Office Hours: Your Pregnancy & Postpartum Questions Answered

0:12Welcome to Office Hours. This is our dedicated one-on-one space to go deeper, get clear, and explore what truly moves the needle for your health. I'm Dr. Mark Hyman, and each week, we're going to pull back the curtain and share the insights, the research, the lessons that don't always make it into our conversations with guests. Because at the end of the day, you are the CEO of your own health. And for many of you, your family's health too. And you might not feel it all the time, but you have far more power and agency than you realize. I'm glad you're here. This episode is brought to you by Function Health, empowering you to live 100 healthy years with over 160 lab tests at just$365 a year.

0:49Sign up today at functionhealth.com slash mark and use code mark2026 to get$50 towards your membership. Once you conceive, the questions don't stop. they just multiply. Pregnancy is a time of profound transformation. Your hormones shift, your metabolism changes, your nutritional needs increase, your nervous system adapts in ways that most women are not really prepared for. And postpartum, well, that may be one of the most misunderstood and underserved stages of a woman's life. So in this office hours, we're slowing things down and answering your most common real-world questions about how to support your body during pregnancy and afterwards.

1:28We're going to talk about things like choosing the right prenatal vitamins and understanding the difference between folate and folic acid. We're going to talk about managing nausea in pregnancy, acne, heartburn, which is common, and many other common pregnancy discomforts. We're going to talk about supporting mental health during pregnancy and why it matters for your well-being postpartum. We're going to talk about reducing the risk of complications in pregnancy like preecampsia, which is high blood pressure in pregnancy. And we'll talk about nourishing your body in the third trimester to prepare for labor and recovery.

2:01And then we're going to move into postpartum. What happens with your hormonal shifts, thyroid shifts? What happens in your pelvic floor? How do you heal that? How do you support your immune system? How do you deal with some of the mood changes that happen with all these shifts in hormones? What about hair loss? And how do you recover after a C-section? This isn't about doing everything perfectly. It's about understanding what your body is going through and learning how to support it with clarity, with some compassion and a few evidence-based tools. So whether you're pregnant now or you're planning ahead in the postpartum phase or supporting someone you love, my goal is to walk you through a process, to walk away feeling informed, to feel empowered, to not feel so alone.

2:43So let's talk about what happens once you conceive and how to support your body through pregnancy and postpartum. All right, let's start with pregnancy and prenatal vitamins and the whole difference between folate or even methylfolate versus folic acid. And the question is, can prenatal vitamins be harmful if I can't process folate? Well, yes. And it's important to take the right forms of these nutrients, especially when you're pregnant. Something called methylated folate is a very important form of this vitamin, also known as vitamin B9. It's different than folic acid, which is what's in most prenatal vitamins, which is often somewhat effective, but not always very effective.

3:29And there's a lot of genetics that play a role here. The form of the nutrient matters. You want to have the right product. So quality is so important. And I would avoid anything with aesthetic fillers, colors, dyes, excipients. and there's some great brands out there. I like WeNatal. It's actually a prenatal for men and women. And we've done some shows on the podcast on male infertility, but guess what folks? Men are half the equation in conception, so they matter and then their health matters and they actually need prenatal too. Before, it doesn't matter once you get pregnant, obviously what the guy takes, but before for sure.

4:02So I like WeNatal. There's many other brands like Pure Encapsulations has prenatal vitamins, Thorne has them. There are many other companies that do, but you want to use the best quality you possibly can. All right. What about question around nausea? This is a big thing. A lot of women get it. Some women don't, but morning sickness, nausea, acne, these are big things. So we're going to talk about them. Now, if you're nauseous, there's some real simple practical things you can do. One is making sure your blood sugar is balanced. So you want to eat, you know, often smaller, more frequent meals. Don't eat a lot of carbs and sugar.

4:34There's certain herbs that can be helpful, like ginger tea. You can just slice up some ginger, boil it. Vitamins matter. B6, very important. Magnesium really matters. And there's actually, you know, some studies that show that if you take, you know, the B6 and magnesium, it can really help. And there's even some sometimes medication like bendectin, which is a weird drug that's used for insomnia, often known as Unisom. And I don't like prescribing drugs that often, but sometimes for women who really have intractable nausea, it can be very helpful in the early period with the B6 at higher levels.

