Hey ,

First of all: congratulations! What wonderful news!

With pregnancy, hormones do shift for sure! Estrogen rises quickly during the first trimester of the pregnancy which can lead to nausea.  This meta analysis from 2014 concluded that the use of ginger (∼1 g daily) for at least 4 days is associated with a 5-fold likelihood of improvement in Nausea and vomiting in early pregnancy. Perhaps this is something she could try!

Here are some other tips that can help:
• Stay hydrated
• Prioritize protein
• Avoid Food & Smell triggers
• Stay vertical (which might seem counterintuitive, but this seems to be best with pregnancy nausea)
• Embrace yourself with pleasant aromas (like peppermint, orange, lemon, etc)
• If she consumes prenatal vitamins, take them at night
• An empty stomach can make nausea worse during pregnancy, so eat every few hours.

Hormones do shift. And yes, sulforaphane helps to break down estrogen more safely. It reduces the metabolites that cause DNA damage and helps to break down estrogen via a better less damaging pathway. It also helps with detoxification in general.

SulforaClear
The ingredients in SulforaClear are dicalciumphosphate (which is safe during pregnancy), broccoli seed extracts and broccoli sprouts and flower powder.

Getting sulforaphane via foods is safe. Unfortunately, getting sulforaphane via supplements has not been studied.

But here are some other good food sources of sulforaphane: broccoli sprouts, cauliflower sprouts and mustard seeds contain the most sulforaphane.

Broccoli, cauliflower, kale, cabbage, and Brussels sprouts are also sources of sulforaphane. To be exact, all food sources don’t contain sulforaphane … but the precursor Glucoraphanin. Glucoraphanin, when you chew, mixes with the enzyme Myrosinase (which is also in these foods) in your stomach and forms there the sulforaphane.

Myrosinase however breaks down when the vegetable is cooked. So to get the sulforaphane from vegetables, eat them raw or, cook the vegetable lightly or add some mustard seeds or mustard powder on top of them. The powder is a good source of Myrosinase and helps to form Sulforaphane.

You did mention your daughter did a hormone detox. Are there other supplements your daughter uses right now besides SulforaClear?

Calcium food sources
The next foods are rich in calcium and are dairy free: beans, lentils, almonds, leafy greens (spinach in particular), rhubarb, amaranth and figs.

Unfortunately, I might not have the best tips for morning sickness, since I have little experience with that.

But I hope these tips can help your daughter!

 there are many reasons why women experience nausea during pregnancy, the shift in hormones being one of them for sure. Is her nausea severe with vomiting?

The increase in hormones does also put more strain on the liver to detoxify the spent hormones, thus removing anything that can strain the liver can help (cleaning up personal hygiene products, eating more organic if possible, eliminating anything that requires liver detox like caffeine, artificial sweeteners, etc), as well as balancing blood sugar levels (how’s her diet?). Sleep quality is important too since good liver and hormone function rely on quality sleep.

In addition to ginger tea/supplements, here are some foods that support liver/gallbladder health:
• Beet kvass (recipe in in handouts in Resources section)
• Beets cooked any way served with a little coconut oil, butter or extra virgin olive oil
• A squeeze of lemon in water
• Turmeric in dishes
• Garlic, lightly cooked
• Extra virgin olive oil
• Broccoli, cauliflower, Brussels sprouts, etc
• Greens (dandelion, turnip, beet, arugula)

Other issues may be associated with morning sickness:
• Estrogen and progesterone imbalances
• Thyroid levels
• Serotonin and leptin levels
• Immune system dysregulation
• H pylori infection and pregnancy induced changes to the upper GI
• High histamine levels

With regards to lower blood pressure, this is actually normal in early pregnancy and will usually return to its previous level during the third trimester. 
Low blood pressure during pregnancy happens mainly because of progesterone which helps relax the walls of the blood vessels and increase the flow of blood to mom and baby.

However if her levels drop below 90/60 and if she’s concerned, seek medical attention right away. Lower blood pressure in pregnancy can be the result of an ectopic pregnancy.

