97- OB & Midwife Aviva Romm on PPD, Thyroid Problems, & MTHFR€¦ · Adrenal Thyroid Revolution, and she focuses on the impact of stress, diet and environmental toxins on health,

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Episode97:OB&MidwifeAvivaRommonPPD,

ThyroidProblems,&MTHFR


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Child:WelcometomyMommy’spodcast.

Katie:ThispodcastisbroughttoyoubyFourSigmatic.IfyoufollowmeonInstagram,you'veprobablyseenmementionthembecauseIhavebeenusingandlovingandInstagrammingtheirproductsforyears.Theyhaveanamazinginstantmushroomcoffee.Hearmeoutbeforeyouthinkit'sweird.Iknow,mushroomcoffeedoesn'tsoundgood.It'snotonlythebestinstantcoffeeI'veevertried,it'salsoprettyhighuponthelistofbestcoffeeI'vetried.It'scheaperthancoffeeshopcoffeeandit'ssoconvenientbecauseit'ssoportableandittastessomuchbetter.Butitisn'tjustordinarycoffee.IthassuperfoodmushroomslikeLion'sMane,Cordyceps,andChagamushrooms.Andthesemushroomshavesomebighealthbenefits,andespeciallyimmunebenefits.Ipersonally,especiallylovethemfortheenergyandthementalclaritywithoutthejittersfromtraditionalcoffee.AnddidImentionhowgoodittastes?SoIalwaystaketheseinstantcoffeepacketswithmewhenItravel,andIalsoalwaysdrinkitathomethesedaysnowthattheyhaveabigtinthatlastsaboutamonthsoIdon'thavetoopenalittlepacketeveryday.Somefriendsofoursrecentlytraveledforthreemonthscarryingonlythebackpacksontheirbacks,andtheybroughtanentirethreemonthssupplyofthisinstantcoffeeintheirbagthathadlimitedspace.Inotherwords,thiscoffeebeatoutapairofjeansforhowimportantitwastomakeitinthebag.It'sthatgood.And,ofcourse,ifyouaren'tacaffeineperson,theyalsohaveavarietyofmushroomteaandotherproductsthatdon'thavethecoffeesoyoucangetthebenefitswithoutthecaffeine.AndIlovethemsomuchthatIreachedoutandtheyagreedtogiveadiscounttomylisteners.Sogotofoursigmatic.com/wellnessmamaandusethecode"WELLNESSMAMA"toget10%off.That'sFourSigmatic,F-O-U-R-S-I-G-M-A-T-I-C.com/wellnessmama.

ThisepisodeissponsoredbyKettleandFireBoneBroth.Ifyoulovethebenefitsofbonebrothbutdon’tlovethetimeittakestomakeandhowtoughitcanbetofindqualitybonestomakebroth,KettleandFireisforyou.Theirbonebrothisaregularstapleinmykitchenthesedaysandit’swhatIusetocreatetherecipesinmynewbonebrothebook.Sotheyonlyusebonesfrom100%grass-fedpastureraisedcattlethatarenevergivenhormonesorantibiotics.Theirbrothisalsouniquebecausetheyfocusonbonesthatareespeciallyhighincollagen,whichisoneofthehealthiestthingsyoucanputinyourbody.YoucanfindthematmanyWholeFoodsonthewestcoastandyoucanalsoorderonlineandgetadiscountatkettleandfire.com/mama.Again,that’skettleandfire.com/mama.

Katie:WelcometotheHealthyMomsPodcast.I'mKatiefromwellnessmama.com,andI'mheretodaywith,Iguess,I'mreallyexcitedtotalktobecausesheisawealthofknowledgeandshealsobridgesthegapbetweennaturalandtraditionalmedicine.So,AvivaRomm,Dr.AvivaRommhasbridgedthebestoftraditionalmedicinewiththebestofscienceforoverthreedecades.Sheisamidwife,anherbalist,andaYale-trainedMD.She'sboardcertifiedinFamilyMedicinewithObstetricsandshe'srecognizedastheinternationalauthorityinthefieldofbotanicalmedicine.Shehaswritteneightbooks,includinghermostrecentbook,TheAdrenalThyroidRevolution,andshefocusesontheimpactofstress,dietandenvironmentaltoxinsonhealth,willpower,foodcravings,weight,chronicdisease,andhormoneimbalance.She'salsojustanincredibleresourceandIcan'twaittodiveintosomeofthesetopicswithher.SowelcomeAviva,thankyouforbeing


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here.Aviva:Thankyou,Katie.It'ssuchapleasurewegetthismomhealthprofessionalentrepreneurhour.It'samazing.Katie:It'sgonnabesomuchfun.AndI'dlovetojumpinbytalkingaboutyourstorybecausewhenIwasresearchingyourbioyouhaveanincrediblyfascinatingstoryabouthowyougrewup,andyouwenttocollegeearly,andyou'vestudiedinavarietyoffields.So,canyoujusttalkusthroughyouramazingstory?Aviva:Yeah.Thankyou.It'sbeenunusual.SoIgrewupinaNewYorkCityhousingproject,withasinglemominthe'60sand'70s.Iwasborninthelate'60sandjustkindtomakealongstoryshortanditkindofplaysintomynewbookactuallysomeoftheback-stories,soit'sinteresting.IwaskindofIguesspeoplewouldsaysupersmart,maybeprodigy,Idon'tknow,likeIwasreadingwhenIwastwoyearsoldandI,youknow,alwaysgotverywellsupportedandrewardedforacademicachievement.AnditturnedouttobeanamazingblessingbecauseIgotintocollegeat14andwasabletogetoutofaverystressfulhomelifeandpersonalandsocialenvironmentinthathousingproject.Soit…waskindofablessingandacurseinthesensethat…andthisiskindofwhereitleadsintothenewbook,inthatalotofushavetheseamazingsuperpowers,right?Somepeoplearesuperorganized,somepeoplearejustveryniceandverygenerous,andsomepeoplearesupersmart.Andsometimeswhenthosesuperpowersendupbeinglifesaversinsomewayoranothertheycanalsobecomeouroverdrivepattern.So,ittookmealotofyearstolearntobewhoIamandalsonothavethatbeinconstantoverdrivewheresortofachievementbecame,youknow,thedefinitionofsuccessandsafety.Soit'sbeenareallyinterestingroadwiththat.AndmykindofearlylaunchintocollegewasinterestingbecauseatayoungageIknewIwantedtobeamedicaldoctor.AndIwentofftoBardCollegeandsuddenlywassurroundednotbyhousingprojectconcretewallsanymorebutbynatureandhippypeopleandpeoplewhowerebacktothelanders.Andsobetweentheageof15whenIactuallywentofftocollege,andkindoflikethatwholefirstyearwasthisintensedeepdiveformeintonaturalmedicine,naturalfood,naturalbirth.ImetmyfirstmidwifewhenIwas15.Istartedusingherbalmedicines,totallychangedmydiet,mylifestyle,andinthatoneyear,itwasamazinglikeinmylastyearathomeIhadgained40poundsfromstressandmydiet.Allofthatcameoff.Ihadalifelongchallengeswithallergies,anemia,andIthinksomeamountofanxietythatIdidn'trealizeIwascarryingandjustthosechangesinmylifestyleandmyperceptionsledtothiswholenewexperienceofmybodylike,"Wow,wecanbehealthy,happypeople."Andthatledtomestudyingherbalmedicineandmidwifery,andthiswasallbackin1981to'82whenthismassivetransformationhappenedinmylife.Andthenby1985,Iwasapprenticingwithmidwives,soIwas,youknow,betweenwhenIwas16and18,bythetimeIwas20Iwasstartingmyownfamilyandpracticingasamidwifealready.Andso,manyofthewomenthatwere...andthemomsanddadsorthemomsandmoms,whoeveritwaswhowerehavingtheirbabiesathometheyreallywantedtotakethenextstep.Youknow,theyhadjusthadthisbeautifulnaturalbirthorhadtriedtoevenifonceinawhilethat,youknow,didn'tgettheexactoutcometheywerehopingfor.Theystillhadthismuchmorenaturalapproachtolifeanddidn'twanttojustgivetheirkidsantibioticsortreatmentsforeverysinglesymptomthatcameupmuchliketheydidn'twanttobeovermedicatedthemselvesduringtheirpregnancy.Soonethingledtoanotherandmywomen'shealth,midwifery,herbalpracticebecamemuchmoreofafamilypracticeifyouwill.


