Source: Edited by Maggie McGrath Reported by Vickie Chachere Date: August 1st, 2024 Marlena Fejzo miscarried two decades ago due to hyperemesis gravidarum (HG), an extreme form of morning sickness that can cause violent illness. Dismissed by doctors who told Fejzo she was exaggerating her symptoms, the Harvard-educated Ph.D. set about conducting a series of genetic studies that have, in the past six years, produced breakthrough findings revealing the gene responsible for HG. With HG’s genetic mechanisms now known, Fejzo is turning her attention toward treating and preventing the condition for patients. To accomplish this, Fejzo joined the founding team of Harmonia Health, which launched in early 2024. About Harmonia Healthcare Harmonia is a highly specialized women's health platform that combines cutting edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum, Harmonia's physician-lead research, diagnostic and treatment programs result in superior health outcomes and subsequently enhanced wellbeing and quality of life. For more information on Harmonia and hyperemesis gravidarum, or to learn if you might be suffering from hyperemesis gravidarum, visit  www.harmoniahealthcare.com  or connect with us on Instagram at @ harmoniahealthcare .

Source: By: NOW Foundation A deserving recipient of NOW Foundation’s Victoria L. Mastrobuono’s Award in Women’s Health, Dr. Marlena Fejzo has led a distinguished career focused on researching health challenges most often experienced by women. In March, Dr. Fejzo was honored as one of Time’s Women of the Year and, in May, she was named one of Time’s 100 Health leaders, advancing safe pregnancy.  Dr. Fejzo has made significant breakthroughs in research on Hyperemesis Gravidarum (HG – a severe form of vomiting during pregnancy), fueled by her own personal experience with the condition. She successfully identified the gene with the greatest risk factor for developing the condition and is now turning her attention to identifying potential therapeutics.  Marlena Schoenberg Fejzo is a women’s health scientist. She received her Ph.D. in Genetics from Harvard University in 1995. From 2000-2020, she worked on ovarian cancer in the Department of Medicine at the University of California, Los Angeles, in the laboratory of Dennis J. Slamon. Currently, she is a research faculty at the University of Southern California, Keck School of Medicine in the Center for Genetic Epidemiology.   Dr. Fejzo has published peer-reviewed scientific articles on many diseases of women including ovarian cancer, breast cancer, multiple sclerosis, and discovered the first genes for uterine fibroids, nausea and vomiting during pregnancy, and Hyperemesis Gravidarum (HG). In 2018, Fejzo, in collaboration with personal genetics company 23andMe, Inc. published the first link between the placenta, appetite, and vomiting hormones. Fejzo made the top 10 list of 2023’s Fiercest Women in Life Sciences. In December 2023, Nature  published a study by Fejzo et al. that identified ways to potentially prevent and treat both nausea and vomiting in pregnancy and HG.    Fejzo is Research Director and Board Member of the Hyperemesis Education and Research (HER) Foundation, Board Member of the Foundation for Women’s Health, CSO of Harmonia Healthcare, and an advisor for NGM Bio. Dr. Fejzo is currently seeking funding opportunities and grants related to her work on Hyperemesis Gravidarum.   About Harmonia Healthcare Harmonia is a highly specialized women's health platform that combines cutting edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum, Harmonia's physician-lead research, diagnostic and treatment programs result in superior health outcomes and subsequently enhanced wellbeing and quality of life. For more information on Harmonia and hyperemesis gravidarum, or to learn if you might be suffering from hyperemesis gravidarum, visit  www.harmoniahealthcare.com  or connect with us on Instagram at @ harmoniahealthcare .

Source: By Lisa Marie Falbo | Host, Co-Founder Leslie Gautam is the co-founder and CEO of Harmonia Healthcare. They recently opened their first morning sickness center in Red Bank, aiming to close the gender gap in healthcare.

