ABOUT THIS EPISODE
Dr. Tabatha sits down with functional medicine doctor Dr. Alexandra MacKillop to unpack the postpartum symptoms nobody warned you about - the ones that started after your babies and never left. Thyroid issues, insulin resistance, mood shifts, autoimmune flares - if you've been told "of course you're tired, you just had a baby," this episode is your permission to dig deeper.
Whether your babies are newborns or grown, this episode is for you. Dr. Tabatha and Ashlee talk with Dr. Alexandra MacKillop, author of The Postpartum Check-In, about the hormone shifts pregnancy and childbirth leave behind - thyroid disorders, insulin resistance, nutritional gaps, and mood changes that get written off as "normal" and never actually resolve. You'll learn what to ask your doctor for, why the postpartum period is a medical blind spot, and how to finally connect the dots on symptoms you gave up trying to explain.
In this episode
Why postpartum hormone shifts can predispose you to health issues decades later
The thyroid testing most women never get - and why it matters
Gestational diabetes, insulin resistance, and the follow-up that rarely happens
A testosterone story that saved a marriage
Why pregnancy is basically a stress test for your future health
A rapid-fire round: normal, common but deserves attention, or needs evaluation?
Scripture referenced
Psalm 139:13-14 - "For you created my inmost being; you knit me together in my mother's womb. I praise you because I am fearfully and wonderfully made."
Mentioned in this episode
The Postpartum Check-In by Dr. Alexandra MacKillop
Dr. Alexandra's newsletter / free resource - dralexandramackillop.kit.com/622e1f5985
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SHOW NOTES 🔗
TRANSCRIPT 🔗
00:02:06.269 --> 00:02:07.469
She goes, Well, of course you're tired.
00:02:07.549 --> 00:02:08.669
You just had a baby.
00:02:08.990 --> 00:02:10.750
That's not what I was talking about, right?
00:02:10.909 --> 00:02:11.710
Of course you're tired.
00:02:11.789 --> 00:02:17.150
Sleeplessness and deep bone-aching fatigue are not the same thing.
00:02:21.949 --> 00:02:26.750
I want every woman over 40 listening to me right now to think back.
00:02:27.150 --> 00:02:38.509
Not to last month, not to when your periods started becoming irregular, not to when you first noticed the belly fat, the poor sleep, the brain fog, anxiety, or hormone changes.
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I want you to think back further.
00:02:41.069 --> 00:02:44.110
What happened after you had your babies?
00:02:44.349 --> 00:02:47.629
Did your hair fall out and never completely come back?
00:02:47.870 --> 00:02:50.590
Did you become anxious for the first time?
00:02:51.069 --> 00:02:54.829
Did you develop constipation that you didn't struggle with before?
00:02:55.389 --> 00:02:56.750
What about your thyroid?
00:02:56.829 --> 00:02:58.909
Did it start acting differently?
00:02:59.150 --> 00:03:01.629
And did your periods become heavier?
00:03:01.789 --> 00:03:03.069
I hear that all the time.
00:03:03.310 --> 00:03:03.629
Okay.
00:03:04.189 --> 00:03:11.870
Lastly, did you develop insulin resistance after having gestational diabetes and just assumed it was all normal?
00:03:12.110 --> 00:03:13.550
Well, of course I'm tired.
00:03:13.709 --> 00:03:14.589
I had a baby.
00:03:14.750 --> 00:03:16.430
Of course I can't get rid of the weight.
00:03:16.509 --> 00:03:17.789
I had a baby.
00:03:18.110 --> 00:03:24.189
We're going to talk about sex being painful, leaking urine, that weight you can't lose.
00:03:24.509 --> 00:03:26.189
So many crazy things.
00:03:26.430 --> 00:03:29.389
Depression, which is something I struggled with.
00:03:29.870 --> 00:03:33.709
It is not just a postpartum issue, ladies.
00:03:34.349 --> 00:03:38.589
This continues on way after postpartum.
00:03:38.750 --> 00:03:41.870
And so we are talking about it today.
00:03:42.269 --> 00:03:47.550
You moved on because your babies got older, but your body is still struggling.
00:03:47.789 --> 00:03:49.389
So let's get into it.
00:03:49.709 --> 00:03:52.589
Whoa, this is gonna be such a good episode today.
00:03:52.829 --> 00:03:54.189
I'm so excited about it.
00:03:54.349 --> 00:04:06.670
And I know that if you're listening right now and you're like, I had a baby 20 years ago, it doesn't matter how long ago it was, you need to hear this episode because what you're feeling today probably started back then, whenever that was.
00:04:06.990 --> 00:04:08.750
Oh my gosh, it's so good.
00:04:08.990 --> 00:04:12.750
And there are women who haven't had children, right?
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Right.
00:04:13.389 --> 00:04:17.469
But they've been struggling since they started their period, since menarchy.
00:04:17.629 --> 00:04:25.310
Like they've never felt their hormones have been in balance, especially if you've been diagnosed with PCOS, now called PMOS.
00:04:25.709 --> 00:04:28.430
Like this episode is for every woman.
00:04:28.589 --> 00:04:35.389
I think the foundational understanding has to be that things develop over time.
00:04:35.709 --> 00:04:36.029
Yeah.
00:04:36.350 --> 00:04:41.389
And they don't just automatically go away because time has lapsed.
00:04:41.469 --> 00:04:42.350
So exactly.
00:04:42.589 --> 00:04:52.110
I also feel like um when I was prepping for this episode, we've come really far in women's health for what they tell them after they give birth.
00:04:52.269 --> 00:05:01.550
So for example, um, my son started high school today, and I feel like just this year I really fixed my pelvic floor and I had a C-section.
00:05:01.790 --> 00:05:07.149
However, I have been blessed with three adult children from my husband, and so I have a grandson.
