Postpartum Lab Testing and Why it's Important
Often women who come see me have not had any lab testing since giving birth. Attention often turns from the mother to the child after the baby is born. It is important to remember that, in the case of breast-feeding anyway, the mother is still growing the baby even postpartum! Whether or not a mother chooses to breastfeed her baby, we know that the well-being of the mother can predict the well-being of the child.
At the PWCB, we focus on the health and wellness of the mother because we know that that directly impacts the health and wellness of her children.
I run labs on all postpartum women. Why? Because pregnancy, birth, and postpartum recovery including lactation are enormously demanding on the physiology of the mother. There are common markers that I often find “off” that indicate the need for treatment. Typically, the things that I look at initially are simple to address.
Let’s look at a classic initial lab panel I may order for a postpartum woman.
CBC – this can reflect if a mother has adequately recovered from blood loss, for example. It also gives an idea if there may be any underlying infection.
Comprehensive Metabolic Panel – I look at this to assess liver function, which is important for hormone balance and neurotransmitter production, among other things. I also get an idea of blood sugar balance, which is critical to a balanced mood and cognition as well as overall and long-term health.
Homocysteine – this is an inflammatory marker and reflects methylation function as well as cardiovascular risk. Methylation disfunction is associated with poor tissue healing and poor neurotransmitter production and therefore is highly implicated in mood disorders such as depression and anxiety.
CRP & ESR – these are general markers of inflammation. When they are elevated, I know that more investigation as to the source is warranted.
Vitamin D – Low vitamin D is present in a subset of nearly all psychiatric conditions as well as poor cognitive function. Some people don’t convert vitamin D from sunshine well and therefore have a higher genetic need for oral vitamin D. Vitamin D is involved in bone density, cell growth, immune function, anti-inflammatory processes, improves blood sugar balance, supports dopamine production, and improves sex hormone balance.
Thyroid function panel – I look at more thyroid markers than primary care providers do so that I can accurately get a comprehensive understanding of how the thyroid is functioning and determine if support may be needed, despite obvious lack of need for thyroid hormone replacement. Low thyroid function can contribute to fatigue, slowed digestion/indigestion, hair loss, depression, brain fog, among other symptoms.
Iron panel including ferritin – More and more conventional providers are looking at ferritin in addition to an iron panel, but I still see simple iron panels being ordered to assess someone’s iron. Ferritin is the gold standard and most sensitive test to assess a person’s iron status. It is arguably much more important than an iron panel. Low iron can lead to fatigue, shortness of breath, anxiety, easy bleeding/bruising, and hair loss, among other symptoms.
Copper:Zinc status – Both copper and zinc are required for growth and healing. Too much of a good thing, however, is not always a good thing. During pregnancy, a woman’s body holds on to a lot more copper than normal in order to grow a healthy baby. After delivery though, that copper is no longer needed. Zinc is required to clear copper. Many women do not efficiently clear the excess copper postpartum, the effort of which can deplete zinc, both of which can contribute to anxiety, irritability, and depression in the postpartum time period and beyond.
Vitamin B12 – is critical for the nervous system. A deficiency in B12 is associated with all sorts of neurological issues, but even a short term or more mild deficiency can contribute to brain fog and mood disorders. B12 is hard to absorb, and it is deficient in many diets. Additionally, many mothers have been on antacids which further diminishes the absorption of this important nutrient, leaving a new mom at high risk for cognitive and mood symptoms.
Carnitine – Carnitine is involved in the production of the main neurotransmitter of the parasympathetic (rest & digest) nervous system, acetylcholine. Symptoms of carnitine deficiency include fatigue, irritability, symptoms of low blood sugar (ie: anxiety). Some people have a genetic need for higher carnitine than others, and high energy demand events (such as pregnancy, birth, and lactation) can also cause a deficiency.
Some postpartum women have had a subset of these tests run before they come to my office but have been told that all of their results are normal. I take a functional approach to interpreting lab results, and often determine areas that need attention where other providers have reported nothing is wrong. You can read more about that here.
If you would like support with investigating your symptoms or even a second opinion on your lab results, please feel free to give me a call: 720-340-0193 or schedule a complimentary Discovery Call here