Source: By: Michael L. Diamond | Asbury Park Press Date: July 26th, 2024 RED BANK - Lara Glassman was miserable. Pregnant during the pandemic with her first child, she battled a constant wave of morning sickness that was so severe that when she was considering two years later whether to have another child, she nearly decided she couldn't go through the experience again. "It was hell," Glassman, 39, of Allenhurst, said of the first pregnancy. Now 14 weeks into her second pregnancy, Glassman has found help. She is visiting Harmonia Healthcare, a startup company that opened on Front Street this spring to treat women with hyperemesis gravidarum, a severe form of morning sickness that produces persistent nausea and vomiting. Co-founded by Rumson resident Kristen Williams, New York-based Harmonia hopes to keep pregnant women hydrated and healthy with IV infusions and emotional support, preventing frequent emergency room visits and trauma that comes with the illness. The Red Bank office opens as health researchers sound an alarm. A report recently released by The Commonwealth Fund found the life expectancy of an American woman is at its lowest level since 2006. The research group provided a state-by-state analysis of outcomes, quality and access for women, and it ranked New Jersey 19th nationwide. "Women's health is in a fragile place, with health care systems in many states struggling to provide comprehensive health care to women across their lifespan," said Sara Collins, a vice president at The Commonwealth Fund. Harmonia's Red Bank office is its first. The company focuses on women who have severe morning sickness, a condition that is seen in 14% of all pregnancies and has left women turning to Google and Reddit chats searching for answers. Hyperemesis gravidarum, or HG, is rarer. It is seen in 1% to 3% of pregnancies and can cause women to lose weight, become dehydrated, and drop out of the labor force. Upwards of one-third of pregnancies among women with the condition result in premature delivery, miscarriage, still birth or termination, the company said. Dr. Robyn Glessner, an emergency room physician who joined Harmonia, said common treatments for HG aren't always effective. So she and nurses there create individual plans that can include IV treatments and emotional support. Harmonia has applied to get private insurers and Medicaid to cover the treatments. For now, it costs between $300 and $500 a visit. "The goal is to keep them functioning, keep them hydrated, keep the vitamin levels goods for the baby's development and for the mother's health," Glessner said. Harmonia was co-founded by Williams, 43, a Middletown High School South graduate who joined an investment firm that focused on the life sciences industry. After the company was sold, she took time off, only to rejoin a former colleague in a new investment company, Emerald Bioventures, hoping to work on projects that would improve women's health. The firm homed in on treating severe morning sickness, partnering with influential experts: Dr. Andrew Housholder, the founder of The Morning Sickness Clinic in Birmingham, Alabama, which has used infusion treatments to reduce emergency room visits among his patients by 95%; and Marlena Fejzo, a California geneticist who was diagnosed with HG and has zeroed in on a gene that could predispose women to the condition. "Once you cross into (HG) … you are compromised, your health is being compromised," Williams said. "The goal is to keep the super severe patients as functioning and as well as we can." Harmonia appears to be stepping into a health care specialty that could use help. While New Jersey has one of the nation's lowest rates of infant mortality, it lags in other categories. For example, its rate of maternal deaths while pregnant or shortly after termination ranks 23rd nationwide; and its rate of pregnant women who begin maternity care during the first trimester ranks 36th, according to The Commonwealth Fund. For now, there are obstacles to Harmonia's care. Its cost can be out of reach for low- and middle-income families, at least until insurers cover the treatment. Glassman said she looked as if she had been through the ringer when she walked into Harmonia's office one recent day, but her disposition improved as she reclined in a chair, with a lollipop, ginger ale and an IV drip that was providing vitamins. Her second pregnancy hasn't been nausea-free, but it has been manageable, she said. "I didn't even think I was going to get to 14 weeks the first go-around because I was so miserable that first trimester," Glassman said. "But having … the option to go in for extra vitamins and infusions has really made the experience a completely different one than the first time around." About Harmonia Healthcare Harmonia is a highly specialized women's health platform that combines cutting edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum, Harmonia's physician-lead research, diagnostic and treatment programs result in superior health outcomes and subsequently enhanced wellbeing and quality of life. For more information on Harmonia and hyperemesis gravidarum, or to learn if you might be suffering from hyperemesis gravidarum, visit  www.harmoniahealthcare.com  or connect with us on Instagram at @ harmoniahealthcare .

Source: by RAE NUDSON July 10, 2024 Hyperemesis gravidarum, or HG, is a debilitating pregnancy nausea that affects 2% of pregnancies. Researchers know how to cure it — if they could only get funding. When Olivia Myers became pregnant with her first child, she was so nauseated that she had to either miss work or work from home in Calera, Alabama, from bed, with a trash can nearby. With her doctor, she attempted to ease the nausea and vomiting. She tried an anti-nausea medication, and then another and another — more than 10 different medications in all. A nurse came to her home to administer IVs to help with the dehydration from vomiting. She would walk around with a needle in her arm, wheeling around a pole that held the fluid slowly flowing into her body. She tried a Zofran pump — an anti-nausea medication that entered her body through a small needle she wore on her skin and a pump that she carried around in a backpack. “It wasn’t working,” she says. At her lowest point, when she was about 12 weeks pregnant and bedridden due to nausea and vomiting, she became terrified she wouldn’t be able to remain pregnant. “I was so scared that I was either going to miscarry or that I just wasn’t going to be able to do this for nine months,” she says. “I was having a mental breakdown.” Her husband considered taking her to the hospital on her worst day, a day she vomited 12 times. Although most people experience some pregnancy nausea, an unlucky group that Myers belongs to experiences such