Preventing Preeclampsia

Preeclampsia is a prenatal and postpartum condition that is hallmarked by gestational hypertension and the presence of protein in the urine. It occurs in approximately 5-8% of pregnant women, and can be life threatening. Woman who have had preeclampsia with a previous pregnancy are at a higher risk of developing it again. 

There have been several studies linking different nutritional deficiencies with an increased risk of developing gestational hypertension and preeclampsia. In this article I will address the individual nutrients linked in these studies, as well as nutritional principles to get you started. ​

Symptoms can include:

• Edema (specifically pitting in the ankles)
• Sudden weight gain
• Headaches
• Vision Changes
• In extreme cases, seizures and death

It is a very serious condition, but there are ways to lessen the incident. There is research that supports nutritional deficiencies to play a role in the onset of the disease. ​​

Nutrient deficiencies associated with a increased risk of preeclampsia

Vitamin A: There are really two dietary forms of Vitamin A. Carotenoids found in plants and Retinol found in animal products. Both forms are fat soluble, meaning they need to be bound to a fat to absorb. Carotenoids, which include Beta Carotene, are strong antioxidants, is converted to retinol in small amounts. Retinol is essential for proper fetal development, and is also important in the functions of many other essential nutrients during pregnancy; Zinc, B Vitamins, and Vitamin D. Without Retinol, these other nutrients cannot function properly. For example: Vitamin A is necessary to unlock the Vitamin D receptor sites. Vitamin D, you will read about below.​

Vitamin B1 Thiamine: It was theorized decades ago that preeclampsia was a B complex deficiency. The B Vitamins work together and if one is deficiency, than most likely others are as well. B1 Thiamine is necessary for proper heart function, and has been found to be deficient in preeclampsia women. Your body needs B1 Thiamine to form ATP, the energy molecule of all cells. It is also necessary for the metabolism of carbohydrates...one reason why preeclamptic women gain weight quickly is due to a poor metabolism of carbohydrates.​

Vitamin B2 Riboflavin: B2 Riboflavin is a coenzyme, meaning it is catalyst for chemical reactions in the body. Specifically many of those necessary to grow your baby's brain, nerves, and muscles. Like B1 Thiamine, deficiencies in B2 Riboflavin have been associated with preeclampsia. Symptoms of B2 deficiency can mimic other nutrient deficiencies, and so it can be hard to diagnose - anemia, dry/cracked lips/nose/mouth, magenta red tongue, skin rash. B2 Riboflavin is necessary for iron metabolism, and without enough you can become iron deficient. B2 Riboflavin supplementation has been used, successfully, to prevent and lessen preeclamptic symptoms.​

Vitamin B5 Pantothenic Acid: B5 Pantothenic Acid is essential in the formation of red blood cells, sex hormones, and the regulation of stress hormones. It is also necessary for the absorption of B2 Riboflavin, so if you are deficient in B5 Pantothenic Acid, you will become deficient in B2 Riboflavin. ​

Vitamin B6 Pyridoxine: B6 is a cofactor for enzymatic reactions that effect the metabolism of proteins, fats, glycogen and Nucleic Acid (DNA/RNA), as well as in the integrity of blood vessel walls.  B6, B12, and B9 (folate) are necessary for blood health and formation, and deficiencies in any can attribute to anemia. Not only do they make up red blood cells, but they work on the fluidity of the blood. Thinning the blood and increasing circulation without increasing the risk of bleeding, making blood easier to pump and reducing elevated blood pressure​

Vitamin B9 Folate: Folic Acid and Folate are different (Don't get me started on the detriment of synthetic vitamins.) Folic Acid is a synthetic form of naturally occurring Folate. It is difficult to utilize in the body and can overwork the liver enzymes. Like I mentioned above, Folate plays a role in blood formation. High sugar and glucose diets deplete Folate and diminish carbohydrate metabolism, leading to a strain on the pancreas, insulin, and increases body weight gain. Folate has been pushed quite a bit as a pregnancy vitamin, for good reason, just make sure you are getting the real vitamin. Folate is used in methylation, and supplementing with Folate and increasing dietary Folate have been shown to decrease preeclampsia in patients.​

Vitamin B12 Cobalamin: B12 is kind of like the glue that hold iron onto red blood cells. Without enough B12 we can get anemia. There is a link with high blood levels of folate and B12 and an increased risk of autism…I personally believe that it is linked the MTHFR gene mutation, and these woman’s inability to process B9 and B12, vs. consuming too much, since B12 is required for the proper development of the Myelin Sheath that covers all nerves (and hence why I dislike synthetic Folic Acid supplementation, which cannot be properly used in the body). Another indication of preeclampsia is elevated homocysteine levels. B12 and Folate work together to remove excess homocysteine, as long as the MTHFR gene mutation is not present. Those with a history of preeclampsia should be tested for the MTHFR gene mutation. Special supplements should then be given if positive.​

Vitamin C & E: Vitamin C is a water soluble vitamin that helps the body absorb Iron, among it's other functions. Vitamin E is a fat soluble vitamin, and must be combined with a fat to be absorbed. There is controversial research on Vitamin E and preeclampsia. Some studies suggest an increased risk of preeclampsia with Vitamin E supplementation because blood levels of Vitamin E and C are higher in those with preeclampsia. Defendants say that the reason levels are so high is that the body is reacting to the inflammation in the blood vessels by increasing Vitamin E and C levels to counteract the oxidation. Both Vitamin C and E work together in the amniotic fluid to reduce inflammation, infection and prevent premature labor. Vitamin C is in the makeup of the amniotic sac and deficiencies can lead to premature rupture of membranes. Vitamin E also regulates the production of progesterone by the uterus and placenta to sustain pregnancy. Making sure that your dietary intake is adequate is essential to a healthy pregnancy, although it does not reduce or treat existing preeclampsia and hypertensive symptoms.​