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Andthenfastforward,manyyearsIhavefourkidsandhomeschoolthemand,youknow,didthewholenaturalmamabreastfeedingforever,youknow,howthatis,familybad,chaos,andwonderfulness,anddecided,youknowwhat?Ireallyneedtobepartofchanginghowfamiliesexperiencehealthcarewhentheyneedtogointothesystem,right?Therewereincreasinglymorecoolmidwivesandpeoplewerecatchingontonaturalmedicinebutwhenyoudidhavetogotothedoctoritcouldsometimesbemostoftenactuallyprettymuchalwaysitwassameold,sameold,yourbabyneedsanantibiotic,youknow,youhavetohaveaC-section.So,Iwantedtobeavoiceontheinsidetohelppeoplesortoutwhentheyreallydidsometimesneedthosethingsbutwhentheydidn'tneedthemtonotgetovertreated.SoIwentbacktoschool,gotmy…finishedmydegreebecauseIhadlefttocollege.Istartedcollegeat15,leftat16todothiswholeotherlifeandthenwentbacktoschooltogetmyMD,IwenttoYale.AndthenIdidmyinternshipininternalmedicineandmyresidencyinFamilyMedicinewithaspecialtyinObstetricsandGynecologyandIntegrativeWomenandChildren'sHealthandherewearetodaytalkingonourSkypemachinescomputerstohavethisconversation.Katie:That'sfascinating,soIdidn'tactuallyknowthataboutyouandyourchildhoodandhowmuchofaprodigyyouwere.That'samazing.ButIshouldsayalsoImetyouinpersonandyoudonotlooklikeyouwerebornoraliveinthe'60sand'70s,youlookvery,veryyoung.Aviva:Thankyou.Yeah,whenpeople...IthinkwhenpeoplesayI'vebeendoingthisworkfor35years,theylookatmelikeI'meitherlyingorfoundShangrilaandthatlikefountainviewsorsomething.And,youknow,Ithinkthatonethingcanbesaidissomanypeoplehavethesestorieswheretheygotsickandthengotintonaturalmedicine.AndeventhoughalotofthehealthprofessionalslikeMarkHymanandothers,AmyMyers,theyhaveastoryofhowtheygotreallysickandthat'swhatgottheminterestedinherbs,orfood,orsupplements.Andmylifeinsomewaysiskindoftheoppositeinthesensethat,Imeanyes,Ihadalotofchildhoodstuffandthengotwellbutdoingthislifestylenowfor…becauseI'mturning51thisyear,almost36years,itiskindofatestamenttowhatcanhappen.Imeanknockwood,theonlytimeI'vehadtotakeapharmaceuticalsinceIwas15wasironicallyinmymedicalresidency.Ijokinglysay,becomingadoctormademesickbecauseyou'resodetachedfromyourbodyduringthattimeandyou'reworkinginsanehoursand,youknow,formeIdidmybesttoeatwellbutitwasreally,reallystressfulandIwasn'tpayingattentiontomyhydrationandevensimplethingslikewhenIneededtogopee,becauseyoujustgetsobusythatyoustopdrinking,soyoudon'thavetoleaveasurgerytogothebathroom.It'scrazythethingswedoandIgotakidneyinfectionandendeduponanantibiotic.ButotherwiseIrealizedIdothinkit'satestamenttogolivingandI'mverygratefulthatIgotintothatatsuchayoungage.Andinterestingly,likeIhadterribleallergiesasakid.Mybrotherhadseriousasthmawherehewasrushedtotheemergencydepartmentmanytimesasayoungkidandofmyfourkids,notoneofthemhasallergies,asthma.Myhusband'sfamilyhadthesamething,seriousallergiesandasthma.SoIthinkthateven,youknow,wecanseetheshiftsinthenextgeneration.Katie:Yeah,that'sdefinitelymygoalaswell.AndIhavetheoppositestoryfromyou.I'mmorewithlikeDr.Hymanabouthavingmyownhealthcrisisandhowthatledmeintowantingtolearnabouthealth.Now,I'veheardthejokethatpeoplegetintopsychiatrytofigureoutwhat'swrongwiththemandIthinktheyhadalsogetintohealthtofigureoutwhat'swrongwiththem.Aviva:It'ssotrue.Andlikeyou,ImeantherearesomanyamazingwomenandthisishowIwasbeforeIwasa


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doctor,andprettymuchIstillam.ImeantheMDhasbeenreallyilluminatingandhelpfulbothinwhatIcandonowforpatientslikeifsomeonecomestomewithathyroidproblemandtheyreallyneedthyroidhormonesupplementIcanprescribeit,butinasmuchasgettingoffofmedication.ButIthinkthatthetruepowerofwhatIbringtomypracticeasanMDissomethingthatyouhaveandsomanyothermomsIknowwhoarelisteningiswhatIcallbeingacitizenscientistwherewe'rehavingtofiguresomuchofthisoutonourownbecauseImean,evennowwithIntegrativeMedicineandFunctionalMedicinebeingmorepopularmostdoctorsdon'tknowandwehavetotakeourownhealthinourownhandbecauseotherwisewedoendupgoingdowntheroadsometimesofalotofunnecessarytreatmentsortheoppositewedon'tgetthediagnosiswhenweneeditandweendupsufferingsometimesforyearswithoutanswersasI'mimaginingitmayhavehappenedforyouifyoucameintoitfromthatotherdirection.Katie:Absolutely.Yeah,Ididn'thavetheadvantageofamedicaltrainingbutIlovethataboutyouandthatyou,Ifeellikethere'sanunspokentensionkindof,andalotoftimesbetweenmidwivesanddoctorsandespeciallyinourstatewe'retryingtolegalizehomebirth.Andthere'saverydefinitetensionbetweenmidwivesanddoctorsrightnow.AndIlovethatyouactuallyhavebothsidesofthatsoyoucanofferareallyvaluableperspectiveandinfact,oneoftheareasI'dlovetoreallydeepdivewithyouisintopostpartumdepression.Ihavealotoffriendswhoarepersonallystrugglingwiththatrightnow.Andeventhoughit'snotsomethingIstrugglewithI'veseenfirsthandhowdifficultitis.AndIkindofputashoutacrossaboutitonmyFacebookandlikewhomshouldIinterview,whocanreallyhelpwomenwiththis,andyournamecameupoverandover.Ihavefriendswhohaditsoseverelythatthey'reafraidtohaveanotherchildbecausetheydon'tthinktheycangothroughitagain.Solet'sgetdeepdiveintopostpartumdepression,whatdoweknowaboutitandwhereisitcomingfromandwhydoesitseemtobeontherisesomuch?Aviva:Yeah.Youknow,myheartjustachesformamaswhoarestrugglingwiththisbecause,one,Imeanit'shardenoughtohaveanewbaby.Imeanbetweenthetwoofuswehave10andthenIhavetwograndbabies.Sobetweenthetwoofus,wehavealotoflittlepeoplethatwe'veseencomingintotheworldandit'salotofwork.AndIthinkthatingeneralwe'reactuallynotpreparedforthatandIthinksometimeseventhesortofmorenaturalmamamovementcanpaintthispictureoverhavinganewbabythatwe'resupposedtofeelacertainway,likeit'ssupposedtobethecrowningmomentofawomancomingintoherpowersespecially,youknow,youhaveanaturalbirthandsoyou'resupposedtofeelallempowered.Andthenyou'vegotthislittlescreamingthingthatyouknow,you'vebeenempoweredwomenyourwholelifeandyoucan'tevengettohandle.Andthenyou'renotgettingsleepatthesametimeandmaybeyouhadaC-section,sonowyou'vejustbeenthroughanesthesia.Probably,youhadaC-sectionbecausethelabormaybewaslongorwasn'tgoingveryeasilysoyou'vegotthataddedstress.Andthenmaybeyouarekindofamorenaturalmama,andnowyou'refeelingreallyguiltybecauseyou'veheard,"Oh,well,ababybornbyC-sectiondoesn'tgetthemicrobiomeor...."I'vehadwomenwhohavecometomewhohavebeenjudgedoutofmommygroupsbecausetheywerenaturalmommygroupsandthewoman'snowfailedbyhavingaC-section.So,therearesomanytensionsandpressuresthatweexperience.Andthenyouaddtothatthedifficultyinandofitselfofbeinganewmom.Thenyouaddtothatourowninternalshould,right?LikethisshouldbeeasierandI'msupposedtobehappy.Andso,interestingly,onestudyshowedthatathirdofwomenwithpostpartumdepressionwhoactuallythoughtthattheyweresufferingfrompostpartumdepression,80%ofthemhadnottoldtheirdoctoraboutitortheirmidwifeaboutitostensiblybecausetheyfeltashamedorguiltyorliketheyhadfailed.Andfirst-timemamasareespeciallyathighriskbecauseitcanbeareallybigshock.