00:05:07.230 --> 00:05:12.189
And when my daughter-in-law gave birth, they sent her to PT the next week.
00:05:12.509 --> 00:05:14.990
And I was like, wait, you're going to PT already?
00:05:15.149 --> 00:05:16.750
I was like, this is amazing.
00:05:16.909 --> 00:05:19.069
So things really have changed.
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But those of us in, you know, like me, I've been struggling for 15 years.
00:05:24.750 --> 00:05:27.149
And so I'm so grateful that things have changed.
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But those of us who have been struggling, there's hope for us.
00:05:29.790 --> 00:05:30.829
We need to do stuff still.
00:05:30.909 --> 00:05:33.949
And it's okay to use the excuse of like I had a C-section.
00:05:34.829 --> 00:05:36.269
Thank you for sharing that.
00:05:36.430 --> 00:05:39.469
That is really important for women to understand.
00:05:39.629 --> 00:05:44.829
And I I have shared that my first delivery, I had a fourth degree tear.
00:05:45.149 --> 00:05:48.750
You ladies who have had issues like that, you know what that means.
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Yeah.
00:05:49.149 --> 00:05:53.230
You don't just bounce back, you don't, you're just not normal after that.
00:05:53.469 --> 00:05:59.149
And like you, there was no physical therapy, there was nothing, there was no exam.
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Like I got stitched up and sent on my way, and I've been struggling ever since.
00:06:04.670 --> 00:06:06.750
So we are making progress.
00:06:06.909 --> 00:06:08.589
I'm excited about that.
00:06:09.149 --> 00:06:19.709
But uh nobody's connecting the dots for women, nobody is helping them understand the uh significance of the postpartum period.
00:06:19.870 --> 00:06:21.870
And so we have a guest today.
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She is dropping an amazing book, The Postpartum Check In.
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I'm so excited because literally, this is not only for women who just had a baby, it's for all of us.
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Yes, it is.
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So I'm really excited.
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Oh my goodness.
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Dr.
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Alexandra, welcome to the podcast.
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Thank you so much.
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It's such a joy to be here.
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Oh my gosh.
00:06:46.990 --> 00:06:54.669
If anybody watched the Midlife Reset Summit that we put on last year, it was a five-day live virtual summit.
00:06:54.909 --> 00:06:56.589
You were an amazing guest.
00:06:56.829 --> 00:07:00.189
And um, by the way, that summit is still available.
00:07:00.269 --> 00:07:07.709
There is so much amazing content, like 50 experts talking about perimenopause from a faith perspective.
00:07:07.870 --> 00:07:09.149
Yes, so good.
00:07:09.310 --> 00:07:10.029
Oh my gosh.
00:07:10.189 --> 00:07:10.829
But Dr.
00:07:10.990 --> 00:07:22.990
McKillop was such a joy to have on that summit because we really talked about irregular periods and all the things women struggle with before going into menopause.
00:07:23.229 --> 00:07:26.509
But now she is serving a new audience.
00:07:26.750 --> 00:07:27.549
This is so good.
00:07:27.629 --> 00:07:30.189
Like she's all things baby infertility.
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But I really think like this book is going to bless all women, not just women who have just had a baby.
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Like you said, you're doing PT 15 years later.
00:07:42.990 --> 00:07:44.189
What the heck?
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It's okay.
00:07:45.149 --> 00:07:47.229
Things are good now, you know?
00:07:47.789 --> 00:07:50.430
He'll graduate high school and I'll graduate PT.
00:07:50.589 --> 00:07:51.310
It'll be great.
00:07:51.709 --> 00:07:52.509
Oh my gosh.
00:07:52.829 --> 00:07:53.149
Okay.
00:07:53.870 --> 00:07:55.629
So let's see.
00:07:55.870 --> 00:07:58.909
What made you write this book, Alexandra?
00:08:00.029 --> 00:08:03.709
Yeah, I the simple answer is all of my patients, right?
00:08:03.789 --> 00:08:13.709
You know, I see primarily women, and I joke that I don't send out screeners to prospective patients to say you have to be a woman in your 30s, 40s, 50s to be my patient.
00:08:13.870 --> 00:08:19.389
That's just kind of what happens because unfortunately a lot of people fall through the cracks, right, in the medical system.
00:08:19.549 --> 00:08:23.389
And so my patients will come and they'll tell me, hey, I've been struggling with this problem.
00:08:23.549 --> 00:08:29.149
And, you know, when you when you conduct a patient interview or you have that first appointment, you know, tell me when did this start?
00:08:29.310 --> 00:08:32.110
And so many times I was hearing the same thing over and over again.
00:08:32.269 --> 00:08:40.269
Well, you know, shortly after I had my first baby or after my last baby, or, you know, I had a baby later in life, and maybe it's related or not, I don't know.
00:08:40.509 --> 00:09:03.549
And I always uh it gave me pause to hear things like that from my patients because when I was in school, I was taught that the hormone shifts associated with pregnancy and childbirth or any hormonal shift in a in a woman or a female's life can predispose them to problems in other avenues of their health because our hormones talk to so many other parts of our bodies.
00:09:03.789 --> 00:09:20.590
And I started to realize wait a minute, if all these women are having problems that started around these major hormonal shifts in their lives and it's not getting diagnosed until now, it means that there is something majorly missing in postpartum care.
00:09:20.909 --> 00:09:35.070
So I took a look at some of what the current recommendations are and I started to find these really upsetting paradoxes where, for example, the American Thyroid Association would suggest, you know, a woman with antithyroid antibodies.
00:09:35.230 --> 00:09:39.389
So that corresponds to a condition called Hashimoto's, it's a thyroid disorder.
00:09:39.629 --> 00:09:48.830
If a woman has those antibodies, she should be tested for her thyroid function every month in the first half of her pregnancy and then postpartum.
