In this episode of the Freedom to Flourish Podcast, Dr. Joel Miller and Dr. Tim Augustyniak discuss natural pregnancy wellness, holistic prenatal care, and root-cause support for common pregnancy symptoms including nausea, morning sickness, heartburn, reflux, fatigue, gestational diabetes, iron deficiency, bloating, constipation, sleep issues, food cravings, and swelling.
The conversation focuses on functional medicine approaches to pregnancy health, with an emphasis on hormone detoxification, liver and gallbladder support, bile flow, gut health, blood sugar balance, prenatal nutrition, nervous system regulation, and natural support for pregnancy symptoms. They also discuss methylation support, prenatal vitamins, omega-3 fatty acids, magnesium, zinc, choline, B vitamins, iron support, chiropractic care, and healthy lifestyle habits for pregnancy and birth preparation.
This podcast transcript is provided for educational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider before making changes to your health routine, diet, supplements, or treatment plan, especially during pregnancy.
Dr. Joel: Hey everyone, welcome to the Freedom to Flourish Podcast. I’m your co-host, Dr. Joel Miller, here with Dr. Tim Augustyniak.
Guys, today we’re talking about thriving in pregnancy. A lot of women experience symptoms like nausea, fatigue, vomiting, reflux, and a variety of other issues during pregnancy.
Dr. Tim, we’ve talked about pregnancy a little bit before. We’ve talked a lot about female hormones and balancing hormones, but the last time we really focused on pregnancy was about two years ago in episode 16.
In that episode we talked about how both the mother and father should ideally prepare their health before trying to conceive. The healthier and stronger you are going into pregnancy, the better the pregnancy and birth experience tend to be.
So we covered some of that in our “Raising Healthy Kids” episode, but today we’re diving deeper into pregnancy symptoms, why they happen, and what women can do to help support their bodies naturally through pregnancy.
Dr. Tim, tell me a little bit about what you’re seeing in the office and some of the mechanisms behind these symptoms. Then we’ll get into what we’re finding clinically that really helps people.
Dr. Tim: Yeah, first off, I can’t believe it’s been 97 episodes since we’ve talked about this. We’re always adding new things, and even though we’ve repeated some topics, most listeners aren’t listening to every single episode.
It’s good to revisit these subjects, especially because both of us have grown a lot clinically over the last couple years. Also, my wife is currently 33 weeks pregnant, so while I personally am not going through pregnancy, I’m living with somebody who is.
She’s had plenty of moments where she’s said, “Hey, let’s go to the office and figure out what’s going on because this doesn’t feel good.” So I’ve gotten a much more firsthand perspective instead of just seeing pregnant patients for an hour at a time.
There are a lot of textbook pregnancy symptoms: morning sickness, nausea throughout the day, ankle swelling, food aversions, heartburn, and so on.
But the theme we keep coming back to with almost every one of these symptoms is hormone detoxification issues leading to poor bile flow. Honestly, if you want the single biggest root issue behind many pregnancy symptoms, it’s poor bile flow and impaired hormone detoxification. That’s the main driver.
So pregnancy creates a huge hormone shift. Hormones increase dramatically and quickly. If the liver and gallbladder are already struggling before pregnancy, then detoxification becomes even harder during pregnancy.
If the liver isn’t making enough healthy bile and the gallbladder isn’t contracting properly to release it, then the body struggles to digest fats, detoxify hormones, and regulate inflammation effectively.
One of the best things women can do is prepare beforehand. Pregnancy symptoms aren’t just “because you’re pregnant.” Yes, there are always exceptions and there’s only so much you can control, but if you go into pregnancy with better bile flow, healthier hormone detoxification, better insulin sensitivity, regular movement, and better metabolic health overall, you’re far more likely to have a healthier pregnancy with fewer symptoms.
So to set the stage here, bile is made from cholesterol. Cholesterol is also the precursor for all sex hormones like estrogen, progesterone, and testosterone. Cholesterol itself isn’t the enemy. It’s essential.
But when the body is overwhelmed with stress hormones and sex hormones, you start depleting the nutrients required to detoxify those hormones. Think about it like a car running out of gas. Hormone detoxification requires fuel.
