For educational purposes only. Consult a doctor if you want to apply this information.
Rachel’s case. This young, “mother-to-be” (first child) heard me explain my treatment for morning sickness (Nausea and Vomiting of Pregnancy, NPV) years ago in a college class. (link to that blurb). So six years later she called me which went something like this: “Dave, I tried your technique for morning sickness, but it didn’t work. I’m desperate.”
It didn’t work BECAUSE she was experiencing hyperemesis gravidarum (HG). I asked her about the pregnancy, and she was nauseas all day and vomited often.
Rachel was 124 pounds before becoming pregnant and was in her fifth month when she called. Guess what she weighed? Eight-two pounds! That’s right. If you read the literature I cite at the end of this blurb, you’ll find a 5% weight loss is typical and 15-30 pounds happens, too. She was down 42 pounds.
Would you suspect something was amiss with that pregnancy? Her OB/GYN said, “It’s normal,” but I told her it wasn’t. He correctly suggested drinking Ensure or a similar product, but she couldn’t keep it down. Supplemented water drinks, e.g., Pedialyte didn’t make it, either. To get liquids in her, she sipped water throughout the day—no normal swallows.
Rachel asked: “What else can I do?”
I told her I read a medical article years ago saying women with HG may have insufficient stomach acid levels. Why would low stomach acid occur with HG? Because your body is smart and, if it can’t digest food, it will get rid of anything you swallow. Undigested food in your stomach is dangerous.
What did I suggest she try? Vinegar, since it’s acidic. I asked her to take two tablespoons of vinegar; she did, and immediately felt better. I told her to see a digestion specialist, a gastroenterologist, and ask for a stomach acid level test.
The doc said, “Your stomach acid levels are the lowest I’ve ever seen.” He prescribed hydrochloric acid (HCL) pills and said, “Take with water, and you should be fine.” Then he told her to contact her OB/GYN first since she was under his care and should get his OK.
The OB/GYN said, “Don’t take the acid pills.” Why? Because he said he didn’t know how it might affect the baby. Hadn’t he read the literature what HG might do to the baby and a mother? Apparently not. See medical articles by London, Grube, Sherer, & Abulafia, 2017; Wegrzyniak, Repke, & Ural, 2012; and many others.
After birthing, Rachel wrote me and said she made it through the pregnancy by taking four tablespoons of vinegar fifteen minutes before eating. In the next pregnancy (and the time after), the severe vomiting started once again. Offto the gastroenterologist; he prescribed the acid pills, and she had no further problems. She didn’t tell the OB/GYN.
Do laboratories test for low acid levels? They can, but do they? After Rachel’s experience, I called a local lab in my city of 100,000 and asked if they performed such a test. The woman said, “Yes, we do.” I asked how often they’d given it. Her answer: “Well, I’ve worked here seven years, and we’ve never given it.” Can you believe that lab had not given that test? This city wasn’t large, but some women must have suffered from HG in seven years. Shocking. What’s going on?
Application to HG sufferers.
So, if you suffer from HG, get your stomach acid levels checked; if one doctor won’t test you, find one who will. It’s your life and the health of your baby.
Is treating hyperemesis gravidarum HCL acid pills mentioned in the medical literature? Not much (see Anderson, 1934, below), but who do you suppose found vinegar effective for morning sickness and, sometimes, HG? Mothers! HG is not just morning sickness (NVP), and the research reports low stomach acid levels in morning sickness as well as HG. Yet, the article don’t mention supplementation with HCL. Apparently, women know the benefits of acidic supplements, e.g., vinegar & lemon juice. Where are the medical researchers?
What about causes and treatments for HG?
As you have doubtless read, a variety of so-called “remedies” exist for NVP (morning sickness) and HG as do many possible “causes.” The fact is: researchers haven’t been able to nail down the origin of hyperemesis gravidarum (Li, Li, Zhou, et al., 2015; Cardaropoili, Rolfo, & Todros, 2014). I presume there may be one cause for one woman and a different one for another. That makes researching the issue difficult. I investigate mostly medical articles, and the views vary; some researchers support one hypothesis and others something else. A confusing field.
Is the answer Rachel found applicable to others with HG? Only time and experience will tell, and a simple stomach acid test might give us the answer and encourage treatment for HG. Once a physician sees fantastic results for one HG sufferer, that doc will help the next woman and the one after. Be sure you talk to a doctor—try nothing on your own!
