pregnancy complications

Thiamine, Pregnancy, and the Energy Connection

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There is an old saying “for any workman who has only a hammer for a tool, everything is a nail”. Thus, I am in danger of writing article after article about one vitamin, B1, or thiamin/thiamine, but write I must. Thiamine is critical for energy production and the energetic demands of pregnancy are substantial. Insufficient thiamine during pregnancy can and does have negative impacts on both maternal and fetal health. Both Dr. Marrs and I have written about this previously, but it bears exploring further. Before we begin, however, let us review a few concepts.

Energy to Respond

In order to understand its therapeutic use in the treatment of many different conditions, you have to understand its function and how it differs from “taking medicine”. Let me first remind you that we live in a hostile environment to which we have to adapt in order to survive. Infection, trauma, weather, work assignments and a variety of changes in life’s journey (stress) have to be met as they occur. Assuming that our genetically determined “blueprint” is intact, all we require is energy. To meet the pressure of stress, an automatically increased supply of energy is necessary. Food provides us with fuel that must be burned (oxidized) in supplying that energy and thiamine is essential in igniting the fuel.

When we are attacked by a microorganism, the brain organizes a comprehensive defensive mechanism that we refer to as an illness or a disease. With trauma, healing requires increased energy so that the healing process can proceed. Let it be clearly understood once again that our food provides both the fuel and the vitamins that enable oxidation to supply the required energy. I have come to the conclusion that illness is either a genetically determined error in the DNA code, a failure to synthesize the energy requirement to meet stress, or a combination of the three. If we are attacked by a microorganism, a healthy organism defeats the foe. This is by no means a new idea. It just has not been put into practice, so we are still stuck with the antiquated concept that each disease is represented by a collection of symptoms and physical signs with a unique cause in each case that must be researched to find the magic cure. In order to understand why a thiamine supplement is so protective in pregnancy, I must try to show that any form of stress requires a genetically determined resistance and energy. It is illustrated by a case in my own clinical experience.

When Genetics, Trauma and Diet Collide: Cataracts and Galactosemia

Some years ago, a 6-year old boy was referred to me by an ophthalmologist, because he had been found to have cataracts in both eyes. The ophthalmologist knew that this could be a manifestation of a rare genetically determined disease known as galactosemia and had asked me to research it. There is a sugar in milk called lactose. When milk is consumed, the lactose is converted to galactose that is then broken down by a recessive gene inherited from each of the parents. In order to bear a child that has the potential to have the disease, the child must have obtained a gene from each parent. With two genes, the galactose accumulates in the blood and affects the eye, causing the density known as cataract.

The level of galactose can be determined in the laboratory and in the case of this child, it was in the normal range, at the time of the study. In the meantime, however, the laboratory had been asked to check the presence of the abnormal gene. It was reported that he had only one copy of the gene. With only one copy, the child was classified as a carrier and on general principles, he could not have the disease. So I sat down with the child’s mother to ask her about the diet that she had been giving and I found that she had a tremendous faith in the health manifestations of milk. Therefore she had insisted on multiple glasses of milk for the child. In addition the child had experienced a head injury with a fractured skull. When he returned to school, the school nurse had insisted that he have eye testing every two weeks because, she said “people go blind after an injury like this”. Whether this was an accurate statement or not, the child’s vision was perfectly normal immediately after his discharge from hospital. Three months later there was a dramatic change, causing her to refer the child to the ophthalmologist who had discovered the cataracts. I had to conclude that the combination of trauma, genetic risk and unknown dietary indiscretion combined to cause the disease. The “stress” of the head injury, or the genetic carrier state, or the excessive intake of milk, would not be damaging on their own. It was their coincidental relationship that precipitated the cataracts.

The Energetic Demands of Pregnancy

In 2013, I received a letter from Dr. John Irwin an OB/GYN specialist in Connecticut and his remarkable book: The Natural Way to a Trouble-Free Pregnancy: The Toxemia-Thiamine Connection. The letter said:

Dear Dr. Lonsdale,

I am writing to you, because I have found another mortal being who is particularly interested in the biological activities of thiamine. I had previously thought that I was nearly the loan believer in the benevolent effects of thiamine, particularly for the treatment and prophylaxis of the toxemias of pregnancy and its many associated problems. I had even written to the chief of the Cleveland Clinic OB-GYN about the “miracles” I was performing and offered to work with him in further development of the concepts, but my information seems to have experienced obstacles.

