Associated with Oxidative Stress. 19(2). Abstract in American Journal of Perinatology. 93-8.
6. Metabolic Healing. https://metabolichealing.com/methylation-detoxification-glutathione-connection/ (accessed May 20, 2021).
7. Research Gate. https://www.researchgate.net/figure/The-methionine-homocysteine-cycle-contains-re-methylation-and-transsulfuration_fig6_286447602 (accessed May 27, 2021).