5:07And you need probably like 50 milligrams and you probably need paradoxal 5-phosphate, again, a very special form of B6. The next thing you can do is support your liver and your gut health, because that plays a role also by helping your microbiome, by supporting it with probiotics. And there's also ways to support your liver with healthy food and nutrients. So all that's really important. What about sciatica and sciatic pain, heartburn? These are other things that women get. And we got several questions about that. For example, Why do you get sadica? Well, it's usually caused by the uterus expanding and you've got this giant nerve that comes off of your spinal cord and goes down through your butt.

5:42And as your uterus expands and there's shifts in your posture and there's ligaments that get kind of loose because of hormones called relaxin that your body makes when you're pregnant, you end up, you know, often getting back pain. So there's some just simple things you can do. Pelvic tilts, cat cow stretch really great prenatal yoga hip opener is really great just moving helps a heat and ice rotating can be very helpful physical therapy massage is great myofascial release learning how to properly sleep so you don't get in bad positions and just walking moving the more you move the better you're going to be i know i have back issues the more i move the better i feel so sitting here doing this podcast is probably the worst thing for me actually heartburn is often very common too.

6:26Why does that happen? Well, there's hormones that change and you get the esophagus relaxing a little bit. So the sphincter, which is a little kind of valve at the top of your esophagus kind of loosens. And then you've got this big uterus pushing up and abdominal pressure grows and then it kind of pushes food up. So how do you address that? Well, eat smaller meals, more frequent meals. If you have a big meal, it's going to make it worse. Try four to six small ones instead of two to three big ones. Watch the trigger foods for reflux, tomato-based foods, citrus-based foods, chocolate, fried foods.

6:58I mean, listen, if I eat fried foods, I get heartburn. I don't get heartburn. Caffeine, coffee, which you shouldn't probably drink anyway while you're pregnant. Carbonated drinks may be an issue. Peppermint, which sounds good if you like peppermint tea, but that can make the sphincter even worse. So watch out for that. Make sure you just kind of keep a log of food you're eating and see like, well, what did I eat and do I got reflux? So that can help. Also, don't lie down after eating. That's just a general recommendation for reflux and heartburn, but give yourself two or three hours, at least ideally three hours.

7:27So you can digest rather than, you know, laying down after a meal. Uh, you can also elevate the head of your bed at night. You know, there's ways to do that with blocks or you can, there's different, even beds that do that. That can be helpful. Certain digestive aids can help like aloe vera juice can help. It's pregnancy safe. A little ginger tea can be helpful. Uh, make sure you chew your food so you don't like have a lot of undigested food in there. Uh, don't wear tight clothing. You know, obviously you're pregnant, your belly's growing, but get pregnancy closed. So you're kind of have loose clothing.

7:57If you have a waistband around your belly that can increase the pressure. Um, also make sure you're hydrating, but, but not during a meal in between meals. It's really bad. And so also don't chug a lot of water. Just, just keep a steady flow going. Certain things are great. Magnesium can be really helpful. It relaxes, um, uh, your system. Calcium carbonate or Tums can be helpful. Uh, but you want to talk to your OB about that. I like magnesium glycinate, often very helpful. A lot of times people are magnesium deficient and that can make reflux worse. And then, you know, if you're stressed, that makes a problem with your digestion.

8:33It slows everything down and it makes heartburn worse. So simple stress techniques like breathing slow through your nose, five breath in, five breaths out, really slow, really simple. It takes a couple minutes or less and it can make a big difference in your nervous system. My favorite massage, you can get a breathing massage that It helps with stress, gentle stretching, movement, being in nature, just simple things, doing things you love all help. What about the mental health stuff in pregnancy? That's something people talk about a lot. And, you know, you got to manage all that anxiety, depression.

9:04It's a thing. And everybody's different. Some women do great. Some women have all kinds of mood issues. But there's some really foundational things around lifestyle that make a big difference in mental health. Obviously, eating a whole food, real diet, moving regularly makes a big impact on mental health. managing stress that we just talked about with meditation, yoga, breath work, sleep, making sure you prioritize sleep, emotional support, you know, friends, therapists, whatever. And then of course, keeping your blood sugar, even your nutrient levels optimized, all that matters. Omega threes, you know, your baby needs a lot of omega threes to make its brain.

