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April 22, 2025 18 mins

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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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Transcript

Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
The postpartum care system is failing, leaving
countless mothers strugglingwith depression, anxiety and
autoimmune conditions.
I'm Miranda Bauer and I'vehelped thousands of providers
use holistic care practices toheal their clients at the root.
Subscribe now and join us inaddressing what modern medicine

(00:22):
overlooks, so that you can giveyour clients real, lasting
solutions for lifelong wellbeing.
What if I told you that many ofthe mothers being diagnosed
with postpartum depression areactually suffering from
something completely differentand entirely treatable, that's,

(00:44):
the brain fog, the fatigue, moodswings, even the deep sadness.
It actually might not be intheir mind after all, but in
their blood.
And in my practice, when I wassupporting women all the time, I
would see this pattern.
Very often, women coming to mereferred to me and they having

(01:05):
depression diagnosis, sayingthings like I just don't feel
like myself, I'm tired no matterhow much I sleep, I'm crying
all the time.
I have no idea why.
And over and over, the labswere run and voila, we
discovered anemia.
So today we're talking aboutone of the most underdiagnosed

(01:27):
root causes of postpartum mentalhealth challenges, one that is
shockingly common but almostnever talked about in the
provider world.
Okay, so let's define thisclearly.
What is anemia?
Anemia is a condition whereyour body lacks enough healthy
red blood cells or hemoglobin tocarry oxygen to your tissues

(01:52):
and postpartum.
It's generally caused by bloodloss from birth, nutrition
depletion from pregnancy andbreastfeeding, and poor
absorption due to gutdysfunction or inflammation,
which is often a biologicalnormal in the very beginning of
postpartum.
But when we are not given thetools to support our body in

(02:13):
healing that, acute inflammationbecomes chronic.
And here's the key Not allanemia is the same.
There's actually several typesof anemia.
There's iron deficiency anemia,which is the most common,
usually from blood loss or lowintake, and then there's B12
vitamin anemia deficiencies, andthat's especially prevalent in

(02:37):
vegan and vegetarian diets, orjust gut malabsorption in
general.
And then there's folatedeficiency anemia, and that's
often masked if providers don'ttest properly.
Anemia of chronic disease orinflammation is even more
complex and often missed as well.

(02:58):
And this is where we asproviders have to pause, because
if we're only running a basicCBC, 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 thingspresent differently and how

(03:18):
they're often missed.
So up to 30% of postpartum womenin the United States are anemic
within 6 to 12 weeks of givingbirth, and in some studies,
rates are even higher amongwomen with postpartum depression
, which is very, veryinteresting.
One of the studies showed thatwomen with iron deficiency were

(03:40):
three times more likely toexperience postpartum depressive
symptoms, were three times morelikely to experience postpartum
depressive symptoms, and thesymptoms overlap.
When we look at depressionversus anemia, they have almost
identical symptoms.
They both present with fatigue,low motivation, brain fog, mood
swings, sleep issues, butanemia can also present with

(04:05):
heart palpitations, pale skinand brittle nails and cravings
of ice or dirt, which is alsoknown as pica.
So we have to stop calling alot of these things normal for
one, okay.
So let's stop overlooking whythis is just not okay and let's
start leading the change.

(04:25):
If you're here, you're listeningto the podcast, Of course.
You are the one leading thechange.
You have the real tools, thereal knowledge and whole person
care.
What we're looking for?
And when we look at this, wehave to be honest.
How many women are being labeledwith mental health illness when
they're actually severelydepleted?

(04:46):
Now, many providers were nevertrained to see nutritional and
physiological roots ofpostpartum 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 tofill together.
So when a mom walks in to aprovider's office and she says

(05:09):
I'm exhausted, I cry all thetime, I'm lost over myself.
She is not asking for adiagnosis, she's asking to be
seen, and sometimes what she'sreally saying is my body is
screaming for help and I needyou to hear it.
We have iron deficiency,mimicking depression.
We have B12 and folatedepletion, tanking mood and

(05:32):
cognition.
We have sleep deprivation,nervous system dysregulation,
trauma responses, right.
We also have blood sugarcrashes, nutrient loss, no real
nourishment, and then we have novillage, no rest, no room to
heal.
So it's not just depression,it's a physiological collapse,

(05:53):
and one we have to absolutelyintervene in, and this is
something that I wish moreproviders knew.
Right, this is something thatI'll share my experience here
shortly with you as well.
But if their ferritin is under30, even with normal hemoglobin,
that is a massive red flag.
If a mom says she is tired anddizzy, we cannot dismiss this.