00:09:48.909 --> 00:09:53.629
But they don't recommend broad screening of the population for antithyroid antibodies.
00:09:53.789 --> 00:10:02.110
And so I thought to myself, well, how is somebody supposed to know if they have antithyroid antibodies if it's not being screened routinely?
00:10:02.190 --> 00:10:14.110
And you know, in my world, I work in functional medicine, antithyroid antibodies, full thyroid panels, autoimmune screenings, nutritional screenings, that's like basic level intake, right?
00:10:14.350 --> 00:10:24.269
So in my vocabulary, I already know if you have antithyroid antibodies, but not every woman has the privilege of ever being seen by someone who's so thorough with their health.
00:10:24.430 --> 00:10:29.549
So I, you know, in my own experience, I have felt dismissed by medical providers.
00:10:29.629 --> 00:10:37.950
And because I'm a physician, I could advocate for myself, but not everybody can say that, and not everybody knows what they need to ask for.
00:10:38.190 --> 00:10:50.909
So I said to myself, hey, I'm gonna make a handbook for women who feel intuitively that something's not right with their health, but they they've been sort of dismissed by their providers, well-meaning providers, right?
00:10:50.990 --> 00:10:55.549
You know, we don't want to over-medicalize women and childbirth and hormone shifts.
00:10:56.110 --> 00:11:00.429
But that sometimes comes at the expense of catching very real health conditions.
00:11:00.590 --> 00:11:21.789
So I wrote this book, The Postpartum Check-in, to help women understand what's changing everywhere else in my body when my hormones change, and what do I need to be on the lookout for so that I could catch an emerging health problem earlier rather than having to wait a year or 10 years to get a diagnosis that's causing suffering in the meantime.
00:11:22.189 --> 00:11:22.990
Absolutely.
00:11:23.230 --> 00:11:29.230
So we joke about the fact that the intake form of our medical practice is like a hundred pages or something.
00:11:29.470 --> 00:11:31.470
I mean, it's not really, but it feels like it.
00:11:32.029 --> 00:11:52.110
And so much of it is your female history, not only like when did you start your period, how are they, what kind of birth control history have you had, but like details of your pregnancies, not only how you had your baby, but what kind of diagnoses did you have?
00:11:52.269 --> 00:12:08.189
Because if you've had preterm labor, if you've had pre-eclampsia, gestational diabetes, thyroid disease, we know as functional providers that that is currently potentially impacting your health right now and going forward.
00:12:08.350 --> 00:12:14.590
So I would love to talk about this because I think some women are probably going to be really surprised hearing this today.
00:12:14.829 --> 00:12:22.429
Something as simple as I had gestational diabetes, but it was diet controlled, and they told me not to worry about it.
00:12:22.590 --> 00:12:33.069
And we're supposed to do a glucose challenge test after delivery, but by and large, that is not being done, right?
00:12:34.990 --> 00:12:35.309
Yeah.
00:12:35.629 --> 00:12:42.269
Yeah, I've I've never had a patient who even had that appropriate a follow-up after a pregnancy condition.
00:12:42.350 --> 00:12:48.750
You know, we focus so much on the imminent sort of acute illnesses that can pop up postpartum.
00:12:48.829 --> 00:12:50.750
And obviously, we need to be aware of those things.
00:12:50.909 --> 00:12:53.149
Postpartum preclampsia, for example.
00:12:53.389 --> 00:13:05.549
You know, those are urgent, but we miss the things that are chronic and affect quality of life or predispose to some of these other diseases that do eventually become urgent.
00:13:05.949 --> 00:13:10.909
I feel like we do so many doctors' appointments when we're pregnant, and especially towards the end.
00:13:11.069 --> 00:13:12.909
And then it's like, we'll see you in six weeks.
00:13:12.990 --> 00:13:14.909
And then it's like, hey, I hope everything's good.
00:13:15.069 --> 00:13:15.789
Good luck out there.
00:13:15.949 --> 00:13:17.949
And I it's so it's so wild to me.
00:13:18.029 --> 00:13:21.870
You get all this attention, and then you finally give birth, and then there isn't any attention.
00:13:22.029 --> 00:13:26.590
The attention's all on the baby, which is important, but you are important too.
00:13:26.909 --> 00:13:37.069
Yeah, I think that's part of the struggle, is that all of a sudden you're going to the pediatrician every week, you know, so you still have doctor's appointments, but they're no longer focused on you.
00:13:37.309 --> 00:13:38.110
Yeah, that's so true.
00:13:38.429 --> 00:13:41.710
And so, yes, things get forgotten.
00:13:41.870 --> 00:13:51.069
And I have seen countless times women who they should have had their thyroid medication adjusted and it didn't happen, right?
00:13:51.309 --> 00:14:02.669
So I would love for you to talk about like what are the biggest things on this checklist that women probably don't realize they need to even know about.
00:14:03.789 --> 00:14:04.669
Yeah, yeah.
00:14:04.909 --> 00:14:08.110
So that I outline um a handful of conditions in the book.
00:14:08.269 --> 00:14:28.829
Those would be autoimmune disorders, which can pop up postpartum or around other major hormone shifts, thyroid disorders, insulin resistance being one of them, nutritional uh deficiencies or other types of problems, sometimes overdoing it with certain nutrients, um, and then mood challenges.
00:14:28.909 --> 00:14:37.230
Um, so things like postpartum anxiety, postpartum depression, um, which can be exacerbated by all those other conditions and and the like.
00:14:37.789 --> 00:14:39.069
Oh my gosh.
00:14:39.629 --> 00:14:44.590
Depression and anxiety, I saw that all the time in my postpartum patients.
00:14:44.750 --> 00:14:53.069
I remember one woman in particular, she was at her six-week checkup, and she just wanted to divorce her husband.