9:38Cause about 60 % of the brain is made up of omega threes. So it's going to take all yours. So you're going to get potentially low. So you want to make sure you get omega threes as well during pregnancy. If you're depressed during pregnancy, there may be an increased risk of getting postpartum depression, which is a real thing. And that's kind of a drag, but there's a lot of ways to prevent that. Just doing all the things I said. Okay, well, there's another big problem we've been asking about, which is this thing called preeclampsia, which is quite a serious problem in pregnancy. And you get fluid retention, you get high blood pressure, it can even lead to seizures.

10:11And there's a lot of good literature that shows that generally getting your metabolic health straight will help. That means balancing your blood sugar And again, you've heard me talk about this forever, but, you know, eating whole foods, not eating a lot of sugar and starch, you know, having lots of fiber, protein, good fats, all common sense stuff. And that works for high blood pressure. The biggest driver of blood pressure issues is insulin resistance. So if you're eating a lot of sugar, you're eating a lot of starch, it's going to drive up your blood pressure and you want to be really, you know, careful about that.

10:40And, you know, I don't like the idea, like just whatever you want, have much ice cream or cake or cookies. I'm pregnant. I could eat. Doesn't, don't do that. It's not good for you. It's not good for the baby. You want to still stay on a really optimally healthy diet. Make sure you have adequate protein, lots of minerals, all that's really important. And omega-3s. You want to be careful with fish during pregnancy, but you can have the small fish, sardines, herring, mackerel, anchovies, small wild salmon can be helpful. All that really helps. Now, sometimes aspirin can help. So there's pluses and minuses on that.

11:14If you have a high risk of preeclampsia, if you've had it before, if you have really, if you're overweight, if you have a lot of insulin resistance, metabolic issues, you might want to take a baby aspirin, but you want to check with your obstetrician about that before taking any drugs during pregnancy. All right. What about food? What should you be eating? Well, it's the same thing you want to be eating anyway, because to create a healthy you is the same thing you need to create a healthy baby. But there's a few things that are particularly important. One is making sure you get adequate protein because you're growing a whole new being.

11:47Two is lots of good healthy fats, particularly omega-3, as I mentioned, a lot of your neurologic tissue, your brain and nervous systems all made up of omega-3s. Choline, which is really important, also important for brain development. And again, it's very low in many Americans' diets and it's important in neurotransmitter function. And you can get it from eggs, particularly egg yolks. So no egg white olives, please. Making sure you stay hydrated and get adequate electrolytes, all that's important. So I think just common sense, but again, don't overeat. Don't just eat whatever you want. You know, not like, you know, it's okay to gain a hundred pounds in pregnancy.

12:26It's not, uh, you're affecting the epigenetic programming of the baby. You're affecting your own health. Uh, and you want to just stay, you know, following the principles of a healthy diet, which I've written about a lot in the vegan diet or food. What the heck should I eat? Okay, so how do I pick a formula? That's another question we got. Well, first of all, ideally you want to breastfeed for at least six months or longer, a year. Sometimes it's not possible, I understand that. And so then the question is, how do you figure out what's going on with formula? And in America, formula is just crap.

12:58It's the average formula has the equivalent of a Coke or two a day that the baby's consuming. Now, you wouldn't give your baby a can of Coke, but you basically are giving it a can of Coke if you're giving it the traditional formula. You don't want the corn syrup solids. You don't want all these additives. You want really clean ingredients. And there are good brands out there. Bobby is one. There's a new thing that happened you should know about. The FDA released a ban. Can you believe this? There was a ban on importing formula from Europe, which is way better formula. It actually has omega-3s in it.

13:33They do a lot of really good things with it. Much better designed. We banned it. Why? To protect the American companies that were making formula. But who was paying the price? The babies and the mothers. Who was, you know, going to the bank all day? The company's making the formula. So that's a good thing. The new FDA rule that lifted the ban on importing foreign formula is a good thing. And there's some great brands out there from Germany and other places. So I just kind of check around on that. Here's the thing about springtime. It's not just a change in weather. It's a season designed for your body to accelerate.