severe nausea that can have serious effects on their bodies and lives. Myers had hyperemesis gravidarum, often known abbreviated as HG — severe pregnancy nausea characterized by a disruption in regular life, the inability to eat or drink regularly, weight loss, and sometimes malnutrition. It can become so severe that it can lead to miscarriage, organ damage, or death. About 0.3% to 2% of pregnancies are estimated to have severe HG. But pregnancy nausea and HG are on a spectrum, and even mild HG can be miserable. Marlena Fejzo, a geneticist at the University of Southern California, was one of those unlucky 2%. Fejzo had HG in two pregnancies. Her first pregnancy, in 1996, left her with nausea and vomiting so severe she couldn’t work for two months and she received IV treatments twice, The New York Times reported . In her second pregnancy in 1999, she became so malnourished from severe nausea and vomiting that she was put on a feeding tube. “I didn’t eat or drink for over a month,” she tells me. She miscarried at 15 weeks. When she came back to work after the loss, she told her boss she wanted to find the cause of HG. Her boss, the chair of the genetics department at the University of California, Los Angeles, laughed at her. So for the next two decades, Fejzo researched HG in her free time, when she wasn’t researching ovarian cancer. “There was sort of a ‘don’t ask, don’t tell’ phase also where I worked on it on the side,” she says. “I couldn’t talk about it, really. It was a bit isolating — until recently.” Fejzo started her first HG study in 2000 by posting a survey about pregnancy nausea on the Internet. Responders faxed their answers to her. One of the women who took the survey was Kimber MacGibbon, who had HG and went on to co-found the HER Foundation , dedicated to research, education, and support for those with HG. Researchers worry that drugs to treat pregnancy nausea won’t be commercially viable because it’s a “one or two shot” drug, only for use during pregnancy. “They like making drugs that people need forever.” Over the next several years, Fejzo continued collecting survey responses and DNA samples, and she began enrolling participants in a larger study that showed HG ran in families. In 2010, after receiving a 23andMe kit for her birthday, Fejzo reached out to the company and asked if it would include questions on its surveys related to HG. And over the following decade, Fejzo tried to connect all the dots. Her research found that HG was related to a hormone known as growth differentiation factor-15 (GDF15). But she didn’t know exactly how GDF15 affected nausea in pregnancy— until recently. In a paper published in Nature in December 2023, Fejzo and her co-authors showed that the likely main cause of severe pregnancy nausea is, in particular, the pregnant person’s sensitivity to GDF15. GDF15 is related to appetite suppression and nausea. Most people have a certain level of GDF15 in their bodies, but the amount of GDF15 depends on genetics and on circumstances — it can increase with age or when cells become stressed, like during an illness. (This is why, for example, cancer patients can also experience nausea and suppressed appetite.) Researchers worry that drugs to treat pregnancy nausea won’t be commercially viable because it’s a “one or two shot” drug, only for use during pregnancy. “They like making drugs that people need forever.” In pregnancy, the fetus produces GDF15 in large amounts. If a pregnant person starts out with higher GDF15 as their baseline, then the increase in pregnancy may not hit them so hard, and they have less risk of severe nausea. If a person starts out with lower GDF15, that increase can lead to higher risk of pregnancy nausea. The amount of GDF15 that the fetus produces is genetic, too, which is why the level of GDF15 — and the nausea it causes — can vary for different pregnancies. After more than 20 years of researching the cause of HG, much of it without institutional support, Fejzo wants to see this to the end. She wants a treatment for HG that works . “I’m trying to do my best to help get this to its final chapter,” she says. “It’s been a long hard road.” She gets emails fairly regularly from HG patients asking her when there will be a cure. “People are always writing nice things, but it is also a lot of pressure,” Fejzo says. But now she can see a clear way forward. In fact, there may be multiple ways forward. One path to easing HG symptoms is to create a medication that blocks the brain from receiving the GDF15 hormone, leaving the pregnant person less affected by the increase during pregnancy. Stephen O’Rahilly, a geneticist and co-author of the paper published in December, knows there will be barriers for companies to develop this kind of drug. The litigious environment in the United States makes it almost impossible for the drugs to be tested in the country — most pharmaceutical companies don’t want to take the risk of testing drugs for pregnant people. He expects it will be developed elsewhere first. Based on the research Fejzo and O’Rahilly published, the pharmaceutical company NGM Bio is currently working toward development of one such drug. According to its website, it is planning a study for the treatment in pregnant women. (The company did not respond to request for comment.) “People still maybe don’t understand how bad this disease is and how much better prevention or treatment methods are needed. Even though I’ve been trying and trying.” But there’s a commercial fear, O’Rahilly says, that the drug won’t be profitable. He’s seen companies say that drugs that treat pregnancy nausea won’t be commercially viable because it’s a “one or two shot” drug, only for use during pregnancy. “They like making drugs that people need forever,” he says. Even so, he’s convinced the rationale to safely treat pregnancy nausea by blocking GDF15 receptors is sound. And there is an enthusiastic demand for treatment, whether companies think it will be profitable or not. “There will be an effective and safe treatment, certainly within my lifetime but hopefully well before that,” he says. “I’ve never been more confident in a medical prediction.” Another way forward is to lessen the sensitivity to GDF15 with a medication that safely increases the baseline GDF15 in someone’s system before pregnancy. Drugs that happen to increase GDF15 already exist, some with decades of safety information available. It’s this scenario that Fejzo is ready and waiting to test. She has a clinical trial ready to go — but she needs funding. One grant she applied for was just rejected. In the meantime, pregnant people like Olivia Myers are desperate for treatment. By Myers’ 14th week of pregnancy, her doctor suggested she reach out to the Morning Sickness and HG Clinic of Birmingham, Alabama. The