Google “morning sickness and vinegar” and “vinegar and hyperemesis gravidarum apple cider.” It’s on blogs and numerous websites—much more than is in the medical literature. How long before doctors and researchers discover this information?
What symptoms accompany HG?
How’s this for a nice list? Low potassium levels, dehydration, weight loss, headaches, acid reflux, a decrease in urination, low blood pressure, constipation, vitamin deficiencies (e.g., folic acid, thiamine, B-12), mineral deficiencies (e.g., calcium, zinc), amino acids, high H pyloric bacterial levels, and more. If you research HG, you’ll find these and others mentioned. (e.g., see Wegrzyniak, Repke, & Ural, 2012, plus blogs and websites at the end of this article.)
Are these findings the causes or results of HG? I believe the above items result from HG rather than cause it. If you can’t digest food, you will lose weight, suffer constipation, and get deficient in vitamins and minerals. Makes sense, right? Most of the literature talks about correcting these problems with medication and IVs (e.g., McParlin, O’Donnell, Robson, et al., 2016), but I prefer avoiding those treatments by enabling a woman to eat. Acid supplementation may be the answer.
The naysayers. My view that low stomach acid contributes to HG will have its distractors. Here’s what the naysayers might argue about low stomach acid as the explanation.
“No one has proved it.” That might be true since perhaps researchers (a) haven’t considered it or (b) there’s no funding to back such a research program.
“It’s an old wives’ tale.” But, “new wives” say it, too. Check out the women saying vinegar helped them with morning sickness and with HG.
“It’s only a case study; just because it worked on one person doesn’t mean it will work on others.” I agree, but it might work for 50% or more of the HG cases. Let’s try it and see.
“It might be the placebo effect.” Any person who says that has NOT suffered from HG.
How you can make a difference.
Let’s try to educate our health care workers in this critical area. Please share this blurb with others so that mothers-to-be suffering from HG may avoid a difficult pregnancy and avoid problems for the baby. Even if you’re not suffering HG, you can empathize with others. Won’t helping women avoid HG be a fabulous reward for you? It will be for me.
Publish this information on your Facebook, Twitter, Pinterest, LinkedIn, and any other social media outlet you can. Let’s get the word out.
And, thank you, for caring.
Want to learn more?
Here are excellent articles to bolster the low stomach acid argument.
How can low stomach acid levels make you think you’re suffering from too much acid? Because people burp up whatever’s in their tummy, acid comes with it even if there isn’t much. This so-called acid reflux can happen if you have inadequate stomach acid levels. Doctors often prescribe an anti-acid pill to lower the acid, but that’s a big mistake if you already are stomach acid deficient. See https://scdlifestyle.com/2012/06/hypochlorhydria-3-common-signs-of-low-stomach-acid/
And see http://www.eatnakednow.com/13-signs-you-have-hypochlorhydria/ in which they suggest taking apple cider vinegar to help raise stomach acid levels. Vinegar, eh?
Here’s an old, medical journal article (1934). That’s almost 100 years ago. IT IS IN THE LITERATURE; WHY ISN’T ANYONE RESEARCHING THIS? Maybe they are, but I missed it despite scouring PubMed which summarizes medical journal articles. Many scientific reports point out the relationship between low stomach acid levels and HG, but they don’t suggest taking acid supplementation. One author said that vomiting might cause the low acid levels. Great thought. Which came first, the low stomach acid level or the vomiting? I vote for the stomach acid problem which led to the vomiting because your system knows you can’t “stomach” any food.
Anderson’s 1934 article reports the vomit of HG women contained little or no acid. Not only that, but he said patients tolerated a weak, hydrochloric acid (HCL) solution. Unfortunately, he didn’t report if it helped nausea. Although recent medical journals mention low acid levels with HG, they say nothing about adding HCL. Isn’t it interesting that women understand vinegar and lemon juice helped and both are acidic? Give Anderson’s article a read.
David F. Anderson (1934) THE TOXEMIAS OF PREGNANCY. I.-Early.
Available from http://pmj.bmj.com/content/postgradmedj/10/101/89.full.pdf
Postgrad Med J10: 89-95 doi: 10.1136/pgmj.10.101.89
Understanding the dangers of HG.
