Postpartum University® Podcast

Is It Postpartum Depression or Postpartum Anemia? EP 212

• Maranda Bower, Postpartum Nutrition Specialist

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What if the crushing fatigue, the anxiety, the brain fog, and the constant crying aren’t mental health issues at all—but signs your client’s body is depleted and screaming for help? 

The truth is; Postpartum depression  symptoms mimic postpartum iron deficiencies and postpartum anemia.

This episode takes a bold look at one of the most underdiagnosed, misunderstood, and easily missed causes of postpartum “depression”: anemia. We’re breaking down how iron deficiency, B12, and folate depletion can mimic mental illness in postpartum women, and how so many providers are missing the signs. If you're a postpartum provider, doula, midwife, nurse, or any practitioner supporting postpartum women—you cannot afford to overlook this conversation. We’re talking labs, clinical clues, testing gaps, and holistic strategies to support deep, root-cause healing.

Check out the episode on the blog: https://postpartumu.com/podcast/is-it-postpartum-depression-or-postpartum-anemia-ep-212/


Key Time Stamps: 

  • 00:00 – The misdiagnosis of postpartum depression
  • 01:40 – What is anemia, and how is it connected to postpartum?
  • 03:19 – Overlapping symptoms of anemia and depression
  • 06:05 – Ferritin levels and common signs of deficiency
  • 07:27 – Maranda’s personal story of missed anemia
  • 09:23 – Why most checkups aren’t helping moms
  • 10:43 – What labs to run + strategies for healing
  • 13:09 – Iron absorption + practical supplementation tools
  • 15:00 – Signs to look for when “depression” isn’t depression
  • 15:35 – MTHFR, genetics, and what really matters
  • 16:36 – Empowering providers to support real postpartum healing



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Speaker 1:

The postpartum care system is failing, leaving countless mothers struggling with depression, anxiety and autoimmune conditions. I'm Miranda Bauer and I've helped thousands of providers use holistic care practices to heal their clients at the root. Subscribe now and join us in addressing what modern medicine overlooks, so that you can give your clients real, lasting solutions for lifelong wellbeing. What if I told you that many of the mothers being diagnosed with postpartum depression are actually suffering from something completely different and entirely treatable, that's, the brain fog, the fatigue, mood swings, even the deep sadness. It actually might not be in their mind after all, but in their blood. And in my practice, when I was supporting women all the time, I would see this pattern. Very often, women coming to me referred to me and they having depression diagnosis, saying things like I just don't feel like myself, I'm tired no matter how much I sleep, I'm crying all the time. I have no idea why. And over and over, the labs were run and voila, we discovered anemia. So today we're talking about one of the most underdiagnosed root causes of postpartum mental health challenges, one that is shockingly common but almost never talked about in the provider world. Okay, so let's define this clearly.

Speaker 1:

What is anemia? Anemia is a condition where your body lacks enough healthy red blood cells or hemoglobin to carry oxygen to your tissues and postpartum. It's generally caused by blood loss from birth, nutrition depletion from pregnancy and breastfeeding, and poor absorption due to gut dysfunction or inflammation, which is often a biological normal in the very beginning of postpartum. But when we are not given the tools to support our body in healing that, acute inflammation becomes chronic. And here's the key Not all anemia is the same.

Speaker 1:

There's actually several types of anemia. There's iron deficiency anemia, which is the most common, usually from blood loss or low intake, and then there's B12 vitamin anemia deficiencies, and that's especially prevalent in vegan and vegetarian diets, or just gut malabsorption in general. And then there's folate deficiency anemia, and that's often masked if providers don't test properly. Anemia of chronic disease or inflammation is even more complex and often missed as well. And this is where we as providers have to pause, because if we're only running a basic CBC, we're going to miss the full picture. Here's what we need to know, here's what we need to understand more, and how things present differently and how they're often missed.

Speaker 1:

So up to 30% of postpartum women in the United States are anemic within 6 to 12 weeks of giving birth, and in some studies, rates are even higher among women with postpartum depression, which is very, very interesting. One of the studies showed that women with iron deficiency were three times more likely to experience postpartum depressive symptoms, were three times more likely to experience postpartum depressive symptoms, and the symptoms overlap. When we look at depression versus anemia, they have almost identical symptoms. They both present with fatigue, low motivation, brain fog, mood swings, sleep issues, but anemia can also present with heart palpitations, pale skin and brittle nails and cravings of ice or dirt, which is also known as pica. So we have to stop calling a lot of these things normal for one, okay. So let's stop overlooking why this is just not okay and let's start leading the change.