clinic, which opened in October 2022, is the first of its kind: a place created to treat severe pregnancy nausea. Instead of getting the up to 2% of pregnancies from the state — the amount estimated to have severe HG — it is getting closer to 5%. In addition to providing one-on-one care for HG patients, making adjustments to medication as needed, and providing regular IV infusions, the clinic is amassing blood samples and data to advance research and care for HG. “As soon as I gave birth to her, all of my symptoms went away. I went from taking 13 medications to one,” says Myers. Myers says that after regular visits to the clinic, her symptoms did improve. There were still days she couldn’t get out of bed, but they were fewer and farther in between, and after several months of treatment and regular IVs, she delivered a baby girl. “As soon as I gave birth to her, all of my symptoms went away. I went from taking 13 medications to one,” she says. Despite the demand and effectiveness of its care, Dr. Andrew Housholder, the clinic’s founder, says it is facing trouble getting insurers to pay for the treatment provided. “I spent hours yesterday trying to gather data to convince them to pay for some of the medicines that we give patients,” he tells me. “We are trying to figure out how to help them see that we are saving them a lot of money by treating them out of the hospital and outside of the ER.” For now, even with exponential growth in the patients it serves, the clinic is operating at a loss. More morning sickness clinics are beginning to open, with the help of Fejzo, who seems to have a hand in every bit of progress related to HG. She connected with Housholder in 2023 to discuss his clinic, and she brought what she learned to the Harmonia Healthcare treatment center, where she’s chief scientific officer. The Morning Sickness Clinic staff in Alabama helped train the staff at Harmonia, which opened its first location in New Jersey in May. Harmonia is planning to open two more locations, in New York and Philadelphia, later this year. When the first Harmonia treatment center opened, the response was overwhelming, says President and co-founder Leslie Gautam. It got calls from all over: Germany, Mexico, and across the United States. They help whomever they can, directing those from out of town to resources they can use. The patient from Mexico happens to have family near the treatment center, so she is flying in for treatment. “Women have been suffering with this,” Gautam says. But prioritizing treatment as a society and educating people on the realities of HG has been lacking. “People still maybe don’t understand how bad this disease is and how much better prevention or treatment methods are needed,” says Fejzo. “Even though I’ve been trying and trying.” “So yes, I want another child. Am I confident that I want to go through that again? No.” Myers’ baby girl, Eileen, is now about 9 months old. The baby coos and plays when I talk to Myers over FaceTime. Myers always wanted multiple children, but after dealing with HG, she’s unsure. “For the first three months, I was like, ‘I’m never gonna be pregnant again,’” she says. Now that time has passed, she and her husband are discussing next steps. They talked about adoption. She’s considering pregnancy again. If she does choose pregnancy again, she says she is going to go to the Morning Sickness Clinic sooner. She believes having resources available to get ahead of the dehydration would help immensely. But she’s still not sure she can face it. “You still kind of have this trauma response from going through that, where you’re like, ‘Oh, my God, I just don’t know if I can do it,’” she says. “So yes, I want another child. Am I confident that I want to go through that again? No.” Fejzo was able to use a surrogate to have her twin daughters after a miscarriage. “I’ve been fortunate in that I’ve been able to complete my family after this horrible experience. And not everyone with HG is that fortunate,” she says. She works hard so that, one day, fewer people will need to make these kinds of decisions because of the disease. And because of her, that day may finally come. About Harmonia Healthcare Harmonia is a highly specialized women's health platform that combines cutting edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum, Harmonia's physician-lead research, diagnostic and treatment programs result in superior health outcomes and subsequently enhanced wellbeing and quality of life. For more information on Harmonia and hyperemesis gravidarum, or to learn if you might be suffering from hyperemesis gravidarum, visit  www.harmoniahealthcare.com  or connect with us on Instagram at @ harmoniahealthcare .

Source: By: M. Fejzo, N. Rocha, I. Cimino, S. M. Lockhart, C. J. Petry, R. G. Kay, K. Burling, P. Barker, A. L. George, N. Yasara, A. Premawardhena, S. Gong, E. Cook, D. Rimmington, K. Rainbow, D. J. Withers, V. Cortessis, P. M. Mullin, K. W. MacGibbon, E. Jin, A. Kam, A. Campbell, O. Polasek, G. Tzoneva, F. M. Gribble, G. S. H. Yeo, B. Y. H. Lam, V. Saudek, I. A. Hughes, K. K. Ong, J. R. B. Perry, A. Sutton Cole, M. Baumgarten, P. Welsh, N. Sattar, G. C. S. Smith, D. S. Charnock-Jones, A. P. Coll, C. L. Meek, S. Mettananda, C. Hayward, N. Mancuso & S. O’Rahilly Published: 13 December 2023 Abstract GDF15, a hormone acting on the brainstem, has been implicated in the nausea and vomiting of pregnancy, including its most severe form, hyperemesis gravidarum (HG), but a full mechanistic understanding is lacking1,2,3,4. Here we report that fetal production of GDF15 and maternal sensitivity to it both contribute substantially to the risk of HG. We confirmed that higher GDF15 levels in maternal blood are associated with vomiting in pregnancy and HG. Using mass spectrometry to detect a naturally labelled GDF15 variant, we demonstrate that the vast majority of GDF15 in the maternal plasma is derived from the feto-placental unit. By studying carriers of rare and common genetic variants, we found that low levels of GDF15 in the non-pregnant state increase the risk of developing HG. Conversely, women with β-thalassaemia, a condition in which GDF15 levels are chronically high5, report very low levels of nausea and vomiting of pregnancy. In mice, the acute food intake response to a bolus of GDF15 is influenced bi-directionally by prior levels of circulating GDF15 in a manner suggesting that this system is susceptible to desensitization. Our findings support a putative causal role for fetally derived GDF15 in the nausea and vomiting of human pregnancy, with maternal sensitivity, at least partly determined by prepregnancy exposure to the hormone, being a major influence on its severity. They also suggest mechanism-based approaches to the treatment and prevention of HG.