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Thenaddtothatsomanywomenarelivingfarawayfromanddisconnectedfromtheirownfamilies,theirownmoms,sisters,cousins,whoeverthatsupportpersonis,ortheirbestfriendsfrom,youknow,theirlife,fromearlierintheirlife,peopletheycanreallyturntoatanytimeofdayornight,andthatmakesitsomuchharderbecauseweknowthatbeingdisconnectedfromyoursocialsupportinanywayisatremendousriskfactor.Weknowthatdepressioninourcultureisontheriseanywayandthere'salotofrisksforthatso,justchronicunderlyinginflammationisahugeriskinsomanypeople.Imean,practicallyoneandtwopeoplenowstatisticallyhasachronicillnessofsomekind.Andchronicillnessbydefinitionusuallyhasinflammationaccompanyingit.Weknowthateventhingsthatwedon'tseeorthinkaboutlikeenvironmentaltoxinsorfoodtriggers,Imean,youknow,youcouldbeeatingglutenordairyorsomethingelsethat'safoodtriggerthatcreatesinflammationandmany,manyenvironmentaltoxinscreateinflammationthatcancausedepression.Thisisawell-knownstatisticthatatthispointasmuchas30%ofalldepressionisprobablyfrominflammation,well-knownintheintegrativeworldandwelldocumentedinevidence-basedmedicinebutnotknownbymostpeopleandnotknownbymostconventionaldoctors.Andthenanotherhugefactoristhyroidproblemswhicharequitestatisticallyhigh,upto20%innewmomsandupto20%postpartumdepressioninnewmoms.Andwealsoknowthatasmuchas15%ormorepercentofdepressionisundetectedhypothyroidism.Sothat'sabiglistrightthere.Youknow,andthereareawholelotofotherfactorswecanaddtoit.Notgettingenoughtimeinnature,sunlight,lackofcommunitysupport,youknow,sharingchildliketraditionally,womeninmanyculturessharedbreastfeeding,theysharedchildrearing.So,youknow,Katieit'sjustlikeawholeheapoffactorsandmostofushaveonetofiveofthosegoingonatanygiventime.Katie:Yeah.Icandefinitely...IwasidentifyingthatasyouaretalkingwithonesthatI'veexperiencedmyselfandwouldyoumindifyouwouldhavegreatinsightsfrombothsidesbecauseIwouldguessthattheherbalistandthemidwiferyapproachtopostpartumdepressiondifferfromtheconventionalmedicineapproach.So,whatarethosetwoapproachessuggest,likewhatcanwomendoonanacutebasiswhenthey'reactuallyexperiencingitandwhatcanwomendotoavoiditifthey'vealreadypotentiallyhaditinthepast?Aviva:Yes.So,greatquestions,andI'veworkedwithwomenwhohavecometomeforsubsequentbabiesafterthatfirstbabywheretheyhadpostpartumdepressionandtheyreallyare,Imean,terrified.It'snotanoverstatementofhowsomewomenfeel.Ihadonewomanwhocametome,ittookhersixyearsbeforeshewaswillingtogetpregnantagain.Sotoaddressthefirstpart,thedifferencebetweenmidwivesanddoctorsandhowpostpartumdepressionisapproached,interestingly,mostmidwivesespeciallydirectentryhomebirthmidwivesaren'treallytrainedtolookoutforpostpartumdepressionandalotofhomebirthmidwivesarenotseeingwomenpastmaybesixoreightweeks.Sotheymighthavelikeafollow-upatthreemonthsbutthere'softenabiggapincare.AndIthinkasmidwiveswe'resotrainedinsomewaystovieweverythingasnaturalthatsometimeswe'rereluctanttogiveanassessmentordiagnosisespeciallyifit'snotsomethingwe'retrainedin.Mostmidwivesaretrainedinthenormalprenatalcareandnormalpostpartum.Andit'sveryeasyformidwives,anddoctors,andfamilymembers,andfriends,andwomenourselvestosay,"Well,youknowwhat?It'sjust...andI'mdoingjustwithairquoteshere...babyblues."Andit'snormalbecauseit'sabigadjustmentandwemaysayit'snormalbecauseit'sabigadjustmentand,youknow,youhaveyourfirstbabyandthat'soverwhelming.Orwemightsay,"Oh,it'snormalandit'sabigadjustmentbecausenowyouhavetwo,three,four."Ithinkbythe


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timewehadthethreekids,prettymuchwecanhandleanythingafterbutnotalways,right?Itcanhappenatanytime.Soitoftengoesoverlookedordismissedasnormaltobefatiguedoverwhelmed,notfeelinglikegettingoutofbedbecauseyou'retired.Maybeyou'renotlosingyourbabyweightbecauseyou'rejustnotlosingyourbabyweightyetoryouhaven'tgottenbackintoanexerciseprogram.Soalotofthesymptomsthatweseeapostpartumdepressiongetkindofshovedundertherugasnormal.AndsoI'veworkedwithalotofwomenwhosehomebirthwonderfulmidwivesjustmissedthatitwaspostpartumdepression.Andsimilarly,MDsarelikelytoalsomissitandtheworstthingwithOBGYNsandfamilydocsisthatinsurance,healthinsurancedoesn'tcoverpostpartumvisitsuntilsixweekspostpartum.Sothepeoplewhoreallyneedtobelookingoutformomswithpostpartumdepressionarepeoplewhoaredoingpediatriccarebecausebabiesgonnagetseemoncetothreetimesinthefirstcoupleofweeksifmomisbreastfeeding,andatleastacoupleorafewtimesinthatfirstsixweeks.Sopediatriciansandfamilydoctorswhoareseeingthebabiesareinagreatpositiontobeaskingquestionsofmomlike,"Howareyoufeeling?""Areyouenjoyingbeinganewmom?""Areyoutakingcareofyourself?"BecauseotherwiseyoumightnotgobacktotheOBorfamilydocwhowasyourbirthproviderforalongtimebywhichtimeyoucanbefeelingprettymiserableandhavenotbondedwithyourbabyand,youknow,you'redepressedormaybeyouhaveathyroidproblemcausingdepressionandsobreastfeedingisfailingforyou.Yourbabyisnotgainingweight.You'retryingeverythingandyou'reexhaustingyourselfevenmore.Soforwomen,Ithinkwehavetogetverycomfortableknowingandtrustingourselves,andspeakingupforourselves,andhavingotherwomenadvocateswhocansupportusandlistentouswhenwesay,"I'mnotfeelingokayorI'mnotenjoyingthisasanewmom."First,wehavetogetcomfortablesayingthat,right?I'mgonnasayformyselfandIcan'tspeakforyoubutI'mgonnaimaginewithsixbabies,thereweredaysyouhatedbeinganewmom.Likeyouloveyourbabybutit'sexhausting.Youcan'tevengo,youknow,takeapoopbyyourselfortakeashoweroryouskimponeatingbecauseit'ssooverwhelmingandtherearedaysyou'rejustlike,"Wow,thisisnotwhatIthoughtit'sgonnabe."ButIthinkwetendtokeepthattoourselvesbecausewethinkthatothermomswilljudgeusforbeingbadmomsorwejudgeourselvesforbeingbadmoms.Sothefirstthingisjustsaying,"I'mnothappyandthisisnotgoingwell,"whichisnormaltohappenonceinawhile.Butifyou'regettingupinthemorningandyou'realreadydreadingit,ifyouare,youknow,reallynotenjoyingitdayinanddayoutorhourafterhour,ifyou'renottakingcareofyourself,ifyou'renotgettingupandbrushingyourhairandbrushingyourteeth,ifyou'renotwantingtofeedyourbabyortakecareofyourbabyorseeyourfriends,allofthesearesignsthatthat'stoomuch,right?That'sgonefrom"babyblues"to"thisisn'tsogood”.AndIthinkasgirlfriends,andasmidwives,andassisters,andcousins,andaunties,andmomswehavetoalsostepupandrecognize20%ofwomenhavingaseveremajordepressivedisorderorI'msorry,majordepressiveepisodeduringthefirstyearofbaby'slife.So,21.9%ofwomenwillhaveamajordepressiveepisodeinthefirstyear.Thatmeans,severeenoughtoreallygetpsychiatrichelp.Thatmeansalotmorewomenhavingsomerangeofdepressionthat'smorethanjustpostpartumblues.Andtherecanbemedicalreasonsthatareeasilyfixablelikeanemiafromawomanwhoisalreadylowironduringpregnancy,andthenmaybehadbloodloss,ormaybehadaC-sectionandtherewasmorebloodlossthansherealizedbecausehowmanypeoplehaveC-sectionsandsay,"Oh,howmuchblooddidIlose?Wasitenoughtobeanemic?"Orathyroidproblemwhichsooftengetsoverlooked.Infact,prenatally,statisticsarenowshowingthat60%ofwomenwhoareatriskforapostpartumthyroidproblemarebeingmissed