(06:18):
And depression symptoms withhair loss and breathlessness or
paleness, that is anemia, thatlooks 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 anythingof the nature, although often
moms don't feel like disclosingthat information because they

(06:40):
feel like it's really weird.
But that is a definitediagnostic tool and that, you
know, I feel off, is just worthinvestigating more.
We have to start asking thesequestions, we have to start
connecting these dots, and ifyou've never been taught how to
connect these dots, I'm tellingyou you are not the only one,

(07:00):
you are not behind.
You are exactly where you needto be right now.
You're learning, you're growing, you're showing up and that's
what makes this kind of providerworth having.
Like, every mom needs you ontheir side, understanding this,
and maybe you've already beentrained in this.
I know a lot of midwives arevery, very familiar with this

(07:21):
work and I was so grateful formy own who recognized this in
myself.
After I had my second baby, Iwas in a lot of pain.
I was very exhausted.
I had a lot of additionalbleeding in pregnancy.
I actually thought that I wasgoing to lose my baby pretty
early on.
I had a lot of bleeding in theearly weeks and, lo and behold,

(07:46):
I still had a baby I carried.
I felt like I had a little bitmore blood loss than normal.
I also had a history of anemiawith my first, and then I was
just, I was so afraid of thisexperience and I ended up with
ulcerative colitis.
But before I even got to thatdiagnosis, I had severe anemia,

(08:09):
and that is not something that alot of people test for.
It wasn't something thatanybody had tested for me, and I
was surviving with a nursingstation, next to the toilet,
trying to take care of my babyin between, laying on the floor,
you know, crying and pain andtrying to put together the
pieces just sheer exhaustion.

(08:32):
And then finally, a providersaid hey, we need to check your
labs, we need to, we need tolook at what's more than just
this so that we can really,really help you.
And, of course, this is like avery extreme situation.
However, there were so manypoints in my own journey where
that didn't it didn't have toget to that extreme that I could

(08:56):
have been checked, I could havebeen looked at, I could have
been listened to, far before weeven got there.
And I see this very frequently,especially for moms who are in,
you know, going to their firstweek checkup, and they, they go
see their provider and they'relike oh, yeah, yeah, I'm going
to fill out this form and I'mgoing to answer these questions,

(09:19):
and it doesn't quitenecessarily show what I'm saying
.
And then if I do say that I'msad, or if I do share and expose
a little bit more about whatI'm truly feeling inside and it
looks like I have postpartumdepression, nothing else gets
done, there's no additionaltesting to be had and what

(09:40):
happens is it's just a referraloftentimes and then some
medication for depression, andthat's not really fair.
We have to zoom in, we have tostart looking at more tests, and
it's not just the CBC, right.
We have to look at, you know,first off, normal hemoglobin

(10:01):
doesn't rule out anemia, right?
Ferritin, your iron storage,can be dangerously low and still
not trigger a red flag if we'rejust checking CBC.
And then we have to check B12and, you know, folate, they're
rarely ever tested and sometimesnot even provided by insurance
companies, so they're often notsupported in the least and then

(10:26):
often misread because, again,providers are not trained to do
this and so you often have tohave, like this, special
education beyond what you weretrained to go read these kinds
of labs.
And that is just really, reallyfrustrating.
And if you're listening intothis as a mom and you're like,
oh my gosh, I need to get thisdone.

(10:48):
Yes, you absolutely need to getthis done.
And if you're a provider, Itell 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 stateof our space.
You might be saying, yeah, Ihave this training and I can't
believe this is not mainstream.
But then again, you also knowthat you probably didn't get it
in your regular education.
You had to go elsewhere.

(11:09):
And there is hope.
This doesn't have to bepermanent, it doesn't have to be
a new normal, it absolutely canbe prevented.
And inside the postpartumnutrition certification we
actually walk through how toidentify root causes of
postpartum anemia and what realpostpartum nutrition looks like
beyond leafy greens, and how tosupport absorption, not just

(11:32):
intake, and how to rebuild thephysiology and confidence of new
moms, because you're not justlearning facts, you're becoming
the provider who sees whatothers miss and heal those
things that are often overlookedfor moms.
So postpartum depletion leadingto anemia can this be reversed?