Source: By: Alexis Kayser (Email) Thursday, February 22nd, 2024 Marlena Fejzo, PhD — a geneticist and clinical assistant professor at the University of Southern California's Keck School of Medicine —  is one of Time's women of the year. Dr. Fejzo, 56, grew ill during her second pregnancy and was diagnosed with hyperemesis gravidarum (HG), a condition causing extreme nausea and vomiting in 1-3% of pregnancies. Her physician downplayed her symptoms, suggesting that many women exaggerate their pain for sympathy, Dr. Fejzo told the magazine. The physician did not prescribe a feeding tube until it was too late, and she lost the fetus. Dr. Fejzo — who received her PhD in genetics at Harvard University, and researched at the University of California campuses in both Los Angeles and San Francisco — began to research the condition. In 2020, more than two decades after her diagnosis, she published a paper in Nature Communications suggesting a genetic variant that could predispose people to HG. In 2023, her second paper in Nature reported that people with the condition have high levels of the hormone GDF15 during pregnancy, but lower-than-average levels prior to pregnancy. By supplementing high-risk patients with the hormone before pregnancy, or lowering the levels during pregnancy, physicians might be able to reduce the system-shock that causes vomiting and nausea. Dr. Fejzo is now the chief scientific officer of  Harmonia Healthcare, a specialty women's health platform that launched Feb. 21, according to a news release shared with Becker's. This year, Harmonia aims to open a HG-specific treatment center in New Jersey, and eventually hopes to expand to New York City. Dr. Fejzo is named alongside 11 other Time women of the year, including "Barbie" Director Greta Gerwig; Singer Audra Day; and Nobel Laureate Claudia Goldin, PhD.

Source: Published: May 6, 2024 RED BANK — Harmonia Healthcare, the specialty women's health platform focusing on underdiagnosed, undertreated and otherwise dismissed female-specific diseases including severe nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG), opened its first center in Red Bank last week. A second location is planned for New York City this fall. The opening of the highly anticipated center — which will treat and innovate around HG — is led by a founding team that includes Co-Founder and President Leslie Gautam and Chief Scientific Officer Dr. Marlena Fejzo, who last week received the TIME 100 Health Award in recognition of her groundbreaking research on the disease. Harmonia said it sets itself apart with its model of providing superior outpatient medical care and fostering seamless partnerships with patients, OB/GYNs, midwives, doulas and other healthcare and pregnancy support professionals. The facility's physician-led, science-backed solutions encompass various components such as medication and vitamin infusion and electrolyte replacement plans, prescription management, diagnostic bloodwork and telehealth assistance. Harmonia's services offer a holistic approach to enhance the short- and long-term health outcomes and quality of life for both the mother and baby. "HG is the leading cause of hospitalization in the first half of pregnancy, but Harmonia is implementing a proven care model that has shown a 95 percent reduction in ER visits and a 90 percent decrease in total cost of care," said Gautam. "Harmonia patients will benefit from the insights of our best-in-class leadership team including world-leading experts in hyperemesis gravidarum. Each patient can expect to receive outpatient treatment rooted in research, patient advocacy, and compassionate care." The economic cost of nausea and vomiting in pregnancy (NVP) in the United States totals over $1.7 billion per year — or $2.2 billion when adjusted for inflation — with emergency room visits being a significant contributor to this amount, despite being an ineffective and broken care model for treating HG. One in 4 women take a pharmaceutical intervention to treat NVP, and on average miss 23 days of work per year. Through community-centered treatment, Harmonia aims to alleviate the economic burden of emergency hospital visits. "My personal experience with HG and the frustration with being unheard and blamed by my doctors is what motivated me to discover GDF15, the hormone responsible for hyperemesis gravidarum," said Fejzo, who today received the TIME 100 Health Award. Part of the publication's annual Impact Awards, the TIME 100 recognition honors those who have made a significant impact on their industries and world. Earlier this year, Fejzo's research on hyperemesis gravidarum also earned her recognition as one of TIME's Women of the Year. "The TIME recognition, as well as the opening of the center, are a demonstrable step forward for women like myself whose symptoms have been overlooked and dismissed – to our detriment," Fejzo said. "Thanks to Harmonia's team of clinicians dedicated to improving patients' lives, I look forward to the ongoing impact our shared experiences will have on the future of healthcare." Currently, Harmonia's services are available to patients in New Jersey. If you are considering pregnancy, think you are pregnant, or think you might be suffering from severe nausea and vomiting or HG, you can receive treatment at Harmonia, no referrals required. Visit www.harmoniahealthcare.com and follow them on Instagram at @harmoniahealthcare for updates on the opening of the New York location this fall. About Harmonia Harmonia is a highly specialized women's health platform that combines cutting-edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated, and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum (genetically derived severe morning sickness), Harmonia's innovative, physician-led research and novel treatment programs are expected to result in superior health outcomes and subsequently enhanced wellbeing and quality of life.