00:14:53.230 --> 00:14:57.870
And this was a woman who was in her 20s and she loved her husband.
00:14:58.029 --> 00:15:09.710
They were like the most beautiful little couple, but it was their second baby, and she was like, I don't want to look at him, I don't want to touch him, I make him sleep in the living room.
00:15:09.870 --> 00:15:14.269
And I was just like so dumbfounded, like, what happened?
00:15:14.509 --> 00:15:18.350
He's been at all the appointments, like they're so happy.
00:15:18.669 --> 00:15:24.029
And something inside of me realized, okay, she's breastfeeding.
00:15:24.189 --> 00:15:30.829
She's on the quote unquote mini pill, which is progestin only, because you can't have estrogen when you're breastfeeding.
00:15:30.990 --> 00:15:34.909
And I just thought, we should check your testosterone level.
00:15:35.389 --> 00:15:42.829
And I was like, okay, don't do anything drastic, just don't even talk to your husband until we get this level back because I'm really curious.
00:15:42.990 --> 00:15:52.829
And she had like zero testosterone, and I just something inside me knew that this was contributing to the way that she was feeling.
00:15:53.069 --> 00:16:00.829
And most doctors would have just called it depression, given her zole loft, and you know, sent her on her way.
00:16:01.230 --> 00:16:12.029
But I was like, let's try to get you off this progestin, let's do a paragraph IUD with no hormones and see if your ovaries come back online and start producing.
00:16:12.429 --> 00:16:16.429
And I'm telling you, I believe that saved her marriage.
00:16:16.509 --> 00:16:25.949
And it, or at least it definitely saved her at least a year of her life being miserable and creating damage in her relationship.
00:16:26.189 --> 00:16:30.429
And I I just I've never forgot that lesson.
00:16:30.669 --> 00:16:42.189
So I'm so excited that you are sharing this message with the world because women need to understand like it is not necessarily what we think it is, right?
00:16:43.149 --> 00:16:44.750
Yeah, absolutely.
00:16:45.309 --> 00:16:59.069
You have to look deeper, you have to connect the dots and remember, as you brought up, you know, in in the beginning here, that history of your health and how that all predisposes your health to evolve over time, right?
00:16:59.629 --> 00:17:09.069
Yeah, so okay, we got this checklist, we we know that we need to look at the different systems, but how do these manifest?
00:17:09.549 --> 00:17:16.190
So, say somebody had gestational diabetes, they had their baby, they're living their life.
00:17:16.350 --> 00:17:19.950
What do we start to see creep in or happen?
00:17:20.670 --> 00:17:21.069
Yeah.
00:17:21.309 --> 00:17:28.029
So one of the big things we want to be on the lookout for with gestational diabetes is potentially that insulin resistance.
00:17:28.350 --> 00:17:32.829
Insulin resistance all always occurs to a to a small degree during pregnancy.
00:17:32.910 --> 00:17:40.190
It's part of the physiology of growing a baby and putting on body fat during pregnancy, but that's supposed to go away when you get rid of the placenta.
00:17:40.269 --> 00:17:43.950
So placenta delivery, I am also delivering away my insulin resistance.
00:17:44.190 --> 00:17:50.750
Well, if that doesn't happen, then we we continue to feel those symptoms associated with insulin resistance.
00:17:50.910 --> 00:18:12.990
So difficulty losing weight or weight fluctuations that don't make sense, potentially irregular cravings, um, signs of inflammation, so swelling, redness, sometimes we see hot flashes, or a woman may have downstream effects of that insulin resistance and its impact on production of ovarian hormones, thyroid hormones, adrenal hormones.
00:18:13.069 --> 00:18:20.750
So we see things like fatigue, extreme fatigue, um, the type of fatigue where people say it's like my batteries were taken out.
00:18:20.829 --> 00:18:23.950
You know, I sleep and I don't feel more energized, right?
00:18:24.029 --> 00:18:28.590
It's a different sort of sleeplessness or different sort of fatigue from sleeplessness, right?
00:18:28.910 --> 00:18:30.110
Um so things like that.
00:18:30.269 --> 00:18:46.990
And, you know, women, women should feel differently as a new parent compared to how they did before, but there's always going to be some um degree where we know intuitively for ourselves that, hey, this is this is different from what normal feels like, right?
00:18:47.150 --> 00:18:53.630
I feel like something is off versus I just notice that my my body has changed or my life has changed, right?
00:18:54.029 --> 00:19:09.950
Um so what we want to do with someone with those symptoms is we want to say, hey, okay, we recognize that many postpartum symptoms are normal, but we don't want to take for granted that they're normal just because they may commonly occur in a given population.
00:19:10.110 --> 00:19:16.509
And then so we want to do some testing to take a look at how your body is functioning in that situation.
00:19:16.670 --> 00:19:26.990
And that's true of any of the postpartum conditions that could be triggered by pregnancy and childbirth and hormone shifts, or that could persist for a long time following postpartum.
00:19:27.150 --> 00:19:33.389
And we want to have a plan to say, hey, we're gonna screen people so that um nothing slips through the cracks.
00:19:34.109 --> 00:19:39.230
Real quick, I just want to interrupt this conversation for something super important.
00:19:40.190 --> 00:19:50.509
Even though we need to take care of ourselves spiritually, emotionally, and physically, we do have to take care of ourselves at a cellular level.
00:19:50.670 --> 00:19:54.029
And that is why I have my Fast to Face supplement line.
00:19:54.109 --> 00:20:02.190
So let's just take a minute to hear about something that might be the game changer that you need in this season.
00:20:02.670 --> 00:20:06.829
We really need to up-level how we're taking care of our temple.
00:20:06.910 --> 00:20:10.990
I used to treat mine like a garbage can, I will just be honest.