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prenatallyforthatwhenwecouldbediagnosingthatandgivingthesewomenextrasupport.Soifwomenarefirstspeakingupandrecognizingit,thatissuchahugestep,andthenlearningthethingsthatwecandobothduringpregnancyandthenoncebabyisborntotakecareofourselves,that'sreallyimportant.Soonethingthatwecandoduringpregnancyisget...ifwe'regettingnormalprenatalbloodworkdonewhichmostofusdoevenwhenwe'rehavingahomebirthwecanhaveourmidwifeordoctorcheckforTPOwhichisthyroidantibodies.Andthosepredictdevelopingathyroidproblemduringpregnancyorinthepostpartumandthyroidproblemsinthepostpartumareahugecauseforpostpartumdepression.Makingsurethatwe'regettingMethylfolatewhetherornotyouknowyouhavetheMTHFRgene.AndKatie,Ithinkyouhavesomearticlesonthat.Ihavesomearticlesandwebothprobablyhavepodcasts,Ido.IknowforsureonMTHFRthatwomencanlistentobutevenifyoudon'tgetcheckedtakingMethylfolateduringpregnancyisreallyimportantandespeciallyimportantifyou'vehadpostpartumdepressionoranydepressionbecauseifyou'vehadanydepressioninthepastyou'remoreatriskforprenatalandpostnataldepression.Makingsureyou'regettingplentyofB12,goodessentialfattyacidseitherafishoiloranalgaesubstitute,VitaminD3,andallofthesethingswecangetfromacombinationofourfood,aprenatalvitamin.Andthenmostprenatalvitaminsdon'thaveenoughVitaminDso,Iusuallyrecommendabout2,000unitsofthatadaymakingsureyou'regettingupto1,200microgramsofB12everyday.Andforanyonewho'vereadthestudythatgettingtoomuchB12ortoomuchMethylfolateduringpregnancyisdangerous,whatitactuallysaidishighbloodlevelswerenotsafe.Itdidn'tsayanythingaboutsupplementing,it'sjustthatmightbeanabsorptionproblemanditwasn'taverygoodstudyfromamedicalscientificperspectivepointofview.Butjustoptimizingnutrition,gettingplentyofgoodqualityproteinandgoodqualityfatsduringthepregnancyandafterthebabyisborn,continuingyourprenatalvitaminwhileyou'rebreastfeeding,makingsureyouhavereallygoodhelpandsupport.Youknow,IalwaysjokeasmuchasweteasemenaboutnotbeingabletoaskfordirectionsIthinkaswomenwecouldequallybeteasedaboutnotbeingabletoaskforhelp.SooneofthethingsthatIdoformygoodfriendsandthenoftendidinmymidwiferypracticewashelpwomentogetafoodtreesetupsothatthere'safoodphonetreesothatfriendscanbringfoodafterthebabyisborn.AndIalwayssetsomeprettyclearruleslikejustbecausesomeone'sbringingfooddoesn'tmeantheygettocomeinandhaveavisitbecauseyoumightbetired.Sojusthavesomewheretoleavethefoodoutsideorknockonthedoorandsomeonecanopenitandgetthefoodwithoutyoubeingobligated.Ifyoudohavedepressionduringpregnancy,gettingonboardwithsomeonewhocangiveyouterrificsupportorifyou'vehaddepressioninthepast,postpartum,prenatal,oringeneral,makingsurethatyou'regettingreallytee’dupduringpregnancy.Probablywewon'tgointoallthenuancesofmedicationbutifyou'reonamedicationandyou'reveryextremelydepressedofthemedication,makingsurethatyouworkwithsomeonewhocanmakesurethatit'sapregnancysafemedicationinsteadofjustanythingrandom,becausestudiesshowthatwomenwhogooffmedicationduringpregnancyoftenhaveahigherriskforreallytankingwiththeirdepression.Soifyou'reonitanddoingwellalthoughit'snotmyfavoritethingforwomentobeonamedicationduringpregnancy,sometimesitisactuallysafeforthisdayonitandworkswithsomeonethroughthat.Ifyou'renotonitoryou'reveryuncomfortablebeingonitthenworkingwithsomeonelikemewho'safunctionaldoctor,orafunctionalmidwife,oranutritionist...well,you'dhavetoreallyworkwithadoctorifyou'regonnacomeoffthemedicationormidwife,butsomeonewhocanbridgethatforyouandmakesurethatyou'recontinuingtodoreallywell.There'ssomeprenatalfunctionalmedicine,psychiatrist,outthereaswellthatyoucould,youknow,lookonlineandconnectwith.


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SothosearesomeofthethingsKatie.Andthendoyouwantmetojustdiverightintosomeofthetreatmentsordoyouhaveotherquestionsformefirst?Katie:Yeah.I'dlovetodiveintothetreatmentsbecauseIfeellikeantidepressantsarekindofthecommononeatleastthatI'mhearingfromfriendsthatarebeingrecommended.AndIknowthesearecommonlyprescribedbutaretheysafeforthemomandthebabyandaretherebetteralternatives?Aviva:Yeah.Soit'sareallyimportantquestion.Solet'sjustbackupeventhoughIknowwe'retalkingaboutpostpartumbecausealotofwomenaregonnabeonthemprenatally.So,ifyouhaveto,likereallyhaveto,becauseyou’reatriskofhurtingyourselforyou’reatriskofnottakingcareofyourself,whichisoneofthebiggerrisksforpregnantwomenwithdepression.Andifyoudon'ttakecareofyourself,you’renoteatingwell,you'renotgettingyourprenatalcare,you'renotdoingwhatyouneedtodo,itdoesposeriskforbaby.So,Iwouldneveractuallysaythesemedicationsaresafeduringpregnancy.WhatIwouldsayissometimesthey'resaferthannotreatmentatall.

SoZoloftisconsideredthefirst-linemedicationforuseduringpregnancyifyouhavetobeonone.Zoloftissertraline,Prozacisfluoxetine.That'sthebeststudiedmedicationwiththehighestsafetyprofilebutithasbeenassociatedwithcongenitaldefectsinthebabyanditmayaccumulatesothatit'spresentinthebreastfeedingbaby.So,whenbaby'sbornthere'salreadyProzacaccumulationandbabiescangothroughsomesymptomsandsomewithdrawalfromthat.So,again,Iwouldneversayit'ssafe.Sometimesit'sjustsaferthannotreatmentatall.So,youknow,it'skindofarisk.

