Clearing the Haze: Naturopathic Approaches to Addressing Postpartum Brain Fog

The journey from pregnancy to parenthood is a transformative experience, filled with joy, challenges, and profound changes within the body. During pregnancy and the postpartum period, the body undergoes significant hormonal changes that affect neurotransmitter levels within the body. Estrogen is a hormone that is known to influence our serotonin levels (ie. the natural “feel-good” chemical), which affects mood and cognition. Throughout pregnancy, estrogen levels are at an all-time high; during the postpartum period estrogen levels decrease, which leads to mood swings, symptoms of anxiety, and cognitive difficulties…commonly referred to as postpartum brain fog. However, other factors can contribute to a decrease in cognitive function (hello, sleep deprivation and stress!), so it is important to keep things in perspective.

As naturopathic doctors, we look at the intricate web of factors contributing to the postpartum brain fog phenomenon and offer holistic approaches to support cognitive function and overall wellbeing during this important time. One of our main goals is to address the root cause and support overall health through personalized, comprehensive care. Here are some ways we can help:

Addressing Hormonal Imbalances

This is a fundamental aspect of naturopathic medicine and care. Hormonal imbalances can include things like decreased estrogen levels, but also things like thyroid dysfunction or adrenal fatigue. It is important to discern where the impairment in cognitive function stems from so that an appropriate treatment plan can be formulated for your individualized needs. NDs can run functional lab testing to pinpoint the root causes of your brain fog; as well, we are also able to requisition common (and naturopathic-specific) blood tests to dig deeper and get a clearer picture of what is going on in your body.

Nutritional Support

Ensuring proper nutritional intake is essential to both maternal and child health during the pregnancy and postpartum period. Proper nutrition also plays a vital role in supporting cognitive function. When discussing nutrition for cognitive health we want to emphasize an anti-inflammatory diet and increase the consumption of whole grains, fruits, vegetables, and healthy fats to lower inflammation levels within the body. Omega-3 fatty acids (found in fish oil and flax seed) are particularly important for maintaining healthy neurotransmitter levels.

Lifestyle Changes

Cortisol is a stress hormone released by the adrenal glands and helps your body deal with stressful situations. Cortisol levels within the body tend to decrease during the postpartum period due to sleep deprivation and an increase in stress levels, so we want to find that sweet spot where you can function optimally without living in “fight-or-flight” mode.

• Practicing mindfulness and stress reduction techniques such as deep breathing exercises or meditation can help manage the mental load of parenting.

• Engaging in regular physical activity (with your medical provider’s clearance) can also help enhance mood levels and cognitive function by increasing blood flow to the brain. It doesn’t have to be complicated – walking, yoga, and impromptu dance parties are good for the body AND the spirit!

• Aiming to establish a sleep routine and seeking support from family and friends can also alleviate the burden of sleep deprivation and stress. Sleep during this period is undoubtedly unpredictable, so any measures you can take to create good sleep hygiene is essential for success. Harvard’s Stress and Development Lab has a useful checklist you can use to help set up better habits.

Parenthood is a very exciting and joyful time for most people, but it can also be a stressful and disheartening experience. We understand the underlying factors of postpartum brain fog and employ holistic approaches to help support new parents in reclaiming their cognitive function and enhance their overall well-being. In the simplest terms – we are here to help you survive AND thrive.

Yours in good health,

Dr. Sami Leung, ND

1. Aparicio, E., Jardí, C., Bedmar, C., Pallejà, M., Basora, J., & Arija, V. (2020). Nutrient Intake During Pregnancy and Post-Partum: ECLIPSES Study. Nutrients, 12(5), 1325. https://doi.org/10.3390/nu12051325

2. Ball, L., De Jersey, S., Parkinson, J., Vincze, L., & Wilkinson, S. (2022). Postpartum Nutrition: Guidance for General Practitioners to Support High-Quality Care. Australian Journal of General Practice, 51(3), 123–128. https://doi.org/10.31128/ajgp-09-21-6151

3. Barba-Müller, E., Craddock, S., Carmona, S., & Hoekzema, E. (2018). Brain Plasticity in Pregnancy and the Postpartum Period: Links to Maternal Caregiving and Mental Health. Archives of Women’s Mental Health, 22(2), 289–299. https://doi.org/10.1007/s00737-018-0889-z

4. Buckwalter, J. G., Buckwalter, D. K., Bluestein, B. W., & Stanczyk, F. Z. (2001). Chapter 22 Pregnancy and Postpartum: Changes in Cognition and Mood. Progress in Brain Research, 303–319. https://doi.org/10.1016/s0079-6123(01)33023-6