00:20:11.309 --> 00:20:13.869
And I'm not okay with that anymore.
00:20:14.109 --> 00:20:29.869
So this is one of the most important things to me, is that I'm taking high-quality supplements that are actually doing what they say they're doing, and I'm getting my money's worth, and I'm not making my body worse by putting the wrong stuff in it.
00:20:29.950 --> 00:20:39.470
So let's talk about Hormone Tame Essential Multivitamin, because even though it gives you all the vitamins and minerals you need, there's extra goodness in there, isn't there?
00:20:39.549 --> 00:20:41.470
I think you have a bottle sitting next to you.
00:20:42.190 --> 00:20:43.629
Tell us about Hormone Tame.
00:20:43.869 --> 00:20:46.269
Hormone Tame is five products in one.
00:20:46.349 --> 00:20:55.150
Um, if you listen to the the other episode, one of the things that we talked about is oftentimes, you know, women are just people were taking a lot of supplements.
00:20:55.389 --> 00:21:07.230
And the nice thing about a lot of the um supplements that we have here at Fast of Faith is that they're just so consolidated, where you could take this and you are basically taking five products.
00:21:07.470 --> 00:21:10.829
So, yes, this is gonna be a multivitamin, but there is so much more.
00:21:10.910 --> 00:21:14.670
We actually kind of refer to it as a multivitamin on um steroids.
00:21:14.910 --> 00:21:18.670
One of the key things that this is gonna be helping is your mitochondria.
00:21:18.990 --> 00:21:25.789
All you need to know is that they are responsible for so many systems and processes in your body.
00:21:25.950 --> 00:21:32.509
The reason that we need supplements is because we're just supplementing areas that we just can't really kind of get with our food.
00:21:32.589 --> 00:21:34.269
So we're filling in those gaps.
00:21:34.430 --> 00:21:39.950
And so hormone tame is inviting the body to just fill in all of those gaps.
00:21:40.109 --> 00:21:43.710
So you gotta fill those gaps, and hormone tame it will help to do that.
00:21:45.710 --> 00:21:46.829
Yeah, absolutely.
00:21:46.990 --> 00:22:00.829
I want to hear about pre-eclampsia, gestational hypertension, because that often um gets diagnosed, it affects their delivery.
00:22:00.990 --> 00:22:04.829
A lot of women get induced because oh, my blood pressure went up.
00:22:04.990 --> 00:22:12.990
They said I have to deliver the baby, they get induced, and then nobody really talks about it again after the postpartum period.
00:22:13.069 --> 00:22:18.670
And it's it is actually a risk factor for cardiovascular disease in the future.
00:22:18.910 --> 00:22:30.349
You need to remember that you had a blood pressure issue, that your cardiovascular system couldn't handle the pregnancy as healthy as it should have, right?
00:22:30.509 --> 00:22:33.629
So, what do we do in in that scenario?
00:22:34.430 --> 00:22:37.069
Yeah, so many things, right?
00:22:37.230 --> 00:22:56.109
So we we don't want to fall into a situation where we say, oh, you know, it's it's your fault that you didn't do something right during pregnancy and this developed, but we do know that there are certain predisposing factors during pregnancy that lead to the development of these conditions of pregnancy, pre-eclampsia, hypertension of pregnancy.
00:22:56.269 --> 00:23:03.789
And if we don't address those risk factors, then they are the same things that will cause cardiovascular disease later in life, right?
00:23:03.950 --> 00:23:11.309
It's sort of this early red flag warning sign, like something's not happy in your body that we need to take another look at.
00:23:11.389 --> 00:23:16.509
Um and if we don't take a look at it, then you're on this trajectory for that development of chronic disease.
00:23:16.829 --> 00:23:25.389
We even have studies that that show a relationship between nutritional insufficiency during pregnancy and the development of some of these conditions.
00:23:25.629 --> 00:23:28.990
And those are the same relationships that we see for cardiovascular disease.
00:23:29.069 --> 00:23:43.549
So, for example, deficiencies of micronutrients, things like magnesium and zinc, potentially even iron and B vitamins, as well as antioxidants as those predispose to development of nitrous oxide and just other things that regulate our blood pressure.
00:23:43.710 --> 00:23:48.910
Sometimes it's an exercise-related anti inflammatory type of control issue.
00:23:48.990 --> 00:24:00.589
So we don't have the healthy lifestyle strategies in place, and our health is suffering when we're under increased demands of pregnancy, and then those can predispose to later in life as well.
00:24:00.829 --> 00:24:17.470
You know, when I was in school, we when we were talking about joint pain, you know, this is a little bit of an aside, but make Said pain develops or injury develops to a joint when you have a healthy joint with an abnormal stress or a normal stress on an abnormal joint, and then you can potentially injure that joint, right?
00:24:17.629 --> 00:24:25.230
And I think it applies to physiology in the scenarios of pregnancy or even perimenopause as things are acutely shifting.
00:24:25.470 --> 00:24:39.629
You know, if you have an abnormal or unhealthy lifestyle behavior applied to a healthy body, over time that's going to lead to metabolic injury, or you could have a normal stress applied to an abnormal state.
00:24:39.789 --> 00:24:41.789
So pregnancy is not our typical state.
00:24:41.950 --> 00:24:45.629
The acute fluctuations of perimenopause are not our typical state.
00:24:45.869 --> 00:24:50.990
If we combine those two things, then we're going to potentially have this abnormality present itself.
00:24:51.150 --> 00:25:03.710
And so we get a little peek into the window of what can our body handle by putting it under this acute stress like we see in pregnancy or a major hormone shift as a clue to what we could expect potentially later in life.
00:25:04.430 --> 00:25:06.029
It's almost like a stress test.
00:25:06.589 --> 00:25:09.230
It it absolutely is, 100%.
