GDF15 linked to maternal risk of nausea and vomiting during pregnancy 2023 Fejzo et al (hyperemesis gravidarum - morning sickness in pregnancy)

https://www.nytimes.com/2023/03/14/...CSVKT-OFKmIh98YnGvcu4ITjOZgAb0&smid=url-share

“Dr. Fejzo was haunted by the dismissal of her illness as having a psychological cause, and by the lack of effective treatments to help her. Nothing would change as long as the condition’s true cause was unknown, she thought.”

 

"Recent research on the GDF15–GFRAL axis has focused on its anorectic action and suggests that it acts as a mediator of the physiological responses to visceral malaise states such as the induction of food aversion, nausea, and emesis preceding the onset of anorexia, as shown in different rodent models and shrews [31,40,41,42]. This fits with the well-known actions of the hindbrain AP in the control of nausea and vomiting [43] beside its role as a control center of food intake [44]."

A quote from this paper

https://www.mdpi.com/2073-4409/10/11/2990

 

Gosh, this is appalling i had heard of HG from when Kate (duchess of Cambridge) had it (i wonder if doctors told her she was attention seeking - i doubt it!
But i had no idea it was one of the 'considered psychosomatic' things. This is shocking but unsurprising. It affects women & doctors dont understand it - that should be next to the dictionary definition of psychosomatic.

I've never been pregnanti know when my own nausea is bad (this is ME nausea, very rare instances of motion sickness as a child/adult & when i had gastroenteritis/norovirus/food poisoning), i always had to have dimly lit silence. I vividly remember on all those occasions begging those around me to go away/give me silence because sound would make me vomit. And that was all long before any ME-related sensory sensitivities came about.

Its abuse if you dont want it & clearly removing a person's phone & denying them visitors is abusive, but for some the sensory relief may have been a blessing - one wonders if that only reinforced the stupid psych ideas - being alone & no stimulation helps... ergo....

It never ceases to amaze me the utter stupidity of some doctors. Its inexcusable

 

Thanks for tagging me @Hutan.

I agree this is a good example that would fit well in the dark history of psychosomatic medicine. The blog is currently on hold due to health and other reasons (there are still a lot of stories on our list to write about). I hope to continue it somewhere in the future and take a closer look at hyperemesis.

 

"And, Dr. Fejzo hopes, it could finally put to rest the idea that the condition is psychological. "

I wonder how those who accuse ME/CFS patients of dualism would respond to that.

 

I had hyperemesis in the late 1970s. I was so ill one day I called a locum who told me with great impatience that I just had morning sickness. The next day I ended up in hospital on a drip.

Apart from the first doctor, I was taken seriously as far as I know and treated appropriately.

 

It still shouldn't take two doctors.

 

My first thought is that some medical professionals are so fixated on the correctness of their ideas, that they are willing to inflict what amounts to torture on their patients in order to ‘help’ them. In terms of a therapeutic model this is no different to the Inquisition inflicting torture and even sanctioned murder on their supposed heretics in order to save their immortal soul. With the Inquisition they believed that the Church had privileged access to a higher truth that justified inflicting whatever was necessary on those they were trying to help. In parallel in this example we see doctors believing their access to a higher truth justifies ignoring their patients reported symptoms and lived experience.

In terms of managing heresy the Inquisition saw it as inherently contagious, just as some of the believers in psychosomatics see hysteria as contagious through social transmission.

 

Wonderful this dedicated and very determined scientist has found the physiological cause of this.

Wow, often people have to figuratively climb mountains for years in order to get to the answer. This definitely applies to "women's issues".

Appalling history regarding this condition. Not surprising though, as women have been treated cruelly for stepping out of the norm, or even just because they are women, for maybe as long as we've had humanity.

 

The same pattern keeps holding up about everything psychosomatic: it's worse in context, and the more context you add the worst it gets.

Everything about this ideology is disgusting. It has destroyed millions of lives. And it's massively popular, beloved even. What the hell is wrong with this profession?

 

I completely agree - but what the hell is wrong with *everyone*? People *love* this narrative about illness - about their own illnesses, even. Someone has managed to sell people on the idea that this validates their trauma. How can we combat this? I see it creeping into conversations, everyday life, the vernacular more and more. It's disturbing and I have no idea how to combat it. Anyone?

 

Merged thread
Abstract

GDF15, a hormone acting on the brainstem, has been implicated in the nausea and vomiting of pregnancy (NVP) including its most severe form, Hyperemesis Gravidarum (HG), but a full mechanistic understanding is lacking [1-4].

Here we report that fetal production of GDF15, and maternal sensitivity to it, both contribute substantially to the risk of HG. We confirmed that higher GDF15 levels in maternal blood are associated with vomiting in pregnancy and HG. Using mass spectrometry to detect a naturally-labelled GDF15 variant we demonstrate that the vast majority of GDF15 in the maternal plasma is derived from the feto-placental unit. By studying carriers of rare and common genetic variants we found that low levels of GDF15 in the non-pregnant state increase the risk of developing HG. Conversely, women with beta-thalassemia, a condition where GDF15 levels are chronically high [5], report very low levels of NVP. In mice, the acute food intake response to a bolus of GDF15 is influenced bi-directionally by prior levels of circulating GDF15 in a manner suggesting that this system is susceptible to desensitization.

Our findings support a putative causal role for fetally-derived GDF15 in the nausea and vomiting of human pregnancy, with maternal sensitivity, at least partly determined by pre-pregnancy exposure to the hormone, being a major influence on its severity. They also suggest mechanism-based approaches to the treatment and prevention of HG.

Paywall, https://www.nature.com/articles/s41586-023-06921-9