The body needs nutrients to process and eliminate hormones effectively. If you keep demanding more from the system without replenishing the nutrients needed for detoxification, eventually you run out of resources and the whole process starts backing up.
A lot of patients ask, “What foods are high in vitamin B6?” And honestly, while good nutrition matters, most people who are deeply depleted can’t just food their way out of the hole immediately.
Modern food is nowhere near as nutrient dense as it used to be. Sometimes people simply need supplemental support to get themselves back to a healthier baseline.
The reason all of this matters is because the same nutrients required to produce bile are also required to detoxify hormones.
To detoxify estrogens, for example, the body first has to methylate them. That process requires nutrients like trimethylglycine, choline, glycine, vitamin B6, and other methylation cofactors.
These nutrients help both bile production and hormone detoxification. So if you run out of the “gas” needed for detoxification, you also compromise bile production.
Then it becomes a vicious cycle because hormones are eliminated through bile. If the liver can’t produce healthy bile or the gallbladder can’t release it properly, hormones back up in the liver and symptoms start showing up everywhere.
So lifestyle becomes extremely important. Eating properly to stabilize blood sugar and reduce excessive cortisol and insulin production is huge because cortisol and insulin depletion drain the exact nutrients needed for hormone detoxification.
Obviously during pregnancy you can’t stop your body from making more hormones, but you can support the body nutritionally so it keeps up with the increased demand.
So generally speaking, bile flow and hormone detoxification affect symptoms like nausea, heartburn, fatigue, ankle swelling, gestational diabetes, and many more. Each symptom has additional layers too, but that’s the overarching theme.
Dr. Joel, do you want to jump into general pregnancy support first or start with individual symptoms?
Dr. Joel: Yeah, let’s start with the symptoms and then we’ll get into support afterward. One other thing to add to the list is iron deficiency. A lot of women develop low iron or blood sugar issues during pregnancy, so we’ll definitely cover those too.
But starting with nausea and heartburn, those are probably the two biggest symptoms we see. Sometimes women have both together and sometimes only one.
Usually these symptoms are worse during the first trimester, especially the first 12 weeks, and then things often settle down somewhat during the second trimester.
By the third trimester, though, the physical strain increases because the baby is growing so much. I also find that closer to labor there can be significant tension through the pelvis and round ligaments.
Chiropractic care can help a lot with that, but there are also internal factors driving some of those issues too.
I had a patient recently who came in about a week before her due date. And honestly, due dates themselves are kind of interesting because they’re really just estimates.
Everybody is different. We act like 40 weeks is perfect and then suddenly at 42 weeks everyone panics, but what if mom and baby genuinely need more time?
As long as everyone is healthy and developing well, sometimes these timelines are more flexible than people think.
Anyway, nausea is one of the biggest pregnancy symptoms we see. The number one thing we find with nausea is poor bile flow.
The liver may not be producing healthy bile efficiently because of increased stress, hormone load, or nutrient depletion.
Then there’s also the gallbladder side of it. Even if the liver makes bile, the gallbladder still has to release it properly.
If bile becomes thick because of hormone overload, it won’t flow well. And different things can also interfere with gallbladder contraction itself.
Blood sugar issues are one of the biggest factors there. That’s why it’s generally not a good idea to completely give in to every carb craving during pregnancy.
You still want to eat healthy. There are ways to satisfy cravings while still supporting your body nutritionally.
Pregnancy cravings don’t mean your body suddenly wants junk food all day long. Your body still needs quality nutrients to support both mom and baby.
Occasionally nausea can also involve stomach-specific issues like food sensitivities or low stomach acid, which also ties into heartburn.
So Dr. Tim, what are some of the things you see driving heartburn during pregnancy?
Dr. Tim: There’s a huge overlap between heartburn, constipation, nausea, and most upper GI symptoms during pregnancy because the gallbladder is usually involved in all of them.
Honestly, we could probably retitle this episode “How Your Gallbladder Messes With Your Pregnancy.”
But seriously, when it comes to heartburn, there’s the bile component, but there’s also a nervous system regulation component that we don’t always talk about enough on the podcast.
Let’s say somebody comes into the office with reflux or heartburn. We’ll go through the basics first: diet, lifestyle, blood sugar regulation, all the things they can control.