Vitamin D: Vitamin D is a hormone. It is formed from cholesterol in the diet which interacts with the UVB rays to create Vitamin D. It is a fat soluble vitamin in the diet, and there MUST be a fat present for absorption. We do know that Vitamin D plays a significant role in the regulation of the hormones of our body. The role of Vitamin D in hypertension is still not fully understood, but we know there is a connection between low Vitamin D preeclampsia. There is an interesting correlation between winter pregnancies (lack of sunlight) and preeclampsia rates. Vitamin D is necessary in the formation of several enzymes produced by the placenta, which are missing in preeclampsia. Vitamin D is necessary for Calcium and Phosphorus to form developing bone and teeth buds. ​

Vitamin K: Vitamin D and K work together, and in combination with Calcium, Magnesium and Potassium.​ Vitamin K2 is a fat soluble vitamin that is produced through bacterial fermentation (either in the form of cultured food products, or by our digestive bacteria in our guts), or in cultured dairy products and bone marrow (bone broth). Its role in the body is only just starting to be understood, but its main known function is that of blood clotting (actually done by K1, not K2). K2 on the other hand works throughout the body. K2 and D3 work together to regulate Calcium deposits and transportation…some studies suggest that taking a Calcium and D supplement without a Vitamin K and Magnesium is actually a CAUSE of calcification in arteries. Vitamin K deficiencies were also associated with an increased risk of preeclampsia. Vitamin K deficiency is so common and big in pregnancy that newborns are given the vitamin K shot to prevent hemorrhaging from lack of vitamin K1. We are also seeing an increase in postpartum hemorrhaging in vaginal birthing mothers, which could have a connection with low Vitamin K levels. ​

Calcium: Calcium interplays with a number of different nutrients (Vitamin D/K/Magnesium). During pregnancy Calcium is very important in the growth of your baby’s bones, teeth buds, and more. Calcium is another nutrient deficiency associated with an increased risk of gestational hypertension. Calcium regulates the hormones that  function on the arteries (tightening and relaxing), and thus regulates blood pressure. In order to work properly, there must be enough Magnesium.​

Magnesium: Magnesium is addressed quite a bit in pregnancy. Not only is it necessary for many of the other nutrients, like Calcium, Sodium and Potassium, to function properly, it is also necessary for the hormone receptors to accept certain hormones. Without proper levels of Magnesium, sodium and calcium build up in the blood causing increased blood pressure, and increasing the risk of preeclampsia. Magnesium is a natural muscle relaxant, and deficiency can cause tightening of the blood vessels. Magnesium deficiency is also associated with increased anxiety and stress management symptoms. The majority of women I come across are magnesium deficient. In hospital care, Magnesium Sulfate is used to prevent seizures in preeclamptic woman, and reduce hypertension. ​

Potassium: The balance between potassium and sodium is crucial to regulating blood pressure. Magnesium is the balancing mechanism that makes sure there is the right ratio of sodium and potassium inside and outside of the cells. Too much sodium in the blood = hypertension. Potassium supplements have been used to treat hypertension for years…often with mixed results because potassium needs magnesium to work properly. Potassium is an electrolyte and you are going through a lot of these during pregnancy in the making and filtering of amniotic fluids, as well as the doubling of your blood volume.​

Zinc: Zinc is an important mineral for hormone development and immune support. It is one of the most essential mineral for pregnancy. Deficiencies are associated with an increased risk of miscarriage, birth defects, and stillbirths. Too much copper or iron can deplete zinc (there is a tricky balance), it is also necessary for proper B6 absorption. Zinc is the catalyst for the millions of enzymatic reactions that are occurring as your baby develops. It is also necessary in protein synthesis (protein is what your oxytocin is going to be made from).  Zinc plays a role in the formation of red blood cells, and deficiency can lead to anemia. ​

CoEnzyme Q10: Another Fat Soluble nutrient, CoQ10 is often not mentioned when talking about prenatal nutrition, and is most likely not in your prenatal. Nevertheless, it is found in high amounts in the Heart, Nerves, Liver and Kidneys, and has been shown in some studies to reduce the risk of preeclampsia in high risk women. It does have an effect on blood clotting and is essential for blood clotting at delivery. ​

​How To Prevent Preeclampsia With Diet

Bear in mind that the development of the blood vessels between the placenta and the uterus begin early on in gestation. In prevention, it is important to begin proper nutrition prior to conception. This doesn't mean that it cannot develop later, or that severity in symptoms cannot be prevented during gestation. The placenta is growing for several months, as your baby develops, and at any point proper nutrition can be used to grow these blood vessels properly, create healthy blood flow, and relax tense blood vessels all to lower hypertension. 

There are some foods that are better than other for providing the nutrition needed in the prevention of preeclampsia. As you noticed when reading the above section, there are some food group that are listed as food sources in most all of the nutrients. My top foods for preventing hypertension and preeclampsia would be:​