Nutrient Deficiencies Associated With Morning Sickness

A pregnant woman experiences morning sickness while sitting on her couch.

Nutritional deficiencies are believed to be both a cause and result of morning sickness, which affects up to 70% of expectant mothers.

Morning sickness is a common and sometimes debilitating symptom of pregnancy, affecting up to 70% of expecting mothers (1). While its exact cause is multifaceted, nutritional deficiencies are believed to play a significant role as both a potential cause and result of the condition. This article shares how nutrient deficiencies can contribute to morning sickness and how morning sickness can lead to deficiencies. This article also offers actionable tips to help expectant mothers increase their nutrient intake and manage morning sickness.

Can Nutritional Deficiencies Cause Morning Sickness?

It has been well established that sufficient nutrient intake is of vital importance for maintaining a healthy pregnancy (2). There is also some evidence that mothers who are low in certain nutrients or who follow less nutrient dense diets may be more susceptible to morning sickness (3).

A review of 56 studies from 21 countries found a correlation between dietary patterns and morning sickness (3). High intake of sugars, sweeteners, stimulants — like caffeine, and certain animal products was linked to increased nausea and vomiting. It was also found that people who consumed diets rich in whole grains and legumes had a reduced likelihood of experiencing these symptoms (3). 


Another interesting study found Helicobacter pylori, a detrimental gut bacteria, in over 90% of the tested women who were diagnosed with hyperemesis gravidarum — a severe form of morning sickness (4). It is important to note that a diet rich in carbohydrates and sweets is associated with the prevalence of H. pylori infection, and a diet characterized by high intake of organ meats, fish, seafood, and poultry is associated with a reduction of prevalence of H. pylori infection (5).


To learn more about what constitutes a healthy diet, read: The Basics Of Anti-Inflammatory Eating For The Whole Family 

A variety of whole grains and legumes.

Nutrient Deficiencies Linked To The Onset Of Morning Sickness

In addition to the above links between general dietary habits and the occurrence of morning sickness, there are certain nutrients that are linked to nausea during pregnancy.

  • Vitamin B6: Vitamin B6 is essential for numerous metabolic processes, including the synthesis of neurotransmitters that regulate mood and nausea (6). Pregnancy increases the body's demand for vitamin B6 (7), and deficiencies are common among pregnant women. Studies have shown that adequate levels of vitamin B6 can significantly reduce the incidence and severity of nausea and vomiting during pregnancy (8,9). Supplementation with vitamin B6 in combination with doxylamine (unisom) can be effective for treating morning sickness and is usually the first-line intervention chosen by OB-GYNs (10).

  • Magnesium: Magnesium plays a role in over 300 biochemical reactions in the body, including muscle and nerve function, blood sugar control, and protein synthesis (11). During pregnancy, the demand for magnesium increases (12), and deficiencies can exacerbate symptoms of morning sickness (13).

  • Zinc: Zinc is necessary for immune function, cell growth, and the absorption of other essential nutrients, like vitamin B6 (14). About 12% of US adults are zinc deficient (15), and due to an increased need for zinc during pregnancy (16), women who are already mildly deficient at the start of pregnancy may become more deficient during pregnancy.

Nutritional Deficiencies as a Result of Morning Sickness

Morning sickness, especially in its severe form hyperemesis gravidarum, can result in significant nutritional deficiencies due to decreased food intake and impaired absorption from frequent vomiting. As noted earlier, specific deficiencies can contribute to the onset of morning sickness, creating a vicious cycle where a lack of nutrients exacerbates the condition. The following nutrients are commonly reported as deficiencies in women with morning sickness:

  • Vitamin B6: Women with morning sickness may experience a deficiency in vitamin B6 due to vomiting and inadequate dietary intake (17). This deficiency is also associated with the onset of morning sickness, so this can become a cycle that is hard to break and supplementation may be especially beneficial in this scenario.

  • Magnesium: Magnesium deficiency can result from increased excretion due to frequent vomiting (18). This deficiency not only has the potential to increase nausea, but it also has the potential to affect mood and energy levels (19).

  • Zinc: Women experiencing frequent vomiting are at a higher risk of zinc deficiency (14).