Source: By: Renée Onque @IAMRENEEONQUE 03-28-2024 Geneticist Marlena Fejzo says she had bad morning sickness during her first pregnancy, but the symptoms she experienced during her second pregnancy in 1999 were much worse. The only time Fejzo wasn’t nauseous, she says, is when she laid “completely still and flat,” and she wasn’t able to hold down food or drinks. Fejzo was eventually diagnosed with hyperemesis gravidarum (HG), but when she talked about her symptoms with her doctor, they didn’t believe they were as bad as she described. “My doctor told me that people [say] this,” about their symptoms of HG, “usually, because they’re trying to get attention from their mothers or family members,” Fejzo tells CNBC Make It. Fejzo wasn’t exaggerating in the slightest: “It was so bad that I could not eat or move without vomiting.” Hyperemesis gravidarum is a condition that causes severe vomiting during pregnancy, and it affects around 1% to 3% of pregnant women, according to the National Health Service. Notably, the U.K.’s Princess of Wales, the former Kate Middleton, struggled with the condition for all three of her pregnancies. Fejzo says this percentage doesn’t account for the people who haven’t been diagnosed and believes the number is even higher. “I ended up on IV fluids and then my doctor tried seven different medications once and nothing helped me to be able to eat or drink anything,” she says. “It really was like a form of torture. And eventually, I was put on a feeding tube, but it was too late. I lost the baby in the second trimester.” Throughout the harrowing process Fejzo kept advocating for herself, but didn’t stop there. She went on to discover the gene that caused her severe morning sickness symptoms. Now, Fejzo is set to open her first healthcare center, Harmonia Healthcare, to support women with obscure health conditions that are often overlooked and underdiagnosed, including her own condition, hyperemesis gravidarum (HG). ‘Every single person in my study that had that mutation had hyperemesis’ Fueled by what she felt was a dismissal of her very real HG symptoms, Fejzo searched for a way to help other women living with the condition. She had a hunch that HG might be genetic and started her investigation there. “I had to show that it ran in families to suggest there was a genetic component,” she says. “I didn’t have it in my family, so I wasn’t sure.” It took two decades to find the answer. “I did a familial aggregation study and found that there was a 17-fold increased risk of having it if your sister has it,” she says. Fejzo then partnered with genetics company, 23andMe, and “asked them to put hyperemesis in their survey, and they did and then we were able to do a genetic study.” With data from nearly 50,000 responses, Fejzo and her team discovered that “the greatest genetic risk factor” for HG was a variant of a gene called GDF15. When Fejzo learned of the connection in 2020, she quit her job at UCLA where she was researching cancer, according to Time Magazine which named her one of their women of the year for 2024. Within a few years, she played a key role in the research that ended in a big discovery about hyperemesis gravidarum: “It turned out that people with HG are genetically predisposed to have lower levels of GDF15 prior to pregnancy,” Fejzo explains. “And so they are hypersensitive to the rise of this hormone during pregnancy.” “Every single person in my study that had that mutation had hyperemesis,” she adds. Now, her focus is finding ways to use this information to prevent women from experiencing the severe symptoms brought on by the condition. “Maybe we can prevent HG by increasing those levels prior to pregnancy,” Fejzo says. “And so Harmonia will be working on efforts to hopefully be able to predict and prevent HG.” Correction: This story has updated to correct the spelling of Marlena Fejzo’s name. Fejzo’s familial aggregation study found there was a 17-fold increased risk. A previous version misstated the number.

Source: By Dr. Marlena Fejzo May 2, 2024 Over 20 years ago, during my second pregnancy, I experienced a debilitating case of hyperemesis gravidarum (HG). Often given the misnomer morning sickness, the symptoms of nausea and vomiting are rarely limited to the morning, and with HG, are usually nonstop. The experience, one of the most horrific of my life, was made worse due to skepticism and derision from the healthcare professional who was supposed to be protecting me. Even today, this remains a common tale for women, with myriad studies showing that women’s pain is more likely to be discounted than their male counterparts and their symptoms ignored. Over the last two decades, I have made it my mission to ensure that my experience becomes an outlier, rather than the norm—generating knowledge which will lead to better treatments for HG and, most recently, launching Harmonia Healthcare, a specialty women’s healthcare platform focusing on commonly dismissed female-specific diseases. It is unconscionable that so little time and funding goes into women’s diseases, with only 1% of investment into healthcare research and innovation going toward female-specific conditions beyond oncology, according to a recent McKinsey study. For too long, women’s suffering has been ignored—and I’m so thrilled to be a part of research and innovation that will have an impact on improving reproductive health. Related: Research has FINALLY pinpointed the cause of severe morning sickness Approximately 14% of all pregnancies are affected by severe nausea or HG, with over one-third of HG pregnancies resulting in premature delivery, miscarriage, stillbirth or termination. The economic cost of nausea and vomiting in pregnancy in the US totals over $1.7 billion per year. Emergency room visits, a main contributor to this sum, represent a broken care model for HG treatment. The same study found that women with nausea and vomiting during pregnancy lost an average of 23 days of work, while their partner lost more than three days on average. In the future, this will no longer be the case due to new treatments that Harmonia plans to implement, which will be grounded in my research. Related: Hyperemesis Gravidarum researcher Dr. Marlena Fejzo is on a mission to understand women’s health My battle with HG was one of the most challenging periods of my life. Faced with constant nausea, I was unable to eat or drink without throwing up, and was put on an IV drip. My doctor at the time was dismissive, even noting that women often claimed these symptoms as a method to seek attention. I was too weak to advocate for myself, and it wasn’t until I had not kept any food down for over a month and tried 7 different medications at once, that a feeding tube was inserted. It was too late; I lost the baby. I tore through medical journals, searching for information on what had happened to me, but few studies existed on this devastating disease. Driven by my own suffering