Thenforpostpartum,they'redefinitelysaferthantheyareduringpregnancybecausenotverymuchgetsthroughtothebabybutsomedoesgetthroughtothebaby.So,duringpostpartum,again,it'ssortofariskbenefit,right?Ifyou'renotgonnagetanyothertreatmentbecausethere'snooneinyourcommunityandyou'renotsureabouttrustingstuffonline,thenIwouldsayit'sdefinitelybetterthannotgettinganytreatmentatall.Butbeforesomebodygoesonanymedication,it'ssoimportanttolookatalltherootcausessociallyintermsofyouradjustmenttobeinganewmom.Areyougettingenoughhelpandrulingouttheunderlyingfactorslikeanemia,lowB12,lowvitaminD,hypothyroidismwhichisjustahugecontributingfactor.Onceyouhavekindoffiguredoutwhatthecauseis,forallwomen,Ialwaysrecommendaddinginsupportivetherapies,lighttherapy.So,usingalightbox.Investinginalightboxifyouhavedepressionprenatallyingeneralorpostpartumcanmakeahugedifference.Justeven20minutesoflighttherapywithalightboxinthemorninghasbeenshowntobeveryeffectivefortreatingdepressionincludingstudiesdoneonpostnataldepression.Ifyoucan'taffordalightbox,thengettingabouthalfhourinthemorningfirstthingideallyinthemorning,sitwithbabyinthewindow,youknow,sunlightinthewindowtobreastfeedhaveyourbreakfast,whateveryourmorningroutineis,expandittoincludesomesunlightinthemorning.Yogahasbeenfoundtobeveryeffectiveforpostpartumdepression,prenatalaswell.Andthethingabout


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yogaisifyoucanfindamommy-and-mekindofclass,you'realsogoingtobeinaclasswithothermamasandtheirbabies.Andso,oneyou'regoingtohaveothersocialconnectionwhichisgoingtobereallyhelpful.Justbeingaroundotherpeoplecanincreaseouroxytocinthatcanhelpasanantidote.Butchancesareifyoushareconfidently...I'msorryconfidentiallyandconfidentlywiththeyogateacherthatyou'restudyingwith...youknow,strugglingwithpostpartumdepressionshemaymentionit.Youknow,notcallingyouout,butshemaybringitupinclassandyou'llprobablyfindthatyou'renottheonlyone.Imean,ifyouareit'sbecauseyou'retheonlyonewho'swillingtoadmititbutstatisticallythere'snowayyou'dbetheonlyone.So,lighttherapy,yoga,somethingcalledcognitivebehavioraltherapy,whichisworkingwithatherapistwhodoesthattypeoftherapycalledCBT.It'sbeenshowntohelpreframeourmindsetsandhelpuscopewithanxietyanddepressionbecauseoftenpostpartumdepressionisaccompaniedbysomeamountofanxietytoo.And,youknow,evenifit'sjustanxietythatyou'renevergonnafeelwellagain.Andthosehaveallbeenfoundeffectiveandnottointerferewithmedicationandhavebeenshowntobeabletohelpyoutoloweryourdoseofmedication.So,again,youknow,toreiteratewhatIsaid,beforeyoudowanttogettestingforthingslikefoodintolerancesordoaneliminationdietbecauseyoucantotallysafelydoaneliminationdietliketheonesIhaveonmywebsite,inmyblogs,orinmynewbook.Youcandothatsafelyaslongasyou'regettingallthenutrientsyouneed.Noneofusneedsglutenanddairytogetallthenutritionweneedandthosecanbebigtriggersfordepression.Makingsurethatyou'regettingenoughprotein,particularlyifyou'reaveganorvegetarian,sometimeswe'regettingmorecarbsthanwerealizeandnotasmuchproteinaswethink.Again,getaproperworkupforpostpartumthyroidproblemsand,youknow,thatwecouldhaveawholeseparateconversationonthat.Idohaveablogandapodcastthatlistenerscandialintospecificallyaboutpostpartumthyroidproblemsandmoreon,youknow,we'reprettymuchcoveringitonpostpartumdepression.Butspecificallywhattogettestedfororwhattolookforthatcouldtellyou,youhaveapostpartumthyroidproblembecausethoseareeasilymissedforalotofreasonsthatItalkedaboutinthatpodcastandofcourse,Katie,I'mhappytodiveintomorewithyoutodayifyou'dliketo.

Makesurethatyou'resupplementingforBcomplex,vitaminDandmethylfolateandthenironifyouneedit.Makesureyou'regettingenoughmagnesiumandomega-3s.Thereareprenatalandpostpartumproductsthatyoucanlookforthathavethat.Andthenanyinflammation,ifyou'rehavingjointpain.Ifyouhaveahistoryofgestationaldiabetes,insulinresistance,highbloodpressureeitherinoroutofpregnancy,thoseareallindicationsthatyoucanbestrugglingwithinflammation.Andinterestingly,justthatsuddendropinestrogenpostpartumcanincreaseourriskofdepressionbecauseitcantriggersomeamountofinflammation.Somegoodstudieshaveshownthatomega-3fattyacidscanhelpwithmooddisordersandweknowthatpregnantwomenareclassicallylowinomega-3s.So,fishoilisagreatsourcethatwomencansupplement,continuingtogetatleast800microgramsofmethylfolateeachdaypostpartumespeciallyifyouknowyouhaveMTHFR.Andthenthereareafewsupplementsthathavebeenfoundtobeespeciallyhelpful.OneiscalledSAM-eandit'sespeciallyhelpfulfrommethylation.Sothat'sprobablywhyitmaybeespeciallyhelpfulforwomenwhohavetheMTHFRgenechange.Butevenforwomenwhodon'thaveit,it'sbeenfoundtobesafeinpregnancyandpostpartum.Andatypicaldoseis400milligramsaday,butupto400milligramstwiceadaymaybeneededforareallyoptimaltherapeuticbenefit.


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Theonlypeoplewhoshouldn'treallyuseitandprobablyneedto...notprobably,definitelyneedtogethelpwithtreatment,arewomenwithbipolardepressionandwomenwhohavepostpartumpsychosis.So,mostpeoplewhohavepostpartumdepressionhave,andIdon'tmeantominimizeitbysayingitthisway,butrun-of-the-millpostpartumdepression.Averytinypercentageofwomenwilldevelopsomethingcalledpostpartumpsychosiswheretheyactuallybecomesuicidalorhavethoughtsofhurtingthebabyandnotjustlike,"OhmyGod.Ican'ttakethisbaby.I'mgonnagiveitaway."Youknowlikethattransient,likeverycrazythoughtanexhaustionmommighthavebutdoesn'treallyhavepsychosiscomparedtosomeonewho'sactuallythinkingabouthowtheymighthurttheirbabyorleavetheirbabysomewhere.Thosewomenneedmedicalemergencyhelp.That'ssevereandcanbelife-threateningformomandbaby.Probiotics,incrediblyimportantduringpregnancyforanumberofprotectivereasonsforbaby,butalsoincreasingevidenceshowsthatdisruptedgutfloracanleadtoadisruptedmoodincludingdepression.So,eatingliveactiveculturesincoconutyogurtorifyoutolerateit,organicdairyfromgoats,sheep,cows.Iwouldtendtoerronthesideofthesheepyogurtandthegoatyogurtbecausethecowyogurtisprobablymoreinflammatoryorsupplementingwithaprobioticthathaslactobacillusandbifidobacteriumstrains,hasbeenshowntobebeneficialtomood,bothdepressionandanxiety.So,Ialwaysrecommendthatforpregnantwomenandpostpartummoms.TherehavebeenactuallythreestudiesthathaveshownthatthatlighttherapythatImentionedcanbehelpfulforprenatalandpostpartumdepression.So,eventhoughitsoundslikeahassletogetalightmachineorlightbox,itcanbeincrediblyvaluable.

Andthen30differentstudieswerelookedatandhaveshownthatexerciseinandofitselfcanalleviatedepression.Andseverallargestudieshavebeendonespecificallyinwomenandfoundthatwomenwhoincreasetheirexercisewilldecreasetheirdepression.Anditdoesn'thavetobegoingbacktothegymorgettingintoacrazyfitnessprogram.Itcanbeassimpleaswalking,whichisgreatbecauseifbaby'sfussyorcolicky,youknow,justwhatyouwantbabytogetquiet,gettingoutsideforawalkcanbetremendouslyhelpful.I'vedonethatlotsoftimeswithmybabies.Justputtheminafrontpackor,youknow,ifyouhadac-sectionyoureallyneedtotakeitlight,putbabyinastrollerandhavesomebody,youknow,pushthebabywithyouandgetoutforanicewalkoragentlerestorativeyoga,whichisreallymuchmoreaboutgettinginShavasana.Youknowgettinginalayingdownpositionandbreathingdeep.Andifyoucan'tgetoutforayogaclass,therearesomewonderfulonlineyogaprogramslikeYogaGlo,whichisrelativelyaffordable.Theydoatrialperiodforliketwoweeks,Ithinkitis,andthenit'ssomethinglike$18amonth.So,youknow,practicallythecostofoneortwoclassesandthenyoucandoitathome.Andtheyhaveprenatalyoga,postpartumyoga,andjuststreamingdownloadsofvideossoyoucandoitwithbabyrightnexttoyou.Andthenanotherthingthat'sreallyimportantisgettingsleepwhenthebaby'ssleeping.AndIknow,asabusymomandaworkingmomlikeyouareKatie,evenifwegettoworkfromhome,it'ssoeasytoputbabydown