Speaker 1:

If you're here, you're listening to the podcast, Of course. You are the one leading the change. You have the real tools, the real knowledge and whole person care. What we're looking for? And when we look at this, we have to be honest.

Speaker 1:

How many women are being labeled with mental health illness when they're actually severely depleted? Now, many providers were never trained to see nutritional and physiological roots of postpartum mood challenges. That is not their fault. This is a gap in education, it's a broken system and it's one that we have the chance to fill together. So when a mom walks in to a provider's office and she says I'm exhausted, I cry all the time, I'm lost over myself. She is not asking for a diagnosis, she's asking to be seen, and sometimes what she's really saying is my body is screaming for help and I need you to hear it.

Speaker 1:

We have iron deficiency, mimicking depression. We have B12 and folate depletion, tanking mood and cognition. We have sleep deprivation, nervous system dysregulation, trauma responses, right. We also have blood sugar crashes, nutrient loss, no real nourishment, and then we have no village, no rest, no room to heal. So it's not just depression, it's a physiological collapse, and one we have to absolutely intervene in, and this is something that I wish more providers knew. Right, this is something that I'll share my experience here shortly with you as well.

Speaker 1:

But if their ferritin is under 30, even with normal hemoglobin, that is a massive red flag. If a mom says she is tired and dizzy, we cannot dismiss this. And depression symptoms with hair loss and breathlessness or paleness, that is anemia, that looks like anemia. We've got to test for that and, of course, I think craving ice and dirt or the pica. It's not a quirky or anything of the nature, although often moms don't feel like disclosing that information because they feel like it's really weird. But that is a definite diagnostic tool and that, you know, I feel off, is just worth investigating more. We have to start asking these questions, we have to start connecting these dots, and if you've never been taught how to connect these dots, I'm telling you you are not the only one, you are not behind. You are exactly where you need to be right now. You're learning, you're growing, you're showing up and that's what makes this kind of provider worth having. Like, every mom needs you on their side, understanding this, and maybe you've already been trained in this. I know a lot of midwives are very, very familiar with this work and I was so grateful for my own who recognized this in myself.

Speaker 1:

After I had my second baby, I was in a lot of pain. I was very exhausted. I had a lot of additional bleeding in pregnancy. I actually thought that I was going to lose my baby pretty early on. I had a lot of bleeding in the early weeks and, lo and behold, I still had a baby I carried. I felt like I had a little bit more blood loss than normal. I also had a history of anemia with my first, and then I was just, I was so afraid of this experience and I ended up with ulcerative colitis. But before I even got to that diagnosis, I had severe anemia, and that is not something that a lot of people test for. It wasn't something that anybody had tested for me, and I was surviving with a nursing station, next to the toilet, trying to take care of my baby in between, laying on the floor, you know, crying and pain and trying to put together the pieces just sheer exhaustion.

Speaker 1:

And then finally, a provider said hey, we need to check your labs, we need to, we need to look at what's more than just this so that we can really, really help you. And, of course, this is like a very extreme situation. However, there were so many points in my own journey where that didn't it didn't have to get to that extreme that I could have been checked, I could have been looked at, I could have been listened to, far before we even got there. And I see this very frequently, especially for moms who are in, you know, going to their first week checkup, and they, they go see their provider and they're like oh, yeah, yeah, I'm going to fill out this form and I'm going to answer these questions, and it doesn't quite necessarily show what I'm saying.

Speaker 1:

And then if I do say that I'm sad, or if I do share and expose a little bit more about what I'm truly feeling inside and it looks like I have postpartum depression, nothing else gets done, there's no additional testing to be had and what happens is it's just a referral oftentimes and then some medication for depression, and that's not really fair. We have to zoom in, we have to start looking at more tests, and it's not just the CBC, right. We have to look at, you know, first off, normal hemoglobin doesn't rule out anemia, right? Ferritin, your iron storage, can be dangerously low and still not trigger a red flag if we're just checking CBC. And then we have to check B12 and, you know, folate, they're rarely ever tested and sometimes not even provided by insurance companies, so they're often not supported in the least and then often misread because, again, providers are not trained to do this and so you often have to have, like this, special education beyond what you were trained to go read these kinds of labs. And that is just really, really frustrating.

Speaker 1:

And if you're listening into this as a mom and you're like, oh my gosh, I need to get this done. Yes, you absolutely need to get this done. And if you're a provider, I tell you, yes, this is the state of our space. You know you might be saying, yeah, I have this training and I can't believe this is the state of our space. You might be saying, yeah, I have this training and I can't believe this is not mainstream. But then again, you also know that you probably didn't get it in your regular education. You had to go elsewhere.