After Dr. Irwin had retired, he spent 25 years in the Commonwealth of the Northern Mariana Islands where he had been concentrating on the use of what he called “megathiamin, 100 mg daily” in the prevention of toxemia and many other complications of pregnancy. His first patient was introduced to him by an introductory meeting with a group of island doctors who were all American board-certified in their specialties. The patient had severe preeclampsia, had been sick for six weeks and was essentially moribund at 36 weeks of gestation. She also had severe heart disease and he recognized the compound symptoms of thiamine deficiency disease. In the face of the open skepticism of the other physicians, he started her on a 100 mg pill of thiamine daily. He reported that she was cured in six days. She had some fetal distress on the seventh day and was delivered of a 3 lbs. 12 oz. baby by cesarean section. The infant’s Apgar was 10-10, an extraordinary result in a situation where death of both mother and infant would be the expected outcome.

He then started all his patients on “prophylactic megathiamin” at the third trimester and he reported that it prevented the development of every type of toxemia completely, including eclampsia, preeclampsia, intrauterine growth retardation of the fetus, premature delivery, fetal death, premature rupture of membranes and in fact virtually any pregnancy complication. To anyone that contemplates pregnancy and can overcome her expected skepticism, this book is an absolute essential.

Thiamine, Energy, and Pregnancy

I believe that we can offer a rational explanation of what superficially appears to be “miraculous”. In many posts on this website I have commented on the energy relationship between stress and maintenance of well-being. There must always be a complete balance between energy synthesis and its utilization. In good health, the rate of synthesis automatically accelerates to meet any increased demand, although there must be a normal limit to that capacity. The stress in pregnancy is enormous. The mother is feeding her fast-growing baby as well as herself, giving rise to a marked increase in energy demand. Thiamine is the key to energy synthesis from the oxidation (burning) of glucose. Her physiology must meet this ever increasing demand to full-term. The failure of this equation obviously imperils both mother and fetus and it also explains many of the complications observed in the neonate’s immediate and future development. The dysregulation of body organs by the energy deficient brain explains the multiplicity of the complications because all of them have a common cause.

Unfortunately, many people have concluded that taking sugar will increase energy production by “throwing fuel on the fire”, a fact that has led to a great deal of energy deficiency illness. There has to be a normal glucose/thiamine ratio for healthy oxidation. Just as an excess of gasoline introduced into the cylinders of a car produces inefficient engine performance, an excess of glucose induces illness. If we insist on ingesting empty calories, we must optimize the glucose/thiamine ratio by supplementing thiamine, thus explaining Dr. Irwin’s success in eliminating many of the common complications associated with pregnancy.

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This article was published originally on February 11, 2019. 

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Heart Problems, Pregnancy, and Nutrient Deficiency

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In the Wall Street Journal, August 14, 2018, Your Health, written by Sumathi Reddy, recorded the case of a 34-year-old pregnant woman who went to the hospital with shortness of breath and dizziness. Doctors decided that they were “pregnancy-related symptoms and nothing to be overly concerned about”. The column goes on to say that eight weeks after her daughter was born she experienced terrible stomach pains, orthopnea (severe breathing difficulty when lying down) and chest pains. At the emergency room, she was diagnosed with peripartum cardiomyopathy, noted  as “a type of heart failure related to pregnancy”. Reddy continues: “the rates of heart-related problems in women before and after childbirth have increased in the US., a problem that some experts think may be contributing to a rise in the country’s maternal mortality rate. It has been reported that the number of women having heart attacks before, during and after deliveries increased by 25% from 2002 through 2013. Around 4.5% of women who had heart attacks died”.

This is truly an appalling statistic, begging for an explanation as soon as possible. I believe that such an explanation is possible. With the necessary clinical knowledge, thiamine deficient beriberi would certainly enter into the potential diagnosis. The combination of “shortness of  breath and dizziness”  as an initial guide to its consideration, together with the later onset of “terrible stomach and chest pain” associated with heart failure 8 weeks after parturition in the case of that 34-year old pregnant woman, should have given  rise to its consideration. The trouble with this description is that it is not pathognomonic (uniquely indicative) of beriberi, a diagnosis that the medical profession refuses to recognize as a possibility in America.

What needs to be understood is that pregnancy is an enormous metabolic stress. The mother has to feed herself and her offspring, requiring a vast amount of cellular energy, not only to meet her own maintenance, but to support the rapid growth of her fetus. The enormous variety of complications in pregnancy can only be explained by a failure to produce sufficient energy to meet the metabolic demand. The diet in America, together with possible and undiagnosed genetic risk, does not always meet that goal. A common problem is known as hyperemesis gravidarum (severe pregnancy vomiting), a thiamine deficiency complication that can result in the much more serious thiamine deficiency brain disease known as Wernicke encephalopathy. So let us look at the evidence to support thiamine deficiency as a cause of pregnancy complications..