Then we’ll use applied kinesiology and our Systemic Self Care approach to figure out what organs are stressed neurologically and what’s actually irritating the system.
For example, someone might have a functional hiatal hernia where the stomach is irritated and pushing upward into the diaphragm.
Through muscle testing we can determine whether the stomach itself is irritated, whether the gallbladder is involved, or whether there’s some other organ dysfunction.
Then we can assess what nutritional support the body needs and treat the neurological reflexes associated with those organs.
A lot of times, when there’s upper abdominal tension and dysfunction, you can literally feel it release after treatment. The whole area relaxes because the nervous system calms down and the organ function improves.
Chemical irritation from foods, hormones, low stomach acid, histamines, infections, or microbiome imbalances can all dysregulate these organs neurologically.
The nervous system and immune system are deeply connected. When the immune system becomes reactive, the nervous system shifts into sympathetic dominance, which disrupts vagus nerve signaling and normal digestive function.
During pregnancy specifically, women naturally shift toward a more TH2 dominant immune state. That means the immune system becomes more reactive and less focused on fighting infections aggressively.
This is part of why pregnant women are often told to avoid things like sushi or deli meat because their immune system response changes during pregnancy.
But what that also means is that hidden food sensitivities or microbiome issues can suddenly become much more symptomatic.
A woman may have tolerated dairy, nightshades, or certain foods before pregnancy without obvious symptoms, but once pregnancy shifts the immune system, those sensitivities become much more noticeable.
So with heartburn during pregnancy, there’s almost always some combination of poor bile flow, food irritation, histamine issues, microbiome stress, or hormonal overload involved.
One thing I do want to caution people about is herbs during pregnancy. You have to be very careful.
There are herbs like berberine that can absolutely be problematic during pregnancy and potentially increase miscarriage risk. So people shouldn’t just randomly start taking every herb they hear about online.
Make sure you’re working with someone who actually understands pregnancy-safe support.
But overall, with heartburn, you really have to figure out what’s aggravating the system. Is it hormones? Is it blood sugar? Is it a specific food?
Sometimes it helps to keep a journal and look for patterns. Maybe symptoms consistently happen after high-carb meals or after certain foods. The more data you collect, the easier it becomes to identify what’s driving the problem.
Dr. Joel: Yeah, absolutely. And one thing I’d add is that the supplements we’ll talk about later that support bile flow and hormone detoxification often help significantly with both nausea and heartburn.
Sometimes they completely resolve the symptoms, and other times they reduce them dramatically.
I’ve had women tell me their nausea improved by 70 or 80 percent after supporting bile flow and liver function.
The nutrients we’re talking about support hormone detoxification, digestion, and overall metabolic balance.
Alright, Dr. Tim, let’s shift into gestational diabetes and iron deficiency because those are two really common pregnancy issues.
Women often discover these during routine labs with their doctor or midwife. So for women struggling with gestational diabetes, what are some of the biggest things you find helpful?
Dr. Tim: Yeah, obviously we just tell everybody to take berberine. No, I’m kidding. Definitely do not do that during pregnancy.
Berberine is generally great for blood sugar support, but not during pregnancy.
But when it comes to gestational diabetes, the root issue is ultimately too much sugar and insulin resistance. I know that sounds overly simple, but that’s really what it comes down to.
My wife had a couple moments earlier in pregnancy where there were maybe a few too many cookies and desserts. I tried to gently encourage her to dial things back a little because her blood sugar numbers were starting to creep upward.
She’s tiny, so if gestational diabetes causes the baby to grow too large, that can significantly complicate delivery. That’s one reason petite women especially need to be careful with blood sugar during pregnancy.
Once we tightened things up nutritionally, things improved a lot. And honestly, it does take teamwork sometimes because pregnancy cravings are real.
When you’re uncomfortable, exhausted, and constantly hungry because you’re growing a human, carbs and sugar are usually the things that sound appealing.
Women often develop strong cravings for processed carbs, sweets, or fast food. So having support and accountability matters.
But gestational diabetes isn’t only caused by eating sugar. Pregnancy itself increases insulin resistance because of a hormone called human placental lactogen.
This hormone helps ensure the baby has an adequate glucose supply, but one side effect is increased insulin resistance in the mother.
