Postpartum Lab Testing and Why it’s Important — Postpartum Wellness Center / Boulder

By Meghan Van Vleet, ND

Often the women who come to me have not had any laboratory tests 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 still breastfeeding, the mother is still raising the baby even postpartum! Whether or not a mother chooses to breastfeed her baby, we know that the mother’s well-being can predict the child’s well-being.

At PWCB, we focus on the health and well-being of the mother because we know that directly affects the health and well-being of her children.

I run labs on all postpartum women. Why? Because pregnancy, childbirth, and postpartum recovery along with lactation are enormous demands on the mother’s physiology. There are common markers that I often find “off” that indicate the need for treatment. Usually, the things I look at in the beginning are simple to address.

Let’s look at a classic initial lab panel that I might order for a postpartum woman.

• CBC – this may reflect whether a mother has sufficiently recovered from blood loss, for example. It also gives an idea if there might be any underlying infection.

• Comprehensive Metabolic Panel – I look at it to assess liver function, which is important for hormone balance and neurotransmitter production, among other things. I also get the idea of ​​blood sugar balance, which is important to balanced mood and cognition as well as overall and long-term health.

• Homocysteine – it is an inflammatory marker and reflects methylation function as well as cardiovascular risk. Methylation dysfunction is associated with poor tissue healing and poor neurotransmitter production and is therefore strongly implicated in mood disorders such as depression and anxiety.

• CRP and ESR – these are general markers of inflammation. When they are elevated, I know that more investigation about the source is necessary.

• Vitamin D – Low vitamin D is present in a subset of almost all psychiatric conditions as well as poor cognitive function. Some people do not convert vitamin D from sunlight properly 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 I can accurately get a comprehensive understanding of how the thyroid is functioning and determine if support may be needed, despite the obvious lack of need for replacement of thyroid hormone. Low thyroid function can contribute to fatigue, slow digestion/indigestion, hair loss, depression, brain fog, among other symptoms.

• Iron panel with ferritin – More and more common providers are looking at ferritin in addition to an iron panel, but I still see simple iron panels ordered to check someone’s iron. Ferritin is the gold standard and most sensitive test to assess a person’s iron status. It is arguably more valuable than a steel panel. Low iron can lead to fatigue, shortness of breath, anxiety, easy bleeding/bursting, and hair loss, among other symptoms.

• Copper: Status of zinc – Both copper and zinc are necessary for growth and healing. However, too much of a good thing is not always a good thing. During pregnancy, a woman’s body takes on more copper than normal in order to grow a healthy baby. However, after delivery, that copper is no longer needed. Zinc is needed to purify copper. Many women do not properly cleanse excess copper postpartum, an effort that can deplete zinc, both of which can contribute to anxiety, irritability, and depression during the postpartum period and beyond.

• Vitamin B12 – is critical for the nervous system. B12 deficiency is associated with all kinds of neurological issues, but even short-term or milder deficiencies can contribute to brain fog and mood disorders. B12 is hard to come by, and it is deficient in many diets. Additionally, many mothers take antacids that further reduce the absorption of this important nutrient, leaving a new mother 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 had a subset of these tests before they came to my office but were told that all of their results were normal. I take a functional approach to interpreting lab results, and often identify areas that need attention where other providers have reported nothing wrong. You can read more about that here.

If you would like support in investigating your symptoms or even a second opinion on your lab results, please feel free to call me: 720-340-0193 or schedule a complimentary Discovery Call here