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andtakecareofeverybodyelseordothechoresthatneedtobedone.Butinthatfirstreallyideallythreetosixmonthswhenbaby'snappingit'ssoimportanttogetanapintooandthere'ssomethingcalledsleepbanking.So,it'sactuallypre-emptiveself-repairandself-care.Youdoitbeforeyou'rewipedoutandtired.Andifyouhaveolderkids,it's,IhatetosayitbutIhadbythetimeIhadmythird...I'msorry,andIwaspregnantwithmyfourthIneededanapeveryafternoonandIwashomeschoolingmykidsandwelivedwayoutinthecountryanditwassocute.Butoneofmymidwiferyclientswhohadfourkids,shesaid,"Youknow,sometimes,Aviva,wemakeadecision.WegetaTVorwekillakid,"and,ofcourse,shewasjokingbutherpointwaswell-taken,andIgotaTV.Just,youknow,TVbackthenitwasthe,"Iwilldatemyself,"butitwasVCRdaysandthenitwasDVDdaysbutIcouldputmykidsinfrontofagreatvideoandbackthenitwas...whatwasit?ReadingRainbowandWishbonenowI'mreallydatingmyself.Butyoucouldgetavideothat'sage-appropriateorahighschoolstudentoradoula,someoneoragirlfriendthatyouknowswapbabysitsandnapsfor,superimportant.Andthenotherthingslikejustkeepingupwithourbasicnutrition.Iknowasabusymomit'ssoeasytojustkeepgoinguntilyousuddenlyrealizeyou'rehavingcoldsweatsandanxietyandyou'reshakingandyouhaven'teateninsixhours.Andwehavetokeepourbloodsugarbalanced.It'sso,soimportantbecausethatinitself...whenyourbloodsugar'slowyourbrainsendsoutallkindsofalarmbells,youstartproducingmorecortisol,adrenaline,youcangetanxious,youcouldstarttogetdepressed.

AndthenIthinkforallofus...ImeanKatie,you'redoingmama'ssuchaservicebyhavingthisconversationtodaybecauseashealthcareproviders,aseducators,it'ssoimportantthatwetalktowomenaheadoftimeaboutdepression,abouttheshamethatcanhappenarounddepression,feelingsofweaknessorthere'ssomethingwrongwithus.So,talkingaboutthatwithmamas,waybeforetheygetpregnant,duringpregnancyandwithnewmamacheckups,issoimportantandit'snottosay,"Oh,wewannasortof,youknow,psychepeopleintohavingahardtime,"butwedowantpeopletobeaware.Andthen,youknow,justtokindofsumitupthereareafewherbsthatcanbeveryhelpful.SoSt.John'swort,there'salotofconfusionoverwhetheritisorisn'teffective.Therehavebeenover5,000patientslookedatandalmost30studies,reallygoodhigh-qualityrandomizedcontrolstudieslookingattheeffectsofSt.John'swortondepression.Andnotonlyisitconclusivelybeneficialformilddepressionbutconclusivelybeneficialforpeoplewhohavemoderate,tosevere,tomajordepression.So,St.John'swortdefinitelyincludedaspartoftheprotocolifyoucanbeforeyouturntopharmaceuticals.Ofcourse,unlessthingsaresevereandyou'rejustreallymoreconfidentwiththepharmaceuticals.PromisingdataforlavenderoilextractsfrommamaswhohaveanxietyandasImentionedthat'sabigcomponentthatoftencomeswiththedepression.AnherbcalledMotherwortisoneofmyfavoriteherbsinthewholeworld.Firstofall,motherworttranslatesit'sanoldEnglishwayofsayinghealingherbformothers.ButtheLatinnameisreallycool.It'sleonuruscardiacaanditmeanstheheartofalion.Andtraditionallyit'sbeenusedforallmannerofwhatwerecalledclassicallyfemalecomplaintsincludingdepressionandanxiety.Sosupergreatfornewmamasandallofthesearesafewhilebreastfeeding.Andthere'sanotherherbcalledrhodiolawhichisintheadaptogenfamily,whichisalsosafenotduringpregnancybutfornewmomswhoarehavingsleepdisturbance,poorfocusandconcentration,irritability,and


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sleeploss.Again,likeIsaidearlierwhenIgaveawarningaboutseveredepressionorbipolardepression,thisherbwouldnotbeusedforsomebodywhohasbipolardepression.Itcanaddtomania.Butvery,veryeffectiveandsafeforuseduringbreastfeeding.

Anotheradaptogen,eleutherococcus.WeusedtocallitSiberianginseng,hasbeenfoundtobehelpfulforfolkswhoarestrugglingwithsleeplossandIthinkmostnewmamaswouldendupinthatcategory.AndthenthefinaloneI'llmentionthatIloveisanherbcalledmaca.TheonlywarningIwouldsaywithmacaisthatit'snotforusereallyinpregnancy.Thisisforpostpartum.Butitdoesgivesomepeopleprettysignificantlyupsetstomach.So,tryasmallamountmaybelikehalfateaspooninasmoothieandseeifyoulikeit.Butit'sbeenusedclassicallyinthePeruvianAndesasatonicfornewmoms,animalsgrazeonittootopromotebreastmilkproductionandusedfordepression,fatigue,anxiety,andlowsexdrivewhichoftenaccompaniesthose.Sothat'salotforeveryonetodigestandthinkaboutandyoucanuseanyofthoseoryoucanusethemincombinations.Likemaca,youcanthrowinasmoothie.St.John'swortyoucantakeasaliquidextractthat'scombinedwithmaybesomeoftheotherherbsImentioned.Andthenofcoursethesupplementstakewithyourfoodandthinkofthemasanextensionoffoodwhenweneedjustalittlebitmoretosupportourhealth.

Katie:Thatwasanamazinglist.I'vebeentakingnotesoverheretomakesureI'llgetthemallontheshownotes.

Katie:ThispodcastisbroughttoyoubyFourSigmatic.IfyoufollowmeonInstagram,you'veprobablyseenmementionthembecauseIhavebeenusingandlovingandInstagrammingtheirproductsforyears.Theyhaveanamazinginstantmushroomcoffee.Hearmeoutbeforeyouthinkit'sweird.Iknow,mushroomcoffeedoesn'tsoundgood.It'snotonlythebestinstantcoffeeI'veevertried,it'salsoprettyhighuponthelistofbestcoffeeI'vetried.It'scheaperthancoffeeshopcoffeeandit'ssoconvenientbecauseit'ssoportableandittastessomuchbetter.Butitisn'tjustordinarycoffee.IthassuperfoodmushroomslikeLion'sMane,Cordyceps,andChagamushrooms.Andthesemushroomshavesomebighealthbenefits,andespeciallyimmunebenefits.Ipersonally,especiallylovethemfortheenergyandthementalclaritywithoutthejittersfromtraditionalcoffee.AnddidImentionhowgoodittastes?SoIalwaystaketheseinstantcoffeepacketswithmewhenItravel,andIalsoalwaysdrinkitathomethesedaysnowthattheyhaveabigtinthatlastsaboutamonthsoIdon'thavetoopenalittlepacketeveryday.Somefriendsofoursrecentlytraveledforthreemonthscarryingonlythebackpacksontheirbacks,andtheybroughtanentirethreemonthssupplyofthisinstantcoffeeintheirbagthathadlimitedspace.Inotherwords,thiscoffeebeatoutapairofjeansforhowimportantitwastomakeitinthebag.It'sthatgood.And,ofcourse,ifyouaren'tacaffeineperson,theyalsohaveavarietyofmushroomteaandotherproductsthatdon'thavethecoffeesoyoucangetthebenefitswithoutthecaffeine.AndIlovethemsomuchthatIreachedoutandtheyagreedtogiveadiscounttomylisteners.Sogotofoursigmatic.com/wellnessmamaandusethecode"WELLNESSMAMA"toget10%off.That'sFourSigmatic,F-O-U-R-S-I-G-M-A-T-I-C.com/wellnessmama.


