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.