  • Vitamin B1 (Thiamine): Frequent vomiting can deplete thiamine (20). It is extremely important for pregnant women who experience frequent vomiting for longer than three weeks to take thiamine supplementation under the care of a doctor to prevent complications (21).

  • Iron: Frequent vomiting can lead to iron deficiency, resulting in anemia (22). Anemia can cause fatigue, weakness, and dizziness (23), which can contribute to feelings of malaise during pregnancy.

  • Vitamin D: Deficiency in vitamin D can result from limited dietary intake due to morning sickness and reduced sun exposure (24). Low levels of vitamin D can affect the mother’s mood and bone health as well as fetal development (25).

  • Vitamin K: Deficiency in vitamin K can occur as a result of poor dietary intake due to nausea and lack of appetite as well as impaired absorption resulting from frequent vomiting (26).

  • Minerals & Electrolytes: Frequent vomiting can lead to imbalances in electrolytes such as sodium, potassium, and chloride (27). These imbalances can exacerbate nausea and fatigue.

Mothers dealing with nausea and vomiting may struggle to maintain sufficient caloric and protein intake (28), both essential for the growth and development of their baby. The effects of nutrient deficiency can continue to be impactful during the postpartum period. To learn more, read: What Is Postnatal Depletion Syndrome?


As shown above, vitamin B6, magnesium, and zinc are the three nutrients most commonly associated with the onset of nausea during pregnancy, and they are also some of the most common nutrients depleted by nausea during pregnancy. It is important to be aware of this potential cyclic action.

Nutritional Strategies For Morning Sickness

Morning sickness can be challenging, but it is essential for mothers dealing with nausea and vomiting to take steps to manage and prevent the nutrient deficiencies associated with it. While the below information does not take the place of individualized medical advice, it is a good general starting place for most expecting women looking to maintain healthy nutrition during pregnancy.


1. Consume A Varied & Balanced Diet

It is important for mothers-to-be to focus on consuming a balanced diet rich in fruits, vegetables, whole grains, proteins, and healthy fats. When possible, this focus on a nutrient dense diet should begin at least three months prior to conception. I recognize that for mothers who are dealing with morning sickness, this is easier said than done. Try to focus on getting nutrients in when you can.


2. Consume Small Meals Frequently

Eating small meals frequently can help to manage nausea and maintain steady blood sugar levels. Try to ensure each snack and meal contains a source of protein. Avoiding large, heavy meals may reduce the risk of vomiting. Find what works for you! You might do best with consuming cold or crunchy foods, or try eating outside. Feel free to pivot and go with what feels best, but keep your focus on consuming nutrient dense foods as much as possible.


3. Focus On Hydration

Stay hydrated by sipping pregnancy safe herbal teas, electrolyte solutions, bone broth, or popsicles throughout the day. Ginger tea can also help alleviate nausea. Staying hydrated can help you feel more energetic and minimize mineral and electrolyte loss.


4. Take A Quality Prenatal Vitamin

Take a prenatal vitamin* that include key nutrients like B vitamins, iron, and vitamin D. If possible, start taking your prenatal prior to conception. Try to take your prenatal vitamin at the time of day where you generally feel the best and with some food to minimize the risks of vomiting.


*Not all prenatal vitamins are created equally. Read this article to learn what to look for in a prenatal vitamin: What To Look For In A Prenatal Vitamin


5. Take Probiotics

Consuming probiotic-rich foods and regularly taking a probiotic supplement can support the maintenance of a healthy microbiome (29). Research shows that a healthy microbiome may reduce the risk of the development of morning sickness (30).


6. Utilize Herbs

Ginger can help relieve occasional nausea and can be consumed in various ways, including as an extract that can also be diluted to make a tea. Other herbs, such as nettle leaf and red clover leaf that are rich in iron, calcium, magnesium, and vitamins A, C, K, and B (31,32), can support nutrient intake.

When To Call A Doctor For Morning Sickness

For most women, morning sickness is mild and goes away over time. But call your provider if:

  • Your morning sickness continues into your 4th month of pregnancy.

  • You lose more than 2 pounds.

  • Your vomit is brown in color or has blood in it. If so, call your provider right away.

  • You vomit more than 3 times a day and can’t keep food or fluids down.