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ThisepisodeissponsoredbyKettleandFireBoneBroth.Ifyoulovethebenefitsofbonebrothbutdon’tlovethetimeittakestomakeandhowtoughitcanbetofindqualitybonestomakebroth,KettleandFireisforyou.Theirbonebrothisaregularstapleinmykitchenthesedaysandit’swhatIusetocreatetherecipesinmynewbonebrothebook.Sotheyonlyusebonesfrom100%grass-fedpastureraisedcattlethatarenevergivenhormonesorantibiotics.Theirbrothisalsouniquebecausetheyfocusonbonesthatareespeciallyhighincollagen,whichisoneofthehealthiestthingsyoucanputinyourbody.YoucanfindthematmanyWholeFoodsonthewestcoastandyoucanalsoorderonlineandgetadiscountatkettleandfire.com/mama.Again,that’skettleandfire.com/mama.

Katie:SoI'llmakesureI'velinkedtothosearticlesthatyou'vementionedandalsojusthavealistofeverythingyoujusttalkedabout.Ithinkthat'sgonnabereallyhelpfulforwomenbecauseIthinksometimesthey...itcanbescarytotakeanythingthatisnotactuallyprescribedpostpartumbecausethereisalwaysthatquestion,isitsafeforbaby?CanIdothiswhilebreastfeeding?So,that'sreallyhelpfultoknowtheherbsandthesupplementsthatfromamedicalperspectiveandanherbalistperspectivethatareconsideredsafepostpartum.That'sreallyamazinglyhelpful.

Aviva:Oh,I'msoglad,yeah.AndthisiswhatI'mstillusinginmypractice.Imean,IcantellyouononehandinthepastfiveyearswhenI'veactuallyprescribedanantidepressantandithasn'tbeenforapregnantornewmomatall.It'sbeen,youknow,otherwomenwithseveredepressionasabridgetonaturaltherapies.Butthesearemyfirstgo-to’sandI'mveryyouknowveryconfidentandsatisfiedinwhatI'veseenastheresultsandhavebeenfor,like,trulythreedecadesnow.

Katie:That'swonderfulandI'msureveryencouragingtopeopletohopefullyhavesomethingstotrythatnotjustpharmaceutical.

Aviva:Anddefinitelygethelp.Ijustwanttoaddthatin.Likereally,reallygethelp.Thisishardtodoonyourown.So,evenifyouwannausenaturaltherapies,talktoyourmidwifeoryourfamilydocorOBorpediatrician.Justletsomebodyknowwhat'sgoingonbecauseit'stoomuchforyourpartnertohandle,right?Partnersdon'tknowhowtohandlethis.Thisisoverwhelmingandthey'restrugglingwithhavinganewbabytooandthentheirpartnerfeelingdown.So,gethelpoutsideofjustaskingyourpartner'shelp.

Katie:That'sagoodpoint.Ithinkyourpointwaswellmadethat,like,mendon'taskfordirectionsandweareequallybadaboutaskingforhelp.Andyou'resorightaboutthatperceptionthatyoujusthavetobethiswonderfullyhappymom,joyfulallthetimeandifyou'renot,somethingiswrong.So,Ithinkletalonehopefullywillencouragepeopletoreachoutandfindsomeonethatcanworkwiththem.Youmentionedseveraltimesthethyroidconnectionandhowalloftheseproblemscanbeworseforsomeonewithathyroidproblempostpartumandhowmanywomengoundiagnosedwiththis.So,yournewbooktalksawholelotaboutthis,butlet'sdelvealittlebitintotheadrenalandthyroidaspectofthisandjusthormonesingeneralandhowwomencanaddressthoseaswell.

Aviva:Yeah.So,aprettysignificantnumberofwomenwhodeveloppostpartumdepressionhaveathyroid


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problem.Evenwomenwhodon'tdeveloppostpartumdepression,womenwhoarestrugglingwithlowbreastmilkproduction.Imean,you'veprobablygottenazillionemailsandphonecalls.IknowIhave,andseenitmypracticewherewomenaredoingeverythingtogettheirbreastmilkproductionupandit'sjustnothappeningandthey'rereallygettingscaredandthey'rebeatingthemselvesup.Andthenifsomeonehadjustcheckedtheirthyroidtheyprobablywouldhavefoundthatitwaslowinthosewomenandtherecanbeotherreasons,butit'ssoimportant.Butalsojustnotlosingbabyweightatallorgettingpoorsleeporfeelingirritableoranxiousorchangesinyourappetite.You'rehungryallthetimeandmaybeyou'reevengainingweight.Itcanbethatit'sathyroidproblem.Thetrickypartisthis,well,thereareabunchoftrickyparts.One,alotofdoctorsdon'tcheck.Two,themedicalrecommendationsorguidelinesarethatwedon'tactuallyhavetotreatwomenwithpostpartumdepressionbecauseabout80%willgointo...Imeannotpostpartumdepression,postpartumthyroidproblemsbecauseabout80%willjustremitgointoremissionontheirown,butthatleavesalotofwomenstruggling.ThewayIdescribedpostpartumdepression...I'msorrypostpartumwithHashimoto's,it'slikepostpartumislikepushingaboulderupahillandthenpostpartumthyroidproblemsarelikepushingaboulderupahillwithonehandwhileyou'reholdingthebabywiththeother.It'ssomuchmoreworkbecauseyou'reexhausted,yourmetabolismisjustnotmoving.Andhere'sanothertrickypart,isthatabouthalfofallwomenwhodeveloppostpartumhypothyroidismandsoslowfunctioningthyroid,gothroughaperiodoftimewherethey'veactuallyhadhyperoroverfunctioningthyroidfirst.Withoverfunctioningthyroidyouhavetonsofenergy,youneedlesssleepyouloseyourbabyweightinahotminute.Like,youknow,thosewomenwhoarelikebacktotheirnormalsize,nothing,twoweeksafterthey'vehadababyandeverybody'sthinking,"Becausethey'rebreastfeedingandtheywerejustsuperwell-adjusted,"butactuallythosewomencouldhave,andoftendohave,atouchofhyperthyroidism.So,iftheyweretogettheirlabscheckedrightthentheirTSH,whichisafunctionofhowfastyourthyroidorhowslowyourthyroidisbeingstimulatedbyyourbrain,wouldbelowormightlooknormal.Butthenallofasuddentheycrossoverina,youknow,six,anywherefromtwoweekstothreemonthsintohypothyroidism.Well,ifyouthinkaboutanumberline,ifyoustartoutbelowzero,right?That'slikealowTSHbecauseit'sbeingsuppressed,becauseyourthyroidisoverfunctioning,andnowyou'recrossingintoaslowfunctioningthyroidwhereyouwouldhaveahighTSH.So,insteadofbeinginthenegativenumbersyou'dbeinthepositivenumbers,trytogetavisualofthatfromlikethirdgradewhenwewerewheneverwestudiednumberlines,Idon'tremember.Somewherealongthereyouhavetocrossoverzero,right?Ifyou'regoingfromnegativenumberstopositivenumbers,youcrossoverlikenegativeone,zero,positiveone.That'sthenormalrange.So,ifyougoandgetyourthyroidlabstestedwhileyou'reinthenormalrange,yourdoctorisgoingtosay,"Youdon'thaveathyroidproblem.It'sjustdepressionoryouneedtoexercisemoreorjustthisorjustthat,"or,"You'rejustanewmomandyou'retired."So,youcanmissthegapandbediagnosedasnormal.Andnowyoucanfeelreallycrazyandreallyawful


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becauseyouthinksomethingiswrong,you'retoldit'snotandnowitreallyisjustbecauseyou'reanewmomwho'snotmanagingitwellwheninfactyoujustgottestedatthewrongtimeinthecycle.Soyouhavetogobackandgetretestedlike,youknow,fourweekslater,eightweekslater,ifyou'restillhavingthosesymptoms.Soitgetsalittletricky,topickitup.AndinmypracticeIdonot,nottreatnewmamaswhohaveHashimoto'sorhypothyroidism,gravesorhyperthyroidism.Isupportthemombecausethatwillusuallyburnitselfout.Unfortunately,itburnsitselfoutveryquicklyintohypothyroidism.Sometimesit'lljustgotonormalbutoftenit'llcrossover.And,Ispendmoretimegettingpeopleoffofpharmaceuticalsthaneverputtingpeopleonpharmaceuticals,whenItellyouIhavehadonepharmaceuticalsinceIwas15,oneantibioticItellyouthatwithallintegrityandauthenticity.So,forme,Ireallyerronthesideawayfrommedications,butwhensomeoneisstrugglingwithsomethingthatisfixablewiththyroidhormonesupplementandthatmeansthatthey'regoingtoproducebreastmilkandbehappieragainandfeelbetterandsleepbetter,andgetmorecomfortableintheirbodyandenjoybeinganewmom,it'ssoworthittotrylowdoseofthyroidhormonesupplement.Andyoucanalwaysgobackoffofit.