Thiamine Treatment of Severe Pregnancy Toxemia

In 2013 I received a letter from a retired American specialist in OB/GYN, John B. Irwin M.D., together with a book that he had written with the intriguing title “The Natural Way to a Trouble-Free Pregnancy” with subtitle “The Toxemia/Thiamine Connection“. He was desperate in trying to locate a physician who could subject his work to further research. His many attempts had fallen on deaf ears. He hoped that I could promulgate his work. In retirement he had hired himself out to the government of the Commonwealth of the Northern Mariana Islands to try to improve upon their system of obstetrical care.  He had attended an introductory meeting with a group of island doctors who were all American board-certified in their specialties. They introduced him to a woman who, at 36 weeks of gestation was essentially moribund with severe preeclampsia (advanced pregnancy toxemia), severe gestational cardiomyopathy (pregnancy heart failure), and with some premature separation of the placenta. Recognizing that the patient had the thiamine deficiency disease beriberi and in spite of the massive skepticism of the assembled doctors, he told them that he was going to make her well with mega-thiamine. He treated her with 100 mg of thiamine daily, reporting that she was physiologically well in six days. She delivered a 3 lbs. 12 oz. infant with a normal Apgar score

Yes, I know how many will react to this. They will say that “this patient was on a tropical island where beriberi was much more likely. This could not happen in America where the science of nutrition is so well known and where all the foods are enriched with vitamins”.

Thiamine Deficiency and Pregnancy Complications

Because of this case, Dr. Irwin started the clinic patients on prophylactic thiamine, beginning in the second trimester. Over a period of 25 years, during his retirement, he had found that it prevented the development of every type of toxemia completely, including eclampsia, preeclampsia, intra-uterine growth retardation, premature delivery, fetal death, premature rupture of membranes, placenta previa and gestational diabetes. In short, he had found that this simple non-toxic administration of megadose thiamine had virtually abolished all the common complications of pregnancy. It is important to recognize that he had spent his professional lifetime before retirement in Connecticut, attempting to bring healthy babies into the world. He was conversant with all the complications of pregnancy, for which he had previously known the absence of adequate treatment. He wondered whether the island doctors had failed to recognize beriberi, or whether toxemias of pregnancy were merely a manifestation of thiamine deficiency.

In his book, Dr. Irwin reports that

“the daily 100 mg thiamine tablet has been given to over 1000 unselected prenatals so far, starting in the second and third trimesters. More than 450 cases were conducted in Saipan of the Mariana Islands, over 600 in Waterbury Connecticut after his return from Saipan and 15 selected high risk cases with a collaborator in Adelaide, Australia. There have been no adverse reactions to thiamine. The expected and predictable number of toxemia patients in this group would be well over 150, but the actual occurrence was zero. This was an almost unbelievably favorable response. Modern science has not been able to do what thiamine has done for my patients. I have treated pregnancy-induced heart failure patients who were very close to heart failure death. They returned to normal, and continued their pregnancies to a normal conclusion at term. Treated patients did not deliver prematurely”.

Why Megadose Thiamine?

There is a lot more to this and I can only suggest that anybody wishing to be pregnant should obtain this book. It is, of course, mandatory for you to undertake this with the permission and care of your OB/GYN physician. However, do not expect that the physician will automatically accept the idea. You may have to show him/her the book. As I have said many times in posts on this website, the emerging truth concerning the application of vitamins in the treatment of disease and the preservation of health has not yet reached the collective psyche of the medical profession. It has been hard won by the few pioneers that have begun to practice what is now called Alternative Integrative Medicine.

It is quite obvious that you might ask the question, why, if this is so important in the lives and well-being of millions, it is not an acceptable practice in modern medicine by the majority of physicians? We all have known for many years that thiamine is acquired from the diet.  The recommended daily allowance (RDA) is only 1 to 1.5 mg. This minute dose acts as what is called a cofactor to many enzymes essential to energy production. Without sufficient cofactor, the enzymes do not function properly and their action gradually deteriorates. Thus, vitamin deficiency has long been regarded as a situation that only requires simple replacement of the RDA dose.