(11:55):
Absolutely, iron rich nutritionis so key, but so is absorption
.
You can't just havenutrient-dense foods, you also
have to focus on theirabsorbability.
So supporting the gut, becauseif you don't have a healthy gut,
there's no healing.
That's going to happen.
Digestion is so necessary.
So making sure that you aregetting the probiotics that you

(12:17):
need, that balanced blood sugaris there to help stabilize
energy and mood, that we'repairing, you know, iron with
vitamin C and avoiding taking itwith calcium and caffeine.
I often see this frequently,like, oh, I'm going to take my
multivitamin, which should haveall of the iron that I need, but

(12:37):
I'm going to drink it with acup of coffee, and so that
doesn't work.
You're actually inhibiting theabsorption of that iron.
So if you're going to take ironsupplementation in any form,
you have to do it away fromcalcium and you have to do it
away from caffeine, which ishard to do when you have a
multivitamin that contains ironand calcium.

(12:58):
It does not work in that way,which is often why I tell women
to not have a multivitamin thatcontains iron.
Just don't do it.
Some of the best sources of ironthat I have ever seen is
through a little thing calledthe iron fish, and I highly
recommend it.

(13:19):
It's an iron fish.
You can go look it up on Amazonand then you just boil that
with your water, you boil itwith your soups, and it is
clinically shown to increaseyour hemoglobin levels
significantly over a period oftime.
I highly recommend it.
I've used it for myself as well.
And then there's other thingstoo.
There's an amazing vegetarianand vegan drink called Floridix

(13:45):
that is liquid and it won'tupset your stomach.
A lot of people have a hard timewith 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 yourorgan meats right, and a lot of
people don't like to cook organmeats.

(14:05):
That's totally fine.
But they have so manysupplements on the line now
where you can just take an organbeef supplement and get a huge
amount of iron into your body ina short amount of time, and
that can be really, reallyhelpful without the gut issues
whatsoever.
So we have a lot of tools atour disposal to really support

(14:29):
us and help us through thisprocess.
That doesn't necessarilyrequire, you know, medical
intervention, such as specificpills or even having some sort
of iron infusion, which can bereally difficult for moms as
well.
You know, of course, if thosethings are necessary absolutely,

(14:50):
but there are some things thatwe can do in addition to things
that we can do in addition to so.
If your clients have depressionsymptoms and hair loss and
shortness of breath or dizziness, please, please, please, test
for anemia.
Always require ferritin, b12and folate, not just hemoglobin.
Low ferritin can look likemental health issues and

(15:13):
treating it can be life-changingand 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, communitiesthey have complete control over
this.
They just need the supporttools to get there, and that is
massive.

(15:33):
That is massive.
I also want to speak to thisquestion.
I always get this in thecertification program is what
about genetics?
What about the MTHFR genevariants and how they can
contribute?
And I will tell you that mostof the time, what we're dealing
with is core nutrition,unaddressed birth, trauma, lack
of professional care inpostpartum, and so, yes, we

(15:56):
inherit the genes.
We inherit also beliefs andhabits and coping mechanisms,
and those are all things that wecan change.
Mthfr is important and we needto address that, but it's not
the root of the problemwhatsoever.
We can have MTHFR and not be ina position where we're

(16:19):
experiencing anemia.
So there is all of that so muchinformation for you in this.
I hope this was absolutelyhelpful and if that lit a fire
under you, I will tell you youare our kind of provider.
We have over 10,000 of usalready revolutionizing

(16:40):
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 pressnewsletter.
I deliver it every singleWednesday.
There's no fluff, no fear, justeverything that you need to
help your clients that muchdeeper, in a way in which most

(17:03):
of us are never taught, and youcan go to postpartumu the letter
ucom, slash press for that andI will get that over to you.
Thanks so much for being a partof this crucial conversation.
I know you're dedicated toadvancing postpartum care and if

(17:26):
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 lastingimpact on postpartum health.
Sign up at postpartumu theletter ucom, which is in the
show notes, and if you foundtoday's episode valuable, please

(17:47):
leave a review to help us reachmore providers like you.
Together, we're building afuture where mothers are fully
supported and thriving.
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