  • Your heart beats faster than usual.

  • You’re feeling extremely tired or confused.

  • You’re making much less urine than usual or no urine at all.

A Note On Medicating Morning Sickness

There is no shame in seeking medication for morning sickness. You and your baby need nutrients, and sometimes medication is necessary to manage your symptoms effectively. If the above tips are not helping, talk to your healthcare provider about safe and effective options to ensure both you and your baby receive the necessary nutrients.

Summary

Morning sickness can be a challenging aspect of pregnancy, and understanding the role of nutrient deficiencies can help expectant mothers both avoid and alleviate symptoms. Ensuring adequate intake of essential nutrients, staying hydrated, and maintaining a balanced diet are all important parts of managing morning sickness. If you are unable to keep food down, it is important to reach out to your doctor.

PRODUCTS MENTIONED IN THIS ARTICLE

References:

  1. Lee, N. M., & Saha, S. (2011). Nausea and vomiting of pregnancy. Gastroenterology clinics of North America, 40(2), 309–vii. https://doi.org/10.1016/j.gtc.2011.03.009

  2. Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Jr, Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L. (2022). The importance of nutrition in pregnancy and lactation: lifelong consequences. American journal of obstetrics and gynecology, 226(5), 607–632. https://doi.org/10.1016/j.ajog.2021.12.035

  3. Pepper, G. V., & Craig Roberts, S. (2006). Rates of nausea and vomiting in pregnancy and dietary characteristics across populations. Proceedings. Biological sciences, 273(1601), 2675–2679. https://doi.org/10.1098/rspb.2006.3633

  4. Li, L., Li, L., Zhou, X., Xiao, S., Gu, H., & Zhang, G. (2015). Helicobacter pylori Infection Is Associated with an Increased Risk of Hyperemesis Gravidarum: A Meta-Analysis. Gastroenterology research and practice, 2015, 278905. https://doi.org/10.1155/2015/278905

  5. Xia, Y., Meng, G., Zhang, Q., Liu, L., Wu, H., Shi, H., Bao, X., Su, Q., Gu, Y., Fang, L., Yu, F., Yang, H., Yu, B., Sun, S., Wang, X., Zhou, M., Jia, Q., Zhao, H., Song, K., & Niu, K. (2016). Dietary Patterns are Associated with Helicobacter Pylori Infection in Chinese Adults: A Cross-Sectional Study. Scientific reports, 6, 32334. https://doi.org/10.1038/srep32334

  6. Abosamak NER, Gupta V. Vitamin B6 (Pyridoxine). (2023).. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557436/

  7. National Institutes of Health. (2017). Office of Dietary Supplements - Vitamin B6. www.ods.od.nih.gov. https://ods.od.nih.gov/factsheets/VitaminB6-Consumer/

  8. Matthews, A., Dowswell, T., Haas, D.M., Doyle, M., O'Mathúna, D.P. (2010). Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. Sep 8;(9):CD007575. doi: 10.1002/14651858.CD007575.pub2. Update in: Cochrane Database Syst Rev. 2014 Mar 21;(3):CD007575. doi: 10.1002/14651858.CD007575.pub3. PMID: 20824863; PMCID: PMC4004939.

  9. Vutyavanich, T., Wongtra-ngan, S., Ruangsri, R. (1995). Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol. Sep;173(3 Pt 1):881-4. doi: 10.1016/0002-9378(95)90359-3. PMID: 7573262.

  10. American College of Obstetricians and Gynecologists. (2020). Morning Sickness: Nausea and Vomiting of Pregnancy. www.acog.org. https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-vomiting-of-pregnancy

  11. National Institutes of Health. (2022). Office of Dietary Supplements - Magnesium. www.ods.od.nih.gov. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

  12. Fanni, D., Gerosa, C., Nurchi, V. M., Manchia, M., Saba, L., Coghe, F., Crisponi, G., Gibo, Y., Van Eyken, P., Fanos, V., & Faa, G. (2021). The Role of Magnesium in Pregnancy and in Fetal Programming of Adult Diseases. Biological trace element research, 199(10), 3647–3657. https://doi.org/10.1007/s12011-020-02513-0

  13. Health Direct. (2023). Magnesium deficiency. www.healthdirect.gov.au. https://www.healthdirect.gov.au/magnesium-deficiency