14:09Your immune system shifts. Your energy picks up. But you can only launch if your foundation is solid. Are your nutrients depleted? Are your hormones balanced? Now, with more outdoor activity, with more stress, more travel, this is your moment to check in. And this is our reason for building function. It gives you over 160 lab tests for your heart, your hormones, nutrients, toxins, metabolism, and lots more. An all-in-one check for your entire body, trusted by hundreds of thousands of members for$365 a year. That's a dollar a day. Get your data at functionhealth.com so your body's ready to go. All right, what happens after you give birth?

14:47Postpartum period is really misunderstood by many people. It's an underserved part of medicine. I didn't learn anything about it in medical school. And it's a really important stage of a mother's life. So you've got to know what happens. The question is, you get all this hormonal imbalance, right? You're on all this flood of hormones when you're pregnant. and you give birth, the placenta's gone, all these hormones are gone, what happens? So the question is how long until your hormones get back into balance? Well, it can take a minute. It can take a minute. And some women are more affected by it than others.

15:16But usually things come back into balance after about four to six weeks. There is a thing that happens often after, and I don't think we exactly know why, but a shift in thyroid function. And women get postpartum autoimmune disease of their thyroid called Hashimoto's. And about 10 % of women do this. And that can cause depression. It can cause lots of things, but depression is one of the key features of low thyroid function. So not only depression, but fatigue, you can get weight gain. That's very psychological. It's hormonal. And you want to make sure you do the right tests. You know, function health, we do full panel of tests.

15:52Really important to get the right test because most doctors don't check the right thyroid test. They just don't. They check TSH and they leave it that, but you want to check the free T3, free T4, thyroid antibodies. At Function Health, we see over almost 15 % of our members, almost 500 ,000 people now have an autoimmune thyroid problem, and most of them have never been diagnosed before, and it's affecting the quality of their life. So you want to make sure you check the right test. Next question is about what happens to your pelvic floor. You get birth, it's a big thing, this big head goes through your pelvic floor, you can get a lot of tissue stretching and lots of vaginal issues.

16:29What do you do after pregnancy to help with that? Well, there's lots of things. Physical therapy can help, and there's pelvic floor therapy that can help, breath work, Kegels exercises, strengthening your core, your abdomen, your abdominal muscles, all really important, and that can help a lot. It's really important both after vaginal birth and even after a C-section. Also, women report getting sick a lot after pregnancy, And the question is, why am I sick so much after having a baby? Well, I hate to say this folks, but the baby's a parasite. It steals all your nutrients. It takes everything out of you and you got to put it back in.

17:05So hopefully you're doing that during pregnancy. Hopefully you're taking the right multivitamin, fish oil, vitamin D and so forth. But you want to make sure your nutrient levels are optimized. And again, at Function Health, we test all your nutrients. You can do the basic function panel, which has a lot, or you can even add the extended nutrient panel and you can go to functionalhealth.com to learn more. The other thing that can make you sick a lot is you're done sleeping because the baby's up all night or you're breastfeeding at night. And so sleep deprivation does affect immune function. Microbiome changes also happen during pregnancy and that can affect you.

17:37So there's a lot of reasons, but as long as you make sure your vitamin D's levels are good, you're getting the right vitamins and minerals, you've got omega-3 fats, you're learning how to do some gentle stress reduction because stress suppresses your immune system too, gets some help with the baby, do some general exercise. All that really can be helpful in supporting your immune system. All right, next question was about postpartum depression. What can we do to prevent it? Well, the key is to do the things that work for depression for anything, which is getting your metabolic health straight.

18:10So balancing your blood sugar because insulin resistance, prediabetes, blood sugar issues, all those cause depression. Making sure your thyroid's right. And those tests I just mentioned are really important. Checking for inflammation. You know, lots of inflammation in your body can cause depression. And you can use that test that we do at Function Health, CRP, which is a measure of inflammation. There's other tests you can do as well. You can check your omega-3 status. Again, you can do that with Function Health. Low omega-3s will lead to more inflammation in the body. So all that's really important.

18:41And there's some simple things around making sure you're getting enough exercise, getting your sleep sorted. that's tricky, but getting support, maybe your husband can take the baby, or maybe you get a support from a family member or even help from a nanny. All that can be helpful, getting time with friends, therapy if you need it. If you've had trauma in your life, sometimes trauma-informed therapy can be really helpful. What about postpartum hair loss is another question about that. Is there a way to prevent so much hair loss after pregnancy? Well, why did this happen? It's something called telogen effluvium, which is a big medical word.