In general, tell her to:
• Slow down and take it easy. Avoid making sudden movements, and take her time when standing up. If she feels dizzy, have her lie down on her left side to increase blood flow to her heart.

• Hydrate! This increases blood volume, and thus blood pressure. In addition, adding ‘sole’ may help. Here’s the video where I discuss hydration further.

Hope this helps!

 I generally start my clients with 400mg of magnesium glycinate and adjust up or down according to bowel tolerance (while never exceeding 1200mg per day). Also make sure she checks her prenatal as there may already be some magnesium in there.

 yes, no issues at all taking betaine while pregnant. BUT if she does have an H Pylori overgrowth, you do not want to be taking betaine as that will cause the bacteria to burrow further down into the gastric lining and potentially cause an ulcer.

Something else I didn’t mention that can contribute to nausea is her prenatal vitamin!! What brand is she taking?

 sometimes prenatal vitamins can contribute to nausea because with some women the iron in the prenatal vitamins can irritate the stomach.

Dr Brightens prenatal is a very good choice, but it does contain iron.

Leaving the vitamin away a few days and observing the changes gives you the fastest clue.

If she has been swallowing her vitamins on an empty stomach she could try to take her vitamins with some food as well!

 some people are also sensitive to methylated forms of B vitamins (which Dr. Brigten’s formula is) so choosing one that is methyl-free can often help reduce anxiety/anxiousness, rapid heart beats and nausea. I like Seeking Health’s Optimal Prenatal Methyl Free

As Daniel mentioned, stopping the prenatal for a few days can help her see if it’s contributing to her symptoms, and then maybe shop around for another form that is methyl-free.

Hope this helps her! And please ask her to join us here in B Better. We’d be happy to support her too.

 not much studies done on the safety of l-theanine during pregnancy. However, phosphatidylserine (a type of phospholipid) is known to help balance cortisol (stress hormone) production, which has a strong clinical record of reducing anxiety and fatigue.

Phospholipids are incredibly important during pregnancy and for milk production since there’s a very high demand for them, especially choline.

As the fetus grows, it requires large volumes of phospholipids to build all of those beautiful new cells. Low maternal choline status has been associated with an increased risk of neural tube defects and altered brain development. Aside from the risks to the baby, it is thought that deficiencies in phospholipids brought on by high gestational demand and low dietary intake can cause shortages of phospholipids in other areas of the mother’s body, including the liver and bile. This could be a major contributor to the reason that gallbladder dysfunction is so much more common during pregnancy and after birth than at other times of a woman’s life. We need the emulsifying property of phospholipids to keep bile smooth and slippery and prevent stagnation.

Phospholipids are also vital ingredients in breastmilk, since the growing baby continues to have a high demand for new cell generation. It is such a vital nutrient, that pregnancy stimulates the up-regulation of genes involved in the production and transport phosphatidylcholine! Isotope studies have shown that pregnancy stimulates the body to shuttle increased levels of choline to the placenta, and likewise, lactation stimulates the body to shuttle choline supplies into the mammary glands. In both cases, oral supplementation with choline enhanced choline content in the placenta and milk.

The choline content of breastmilk is not only important nutrition for baby, but the emulsifying function of choline is thought to help prevent the high fat content in the milk from solidifying and contributing to mastitis. This is why supplementation with lecithin or choline is often used as a treatment for recurrent plugged mammary ducts, and sufficient intake of dietary choline can reduce the risk of mastitis and clogged ducts.

It is important to note that many prenatal supplements and multivitamins do not contain choline, and those that do often contain the choline chloride form, which is not as bioavailable.

Unfortunately, there is still no solid consensus on how much dietary choline we actually need. The Institute of Medicine (whose recommendations tend to be on the low side) suggests that adequate intake values are 425 mg per day for adult women, with an increased need during pregnancy and lactation. It is thought that ~95% of pregnant women consume less choline than they need!

The great news is that 3 ounces of beef liver contains 356 mg of choline and one chicken egg has about 147 mg – a pretty great start!

Liver paté is another excellent source of choline and you can find the recipe in the resource section here.

If she won’t eat more of these foods, then here’s a supplement suggestion by Seeking Health as an example.