The Answer to the Big Question

* This article is Part II in a series. To see Part I, click here. To see Part III, click here. 

Okay, folks.... It's time to wrap up my year-and-a-half research mission into the big question....

"Does a very-low-carbohydrate diet work to prevent hyperemesis gravidarum?"

And the answer, the definitive answer, based on eighteen months of research and one practical experiment during our last pregnancy, is....

"Errrr.... I think so."

You can read about how I found out about the very-low-carb diet here. You can read my summary of results from using that diet before and during pregnancy here.

To sum up my pregnancy (more detailed summary at the above link):

I used the VLC (Very Low Carb) diet for 40 days before getting a positive pregnancy test. I started a strong HG slide at 3w6d, which mysteriously began to resolve 36 hours later until I felt almost well again within a couple of days. However, I also started to experience other miscarriage symptoms (cramping and spotting), which led me to believe that I was about to miscarry... and I started cheating on the diet. Three days after I started cheating, the nausea came back and I had to go on medication (Unisom and Zofran).

However, (1) This was the easiest pregnancy I have ever experienced, and (2) Barring the brief HG slide, I was able to stay off of medication for two weeks during a time that I am normally desperately ill.

This experience left two big unanswered questions:

(1) If the diet was working, why did I start going into an HG slide? And why did I recover?

(2) If I had not started cheating on the diet, would I have been able to do a pregnancy without medication?

This past week, I heard back from the doctor with whom I have been communicating, acknowledging his receipt of my results which I typed out for him. We had a brief email conversation, and then signed off for the time being. I did not receive any additional information toward answering the above questions.

The difficulty is that although I have many questions that I would like to ask this doctor, I do not feel justified in doing so when he is a busy doctor and has so graciously communicated with me by email. His phone consultation fee is quite high (as becomes a busy reproductive endocrinologist), and I feel that if I want a more detailed conversation, then I am honor-bound to make use of that rather than demand more detailed email communiques.

So, HG mamas, if any of you are in or near Jacksonville, FL, consider checking in with this fellow for pre-conception nutritional counseling! He did tell me that his practice specializes in dealing with problems that cause other OBs to throw up their hands - such as nausea or metabolic disorders.

With all that in mind....

I believe that this diet works. However, I cannot say for sure because of the following:

(1) I cheated. Thus, my results are tainted.

(2) Every pregnancy is different, and sometimes an easier pregnancy can lull us into thinking that something we used worked, when, in fact, it was just an easier pregnancy.

(3) The HG that I get in an unmedicated pregnancy is "mild" compared to you severe-HG mamas out there. The diet would have to be used by a severe-HG mama for more conclusive results.

* Note - I have given the diet sheets out to about twenty or so women - please make sure to write back to me with results when you have them!

The best evidence that I have for the diet is from the doctor who prescribed the diet, who told me that a woman who had aborted multiple times for HG (and thus, a severe-HG mama) was able to have a normal pregnancy using this diet before and after conception. That's pretty serious positive evidence.

For myself.... The only way to know for sure is to do it again. Without cheating. 

And there you have it.

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For those of you who wish to try this diet for HG prevention, here are some practical notes:

(1) If you want me to send you the diet sheets, leave your email address in the comments.

(2) The diet phase recommended is Phase II (the hardest one). Please do your research to determine if you believe this to be safe - there are many who do not believe a low-carb diet (resulting in possible ketosis) is safe for a developing baby. I believe that it is perfectly safe, based on the fact that exclusively-meat-eating cultures (Inuit, for example) live their entire lives in ketosis and have perfectly healthy babies. I can also testify that I have produced a healthy, normal-sized, incredibly advanced and intelligent baby doing the entire first trimester in ketosis (assumed). But make your own decisions.

(3) On the diet, the only food choices are meat, eggs, nuts, cream, cheese, and non-starchy/sugary vegetables. For me, I find vegetables unutterably disgusting while nauseated with pregnancy hormones - so my food choices were limited. Two challenges that I faced were, (1) cooking meat, which was horrible due to the smell, and (2) coming up with new choices since the ability to eat something usually only lasted a day or two once the nausea was back. Here are some of the choices I came up with:

- Cheddar cheese
- Swiss cheese
- Fried eggs, with or without cheese (and dill pickles to cover up the taste)
- Tuna salad (plain, on a salad, or served on cucumber or zucchini round "crackers")
- Rotisserie chicken from the store
- Taco salad
- Hamburger patties
- String cheese
- Almonds
- Peanuts (watch out for storebought nuts - they often have spices that contain sugar)
- Wrap using low-carb tortilla, lunchmeat, cheese, mustard, and cream cheese
- Ham lunchmeat
- Turkey lunchmeat
- Protein shakes using no-sugar powder (I used Sprouts brand) and cream/water instead of milk to mix it up with (these did not work as well as solid food for quelling nausea, but they came in handy)
- Celery with no-sugar peanut butter

Things I didn't think of but should have:
- Hardboiled eggs
- Scrambled eggs
- Steak
- Chicken salad from canned chicken
- Egg salad
- Nut butters put on thin slices of cucumber (this is great!)