The Hyperemesis Education and Research Foundation educate expectant mothers experiencing the severest form of morning sickness. www.hyperemesis.org
http://morningsickness.net/SEVERE-HYPEREMESIS-GRAVIDARUM-AND-INTRA-UTERINE-FETAL-DEMISE-Poster-2017.pdf A short view of evidence that HG can affect the fetus from Miriam Erick.
http://morningsickness.net/ Website from Registered Dietitian Miriam Erick, a registered dietitian. She wrote two books plus provides info on her website. Check it out.
Excellent article by Maya S. Cook asking, “Is Low Stomach Acid the Cause of H Pylori?”
If H Pylori grow in a less acid environment, it could explain why women with HG have higher levels of H Pylori (present in up to 90% of HG sufferers) than non-pregnant (about 60%)? These percentages vary from study to study. There still is no consensus if H Pylori causes HG or merely related to it (Cardaropoli, Rolfo, & Todros, 2014). So, higher levels of pylori make sense since HG accompanies low stomach acid levels. HG = less acid; less acid = more pylori. It all fits together. I bet correcting low stomach acid levels will control this bacterium.
Medicine is grappling with this problem and has for decades as Anderson’s 1934 article affirms, and now it’s been eight more decades. Even we psychologists get in the act and say stress causes HG in some cases, but I doubt that because the nausea is severe and long-lasting. Something physical is going on. The stress is a result of HG as the writers of the stories below will convince you.
The following website has a wealth of information for morning sickness (nausea and vomiting of pregnancy). It mentions many treatments—one will work for one person but not another, so it’s a “try it and see” approach. This site also mentions hyperemesis gravidarum (HG) with a link for more information. Hyperemesis gravidarum is more likely to cause weight loss reduction and contacting a doctor is essential.
The following site from a woman who will tell you how horrible it is. Her children came early (one seven weeks, another six weeks), she lost 30 pounds, and spent time in the hospital. HG is a serious issue, so if you or someone you love has more than just morning sickness, contacting a doctor is paramount. Read her story at http://apieceofcraft.blogspot.com/2011/06/my-struggle-with-hyperemesis-gravidarum.html
Here’s a site dedicated to hyperemesis gravidarum with excellent information and warnings. They present a chart comparing “normal” morning sickness and HG.
Another great site is http://www.hyperemesis.org/ An organization for the HG pregnancy issue.
You can Google “hyperemesis gravidarum” and discover many other websites and blogs. Learn all you can. If you read too much, you might fear for your health and that of your child—and you should. HG is not morning sickness. You can lose weight, be nauseous for the entire pregnancy, and have various medical problems. Your HG might also affect your child. I’m not trying to frighten you but encourage you to get the right help.
http://adventuresandplay.com/hyperemesis-gravidarum-story/ One mom’s story of her 245 days of nausea, hospitalization, and a lot more.
http://tricianoel.blogspot.com/p/my-battle-with-hyperemesis.html Here’s another story of a frightful pregnancy. This blog, like the above, illustrates how difficult and dangerous such a pregnancy is.
https://www.popsugar.com/moms/What-Like-Have-Hyperemesis-Gravidarum-36586073 A case of HG plus losing her next baby.
Medical References Cited
Cardaropoli, S., Rolfo, A., & Todros, T. (2014). Helicobacter pylori and pregnancy-related disorders. World Journal of Gastroenterology, 20 (3), 654-664. Online: http://firstname.lastname@example.org doi: 10.3748/wjg.v20i3.654
Li, L. et al. (2015). Helicobacter pylori infection is associated with an increased risk of hyperemesis gravidarum: A meta-analysis. Gastroenterology Research and Practice, http://dx.doi.org/10.1155/2015/278905. You can get this online.
London, V., Grube, S., Sherer, D.M., & Abulafia. (2017). Hyperemesis Gravidarum: A review of recent literature. Pharmacology, 100 (3-4), 161-171.
Wegrzyniak, L.J., Repke, J.T., & Ural, S.H. (2012). Treatment of hyperemesis gravidarum. Reviews in Obstetrics & Gynecology, 5 (2), 78-84. Doi: 10.3909/riog0176. You can get this online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410506/
McParlin, C., O’Donnell, A., Robson, S.C. et al. (2016). Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: A systematic Review. JAMA, 316 (13), 1392-1401.