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

Naturopathic Supports for Alzheimer's Disease

naturopathic medicine can provide a great deal of support for patients dealing with alzheimer’s disease and other cognitive conditions.

Alzheimer’s Disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide and is the most common form of dementia. Risks for AD can include smoking, diabetes, hypertension, alcohol consumption, obesity, and increasing age as these can cause neuroinflammation within the body. While there is no cure for AD, naturopathic approaches offer a holistic perspective by focusing on lifestyle, nutrition, and complementary therapies.

As it is never too early to begin thinking about your cognitive health, here are some things you can start doing today to reduce your risk of developing Alzheimer’s disease.

Mediterranean Diet

Studies have shown that individuals who adhered to a Mediterranean diet were associated with a reduced risk of dementia and cognitive decline in comparison to individuals who did not adhere to the diet. The Mediterranean diet is a diet that emphasizes the consumption of whole grains, fruits, vegetables, and healthy fats to lower inflammation within the body thus lowering the risk of developing AD.

Omega-3 Fatty Acids

Dietary intake or supplementation of omga-3 fatty acids has also been shown to help reduce risk of cognitive decline due to their anti-inflammatory properties. Foods rich in omega-3 include nuts and seeds including flaxseeds, walnuts and chia seeds or cold-water fish including salmon, mackerel, sardines, and herring.

Vitamin D

Patients with AD have a higher prevalence of Vitamin D deficiency, low mood and impaired cognitive performance so ensuring that Vitamin D levels are being tested and supplemented accordingly with foods and fats is beneficial.

Yours in good health,

Sami Leung

1. Lu’o’ng, K. V., & Nguyên, L. T. (2011). The beneficial role of vitamin D in Alzheimer’s disease. American Journal of Alzheimer’s Disease & Other Dementias, 26(7), 511–520. https://doi.org/10.1177/1533317511429321

2. Scarmeas, N., Stern, Y., Tang, M. X., Mayeux, R., & Luchsinger, J. A. (2006). Mediterranean diet and risk for Alzheimer’s disease. Annals of Neurology, 59(6), 912–921. https://doi.org/10.1002/ana.20854

3. Sobue, A., Komine, O. & Yamanaka, K. Neuroinflammation in Alzheimer’s disease: microglial signature and their relevance to disease. Inflamm Regenen 43, 26 (2023). https://doi.org/10.1186/s41232-023-00277-3

4. Wei, B. Z., Li, L., Dong, C. W., Tan, C. C., Alzheimer’s Disease Neuroimaging Initiative, & Xu, W. (2023). The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers. The American Journal of Clinical Nutrition, 117(6), 1096–1109. https://doi.org/10.1016/j.ajcnut.2023.04.001

5. Welty F. K. (2023). Omega-3 fatty acids and cognitive function. Current Opinion in Lipidology, 34(1), 12–21. https://doi.org/10.1097/MOL.0000000000000862

Omega-3s for Inflammation-Associated Depression

Essential Fatty Acids (EFAs)

Omega-3 and omega-6 fatty acids are essential fatty acids, meaning the body cannot make them on its own so they must be obtained through diet. They are both polyunsaturated fatty acids, however, they are found in different foods and have different roles in the body. Omega-3s are found in fish, nuts, seeds, and plant oils, while omega-6s are found in meats, vegetable oils, nuts, seeds, and processed foods.

The body requires a balance of omega-3 and omega-6 fatty acids for good health. However, the western diet is abundant in omega-6-rich foods, shifting this balance in some cases by 20:1 or higher. While both beneficial and necessary for the maintenance of good health, omega-3 and omega-6s have opposite effects on inflammatory modulation – the omega-6 pathway being more pro-inflammatory, the omega-3 being more anti-inflammatory.

Inflammation & Depression

Neuroinflammation is an inflammatory response within the brain and is a known component of many brain disorders. Rapaport et al., conducted a study exploring whether inflammatory biomarkers might act as measures of clinical response to omega-3 fatty acids – specifically eicosapentaenoic acid and docosahexaenoic acid – in subjects with Major Depressive Disorder (MDD).

The subjects were assessed for their baseline biomarkers of inflammation, as well as the presence and severity of their depressive symptoms using the Hamilton Depression rating scale. They were then randomized to 8 weeks of double-blind treatment with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), or placebo. Those given EPA who had high inflammation consistently reported a significant decrease of depressive symptoms by treatment week 8. While also critical to brain function, DHA did not produce the same effect. This difference is possibly explained by the fact that EPA has the ability to dampen the inflammatory response, while DHA does not.

This study highlights the importance of individualized assessment and treatment in mental health, and the value of EPA as part of a comprehensive treatment plan for depression.

Written by Dr. Jacalyn Sieben ND

References:

Kalkman H. O. (2020). The Association Between Vascular Inflammation and Depressive Disorder. Causality, Biomarkers and Targeted Treatment. Pharmaceuticals (Basel, Switzerland), 13(5), 92. https://doi.org/10.3390/ph13050092

Rapaport, M. H., Nierenberg, A. A., Schettler, P. J., Kinkead, B., Cardoos, A., Walker, R., & Mischoulon, D. (2016). Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder: a proof-of-concept study. Molecular psychiatry, 21(1), 71–79. https://doi.org/10.1038/mp.2015.22