AndthentheotherthingisthatwomenwhododevelophypothyroidismpostpartumorHashimoto'spostpartumhaveabouta50%chanceormoreofdevelopingHashimoto'slateron.Sotheyshouldgetcheckedmaybelikeonceayearandtheneveryfiveyearsoranytimetheystarttodevelopsymptomsofhypothyroidism.SeleniumisprobablythemostimportantthingthatwomenwithelevatedTPOantibodies,theonesImentionedearlierthatwomenoughttogetcheckedinpregnancytohavesomepredictionofwhetherthey'regonnahaveathyroidproblem.Andthathasbeenshownselenium200microgramstotallysafeduringpregnancy.EvenconventionalmedicinehasgreatstudiesonusingthistoreversethatelevatedTPO,protectthethyroidfromdamagebecauseit'stheTPOthat'sattackingthethyroid.AndanynewmompostpartumwhodevelopsHashimoto'sorhypothyroidism,samedrill,lookfortheglutenintolerance,lookfordairy,otherfoodintolerances,addressinflammation,andtakeselenium.

Katie:That'sanothergreatlistandIthinkthatwouldreallybehelpfulforpeople.Again,Iwantedtomentionyourbookthe"AdrenalThyroidRevolution."Iwillhavealinktothatintheshownotesbutit'salso,I'msureonAmazonandBarnesandNoble,ifpeoplewanttofindthatbecauseIthinksomeofthiswillalsogivesomeofthesetipsinaveryspecificwayandpeoplecanidentifytheirspecificproblemsandwhatcanhelp.AndaquestionIalwayslovetokindofaskattheendtowrapupare,whatarethreethingsthatpeopledon'tknoworunderstandaboutyourareaofexpertiseandhowwouldyoustraightenthemout?Whatwouldyoutellthem?

Aviva:That'sagreatquestion.So,Iwouldsaythatthefirstthingisthatit'sveryimportantandespeciallyaswekindofedgeintofunctionalmedicinebeingsopopular,torememberthattheanswerisn'talwaysina


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supplementoranherborevenamassivedietchange.Sometimestheanswerislookingatourownhappinessandisourlifesupportingus?Areweabletogetthehelpweneed,thecareweneed?Andit'sthatmind-bodypieceofthingsthatissoveryimportant.

IwouldsayanotherthingisthatIthinkthatweasphysicians,sotoclarifythisalmosttohealthprofessionalswhoarelisteningbutalsotowomenwhoaregoingtodoctors,youknow,wereallyareactuallytaughtinmedicalschoolthatwe'rethetop2%ofpeopleinthecountryintelligently.Likewe'rereally...Iwasreallytoldthat,youknowourclasswastold,"You'rethetop2%ofintelligence,"andwearesortoftaughttobelievethatwedohavealltheanswers.

Imean,fortunatelyformeIspent25yearsasahomebirthmidwifebeforeIwentandgotthattraining.So,itwasprettyeasytoseetheindoctrination.Butalotofpeople...so,alotofdoctorsgointoitfeelinglike,we'resupposedtohavealltheanswers,andwekindofposturethatway.AndIthinkalotofwomenaretaughtthatwe'renotasempoweredaswemaybecouldorshouldbe.Sowe'retaughttodefertoauthorityandIcantellyou...andIwroteablogaboutthiscalled,"Howbeingagoodgirlcanbehazardoustoyourhealth."So,Iwouldsayforwomenlisteningandespeciallyifyouhavesymptomsandyou'renotgettingtheanswersyouneedfromyourdoctor,it'sreallyimportant...ormidwifeforthatmatter,becausewecanassumeanyhealthprofessionalisanauthorityoverus.It'sreallyimportanttoquestionauthority.It'sveryimportanttomakesurethatyou'reworkingwithpractitionerswhorespectyou.It'sokaytofireyourdoctor,yourmidwife,oranybodywho'snottreatingyouwitharespectorgivingyouanswersthatarehearingwhatyou'reaskingandit'sokaytochallengeyourmedicaldoctor.Andifsomebodytreatsyouas"adifficultpatient"becausethat'softenthelabelthatgetsgiventopeopleeitheryou'redirectlytoldthatoryou'rebeingtreatedthatwaywith,youknow,eyerollingkindofattitudes,findsomebodyelseorstickupforyourself.Andthenthethirdthing,that'satoughoneKatie.ThethirdthingaboutmyprofessionthatIwouldclarifyis,IguessIwouldsaythatfrom32yearsnowofdirectlyworkingwithwomen,andthat'sonmyownbecausetherewastheapprenticeshipbeforethat,so35yearsofworkingwithwomen'shealthandourchildren,wehavebeensoledtobelievethatillhealthanddiseaseareinevitable.Andit'sjustafactofgettingolder,thatpregnancyandbirtharediseases.Andwhiletherearecertainlysomegeneticconditionsthatwegetandwehaveto,youknow,accommodateourlivesaroundandwelcomeaspartofwhoweare,ourbodieshavetheabilitytohealbeyondfarbeyondwhatwehaveeverbeenledtobelieve.Andnaturalremedieshavesuchagreaterroleinthanwe'vedonewe'veeverbeenledtobelieve.

Soit'snotsomuchclarifyingsomethingaboutmyprofessionasanherbalistandmidwifebutclarifyingthataspartofhealthingeneral.Ithinkit'ssoimportantforustoembraceadeeperleveloffaithandconfidenceinourbodiesandwhateverfaithandconfidenceyouhaveintheuniverse.Whateverthatlookslikeforyou,believeinthathealingpowerthatitisthereforustotapinto.

Katie:Absolutely.Yeah,thatwasreallyhelpful.Ithinkyou'resoright.Ithinkalotofus,especiallywhen


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there'saproblemlikewekindoftendtofreakoutandignorethatinnatewisdomthatourbodieshave.Ithinkthat'sgreatthatyouspoketothatandalsojustprovided,Ifeellikethatwasasuperpracticalvery,verymuchinformationpackedepisodethatIreallydohavehopewillhelpalotofwomen.Because,likeIsaid,it'snotastruggleIhavehadpersonallyoronethatI'vehadtolearnandsoIdon'tthinkI'maverygoodresourceforwomenonthatandyouabsolutelyare.So,Iappreciatesomuchyourtimeandallyourresearch.

Aviva:Thankyou,you'resowelcome.Ihaven'thadtostrugglewithiteitherthankfully.ButIcantellyouI'veworkedwithhundredsofwomenandcertainlybeencontactedandsharedinformationwithtensofthousandsofwomenovertheyearsandit'sahardstruggle.AndI'msogratefulforthewomenwhohavespokenupandgonepublicwiththeirownstrugglearoundit.

AndIhopethateachofourlistenerswillfeelempoweredtodothatbecauseifyouarestrugglingwithitandyouspeakup,someoneelseisgoingtohearaboutitandalsobehelpedoutofthat,whatisareallydarkplace.So,thankyouforgivingmetheopportunitytoshareaboutthis,Katie.

Katie:Absolutely.ThankyouforyourtimeandI'llmakesuretolinkto,youmentionedseveralblogspostsandpodcastthatyouhavesothatpeoplecanfindyouandfindoutmoreandspecificallyfortheirowncases.AndlikeIsaid,alsosotheycancheckoutyourbook.Butagainthankyouforyourtime.Iknowyou'reincrediblybusyandI'msograteful.

Aviva:Thankyou.Well,backatyou.Thankyouforhavingmeandbringmeonagainanytime.Ilovetalkingwithmamas.That'smyfavoritethingtogettodo.

Katie:Absolutely.We'llhavetodoroundtwoandthankstoallofyouforlistening.I'llseeyounexttimeonTheHealthyMomsPodcast.

Ifyou'reenjoyingtheseinterviews,wouldyoupleasetaketwominutestoleavearatingorreviewoniTunesforme?Doingthishelpsmorepeopletofindthepodcast,whichmeansevenmoremomsandfamiliescouldbenefitfromtheinformation.Ireallyappreciateyourtime,andthanksasalwaysforlistening.

Documents

97- OB & Midwife Aviva Romm on PPD, Thyroid Problems, & MTHFR€¦ · Adrenal Thyroid Revolution, and she focuses on the impact of stress, diet and environmental toxins on health,