Sick of “morning” sickness - Unexplainable

Summary

Episode Summary: "Sick of 'Morning' Sickness"

Unexplainable delves deep into the perplexing phenomenon of morning sickness, particularly focusing on its most severe form, hyperemesis gravidarum (HG). Hosted by Julia Longoria and featuring insights from geneticist Marlena Fejdo, this episode explores the historical context, personal struggles, and groundbreaking research that sheds light on why morning sickness occurs and how it might be effectively treated.

1. Introduction to Morning Sickness

Julia Longoria opens the episode with a personal touch, sharing her own battle with persistent nausea during pregnancy. She questions the misnomer "morning sickness," highlighting how the discomfort extends beyond the early hours.

Julia Longoria (01:59): "I don't know why they call it morning sickness when it's all day long."

2. Personal Stories of Severe Nausea

Marlena Fejdo recounts her harrowing experience with HG during her pregnancy in the late 1990s. Despite being a geneticist herself, Marlena found the medical community unprepared and dismissive of her severe symptoms.

Marlena Fejdo (07:04): "It was torture. I didn't keep any food down for over a month."

Her ordeal included multiple hospital visits, intravenous treatments, and even a feeding tube, underscoring the debilitating nature of HG.

3. Historical Context and Medical Missteps

The episode traces the understanding of pregnancy nausea back to ancient civilizations, noting that while the Greeks documented it around 2000 BC, significant medical advancements were stymied by tragedies like the Thalidomide disaster in the 1950s and 60s. The aftermath led to a chilling effect on research into effective treatments for HG.

Julia Longoria (16:35): "The drug thalidomide was given in the 50s and 60s for nausea and vomiting hyperemesis in pregnant and unfortunately that drug led to babies being born with severe limb deformities for decades after that."

4. Marlena Fejdo's Research Journey

Motivated by her personal suffering and the lack of scientific literature, Marlena embarked on a quest to uncover the genetic underpinnings of HG. Starting with a comprehensive survey, she gathered over 800 responses, revealing a significant familial link.

Marlena Fejdo (20:34): "We found that there was a 17 fold increased risk of having it if your sister had it. Women that had it once had it again in 80% of their pregnancies, which also suggests a genetic component."

5. Discovering the Role of GDF15 Hormone

Despite initial funding rejections, Marlena's perseverance paid off when she collaborated with 23andMe to include HG-related questions in their surveys. This collaboration led to the identification of the GDF15 gene, a hormone linked to vomiting.

Marlena Fejdo (22:12): "We found the first connection with the vomiting hormone GDF15."

Further collaboration with Regeneron enabled the sequencing of these genetic samples, solidifying the connection between GDF15 and HG.

6. Current Findings and Implications

The breakthrough research revealed that individuals with HG have lower baseline levels of GDF15 before pregnancy. Upon conception, the hormone levels surge dramatically, overwhelming the body's system and triggering severe nausea and vomiting.

Marlena Fejdo (25:07): "People with hyperemesis have lower levels before pregnancy."

This discovery not only demystifies the biological mechanism behind HG but also opens avenues for targeted treatments. Marlena discusses innovative approaches, such as desensitizing the body to GDF15 to prevent the extreme reactions seen in HG patients.

7. Challenges and Future Directions

Despite her groundbreaking findings, Marlena continues to face institutional hurdles, including repeated funding denials from the NIH. Undeterred, she pursues alternative research methods and supports women experimenting with new treatments based on her discoveries.

Marlena Fejdo (27:58): "I am doing a study of women that are trying it on their own, because many people are trying it on their own anyway with their doctors and are contacting me saying they're trying it."

8. Conclusion: Understanding and Moving Forward

The episode concludes by emphasizing the importance of Marlena's research in transforming the understanding of morning sickness from a mere inconvenience to a scientifically explicable condition. Her work not only provides relief to those suffering from HG but also challenges the medical community to recognize and address the profound impact of severe pregnancy nausea.

Julia Longoria (26:13): "She says other factors might also contribute to it, but she's convinced this is the main cause."

Marlena Fejdo's dedication underscores a broader message: persistent curiosity and resilience can lead to significant scientific breakthroughs, even in areas previously deemed "unexplainable."

Notable Quotes:

Julia Longoria (01:59): "I don't know why they call it morning sickness when it's all day long."
Marlena Fejdo (07:04): "It was torture. I didn't keep any food down for over a month."
Marlena Fejdo (20:34): "We found that there was a 17 fold increased risk of having it if your sister had it."
Marlena Fejdo (22:12): "We found the first connection with the vomiting hormone GDF15."
Julia Longoria (26:13): "She says other factors might also contribute to it, but she's convinced this is the main cause."

This episode of Unexplainable not only sheds light on the scientific intricacies of morning sickness but also humanizes the struggle faced by countless individuals, advocating for greater empathy and understanding within the medical field.

Transcript

Sponsor Voice 1 (0:00)

Support for this show comes from WhatsApp the personal chat on WhatsApp is a place where you share everything, from the mundane connections to the memories that mean everything. It's a place that can truly feel like it's your own, and WhatsApp makes sure everything stays protected from outside eyes, even theirs. No one, not even WhatsApp, can see or hear your personal messages. That includes personal calls plus any documents, photos or media that you share in your personal chat. WhatsApp message privately with everyone. Visit WhatsApp.com privacy to learn more.

Sponsor Voice 2 (0:39)

Support for this show comes from Shopify. With Shopify, it's easy to create your brand, open up for business and get your first sale. Use their customizable templates, powerful social media tools, and a single dashboard for managing it all. The best time to start your new business is right now, because established in 2025 has a nice rang to it, doesn't it? Sign up for a $1 per month trial period at shopify.com Vox Business all lowercase go to shopify.com Vox Business to start selling with Shopify today. Shopify.com Vox Business.

Julia Longoria (1:17)

I'm Julia Longoria. This is unexplainable, and this one's going to get a little personal. That is the sound of me about to hurl. I really don't like making things about me, but that's not the reason I'm about to barf right now. If you've watched tv, sitcoms or rom coms in the last few decades, there's only one real reason a woman like me would be unexpectedly puking for a studio audience. She's been barfing for an hour.

Marlena Fejdo (1:56)

The flu. I don't know.

Julia Longoria (1:59)

I hope you're not pregnant. That sounds like morning sickness, Miranda. I don't know why they call it morning sickness when it's all day long.

Miranda (2:10)

Yep, it's morning sickness, and I can assure you it's not just in the morning.

Julia Longoria (2:15)

I haven't been able to track down whoever coined that term, but I hope they have the afterlife's equivalent of diarrhea. Misery Loves Company in early pregnancy, I was vomiting every day or every other day, mostly in the evenings. At week 15, I gave my pregnancy tracker apps the middle finger as they congratulated me on the end of my nausea. For lots of people, it stops in the second trimester, but not for me. I just puked everything I'd eaten that day. Some people have helpfully told me to eat more protein, just as others told me to eat less protein. Friends have gleefully announced that it must be a girl, while other family members maintained, well, that means it's a boy. My doctors have been just as unhelpful. Some pills prescribed to me seem to be helping some days, but other days I still retch multiple times. The question I'm left with shouted dramatically at the heavens why today on Unexplainable. You're gonna have to bear with me as I, Julia Longoria, turn my pain into art or at least into journalism. And I'll ask why? Why do pregnant people, who are presumably eating for two, why do so many of us barf so so much?