and a desire to ensure better care for women in the future, I embarked on a quest to discover the root cause of HG and validate the experiences of countless women who, like me, had been disregarded. Related: How to cope with hyperemesis gravidarum (HG), from a mama who’s going through it My experience with HG and suggestion by my doctor that I was purposely exaggerating symptoms is an experience that likely rings true with many women, whose very real pain and suffering is often dismissed, leading to an unacceptable number of women in crisis throughout the country. I spent the following two decades dedicated to the research of HG, identifying its causes and now searching for innovative treatments. Most recently, I helped to launch Harmonia as its Chief Scientific Officer. Harmonia, which opened its first center in New Jersey this May, will be a game-changer for HG patients by offering them better care now while simultaneously developing innovative methods to improve care in the future. I’ve also been advising, collaborating and directing research with the HER Foundation since 2001. Related: 5 tips on how to manage hyperemesis gravidarum A familial aggregation study I led found that if a patient’s sister had HG, they had a 17-fold increased risk of having it themselves. I worked with genetics company 23andMe, Inc. to conduct a genetic study, which found that the greatest genetic risk factor for the disease was a variant of the nausea and vomiting hormone gene GDF15. In a second study, I used an alternate genetic technique and found a rare mutation in GDF15 in some HG patients, providing further evidence for a causal role for GDF15. Most recently, I partnered with an international team of researchers and discovered that people with HG are predisposed to having lower levels of GDF15 prior to pregnancy, making them hypersensitive to the rise of the hormone during pregnancy. In addition to new predictive capabilities, this opens healthcare providers up to innovative new treatments, as raising a patient’s GDF15 levels prior to pregnancy has the potential to prevent HG. Harmonia endeavors to predict, prevent and treat HG with its extremely knowledgeable and versatile team. The center is grounded in the research I’ve helped generate on the condition, but the true stars are our incredible group of patient advocates and leading clinicians. Our approach will combine cutting-edge treatments with compassionate care, offering solace to those who have long suffered in silence. It is paramount to our mission that in addition to innovative treatments, we are providing concierge care and a team of health advocates to our patients, so they no longer have to advocate for themselves while battling a debilitating disease. Related: Hyperemesis gravidarum is about so much more than just morning sickness Our mission extends beyond mere treatment; it encompasses a commitment to research, innovation, and advocacy. We—along with other revolutionary centers, like The Morning Sickness & HG Clinic of Birmingham, AL—stand at the forefront of a movement, championing the cause of women’s health and challenging the status quo that has long relegated conditions like HG to the shadows. Harmonia’s expert-led research, diagnostic and treatment programs will result in superior health outcomes. It is my hope that with our centers, no one experiencing pregnancy will ever have to go through what I went through, and we will play a critical role in improving wellbeing and quality of life for women. About Harmonia Healthcare Harmonia is a highly specialized women's health platform that combines cutting edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum, Harmonia's physician-lead research, diagnostic and treatment programs result in superior health outcomes and subsequently enhanced wellbeing and quality of life. For more information on Harmonia and hyperemesis gravidarum, or to learn if you might be suffering from hyperemesis gravidarum, visit www.harmoniahealthcare.com or connect with us on Instagram at @harmoniahealthcare.

Source: BY JENNIFER AMATO Published: May 7, 2024 A new healthcare center in Central Jersey has opened to offer much-needed relief to pregnant women experiencing severe nausea and vomiting. Harmonia Healthcare, a specialty women’s health platform focusing on underdiagnosed, undertreated and otherwise dismissed diseases that affect women, opened its first center in Red Bank this week, with another planned for New York City in the fall. The focus is on hyperemesis gravidarum, which is such severe vomiting that it can cause weight loss and excessive ketones in the urine and blood. Harmonia offers outpatient care and established partnerships with patients, OB/GYNs, midwives, doulas, and other healthcare and pregnancy support professionals. Other treatments include medication and vitamin infusion, electrolyte replacement plans, prescription management, bloodwork, and telehealth assistance. Harmonia’s Chief Scientific Officer Dr. Marlena Fejzo received the TIME 100 Health Award on the day of the opening in recognition of her groundbreaking research on the disease. “My personal experience with HG and the frustration with being unheard and blamed by my doctors is what motivated me to discover GDF15, the hormone responsible for hyperemesis gravidarum,” says Fejzo, who earlier this year was also named one of TIME’s Women of the Year. The economic cost of nausea and vomiting in pregnancy (NVP) in the United States totals over $1.7 billion per year—or $2.2 billion when adjusted for inflation—with ER visits being a significant contributor to this amount, according to stats provided by Harmonia. One in 4 women need meds to treat NVP, and on average miss 23 days of work per year. “HG is the leading cause of hospitalization in the first half of pregnancy, but Harmonia is implementing a proven care model that has shown a 95% reduction in ER visits and a 90% decrease in the total cost of care,” says Co-Founder and President Leslie Gautam. Currently, Harmonia’s services are available to patients in New Jersey. If you are trying to get pregnant, are pregnant or are suffering from severe nausea and vomiting or HG, contact Harmonia Healthcare; no referrals are required. The Red Bank location is at 21 E. Front St., Suite 300; headquarters are located at 555 Madison Ave., Suite 11D, New York. For more information, call 732-538-5149. About Harmonia Healthcare Harmonia is a highly specialized women's health platform that combines cutting edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum (severe morning sickness), Harmonia's physician-lead research, diagnostic and treatment programs result in superior health outcomes and subsequently enhanced wellbeing and quality of life. For more information on Harmonia and hyperemesis gravidarum, or to learn if you might be suffering from hyperemesis gravidarum, visit www.harmoniahealthcare.com or connect with us on Instagram at @harmoniahealthcare.