That’s why gestational diabetes screening is so standard during pregnancy.
So the best approach is supporting blood sugar regulation while also supporting hormone detoxification and bile flow.
One of my favorite nutrients for this is artichoke extract because it supports glucuronidation, which is one of the primary detox pathways for insulin and hormones.
Artichoke contains glucuronic acid, which is important both for hormone detoxification and bile production.
Bilirubin, which is a component of bile metabolism, also relies on glucuronic acid for proper conjugation.
So artichoke is fantastic for supporting liver function, bile flow, insulin regulation, and hormone balance.
Minerals like chromium, manganese, and magnesium are also really important for blood sugar regulation.
A good prenatal often covers some of those basics, but nutrition still matters tremendously. You can’t out-supplement a diet full of processed carbs and sugar.
So overall, blood sugar balance during pregnancy is a combination of eating properly, supporting detoxification pathways, moving your body regularly, and using targeted nutrients when needed.
Dr. Joel: Yeah, absolutely. One thing I’d add is that women often crave carbohydrates around their menstrual cycle because complex carbs help support progesterone sensitivity.
Dr. Mindy Pelz talks about this a lot. Things like sweet potatoes, rice, and healthy carb sources can actually help support hormone balance when used appropriately.
I think some of those same mechanisms can show up during pregnancy too.
Also, poor bile flow during pregnancy can contribute to gut imbalances, and certain bacteria or fungi can actually drive cravings for sugar and processed carbs.
Bile normally helps regulate the microbiome and keep those organisms under control. So if bile flow slows down, cravings can intensify.
For women who are eating very healthy but still struggling with blood sugar issues, I’d really focus on liver support, bile flow, hormone detoxification, and movement.
When those things are addressed properly, we often see blood sugar normalize really well.
Then there’s the iron conversation. A lot of women develop low iron during pregnancy.
When evaluating iron, you really want to look at both serum iron and ferritin because ferritin reflects iron storage.
What I often find clinically is that low iron isn’t always simply from low intake, especially if the person already eats meat regularly.
A lot of times infections, bacterial imbalances, fungal overgrowth, or parasites are feeding on nutrients like iron, B12, copper, and B2.
During pregnancy, the immune system shifts focus toward supporting the baby rather than aggressively fighting infections, and if bile flow is poor, those microbiome issues can become even more prominent.
I had a patient recently whose ferritin was at 7 and serum iron was around 36. Instead of just throwing iron supplements at her, we focused heavily on liver support, bile flow, hormone detoxification, fish oil, zinc, magnesium, and overall gut support.
About six weeks later her ferritin had risen significantly and her iron jumped all the way up into a healthy range, and we didn’t even use an iron supplement.
So a lot of times addressing the underlying physiology matters more than simply forcing more iron into the body.
Dr. Tim: Yeah, absolutely. But with that being said, there actually is one iron supplement I really like when iron support is needed.
It’s called Ferrofood from Standard Process. Out of all the forms of iron I’ve used clinically, that one tends to work the best and causes the fewest digestive side effects.
One of the biggest problems with iron supplementation is that certain microbiome imbalances can feed on iron and actually worsen symptoms like constipation or bloating.
So anytime we give someone iron, we always want to cross-check and make sure it’s not aggravating an underlying gut issue.
Ferrofood is a whole-food-based iron supplement, and I find it’s much more tolerable than a lot of the synthetic forms.
I had one patient whose iron had been chronically low for years. She and her family were Hindu and didn’t eat meat, so that was definitely part of the issue.
Eventually she started using Ferrofood and within one bottle her iron levels improved dramatically. So if someone truly does need an iron supplement during pregnancy, that’s generally the one I trust most.
As far as overall pregnancy support, I focus heavily on hormone detoxification, methylation support, and bile flow support.
So nutrients like choline, glycine, trimethylglycine, omega-3 fatty acids, and quality prenatals are huge.
One thing we were talking about before recording is how people in different parts of the country can react differently to supplements and herbs.
For example, Dr. Justin Heideman out in Utah says some patients react negatively to herbs like noni all the time, whereas I almost never see reactions to it here.
I don’t know if it’s environmental exposure, genetics, or what, but people definitely respond differently regionally. So because of that, there’s always some individualization involved.