(4) One thing mentioned via email was to make sure that fat makes up at least 50-80% of calories. Use lots of butter and healthy oils (coconut, olive, ghee, etc.). Keep the diet high-fat as well as low-carb.

(5) Being "very low carb" is one component - being "very high protein" is another. Even if you can eat vegetables, pump protein anyway - in any form possible. One midwife told me that she has noticed that in situations (like pregnancy or HG) that stress the body immensely, the body's need for protein skyrockets. This blogger writes:

"Protein, protein, protein. I eat tons of it (or so it seems). I’ve been doing this for several pregnancies with good results. No, I still don’t feel great, but before I implemented a higher protein pregnancy diet, things were much worse. I haven’t had what I would call hyperemesis since I added so much protein to my diet."

Read more of this blogger writing on the protein connection (and low-carb connection) here.

(6) I would highly recommend that this diet be started before conception. This means either (1) planning pregnancies, or (2) for you Quiverfull (or accident-prone) mamas out there, living on this diet once you get your period back or would reasonably expect it.

I do think that the diet might be helpful even if you find you are pregnant before you start. But, (1) since this diet deals with hormone regulation, it would be easier to get your body functioning well on the diet before you have to deal with the onslaught of pregnancy hormones, (2) this is a very difficult diet, and easier to learn when you're not freaking out about oncoming HG, and (3) it's easier to start something like this when you're not nauseated, especially with HG-type nausea which usually precludes eating anyhow.

I had brief issues with nausea on the first day that I started the diet - so initiating it was definitely easier when I was not pregnant and dealing with pregnancy nausea.

(7) As always, eat, eat, eat. All the time. Hourly at least, especially when starting the diet and when pregnant.

(8) Other things I used: I used Vitamin B/Folate/Magnesium shots at our local naturopathic college, zinc and magnesium and vitamin B-complex supplements orally (as well as multi, probiotic, omega-3s, etc.), Morning Sickness Magic, and an herbal detox pre-conception (by accident!), as well as Zofran and Unisom.

Next time, I would add acupuncture to the list. I now have the name of a good acupuncturist, so I would add that to the repertoire.

(9) There are some lines of thought linking high-protein pregnancy diets to bigger babies. Do your research and, again, make your own informed decision about whether or not this is something you can deal with. My experience was that the diet did indeed produce a bigger baby.

• Baby #1 (no high-protein diet) = 7#12. 
• Baby #2 (no high-protein diet) = 7#15. 
• Baby #3 (VLC high-protein diet) = 9#9. 

And you know what? It was just fine. I loved it. Baby #3 went from in to OUT in something like thirty seconds. No tearing, no health problems, my healthiest baby and my best and strongest nurser. So I am all about bigger babies, and in fact would probably do a high-protein diet just to ensure that our baby was nice and big! 

But again, do your own research and make your own decisions! 

(10) My disclaimer: I have no guarantees that this will work. So PLEASE do not neglect to make other plans (for medication, etc.) if you decide to give this a whirl. Make your usual plans and add this on top of them.

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Ladies, is there anything else that I need to add to this explanatory document? Do you have any questions that I need to answer? I want this information to be available to all comers, so please let me know if I have left anything out. And please do let me know, if you use the diet, how it goes with you.

Thank you to all who shared this past pregnancy journey with me, and for all of your prayers and encouragement! They have meant so much, and I really appreciate it.

Signing off for now!

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Later Note: Please note the excellent discussion in the comments! Some alternate viewpoints, and some great additional thoughts.

An Even Later Note: Click over here to see Part III in this series, "Practical Tips for Living Life the Very-Low-Carb Way." (This entry is not the official diet sheets, but rather my collection of tips on following the diet sheets.)

An Even Later Note: See my final summary post from November 2014, Avoiding Hyperemesis Gravidarum With a Very Low Carb (VLC) Diet

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Material on this blog is provided for informational purposes only. It is not a substitute for medical care or advice. Please consult your healthcare provider before undertaking any dietary changes. Under no circumstances, shall the author be liable under any theory of recovery for any damages arising out of or in any manner connected with the use of information or documents from the site.