00:25:09.789 --> 00:25:16.029
It is a stress test, and we need to pay attention to the results of that test for sure.
00:25:16.190 --> 00:25:46.829
I'm just having flashbacks of so many patients, and it's heartbreaking to me because even though OBGYNs have gotten to the point where we now test vitamin D at the beginning of pregnancy and we test um hemoglobin looking indirectly for low iron or anemia, we still don't do a good job at actually helping replace those vitamin and mineral deficiencies.
00:25:46.990 --> 00:25:52.190
We don't ask the question, why is this happening and what can we do about it?
00:25:52.349 --> 00:26:00.589
We just say, go to your local CVS and get some iron over the counter or get a vitamin D supplement.
00:26:00.750 --> 00:26:08.190
Like we really do not understand as OBGYNs the physiology that is happening.
00:26:17.549 --> 00:26:20.670
Like there is this disconnect still happening.
00:26:20.910 --> 00:26:33.150
So I just find your book really, really important and really essential for women to understand that we're we're talking to a sick care medical system.
00:26:33.710 --> 00:26:38.430
And by and large, pregnancy is a healthy state.
00:26:39.309 --> 00:26:45.230
It is a physiological stress, but our body should be able to handle it.
00:26:45.549 --> 00:26:50.589
And we need to come at it from like, okay, we can naturally support it.
00:26:50.750 --> 00:26:55.389
We need our diet to be evaluated and changed, probably.
00:26:55.549 --> 00:26:57.789
We need to talk about environmental things.
00:26:57.950 --> 00:27:00.589
We need to talk about all these things, right?
00:27:01.069 --> 00:27:05.069
So we could go into that, that would be a whole nother episode.
00:27:05.309 --> 00:27:16.349
But I would love for you to also talk about the thyroid, because I would say the big three are gestational hypertension, di preclampsia, gestational diabetes, and then thyroid.
00:27:16.509 --> 00:27:33.789
You mentioned like the majority of women are not getting thyroid antibody levels checked, and that just you know angers me because I developed Hashimoto's after my pregnancy and delivery at 17, and it has affected my entire life.
00:27:34.109 --> 00:27:40.269
Thankfully, my doctor was a DO and he knew to check antibody levels.
00:27:40.430 --> 00:27:48.509
Um, back in the day, DOs actually didn't practice like MDs, they were very much mine, body, and soul.
00:27:48.670 --> 00:27:53.470
And so I feel blessed that he actually gave me that diagnosis.
00:27:53.710 --> 00:28:06.269
But you're right, there are probably millions of women who develop this autoimmune condition from postpartum and no one's telling them, right?
00:28:06.430 --> 00:28:08.190
So can you talk about that?
00:28:09.309 --> 00:28:10.109
Yeah, yeah.
00:28:10.269 --> 00:28:17.629
So a big part of my practice in general, but especially in the postpartum period, is to do those early thyroid screenings.
00:28:17.710 --> 00:28:37.950
Now, there is a sub-demographic of women who get a little extra thyroid care, and that's the IVF community because many of them are put on thyroid medication because we know in the research how essential proper levels of thyroid hormone are for conception and sustaining a pregnancy.
00:28:38.109 --> 00:28:45.549
I'm digressing a little bit, but the majority of people maybe don't get that active care pre-conception.
00:28:45.629 --> 00:28:47.710
They don't really know what's going on with their thyroid.
00:28:47.869 --> 00:29:02.269
Now, we do have a standard screening around the end of the first trimester to test, you know, how's your thyroid doing and whether or not those those lab ranges are sufficient to capture all thyroid conditions is a different story for a different time.
00:29:02.509 --> 00:29:12.670
But let's say that a woman has a standard pregnancy, she conceives without additional medical intervention, she carries her pregnancy to term, she was never put on thyroid medication during her pregnancy.
00:29:12.910 --> 00:29:14.910
Nobody looks at her thyroid again, right?
00:29:15.069 --> 00:29:26.990
There is no standard plan in the world of obstetric medicine to follow up with a normal pregnancy, a normal, uncomplicated conception, pregnancy, and delivery to look at her thyroid.
00:29:27.309 --> 00:29:32.750
Unless she develops really overt symptoms or she goes in and she's advocating for herself, asking for it.
00:29:33.069 --> 00:29:42.910
But those thyroid uh symptoms, thyroid-related symptoms, include anything from weight changes, fatigue, hair loss, right?
00:29:43.470 --> 00:29:49.470
And just to share from my own experience, um, I I alluded to this a little bit earlier, and I definitely talk about it in my book.
00:29:49.710 --> 00:29:53.069
I developed postpartum thyroiditis and I knew what it was, right?
00:29:53.230 --> 00:30:00.910
So when I went into my primary care office and I and I was explaining this to my provider, um, I already knew what I needed to have tested.
00:30:00.990 --> 00:30:04.509
I knew what I needed as far as follow-up, I needed some laps done ultimately.
00:30:04.750 --> 00:30:12.670
And um what she first said to me when I said, Look, I'm so tired and I know something's off, she goes, Well, of course you're tired, you just had a baby.
00:30:12.910 --> 00:30:14.750
That's not what I was talking about, right?
00:30:14.910 --> 00:30:15.629
Of course you're tired.
00:30:15.789 --> 00:30:20.670
Sleeplessness and and deep bone aching fatigue are not the same thing.
00:30:20.910 --> 00:30:29.470
And not everybody knows to be able to differentiate among those things because if you look online at normal postpartum symptoms, they could list anything, right?
00:30:29.549 --> 00:30:30.829
I mean, I I almost laughed.
00:30:30.910 --> 00:30:37.309
The Cleveland Clinic listed things as vague as pain on their list of normal postpartum symptoms.