  14. National Institutes of Health. (2022). Office of Dietary Supplements - Zinc. www.ods.od.nih.gov. https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/

  15. Oregon State University. (2009). Zinc deficiencies a global concern. https://today.oregonstate.edu/archives/2009/sep/zinc-deficiencies-global-concern

  16. Chaffee, B. W., & King, J. C. (2012). Effect of zinc supplementation on pregnancy and infant outcomes: a systematic review. Paediatric and perinatal epidemiology, 26 Suppl 1(0 1), 118–137. https://doi.org/10.1111/j.1365-3016.2012.01289.x

  17. Lee, J.-H., Lee, J.-A., & Lim, H.-S. (2004). Morning sickness reduces dietary diversity, nutrient intakes, and infant outcome of pregnant women. Nutrition Research. https://doi.org/10.1016/j.nutres.2003.10.011

  18. Ahmed, F., & Mohammed, A. (2019). Magnesium: The Forgotten Electrolyte—A Review on Hypomagnesemia. Medical Sciences, 7(4), 56. https://doi.org/10.3390/medsci7040056

  19. Eby GA, Eby KL. Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006;67(2):362-70. doi: 10.1016/j.mehy.2006.01.047. Epub 2006 Mar 20. PMID: 16542786.

  20. Kumar, N. (2007). Nutritional Neuropathies. Neurologic Clinics, 25(1), 209–255. https://doi.org/10.1016/j.ncl.2006.11.001

  21. HER Foundation. (2022). Why is thiamin (B1) important for HG patients? https://www.hyperemesis.org/what-is-hg/why-is-thiamin-b1-important-for-hg-patients/

  22. Febrianti, R. (2022). The Relationship of Hyperemesis Gravidarum with Anemia in First Trimester Pregnant Women at the Midwife Clinic Yani Delitua in 2022. International Archives of Medical Sciences and Public Health, 3(2), 7–13. https://www.pcijournal.org/index.php/iamsph/article/view/391

  23. Mayo Clinic. (2022). Iron deficiency anemia - Symptoms and Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

  24. Krati Chauhan, & Huecker, M. R. (2019). Vitamin D. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441912/

  25. Vitamin D: Screening and Supplementation During Pregnancy. (2024). Acog.org. https://acog.org/clinical/clinical-guidance/committee-opinion/articles/2011/07/vitamin-d-screening-and-supplementation-during-pregnancy

  26. Nijsten, K., van der Minnen, L., Wiegers, H. M. G., Koot, M. H., Middeldorp, S., Roseboom, T. J., Grooten, I. J., & Painter, R. C. (2022). Hyperemesis gravidarum and vitamin K deficiency: a systematic review. The British journal of nutrition, 128(1), 30–42. https://doi.org/10.1017/S0007114521002865

  27. More About HG. (n.d.). HER Foundation. https://www.hyperemesis.org/about-hyperemesis-gravidarum/assess-diagnose/more-about-hg/

  28. Lee, N. M., & Saha, S. (2011). Nausea and vomiting of pregnancy. Gastroenterology clinics of North America, 40(2), 309–vii. https://doi.org/10.1016/j.gtc.2011.03.009

  29. Hemarajata, P., & Versalovic, J. (2013). Effects of probiotics on gut microbiota: mechanisms of intestinal immunomodulation and neuromodulation. Therapeutic advances in gastroenterology, 6(1), 39–51. https://doi.org/10.1177/1756283X12459294

  30. UC Davis News. (n.d.). Probiotics improve nausea and vomiting in pregnancy, according to new study. News. https://health.ucdavis.edu/news/headlines/probiotics-improve-nausea-and-vomiting-in-pregnancy-according-to-new-study/2021/12

  31. Rutto, L. K., Xu, Y., Ramirez, E., & Brandt, M. (2013). Mineral Properties and Dietary Value of Raw and Processed Stinging Nettle (Urtica dioica L.). International journal of food science, 2013, 857120. https://doi.org/10.1155/2013/857120

  32. Mount Sinai - New York. (n.d.). Red clover Information. Mount Sinai Health System. https://www.mountsinai.org/health-library/herb/red-clover

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