19:13It's really common. It peaks around three to five months after birth. And it's mostly caused by hormonal swings, especially estrogen after you give birth. And it also can be from nutrient depletion because you're, like I said, the baby's a parasite. It's taking all your nutrients. So making sure you're on a healthy diet, adequate protein, hair's made of protein, things like biotin can be really important. And also just making sure you have omega-3s, which are important per hair, hair health, and your thyroid's okay. All that can affect your hair loss. And it can really be from nutrient not just in pregnancy and the birth, but breastfeeding also.

19:48So you're still feeding another human and you need to make sure you're getting yourself enough quality nutrition. Stress, you know, people say, you know, I'm so stressed my hair's falling out. Well, that's a thing. So I know it's hard if you're a new mother or new family, it's sometimes tricky, but do the best you can to find ways to kind of reset your nervous system, whether it's a yoga nidra, you can listen on Spotify or breath work or meditation or yoga or hot bath, just simple things make a big difference. And sleep disruption also, again, something sometimes hard to avoid, also can be a big factor in stress and causing more hair follicles to go into the shedding phase.

20:25Like I said, thyroid, you want to check that. Very common. A big cause of hair loss. And, you know, there's a lot of ways to support regrowth of your hair, even if you totally can't prevent all the hormone shifts, right? So you need a lot of nutrients for hair growth. And pregnancy can deplete a lot of these, like iron. For example, if your ferritin is low, because women lose a lot of blood. Again, you have to have a ferritin, even if you're not anemic, if you're ferritin, which is the iron stores, like the money in the bank, as opposed to in your pocket, if your iron stores are low with low ferritin, that can cause hair loss.

20:57And if it's under 45, it's a problem. And most lab reference ranges are like 16 is normal. That's not normal. That's optimal. That's not optimal. It's quote normal because people are low. So you want to make sure you check that. And again, on function health, you can check iron and you can check ferritin levels. you can check for zinc also really important for follicle repair biotin really important for keratin production omega-3s we check that at function health vitamin d we also check that that vitamin d can if it's not adequate can lead to thinning of your hair omega-3 fats also really critical for hair i mean they give racehorses omega-3 fats to make their coat shiny and protein you know hair is made up of protein it made up amino acids so you need at least 80 to 100 grams a day especially if you're breastfeeding so how do you do all this well stay on your prenatal vitamin, not just for when you're pregnant, but at least six to 12 months after.

21:45Eat a lot of iron rich foods. I was talking to this nanny service because my daughter's going to have a baby soon. And they were like, well, do they, she eat liver or does she eat kidneys? And I'm like, so all that stuff, liver is probably one of the richest source of iron in the diet. I love liver, but you can also get it from grass fed beef, from lentils, from spinach. You want a lot of zinc rich foods, pumpkin seeds, oysters, beans, and you want protein every meal. So chicken, fish, meat, nuts, seeds, beans, all that's really important. Make sure you check your labs, folks. You got to check your labs.

22:18If you don't know what's going on in your body, you can't manage it. No, I think some tech guy said what doesn't get measured can't be managed. So you need to know what's going on. It's like your dashboard in your car. I mean, if you imagine you didn't know how fast you're going, how much gas in the tank, like you need to know that stuff. The thyroid's really key, as I mentioned around postpartum depression, hair loss, and many other things. And this thyroid thing is a big thing. You know, a lot of, it's really common, as I said, and it can cause anxiety, depression, exhaustion, fatigue, hair loss, fluid retention, prevent you from losing the pregnancy weight.

22:49And you want to get the right test. Like I said, you don't just want the TSH. You want the free T3, the free T4, the thyroid antibodies. There's even something called reverse T3, which can be very helpful. Sometimes if there's stress that can go up and it's like a blocking thyroid hormone. So until you fix those, your hair loss isn't going to get better. So you've got to make sure you check that. What about C-sections and recovery from C-sections? Well, what are tips for recovering? And I delivered 500 babies. I used to do lots of C-sections. It's a big surgery, right? It's not a little surgery.