Digestion during pregnancy can be all over the place. This is a time of increased estrogen and progesterone production which can lead to an increase in constipation. The rise in estrogen in particular, can lead to numerous changes in the body (hello breast tenderness and acne). Another body system that undergoes changes we hear less often is the digestive system. We love talking with pregnant patients about how they can keep digestion, especially bowel movements, regular.
This post is going to focus attention on one particular digestive organ: the gallbladder. The gallbladder sits on the right side of your upper abdomen, under your right rib cage, nestled up to your liver. Its biggest and most important action is secreting bile which travels to the small intestine and helps your digestive system absorb fats and fat soluble vitamins (A, D, E & K). The bile that is stored in the gallbladder is made in the liver, hence their close proximity and intimate functional relationship.
What changes in pregnancy?
With the rise in hormones for a pregnant person, there is more demand on the liver to process and transport estrogen, in particular, for excretion. When the liver is burdened, there can be a decrease in production of bile sent to the gallbladder. With less bile flow, there is not enough lubrication of the stool to prevent constipation, absorption of fat and fat soluble vitamins.
What to do about it?
This is where our favorite superfood for digestion in pregnancy comes in: BEETS. Beets contain betaine which helps thin bile, promoting bile flow from the gallbladder. Additionally, beets contain phytonutrients that help the liver detox hormones, chemicals and toxins and helps the liver produce bile. By eating ¼ of a beet or more a day, you will be using food as medicine to support liver and gallbladder function. It’s a total win-win!
Does having a MTHFR variant make digestion during pregnancy any different?
Yes, it can. Having the MTHFR genetic variant increases your risk of folate deficiency. With an increased risk of folate deficiency combined with the higher demands for folate to grow a fetus and metabolize estrogen, liver detoxification can be slower. When liver function slows, we see a decrease in secretion of many enzymes, one of which is bile. With less bile, it's possible to experience more constipation.
In addition to adding beets to your diet you can also double check your prenatal vitamin supplement. Make sure that it contains folate (methyl tetrahydrofolate and calcium folinate) rather than folic acid. Folate is the more active form of the nutrient and it is necessary for making cells (re: fetus), rebuilding intestinal lining and so, so much more.
What are some ways to incorporate beets into my diet?
Steamed beets: cut into 1” chunks, cover with water in a pot. Bring water to a boil, then simmer for 20 minutes or until tender.
Roasted beets: cut into 1” chunks, toss with coconut oil, S & P. Place in oven at 400° and roast for 30 minutes, until tender.
Instant Pot: Place beets on instant pot rack, add 1 cup water. Set to manual, high pressure for 25-30 minutes, depending on the size of beets. Allow slow release for 5 minutes.
Beet Juice: another great way to get beet nutrients is by juicing! Beet, carrot & apple is a delicious combination.
Smoothies: adding ¼ beet to a smoothie is a great way to “hide” the flavor if you’re sensitive to that.
Happy beet cooking!
Dr. Curtiss & Dr. Stang
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