Unfortunately, what has not sufficiently been realized is that a megadose of the cofactor is required to resuscitate the enzymes that have been damaged by prolonged use of an overload of empty calories (high calorie malnutrition). Pregnancy requires energy for the development of the fetus as well as the health of the mother so the demand is greatly increased. Cells will use what is needed of the megadose for the resuscitation to take place and will discard the excess in urine. The beauty of this new way of thinking about treatment of disease is that it is non-toxic and harmless. We even know now that some of the diseases, previously thought to be entirely genetic in origin, respond to megadoses of vitamins. This has opened up a brand-new science called epigenetics that studies the effect of lifestyle and nutrition on genes. Genes are no longer considered to be solely in charge of our health destiny. We each have a responsibility towards the preservation of the blueprint (inheritance) by what we eat and our lifestyles.

Heart Problems and Insufficient Maternal Thiamine

In our book entitled “Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition” Dr. Marrs and I demonstrated that thiamine deficiency is widespread in America, causing diverse symptomology responsible for a host of puzzling diseases. We provided evidence that different forms of physical and mental stress result in an increased energy demand in the part of the brain that deals with environmental adaptation. It is suggested here that the stress of pregnancy, superimposed on marginal high calorie malnutrition, is responsible for the increase in heart failure. It is well known that the heart and brain have the highest metabolic rate, making these organs more susceptible to the effects of limited energy synthesis.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

Image by Manuel Alejandro Leon from Pixabay.

This article was published originally on August 21, 2018

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Recurrent Miscarriage

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When I was pregnant for the first time, one night very early on in the pregnancy, I had a dream that my baby was going to be a little boy with blond hair and blue eyes, a little mini version of my husband. Eight years and six miscarriages later, I did give birth to a little boy, and oddly enough, the consensus is that he looks just like my husband. Those eight years before our son was born were filled with emotional highs and lows, and I still ask myself:  why did I, and so many women like me, end up with so few answers about my miscarriages?

Recurrent miscarriage, defined as more than three consecutive pregnancy losses, affects about one percent of women.  Although there are some known causes (the most common is antiphospholipid syndrome), which have effective treatments, for 50 percent of women with recurrent miscarriages, all diagnostic tests are normal and no cause can be found.  In this group of women with unexplained recurrent miscarriage, the prognosis is fairly good, as many of these women will eventually have a successful pregnancy without any treatment. However, research suggests that the group of women with unexplained recurrent miscarriages may actually be made up of two groups. In one group, the miscarriages are due to chance alone, and women in this group have an excellent chance of eventual success. In the other group, there is an underlying problem that is not identified by current clinical investigations, and this group has a much poorer prognosis.

During the time I was trying to have a baby, I saw four different doctors (three gynecologists and eventually, a reproductive endocrinologist). I had many tests, and they all seemed normal. I was a relatively healthy 28 year old. I was told that if I just kept trying, I might eventually be successful. Although that approach is understandable given the potentially good prognosis for some women, it was difficult for me to believe that it was true, and it was even more difficult to consider getting pregnant a fourth time without trying some sort of treatment. Instead of trying to get pregnant again, we decided to adopt, and my husband and I were lucky enough to adopt two newborn girls, 15 months apart.

As the girls got older, we decided to try to get pregnant again, and see if my doctors could offer any new approaches. It felt to me that if I at least tried something different, that I could have some hope for a different outcome. My doctors tried various fertility treatments with the rationale that perhaps just increasing the number of embryos would result in one that could “stick.” I never got pregnant on fertility treatment despite a seemingly good response to it.  Because I had always had painful periods that were worsening as I got older, I asked every doctor I saw about endometriosis and every time was told: “Endometriosis causes infertility. If you are getting pregnant, you don’t have endometriosis.” During that time, I had three more miscarriages.

Eventually I made my way to a reproductive endocrinologist. She agreed with my other doctors that there was no apparent reason for my miscarriages. However, by that time I had a large mass on my ovary, and I had laparoscopic surgery and was diagnosed with endometriosis. According to the scientific literature, there is insufficient evidence for a link between recurrent miscarriage and endometriosis, although it’s possible that many women with recurrent miscarriage have undiagnosed endometriosis, due to the assumption most doctors make that women with endometriosis are always infertile. My doctor did not think that my endometriosis was related to my miscarriages. However, she did decide to treat my miscarriages with a “cocktail” of medications: heparin injections, progesterone, low dose prednisone, and low dose aspirin. The rationale was that there was probably some undiagnosed problem causing the miscarriages, and the cocktail could cover a range of potential causes such as hormone imbalance, autoimmune issues, and thrombosis (which is known to be associated with recurrent pregnancy loss, through antiphospholipid syndrome).