Source: By Anastassia Gliadkovskaya May 10, 2024 1:10pm Harmonia Healthcare, a new provider focused on specialty women’s health, has opened a clinic in New Jersey to treat hyperemesis gravidarum (HG). HG can bring nausea and vomiting during pregnancy severe enough to prevent proper food intake and can lead to weight loss, dehydration and ultimately hospitalization. It can cause complications for mothers and their babies and is estimated to affect up to nearly 11% of pregnant women. Harmonia’s new clinic will offer evidence-based treatments and educate patients on the latest science around HG. Its offerings include medication and vitamin infusion, electrolyte replacement plans, prescription management, diagnostic bloodwork and telehealth. A second clinic is planned to open in New York City this fall. The clinic does not require referrals. Its chief scientific officer, Marlena Fejzo, Ph.D., a women’s health researcher with lived experience of HG, will also leverage her and colleagues' groundbreaking discovery of the hormone associated with the condition—GDF15—to drive innovations in prognostics, prevention and treatment. Fejzo was a 2023 Fiercest Women in Life Sciences awardee. Marlena Fejzo, Ph.D., chief scientific officer, Harmonia Healthcare (hyperemesis.org ) “We really want to fix the broken care model in women’s health and improve care,” Fejzo told Fierce Healthcare. “We hope to expand this to be the future of care for these undertreated and underdiagnosed diseases.” Harmonia’s online platform will offer educational resources and eventually telehealth, though women should still ideally first come into the clinic in person. The current status quo for women with HG is unacceptable and costly, Fejzo says. If they end up in an emergency room, they are treated with fluids or antiemetic drugs and released. But because HG causes persistent nausea and vomiting, women need persistent medication management, Fejzo argues. If they are discharged without a prescription, many will inevitably wind up back in the hospital again; 60% of women have multiple hospital visits, per Fejzo. And, while HG is starting to be diagnosed properly more often, Fejzo said, it can still be misdiagnosed or not diagnosed at all. “A lot of people think that it’s just regular nausea and vomiting and that everything’s going to be fine … when actually there are really adverse outcomes associated with HG for the mother and the baby,” Fejzo said. During a recent conference, Fejzo said she discovered ER doctors affiliated with Harvard discharge HG patients without a prescription. Their justification for it was that the medications might make them tired, and then they would have to miss work. “That’s a real misunderstanding of HG,” Fejzo said, adding that if Harvard-affiliated docs are doing it, “I assume it is common.” RELATED: New study finds cause and potential treatment for dangerous morning sickness Part of the reason Fejzo believes this is happening is due to a famous historic incident known as the thalidomide disaster. After women being treated with thalidomide for nausea had babies with birth defects, it launched a widespread hesitancy to prescribe medications during pregnancy, Fejzo said. There also remains a misguided belief that HG is psychological or resolves on its own. And because HG typically starts early in pregnancy, many women see ER docs before even seeing their obstetrician, meaning many providers may not be aware of how sick their patients have really been. Obstetricians are also generally not trained to ask their patients about their levels of nausea and vomiting—and patients, too, may not talk about it, Fejzo explained. To address this, Harmonia will be monitoring women receiving medication management and coordinating with their other providers, like OB-GYNs, midwives and doulas. The goal is to intervene as early as possible with more aggressive treatment before the condition spirals out of control. The best medications for HG being prescribed off-label include Zofran, Phenergan and Reglan, according to Fejzo. Yet doctors usually begin with doxylamine and pyridoxine, as recommended by the American College of Obstetricians and Gynecologists, which Fejzo says are “pretty much a placebo for HG.” By serving patients with HG, Harmonia will have the infrastructure in place to run clinical trials on potential new treatments, Fejzo said. She is already advising NGM Bio, which recently announced it is interested in testing its drug NGM120 in HG patients. While Fejzo doesn’t anticipate challenges with patients getting their scripts filled, Harmonia providers will educate patients on how to have conversations with pharmacists in case they do run into pushback. In recent years, pharmacists have sometimes refused to fill opioid prescriptions with doses they perceived as too high or poorly monitored by the prescriber. One of the country’s only other clinics in this space, Alabama’s Morning Sickness Clinic, claims its model has led to a 95% reduction in ER visits and a 90% decrease in total cost of care. Its co-founder, an emergency medicine physician, is one of Harmonia’s clinical advisers. Harmonia eventually hopes to expand to serve other under-researched women’s health conditions. While the company does not currently plan to pursue formal health system partnerships, it hopes that its clinics will come to be known locally as the go-to expert for these conditions. And, while it isn’t yet, Harmonia plans to be working with commercial and Medicaid insurance plans by the end of this year. About Harmonia Healthcare Harmonia is a highly specialized women's health platform that combines cutting edge functional medicine treatment with science-backed resolution for underdiagnosed, undertreated and otherwise dismissed female-specific diseases. Initially focused on hyperemesis gravidarum, Harmonia's physician-lead research, diagnostic and treatment programs result in superior health outcomes and subsequently enhanced wellbeing and quality of life. For more information on Harmonia and hyperemesis gravidarum, or to learn if you might be suffering from hyperemesis gravidarum, visit www.harmoniahealthcare.com or connect with us on Instagram at @harmoniahealthcare.