5. Deems, N. P., & Leuner, B. (2020). Pregnancy, Postpartum and Parity: Resilience and Vulnerability in Brain Health and Disease. Frontiers in Neuroendocrinology, 57, 100820. https://doi.org/10.1016/j.yfrne.2020.100820

6. Guo, Y., Kehoe, P., Pimentel, P., Rousseau, J., Axelin, A., Rahmani, A. M., & Dutt, N. (2021). Exercise and Stress in At-Risk Women During Pregnancy and Postpartum. MCN: The American Journal of Maternal/Child Nursing, 46(4), 217–222. https://doi.org/10.1097/nmc.0000000000000722

7. McGrattan, A. M., McGuinness, B., McKinley, M. C., Kee, F., Passmore, P., Woodside, J. V., & McEvoy, C. T. (2019). Diet and Inflammation in Cognitive Ageing and Alzheimer’s Disease. Current Nutrition Reports, 8(2), 53–65. https://doi.org/10.1007/s13668-019-0271-4

8. Qiu, T., Wen, H., Liu, Z.-X., Pan, X.-P., & Zeng, T. (2021). Investigation Regarding Early Cognitive Function of Women in the Postpartum Period and the Analysis of Influencing Factors. Risk Management and Healthcare Policy, Volume 14, 3747–3754. https://doi.org/10.2147/rmhp.s309553

Your Health, Your Comfort: Embracing a Scent-Free Environment

We talk a lot about keeping our clinic a scent-free space, but we thought it would be important to explain the reason WHY. You may be thinking, “I don’t wear perfume”, but you may be surprised to know that scents can be following you around through the detergent or fabric softener you use, the shampoo you wash your hair with, or the cleaning products you just used to clean your home and have stuck onto your clothes. In fact, these substances can be found in thousands of consumer and industrial products - and they may be wreaking havoc on your body.

A growing number of scented products are available on store shelves, and our homes are becoming more and more saturated with airborne chemicals. It’s almost impossible to avoid exposure to these substances, and they are contributing to poor indoor air quality all around the world. While Canadians spend approximately 90% of their time indoors [i], the concentrations of some pollutants are often 2 to 5 times higher than typical outdoor concentrations [ii] [iii]. Usually this boils down to a lack of ventilation. In addition to scents and fragrances from various products we use indoors, when outdoor pollutants make their way indoors (tracked in on shoes, residue on clothing, etc.), they end up concentrating in higher amounts than they would outside (because there is less airspace for them to occupy inside). [iv] All of this adds to the challenges of keeping your indoor air clean.

Let’s look at one of the biggest offenders: Phthalates.

What are phthalates? Phthalates are the reason why your deodorant keeps you smelling fresh on hot summer days. They are why a new diaper has that powdery-soft baby smell. Or why your sheets still smell clean even after sleeping in them for a day or two. Phthalates are used to make fragrances last longer.

But it doesn’t stop there. Fake Christmas trees have phthalates. Vinyl flooring contains phthalates. Rubber duckies contain phthalates. Phthalates can even be found in food products. This is a reason why phthalates are called the “Everywhere Chemical”.

A single product may contain up to 300 different fragrance ingredients, but there are over 3000 different chemicals a manufacturer can choose from – even ones that are known irritants, allergens, and carcinogens. Health Canada says that most phthalates don’t pose a risk to health, and therefore phthalates will not appear on ingredient labels; instead, they are grouped in as “fragrance” or “perfume/parfum.”[v]

After tobacco smoke, perfumes are one of the most noticeable air contaminants in public places and the workplace. They are reported to cause difficulties for most people with environmental sensitivities.[vi] A 2009 study that appeared in the Journal of Environmental Health showed that around 30% of the general population found other people wearing fragrances to be irritating.[vii] “Irritating” doesn’t mean that someone is merely bothered by it – we are talking nausea, migraines, difficulty breathing, rashes, stuffy or runny noses…the list goes on. For people who have asthma, the study found that 37% of people were aggravated by scented products.

Further, there is growing evidence that shows the link between these chemicals and a long list of health conditions. We’re talking changes to fertility, hormonal imbalance, inflammation, excess weight, sleep disturbances, elevated stress levels, issues with childhood growth and development…this list also goes on.

When we ask for your help to make Saskatoon Naturopathic Medicine a scent-free space, it’s so we can make our clinic a safe and comfortable place for all patients who visit. As your trusted experts in natural health care, it is our job to share our knowledge to help you make better choices for yourself and those around you. If you are interested in learning more, our NDs would love to chat with you!