The month after my endometriosis surgery I was pregnant again. I immediately started taking medications once I found out I was pregnant. Two days before Christmas we saw the baby’s heartbeat by ultrasound, but on Christmas morning I started bleeding. Six long weeks of watching and waiting began—I had a subchorionic hemorrhage, bleeding between the gestational sac and the uterus. Although this is not uncommon (3.1 percent of pregnancies), with my history it was worrisome, and I was on limited activity or bedrest until it resolved at 13 weeks.  I could barely believe it when my son was finally born, healthy and full-term.

My doctors said that the endometriosis surgery had nothing to do with the fact that I finally had a successful pregnancy, even though the coincidence of having success only immediately after that surgery makes me wonder. Or perhaps my success was due to one or more of the medications I took during the first trimester—the recurrent miscarriage cocktail prescribed by my doctor. Having been diagnosed with a bleeding disorder recently (see my story here), five years after that pregnancy, I now realize that the heparin and aspirin were exactly the wrong medications to give me and probably exacerbated the subchorionic bleeding. But maybe the prednisone or progesterone, or both, were helpful. Or maybe it is just that I ended up being among the percentage of women with unexplained recurrent miscarriages who will eventually succeed without any treatment.

As a scientist, I wouldn’t normally be inclined to agree to the sort of treatment I ended up receiving for my miscarriages: they were hit or miss treatments, some of which were untested for safety during pregnancy (the prednisone), and all of which had no proven efficacy from clinical trials for treating unexplained recurrent pregnancy loss. However, as a woman with six prior pregnancy losses, I probably would have tried anything I thought had a hope of helping, as long as the risk seemed minimal. More research into this area is critical, so that other women don’t have to decide whether to choose treatments with unknown side effects and effectiveness, or no treatment at all, with the emotionally devastating risk of another miscarriage. Unfortunately, such research does not seem to be a high priority for our society.

 

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Vitamin D3 and Pregnancy: Are Prenatal Vitamins Enough?

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When a pregnant woman is asked if she is hoping for a boy or girl, her inevitable response is similar to, “I only care that my baby is healthy.” Many expectant mothers do their best to have a healthy baby by leading a wholesome lifestyle and following doctors’ orders. Nonetheless, millions of babies are born with medical conditions, many of which affect children throughout their lives. 

Medical research suggests a number of health issues may be prevented if pregnant mothers enjoy sufficient vitamin D3 levels, ideally prior to conception.

Vitamin D3 is vital to pregnant women’s health. An expectant mom with adequate vitamin D3 levels may enjoy a decreased risk of pregnancy complications including: anemia; bacterial vaginosis; Caesarian section; gestational diabetes; and pre-eclampsia.  University of Pittsburgh researchers ascertained that women with low vitamin D3 blood serum levels (less than 15ng/mL) have five times the risk of developing pre-eclampsia, a common obstetrical condition that can lead to a fatal stroke.

Vitamin D3 is vital to fetal bone and cell development. A pregnant woman’s vitamin D3 levels may play a significant role in the health of a developing fetus, according to recent medical studies. Low maternal vitamin D3 levels may contribute to premature delivery and low birth weight.  Furthermore, babies born to mothers with a vitamin D3 deficiency are more likely to develop, inter alia; asthma; autism; soft bones (craniotabes, rickets); brain tumors; cardiovascular malformation; type 1 diabetes; epilepsy; pneumonia; and seizures.

Harvard researchers led a study (published in 2010) that examined the vitamin D3 status of over 900 New Zealand newborns. They found that babies born with adequate vitamin D3 from their mothers had a greater chance of a stronger, inherent immune system. The researchers concluded vitamin D3 was crucial not only to a newborn’s health but to his or her well-being throughout life.

Are Prenatal Vitamins Enough?

Unfortunately, the majority of pregnant women reportedly have vitamin D3 serum levels less than 50 ng/mL, a measurement on the lower side of adequate. (A number of vitamin D experts believe a healthy vitamin D3 range is at least 50-80 ng/mL.) You may be thinking, “My prenatal vitamin includes vitamin D, so I do not need to be concerned about my vitamin D levels.”  Most prenatal vitamins only contain 400 IU of vitamin D3—a woefully inadequate daily dose.  A 2010 National Academy of Sciences Institute of Medicine report stated that a safe upper limit for pregnant women for a daily vitamin D3 dose is 4,000 IU, an amount 10 times more than contained in prenatal supplements!

Why risk pregnancy and neonatal complications? Get your blood tested by your healthcare practitioner and talk to them about what you should do based on the results of your test. You will be on the road to becoming a vitamin D-healthy mother!

Copyright ©2012 by Susan Rex Ryan

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