Postpartum fatigue affects up to 64% of new mothers and usually has a mixture of underlying causes such as nutrient insufficiencies, thyroid abnormalities, poor sleep, and hormonal imbalances. If you're a new parent navigating the overwhelm of a newborn baby and getting up throughout the night, being tired makes sense. However, persistent, more severe, and often prolonged fatigue despite sound sleep may warrant further investigation.
Even though postpartum fatigue is common, it is unfortunately understudied and often overlooked. It can have a considerable negative impact on a woman's well-being and quality of life. Our healthcare model often downplays the hormonal shifts, nutritional needs, and physical demands a new mother juggles. This means that many women are experiencing symptoms without knowing that their well-being could be supported with a functional medicine approach. Functional Medicine focuses on addressing the underlying factors instead of only managing or masking the symptoms. Your health is not just the absence of disease. It also includes overall vitality, nutritional status, fitness, emotional balance, clarity of thought, and connectedness to others.
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Postpartum Fatigue Signs & Symptoms
Pregnancy can lead to long-lasting changes in the human brain. Women might feel fatigued, overwhelmed, anxious, and low mood in the postpartum period. Poor concentration, mood swings, and feelings of being 'wired and tired' with difficulty falling and staying asleep are other common symptoms often referred to as 'baby brain.'
Postpartum Fatigue Possible Causes
Nutrient Insufficiencies
The WHO estimates around 2-billion people are deficient in micronutrients, with women being at particular risk because of menstruation and metabolic demands of pregnancy. Evidence suggests that even marginal deficiencies of micronutrients can have negative consequences on physical and mental fatigue.
Stress
Stress, by definition, means 'change' and has been demonstrated to be a predictive factor of postpartum fatigue.
Poor sleep
Sleep deprivation and disturbances in the sleep-wake cycle can contribute to feelings of fatigue, and it's not uncommon for women to experience ongoing interference in their sleep-wake cycle for many years postpartum.
Hormone fluctuations
Cortisol shifts and estrogen and progesterone changes can all contribute to fatigue levels. Low testosterone levels are associated with persistent fatigue and a decreased sense of personal well-being.
Postpartum Depression
A thorough medical history and physical exam are essential to assess for and rule out postpartum depression. A scientific review revealed the prevalence of postpartum depression was 17% among healthy mothers without prior history of depression.
Thyroid
Postpartum thyroid dysfunction is found in 5-10% of women within one year after delivery.
How Long Does Postpartum Fatigue Last?
Postpartum fatigue is a common experience for many new mothers and can last anywhere from a few weeks to several months. The duration and severity of postpartum fatigue can vary depending on factors such as the mother's physical health, sleep patterns, support system, and individual circumstances.
Typically, postpartum fatigue tends to be most intense during the first few weeks after delivery and gradually improves as the mother's body heals and adjusts to the demands of caring for a newborn. However, it's important to note that some women may experience ongoing fatigue or exhaustion for several months after giving birth.
If you're experiencing persistent or severe postpartum fatigue, it's important to talk to your healthcare provider, as it may be a sign of an underlying medical condition such as postpartum depression, anemia, micronutrient imbalances, or thyroid dysfunction. Your provider can help determine the cause of your fatigue and recommend appropriate treatments or support resources.
Functional Medicine Labs to Test for Postpartum Fatigue
Functional medicine labs can be a valuable piece of the puzzle to identify individualized nutritional needs and ensure a targeted approach.
Testing for Nutrition/MicroNutrient Deficiencies
The Metabolomix+ test is an at-home test that provides a comprehensive assessment of micronutrients to assess the functional need for antioxidants, B-vitamins, minerals, digestive support, fatty acids, and amino acids.
Adrenal/Sex Hormone Testing
The DUTCH Complete™ uses dried urine samples to evaluate sex hormones, adrenal hormones, cortisol, and melatonin, which are incredibly useful when evaluating energy patterns. It is suggested to wait until women have had three menstrual cycles for their hormones to return to a true baseline level. It is not recommended for women who are currently breastfeeding to test the sex (estrogen, progesterone, and testosterone) hormones, but instead do adrenal testing such as the DUTCH Adrenal.
Full Thyroid Panel
Every cell in the body needs thyroid hormones to function. Most conventional medicine practitioners will test TSH levels, but evidence suggests that screening with TSH alone can miss 7% of individuals with thyroid hormone abnormalities. TSH is a hormone produced in the brain that tells the thyroid gland to make more T3 and T4 thyroid hormones. However, measuring TSH alone isn't enough to give you a complete picture of thyroid health status in response to stressors. A complete thyroid panel is recommended to explore thyroid health.
CBC & CMP
Other serum lab tests to check include a Complete Blood Count (CBC) and Comprehensive Metabolic Panel (CMP), which can assess electrolytes, blood glucose, and kidney and liver health. Nutrient deficiency levels of Iron and Ferritin, as well as Vitamin D, are associated with fatigue.
Functional Medicine Approaches for Postpartum Fatigue
Nutrition
Food is an important part of health. The body is focused on recovering from pregnancy and labor and adjusting to hormonal fluctuations. Centering meals around iron-rich protein, healthy fats, and fiber to help heal the body and stabilize blood sugar may support energy levels and mood fluctuations. Coldwater fish such as salmon, red meat, liver, and eggs can help boost omega-3 fats, iron, zinc, and B Vitamins.
Hydration
The human body is up to 60% water, and although it may seem basic, fatigue is often impacted by dehydration as many of us do not drink enough water. It is particularly important for postpartum women, especially if breastfeeding, to stay hydrated as our cells, tissues, and organs require water to function correctly.
Approach Based on Individual Labs
Addressing Postpartum Fatigue may require a functional medicine approach that considers underlying factors identified on lab testing to find out in which areas patients have deficiencies or excesses. Addressing these imbalances and taking into account an individual's lifestyle are keys to successful management. Personalized strategies may include nutrition and lifestyle modifications to provide effective support and recovery.
If nutrient deficiencies are identified, a practitioner may focus on a nutritional plan or recommend supportive dietary supplements. If sex hormones such as estrogen, progesterone, or testosterone are out of balance, hormone support may be considered. Common thyroid support based on a complete thyroid panel may include levothyroxine thyroid supplementation and supplements to aid the conversion from T4 to T3.
Additional Lifestyle Modifications
Incorporating tools for managing stress, creating good habits to optimize sleep, and ensuring exercise/movement are all equally important for supporting fatigue.
Supportive Supplements
The below foundational supplements may help support energy, mood, and hormone balancing.
- Prenatal including iron and B Vitamins: B Vitamins are involved in several steps of energy production and linked with mood and hormone support.
- Vitamin D: Vitamin D is a vitamin that has many hormone functions. Adequate levels have been shown to improve fatigue levels significantly.
- Omega 3 Fatty Acids are linked with improvement of fatigue, memory, and concentration.
- Minerals such as magnesium, iron, and zinc have been shown to enhance well-being by decreasing perceived mental and physical fatigue.
Summary
Although postpartum fatigue is common in 64% of new mothers, it is often dismissed and frequently overlooked. The good news is that by exploring the underlying and individualized factors for fatigue with easy at-home testing for nutritional deficiencies and hormonal imbalances, nutrition, and lifestyle adjustments, the body can begin its pathway to support and recovery.
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