Speaker 1:

And there is hope. This doesn't have to be permanent, it doesn't have to be a new normal, it absolutely can be prevented. And inside the postpartum nutrition certification we actually walk through how to identify root causes of postpartum anemia and what real postpartum nutrition looks like beyond leafy greens, and how to support absorption, not just intake, and how to rebuild the physiology and confidence of new moms, because you're not just learning facts, you're becoming the provider who sees what others miss and heal those things that are often overlooked for moms. So postpartum depletion leading to anemia can this be reversed? Absolutely, iron rich nutrition is so key, but so is absorption. You can't just have nutrient-dense foods, you also have to focus on their absorbability. So supporting the gut, because if you don't have a healthy gut, there's no healing. That's going to happen.

Speaker 1:

Digestion is so necessary. So making sure that you are getting the probiotics that you need, that balanced blood sugar is there to help stabilize energy and mood, that we're pairing, you know, iron with vitamin C and avoiding taking it with calcium and caffeine. I often see this frequently, like, oh, I'm going to take my multivitamin, which should have all of the iron that I need, but I'm going to drink it with a cup of coffee, and so that doesn't work. You're actually inhibiting the absorption of that iron. So if you're going to take iron supplementation in any form, you have to do it away from calcium and you have to do it away from caffeine, which is hard to do when you have a multivitamin that contains iron and calcium. It does not work in that way, which is often why I tell women to not have a multivitamin that contains iron. Just don't do it.

Speaker 1:

Some of the best sources of iron that I have ever seen is through a little thing called the iron fish, and I highly recommend it. It's an iron fish. You can go look it up on Amazon and then you just boil that with your water, you boil it with your soups, and it is clinically shown to increase your hemoglobin levels significantly over a period of time. I highly recommend it. I've used it for myself as well. And then there's other things too. There's an amazing vegetarian and vegan drink called Floridix that is liquid and it won't upset your stomach.

Speaker 1:

A lot of people have a hard time with digesting iron supplementation and, of course, of course, of course, iron supplementation and of course, of course, of course, making sure that you are getting your organ meats right, and a lot of people don't like to cook organ meats. That's totally fine. But they have so many supplements on the line now where you can just take an organ beef supplement and get a huge amount of iron into your body in a short amount of time, and that can be really, really helpful without the gut issues whatsoever. So we have a lot of tools at our disposal to really support us and help us through this process. That doesn't necessarily require, you know, medical intervention, such as specific pills or even having some sort of iron infusion, which can be really difficult for moms as well. You know, of course, if those things are necessary absolutely, but there are some things that we can do in addition to things that we can do in addition to so.

Speaker 1:

If your clients have depression symptoms and hair loss and shortness of breath or dizziness, please, please, please, test for anemia. Always require ferritin, b12 and folate, not just hemoglobin. Low ferritin can look like mental health issues and treating it can be life-changing and we need to just not dismiss the. I feel off. That's not the only thing and, again, it can be reversed. And moms, women, communities they have complete control over this. They just need the support tools to get there, and that is massive. That is massive.

Speaker 1:

I also want to speak to this question. I always get this in the certification program is what about genetics? What about the MTHFR gene variants and how they can contribute? And I will tell you that most of the time, what we're dealing with is core nutrition, unaddressed birth, trauma, lack of professional care in postpartum, and so, yes, we inherit the genes. We inherit also beliefs and habits and coping mechanisms, and those are all things that we can change. Mthfr is important and we need to address that, but it's not the root of the problem whatsoever. We can have MTHFR and not be in a position where we're experiencing anemia.

Speaker 1:

So there is all of that so much information for you in this.

Speaker 1:

I hope this was absolutely helpful and if that lit a fire under you, I will tell you you are our kind of provider.

Speaker 1:

We have over 10,000 of us already revolutionizing postpartum care. So if you want to be in on this, where I actually send out information, science, wisdom, clinical insights all of that get onto our provider press newsletter. I deliver it every single Wednesday. There's no fluff, no fear, just everything that you need to help your clients that much deeper, in a way in which most of us are never taught, and you can go to postpartumu the letter ucom, slash press for that and I will get that over to you. Thanks so much for being a part of this crucial conversation. I know you're dedicated to advancing postpartum care and if you're ready to dig deeper, come join us on our newsletter, where I share exclusive insights, resources and the latest tools to help you make a lasting impact on postpartum health. Sign up at postpartumu the letter ucom, which is in the show notes, and if you found today's episode valuable, please leave a review to help us reach more providers like you. Together, we're building a future where mothers are fully supported and thriving.

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Maranda Bower

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