00:30:37.549 --> 00:30:38.430
What kind of pain?
00:30:38.589 --> 00:30:39.470
Where is the pain?
00:30:39.629 --> 00:30:40.829
What does the pain feel like?
00:30:40.990 --> 00:30:42.029
How long has it been there?
00:30:42.190 --> 00:30:43.069
When did it start?
00:30:43.230 --> 00:30:48.910
Like that could be I have appendicitis, or it could be I bumped my elbow while I was walking through the hallway.
00:30:49.069 --> 00:30:50.109
You know what I mean?
00:30:50.349 --> 00:31:02.190
It's it's frightening actually how normalization of so many of these intense postpartum experiences could lead someone to just think their thyroid blowing up on them postpartum is normal.
00:31:02.509 --> 00:31:18.589
So, what what should a woman do postpartum is they should ask for, and that's what I advocate for in my book, is to be the standard to look for the full thyroid panel, including free and total T3, free and total T4, TSH, and then those thyroid antibodies.
00:31:18.910 --> 00:31:28.670
Pregnancy is one of the unique times in a woman's life because not only is there the hormone shift, but there's the immune system shift as well, and then the nutritional demands.
00:31:28.829 --> 00:31:37.389
So you're kind of at risk of developing, really three or four, depending on how you look at it, different types of thyroid disorders because of this postpartum condition.
00:31:37.549 --> 00:31:44.109
And if you never have that diagnosed in that acute postpartum time, you're gonna be dealing with a thyroid issue for the rest of your life.
00:31:44.430 --> 00:31:58.509
And then it, you know, let's say you enter perimenopause and you have this another, another heightened hormonal experience and you start to feel really out of sorts, and someone then sell tells you, well, that's normal for perimenopause, right?
00:31:58.670 --> 00:32:06.269
What are you supposed to do with that if you don't, if you're not equipped with the tools to get what you need for appropriate health care.
00:32:09.789 --> 00:32:10.269
Yeah.
00:32:10.430 --> 00:32:12.269
So what are you thinking, Ashley?
00:32:12.349 --> 00:32:17.629
You're like, oh my gosh, I haven't even checked this, or do you feel like you got a good workup?
00:32:17.789 --> 00:32:30.750
Or yeah, so here's actually what I'm thinking about is all the women that we serve and all the women who are who listen to our podcast or participate in Fast of Faith, sometimes we silo things.
00:32:30.910 --> 00:32:44.190
So we talk about this a lot here on the podcast about how it's important when you're working with us at the medical practice, that even if you go to the dentist and they you have to get a cavity filled or they want to put you on antibiotics that you let us know.
00:32:44.349 --> 00:32:59.629
And so I look at this as we have to stop siloing what happened in our pregnancies, even though some people listening to this that was 30 years ago, they need to tell their now primary care, they're probably not going to the same OB that they did 30 years ago.
00:32:59.789 --> 00:33:07.950
So they need to tell their primary care or whoever they're seeing, even if it's a functional doctor, what is happen what happened during their pregnancy.
00:33:08.029 --> 00:33:16.109
That is why we have them fill out that 45-minute um intake form because we want to know what happened in your pregnancies because it does matter.
00:33:16.349 --> 00:33:17.549
All these things impact.
00:33:17.629 --> 00:33:28.430
So that's what I'm thinking about is we have to stop siloing our health care and we have to let the doctors that are serving us now, 30 years later, know what happened to us.
00:33:28.750 --> 00:33:29.629
That's so good.
00:33:29.789 --> 00:33:30.670
Oh my goodness.
00:33:30.910 --> 00:33:31.230
Yeah.
00:33:31.389 --> 00:33:35.710
Whatever you're struggling with right now, it didn't just start right now.
00:33:36.109 --> 00:33:37.789
It didn't just start with perimenopause.
00:33:38.029 --> 00:33:46.190
I guarantee that if you're listening to this and you've got a group of perimenopause friends like I do, I'm thinking about like, I know you had pre-clampsia.
00:33:46.269 --> 00:33:48.109
I know you had gestational diabetes.
00:33:48.269 --> 00:33:49.869
Like, you actually still talk about it.
00:33:49.950 --> 00:33:51.710
And you know, I'm like, oh crap.
00:33:51.869 --> 00:33:53.389
Like they need to do this.
00:33:53.629 --> 00:34:06.990
So I feel like we should end with a fun little like rapid fire game where we ask Alexandria a question, and um it's something that women experience after the babies, and you can tell us is it normal?
00:34:07.150 --> 00:34:10.670
Is it common but deserves attention, or does it need evaluation?
00:34:10.829 --> 00:34:11.550
How does that sound?
00:34:11.789 --> 00:34:12.670
That would be amazing.
00:34:12.829 --> 00:34:13.230
Let's go.
00:34:13.630 --> 00:34:14.829
All right, are you ready?
00:34:15.070 --> 00:34:18.430
All right, so exhaustion after having a newborn.
00:34:19.470 --> 00:34:20.269
Oh my.
00:34:20.430 --> 00:34:24.349
Uh, I think that category of could be normal but needs evaluation.
00:34:24.590 --> 00:34:25.630
All right, I love it.
00:34:25.789 --> 00:34:26.030
Okay.
00:34:26.430 --> 00:34:29.150
Exhaustion that persists for years.
00:34:29.950 --> 00:34:31.150
Never normal.
00:34:31.789 --> 00:34:35.150
Some urinary leakage immediately postpartum.
00:34:36.110 --> 00:34:36.430
Okay.
00:34:36.750 --> 00:34:38.269
So common, never normal.
00:34:38.430 --> 00:34:41.309
Everybody should be allowed to have this evaluated right away.
00:34:41.470 --> 00:34:44.030
I'll just add my additional qualifiers on there.
00:34:44.349 --> 00:34:44.670
All right.
