Nausea, or “morning sickness” is one of the most common symptoms women experience during pregnancy, affecting 50% to 80% of pregnant women.1 The typical presentation women experience is mild nausea at one point of the day (not just in the morning!) that is relieved by eating, is limited to the first trimester (week 6 to 12 being most common time period), and approximately 1/2 will experience vomiting as well. However can range between mild to severe symptoms depending on the pregnancy. There are a number of women who experience additional symptoms such as persistent nausea, food and smell aversions, fainting, motion sickness, with some cases so severe, they last the entire pregnancy.
Regardless of the type, this is not pleasant for any woman to experience and many seek out alternative options in order to avoid the use of prescription medication. There have been a few natural remedies well studied and shown to be quite effective for reducing symptoms of “morning sickness” especially in the mild to moderate forms.
Dietary Strategies
Though there is limited evidence of dietary treatments to help with nausea, clinically, many women report that nausea is much better with eating. It is therefore recommended that women experiencing nausea have small, frequent meals throughout the day.1 I typically recommend keeping meals balanced with lean protein, healthy fats and low in refined and simple sugars to keep blood sugars stable throughout the day. There is some reason to believe that nausea could be due to hypoglycemic (blood sugar) drops during the day, which is why mild nausea tends to be relieved by eating food. Bland, low fibre foods, such as crackers, seems to help relieve nausea for most women, perhaps due to the their ability increase blood sugars quickly and their light nature – it’s always good to keep these on hand if you experience nausea throughout your pregnancy.
Ginger Root
Ginger root has been found to be an effective and safe way to improve mild to moderate nausea in pregnancy, specifically in nausea cases during the first 16 weeks.2, The form of ginger used in studies are typically a powdered extracts in capsule form, equalling about 750mg to 1g daily, in divided doses.2,3 Ginger root in tea form, or candied form can also help alleviate symptoms, but may not be strong enough alone to illicit an effect. However, I typically do not discourage these methods as everyday strategies to help settle nausea as they are safe, and can also help with other symptoms of digestive upset, such as bloating.
Vitamin B6
Vitamin B6 in the form of pyridoxine has been studied and found to be helpful in the treatment of nausea during pregnancy. In fact, pyridoxine is generally recommended as first-line therapy for nausea before pharmaceutical interventions are offered and is one of the key ingredients in anti-nausea medications recommended by physicians.4 Though the anti nausea effects are present, many studies have actually found that ginger is more effective at reducing nausea and vomiting compared to Vitamin B6.5 Perhaps one of the reason for the weaker anti-nausea effect of Vitamin B6 in pyridoxine form is because it is not the active form of vitamin B6. A recent study found that the anti-nausea effect of Vitamin B6 is from its active form, pyridoxal-5-phosphate (P5P).6 In practice, I often like to combine Vitamin B6 (in P5P form) with ginger in order to achieve the best relief.
Other forms that have been traditionally used to help naturally alleviate nausea include acupuncture and homeopathic remedies. Though there isn’t sufficient evidence that supports efficacy of these methods, clinically, many people do report experiencing significant relief. Acupuncture has been found to be safe, and is backed by a few studies demonstrating relief by stimulating the PC-6 point, which is located on the inner forearm, about 2 inches above the wrist crease that separates the hand from wrist.7 Homeopathic remedies should be chosen by a qualified health professional who chooses a remedy based on the specific characteristics of your symptoms.
Severe cases of nausea are difficult to treat and can have a large impact on a women’s social, psychological and physical well-being. Women who typically fall in to the severe category are diagnosed with the condition, Hyperemesis Gravidum, which affects 0.3% to 3% of pregnant women, who experience vomiting so severe it leads to weight loss and hospitalization.1 In my practice, I’ve found good success using natural remedies to help reduce and relieve nausea symptoms. However, I have been faced with cases where natural remedies were not sufficient to relieve nausea and therefore suggested using stronger pharmaceutical medication recommended by their M.D. In this particular scenario, the effects of the nausea (such as vomiting, fatigue, nutrient loss and deficiency) have been found to be far more detrimental to the pregnancy than taking medication and thus is recommended in order to keep mom and baby safe and well-nourished. It is also important to rule out other causes for nausea, such as peptic ulcers, infections of the kidney and intestinal tract, hepatitis or gallstones.
Nausea is an extremely common, self-limiting symptom many women experience during pregnancy. Mild to moderate cases can be well-controlled using some simple, natural methods, found to be effective not only clinically, but through a number research studies.
Dr. Tanya Lee, N.D. received her Honours Bachelor of Science degree in Biochemistry and Biomedical Sciences from McMaster University, and was trained as a Naturopathic Doctor at the Canadian College of Naturopathic Medicine. Dr Lee practices full-time between two clinics located in Toronto and Milton Ontario and has been voted Milton’s favourite Naturopath in 2013 and 2014. Her primary care practice focuses on family medicine, treating a wide variety of conditions such as hormonal (endocrine) disorders, fertility, digestive problems, cardiovascular disease, diabetes, insomnia and fatigue. She has a special interest in the treatment of autoimmune diseases, paediatric and perinatal health. Tanya offers her clinical knowledge to a number of publications, including the Natural Path.
References:
- Matthews A a.l Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD007575. doi: 10.1002/14651858.CD007575.pub2.
- Saberi F et. al. Effect of ginger on relieving nausea and vomiting in pregnancy: a randomized, placebo-controlled trial. Nurs Midwifery Stud. 2014 Apr;3(1):e11841. Epub 2014 Apr 17.
- Vutyavanich T al. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol. 2001 Apr;97(4):577-82.
- Herrell HE Am Fam Physician. Nausea and vomiting of pregnancy.2014 Jun 15;89(12):965-70.
- Ensiyeh J, Sakineh MA. Comparing ginger and vitamin B6 for the treatment of nausea and vomiting in pregnancy: a randomised controlled trial. Midwifery. 2009 Dec;25(6):649-53. doi: 10.1016/j.midw.2007.10.013. Epub 2008 Feb 12.
- Matok I. Studying the antiemetic effect of vitamin B6 for morning sickness: pyridoxine and pyridoxal are prodrugs. J Clin Pharmacol. 2014 Dec;54(12):1429-33. doi: 10.1002/jcph.369. Epub 2014 Aug 7.
- Smith CA, Cochrane S. Does acupuncture have a place as an adjunct treatment during pregnancy? A review of randomized controlled trials and systematic reviews. 2009 Sep;36(3):246-53. doi: 10.1111/j.1523-536X.2009.00329.x.