[i] https://www.canada.ca/en/environment-climate-change/campaigns/canadian-environment-week/clean-air-day/indoor-quality.html          

[ii] https://www.epa.gov/report-environment/indoor-air-quality#note2    

[iii] https://www.epa.gov/indoor-air-quality-iaq/inside-story-guide-indoor-air-quality             

[iv] https://www.airqualitycanada.ca/news/indoor-and-outdoor-air-pollution          

[v] https://www.canada.ca/en/health-canada/services/chemicals-product-safety/phthalates.html

[vi] https://www.chrc-ccdp.gc.ca/sites/default/files/envsensitivity_en.pdf

[vii] https://pubmed.ncbi.nlm.nih.gov/19326669/

STRESS AND THE HORMONE CONNECTION

Stress is one of the top concerns for which patients seek medical support. Stress is a hormonal response of the body when we perceive we are under threat. The “fight or flight” response is a sympathetic nervous system response which is engaged when we encounter a stressful event, such as running into a predator. This response allows our bodies to fight or flee, protecting ourselves from danger. Once the danger has passed, our bodies shift to a relaxation state, or an activation of the parasympathetic nervous system.

Today, it is common to see chronic stress - stressful events or situations that do not pass, which results in our sympathetic nervous system being active for much longer than it is meant to be. Having chronic stress responses can lead to a variety of changes in our body, including changes in blood pressure, blood sugar, digestive issues, and hormonal imbalances.

Cortisol

Cortisol is one of the main hormones released by our adrenal glands (which sit atop the kidneys) during periods of stress. Normally, cortisol is released in a diurnal pattern - this means they rise and fall in a similar pattern throughout a 24 hour period. This is called our circadian rhythm. Typically, cortisol should be at its highest in the morning right after we wake up, and will drop throughout the day until it reaches its lowest levels in the evening around bedtime. Throughout the night, they will slowly begin to increase again until waking time the next day, and so on. In this normal pattern, cortisol functions in regulating the immune system, managing inflammation, and regulating our blood sugar and metabolism. However, during periods of increased stress, more cortisol is released into our bloodstream, which can impact our circadian rhythm and lead to health consequences - such as changes in appetite and weight, blood sugar imbalances, high blood pressure, memory impairment, and interference with other hormones such as melatonin, estrogen and testosterone.

How can I measure my cortisol levels?

Cortisol levels can be measured in the blood through regular blood work - keep in mind that because of cortisol’s diurnal rhythms, cortisol levels will change throughout the day and will be different depending on the time the blood draw is done. Also, cortisol may increase if you are nervous about getting a needle. Alternative ways to measure cortisol include through saliva and urine, which can be easily done at home multiple times throughout the day to provide a “4-point” measurement of cortisol (measured at four points throughout the day to make a graph of your diurnal rhythm).

Your naturopathic doctor has access to all of these types of testing, and can requisition a test for you to assess your cortisol levels. There are urine testing options, specifically Rocky Mountain Analytical’s Comprehensive Hormone Insights (CHI) test and Precision Analytical’s DUTCH test, both of which offer cortisol testing at multiple points throughout the day as well as an extensive assessment of hormonal health, including levels of estrogens, androgens and progesterone and their metabolites. These tests allow for an assessment of your hormone levels and an analysis of the interplay between them!

Based on the results of your test, your naturopathic doctor will recommend a holistic plan for you to support your hormones and decrease the impact stress has on your body and health. There are lots of modalities that have been found to help manage stress and reduce cortisol levels, including nutritional supplements, dietary changes, lifestyle recommendations, and even traditional medicine such as acupuncture and homeopathy.

Keep in mind that cortisol levels can be altered for medical reasons other than stress, and these conditions would be approached and treated differently!

Have questions about stress and cortisol testing? Call us today to get more information and to set up an appointment with one of our naturopathic doctors!

References:

https://www.ncbi.nlm.nih.gov/books/NBK538239/

HAPPY HORMONES - A NATUROPATHIC APPROACH

Hormones direct many different systems in your body. They are involved in stress management, thyroid function, glucose regulation, and reproductive health.  

Join naturopathic doctors Dr. Darlene Reid-Ahenakew and Dr. Amy Velichka on Monday, May 14th for an integrative perspective on hormonal health. This presentation will begin at 7 pm at McNally Robinson Bookstore on 8th Street in the travel alcove. 

Learn ways to promote a healthy hormonal balance to improve the way you look, feel and age. There is no cost to attend. Come on out and bring a friend!