The prenatal I currently like best is the Good for Mama’s prenatal from Supreme Nutrition. That’s the one my wife is taking and the one we recently started carrying in the office instead of the Thorne prenatal.
I’ve had a surprising number of women feel nauseous on the Thorne prenatal for some reason, whereas they seem to tolerate the Good for Mama’s formula much better.
Part of why I trust that product is because I personally know the people behind it. With huge supplement companies, it’s harder to have that level of direct trust and communication.
Beyond prenatals, magnesium is often really helpful during pregnancy, especially magnesium citrate powders like Magnesium Calm. It can help with constipation, sleep, stress, and muscle tension.
Really, though, support depends on the specific symptoms someone is dealing with.
At bare minimum, I think a good prenatal plus omega-3 support with EPA and DHA are foundational.
Then beyond that, it becomes more individualized. You can easily end up with a giant handful of supplements if you’re not careful, and I don’t think that’s always ideal either.
Dr. Joel: Yeah, absolutely. So when we look at the big picture with pregnancy symptoms like nausea, heartburn, fatigue, ankle swelling, sleep issues, iron deficiency, and blood sugar dysregulation, the first thing we always emphasize is whole foods.
That means two things. Number one, eating nutrient-dense foods gives the body the raw materials it needs. But number two, avoiding processed foods matters because poor-quality foods actually drain nutrients and create more stress on the body.
So if you’re craving carbs during pregnancy, focus on healthier carb sources like sweet potatoes, rice, fruit, honey, and things like that rather than processed sugar and seed oils.
The supplement side is the second major piece.
I’ve generally used the Thorne prenatal and seen good results overall, though after this conversation I’m definitely going to look more into the Good for Mama’s prenatal as well.
Beyond prenatals, some of the most common things we use clinically are methylfolate, choline, trimethylglycine, vitamin B6, zinc, omega-3s with EPA and DHA, magnesium, and occasionally herbs like Chinese skullcap, also called scutellaria.
That’s one herb I do find helpful and generally safe during pregnancy when used appropriately.
Usually we’ll use something like one capsule morning and night with the Supreme Nutrition version. It’s been used traditionally for a very long time.
But ultimately, one of the biggest things I want to encourage listeners with is that these things really do matter.
Eating healthy, moving your body, walking, exercising appropriately during pregnancy, supporting your nervous system, reducing stress, and taking care of your overall health can genuinely make a huge difference in pregnancy and birth outcomes.
We hear so many stories where labor is extremely long and exhausting, but clinically I’ve consistently found that women who prioritize their health before conception and continue supporting themselves throughout pregnancy tend to have smoother births overall.
I had one patient I worked with throughout pregnancy who came in about a week before her due date. We had already spent months supporting her digestion, hormones, pelvis, nervous system, and overall health.
That final visit we addressed a little remaining pelvic tension and added one additional nutrient she needed. She went into labor that night.
For a first pregnancy, where labor often lasts 12 to 24 hours and pushing can take anywhere from 30 minutes to several hours, her labor lasted about nine hours total and she only pushed for five minutes.
She had an all-natural birth, both she and baby were healthy, and the midwives told her, “Your body was made for this.”
And yes, maybe part of that is true, but I also think all the work she put into her health beforehand played a huge role too.
So for anybody listening, thriving during pregnancy is absolutely possible. There’s a lot you can do proactively to support your body and your baby.
Hopefully this episode gave people practical tools and encouragement. Dr. Tim, any last thoughts before we wrap things up?
Dr. Tim: Nope, I think this was a super practical and hopefully really helpful episode for pregnant moms and anyone preparing for pregnancy.
So I’d say let’s wrap it up. I’m Dr. Tim Augustyniak here at Flourish Functional Wellness Center in Bentonville, Arkansas.
If you have questions, comments, or concerns, feel free to reach out. My website is flourishfwc.com, and all my socials and office contact information are there.
Dr. Joel: Awesome. And I’m Dr. Joel Miller at Freedom Health and Wellness in Flower Mound, Texas. You can find me online at DrJoelMiller.com.
If you guys have questions or suggestions for future episodes, we’d love to hear from you.
Thanks so much for listening, and we’ll see you guys in the next one.