00:34:44.750 --> 00:34:48.430
So still leaking every time you sneeze 15 years later.
00:34:50.269 --> 00:34:50.590
No.
00:34:54.110 --> 00:34:56.430
Temporary postpartum hair shedding.
00:34:57.950 --> 00:35:01.550
Potentially normal, depending on the magnitude and the type.
00:35:01.710 --> 00:35:07.869
You know, if it's a little bit around the hairline and it is self-limited within a couple of weeks, probably normal.
00:35:07.950 --> 00:35:13.389
If it persists, if it's patchy, if it's diffuse throughout the scalp, uh, definitely needs a workup.
00:35:13.789 --> 00:35:17.150
Okay, so what if it's been 30 years and my hair never recovered?
00:35:18.269 --> 00:35:19.070
Not normal.
00:35:19.230 --> 00:35:23.070
Usually an additional layer of consideration needs to be taken.
00:35:23.389 --> 00:35:23.710
All right.
00:35:24.269 --> 00:35:24.750
Mood changes.
00:35:25.070 --> 00:35:26.510
Your hair looks beautiful though.
00:35:27.389 --> 00:35:27.869
Thank you.
00:35:28.110 --> 00:35:31.550
Mood changes during a major hormonal and life transition.
00:35:32.430 --> 00:35:35.150
Yeah, so of course that's going to take an emotional toll.
00:35:35.230 --> 00:35:36.349
There's a spiritual toll.
00:35:36.590 --> 00:35:47.550
The baby blues are differentiated from postpartum depression by the amount of time, so they should, you know, resolve within two weeks and not persist longer than that, and it's that first two weeks.
00:35:47.789 --> 00:35:54.829
Mood shifts that are profound that develop sometime thereafter definitely need to be evaluated.
00:35:57.070 --> 00:35:57.630
Awesome.
00:35:57.789 --> 00:35:59.950
And you mentioned the spiritual health, and I think that's how Dr.
00:36:00.030 --> 00:36:02.110
Tapitha's gonna wrap us up here today.
00:36:02.590 --> 00:36:03.389
Oh my gosh.
00:36:03.710 --> 00:36:06.990
Do you want to say anything before we close?
00:36:09.550 --> 00:36:16.349
On the note of spiritual health, I just um I feel very strongly that God made our bodies with wisdom.
00:36:16.429 --> 00:36:25.630
Um, I don't think he makes mistakes, and he also allows us the tools that we need to be able to sense, hey, there's a disconnect somewhere here.
00:36:25.710 --> 00:36:35.389
And so I just think that in my study of medicine, it has just led to worship of our creator and his incredible design, his wisdom, his intelligence, and his love for us.
00:36:36.030 --> 00:36:38.110
Oh, amen, girl.
00:36:38.269 --> 00:36:38.909
I love that.
00:36:39.070 --> 00:36:39.949
That is so good.
00:36:40.190 --> 00:36:45.389
Yeah, and go and get um your book because I will be buying it for everyone who gives birth in the future.
00:36:45.469 --> 00:36:48.269
And I might even buy it for my Perimenopause friends.
00:36:48.909 --> 00:36:49.630
I love it.
00:36:49.949 --> 00:36:50.509
So good.
00:36:50.670 --> 00:36:52.909
Yes, the link is in the show notes.
00:36:53.070 --> 00:36:54.670
Get your postpartum check-in.
00:36:55.309 --> 00:37:00.429
But I want to leave you with this scripture to meditate on this week.
00:37:01.309 --> 00:37:03.230
Psalm is so beautiful.
00:37:03.389 --> 00:37:07.550
Um, 139, Psalm 139, 13, and 14.
00:37:07.869 --> 00:37:12.989
I want you to just really talk to God about this because um Dr.
00:37:13.150 --> 00:37:15.150
Alexandra is correct.
00:37:15.469 --> 00:37:19.070
For you are created my inmost being.
00:37:19.309 --> 00:37:21.949
You knit me together in my mother's womb.
00:37:22.110 --> 00:37:26.030
I praise you because I am fearfully and wonderfully made.
00:37:26.269 --> 00:37:30.590
Your works are wonderful, and I know that full well.
00:37:30.909 --> 00:37:48.030
If you start believing that your body is full of wisdom and intelligence, and it was made so beautifully and designed to actually get you through and thrive, not just survive, you will start to shift and show up differently.
00:37:48.269 --> 00:37:52.030
You will stop carrying disease and you will start healing.
00:37:52.269 --> 00:38:03.550
So I pray that you meditate on that scripture this week and really just thank God for the body that He gave you because it is beautifully and wonderfully made.
00:38:03.789 --> 00:38:04.590
Thank you, Dr.
00:38:04.750 --> 00:38:05.789
Alexandra.
00:38:06.030 --> 00:38:06.750
Thank you so much.
00:38:06.829 --> 00:38:08.030
Have a good week, ladies.
00:38:08.269 --> 00:38:09.070
Thank you.
00:38:14.509 --> 00:38:18.909
If you like that episode, I have one favor to ask, maybe two.
00:38:19.309 --> 00:38:23.070
Can you hit subscribe and give me a heart?
00:38:23.230 --> 00:38:30.829
I want Apple to know that this is important information to you because when we tell them that, you will get more of it.
00:38:30.989 --> 00:38:32.670
So use your voice.
00:38:32.829 --> 00:38:37.710
Hit subscribe, hit the like button, share with a friend.
00:38:37.949 --> 00:38:43.309
And the other thing, I want you to download the five day challenge and get started on it.
00:38:43.469 --> 00:38:44.989
Take imperfect action.
00:38:45.150 --> 00:38:47.389
I will see you in the Fast of Faith Sisterhood.
00:38:47.550 --> 00:38:48.509
Till next time.