s7 e04: Mineral Shifts In Pregnancy

Mineral Shifts In Pregnancy

Mineral Shifts In Pregnancy

In this episode, I am focusing on mineral shifts that happen during pregnancy, mineral needs that increase, as well as highlighting minerals that I often get asked about when it comes to pregnancy. 

As always, this episode is for educational purposes only. Please make sure you talk with your provider before making any changes. 

I cover:

  • Natural fluctuations in copper and iron levels during pregnancy and their crucial roles in maternal and fetal health
  • Importance of preparing for postpartum by addressing mineral imbalances
  • Why it’s important to maintain healthy levels of crucial minerals like iron, zinc, magnesium, sodium, potassium, and iodine during pregnancy
  • Food source recommendations to support your mineral levels during pregnancy

Thyroid Mineral Training

Links/Resouces:
Copper deep dive episode

Postpartum depression and copper:
Article 1
Article 2

Minerals and pregnancy article

Iron deep dive part 1

Iron deep dive part 2

Iron & iron shifts in pregnancy:
Article 1
Article 2

Iron supplementation:
Article 1
Article 2

Lactoferrin

Magnesium

Iodine:
Article 1
Article 2
Article 3

Potassium

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Free Resources:
Minerals 101 Free Guide
Free Healthy Period Starter Guide
Mineral Imbalance Quiz
Mineral Training
Thyroid Mineral Training
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Amanda Montalvo [00:00:01]:

Welcome to the Are You Menstrual podcast, where we dive deep into all things women’s health to support you on your healing journey. I’m Amanda Montalvo, functional and integrative dietitian, also known as the Hormone healing Rd. If you enjoyed this podcast and you want to keep learning, check out the podcast Patreon, where I share a bonus episode with additional downloadable resources. Each week you can go to patreon.com, hormonehealingrdez or check out the link in the show notes. Okay, we have our episode on mineral shifts in pregnancy. I’m excited to talk about this. Today I’m going to be talking about certain minerals that shift. You know, they increase, some minerals decrease naturally and what that looks like, why it happens, how to support, like, healthy levels of those.

Amanda Montalvo [00:00:46]:

And then I’m going to get into mineral needs that do increase and just minerals that you want to keep an eye on and things that I typically get questions about, like calcium, things like that. So I’m going to dig into all of that. Just remember, like, all my episodes. This is for informational and educational purposes only, and I hope that you learned something. Just make sure you talk with your provider before you implement anything because you never know if it’s a good fit for you, depending on your health history. And we just want to be careful. So that’s my only ask. If you’re watching the YouTube version of this and you’re like, amanda, why is your face, like a little bit reduced? It’s because I’m recording this on a Sunday morning, which I don’t typically do, and I derma roll on Saturday nights.

Amanda Montalvo [00:01:25]:

And I was like, maybe I shouldn’t derma roll. Cause I’m gonna have to record a podcast tomorrow. My face will be red. And I was like, you know, this is a part of my routine and I really like it, so I’m gonna do it. And hopefully people don’t notice. Don’t really care if you’re like, why do you derma roll? I can do content around. I’m in a my holistic, supportive aging era right now, and I’m obsessed with all things like how to support mostly like your skin and things like that long term. So to support, like, I don’t want to say anti aging because I think aging is an absolute privilege and we should be grateful for it.

Amanda Montalvo [00:01:59]:

But just like, how do I do it? In a very graceful, mindful, intentional way. And now I derma roll. I face tape, and I do face cupping. So who ever thought, I never thought I’d do that, but it’s really fun. It’s really interesting. It’s very. I mean, I’m very big on, like, learning about the fascia and how can I support my fascia? It’s the same thing on your face, so very cool. If you’re like, I would love to learn about that kind of stuff.

Amanda Montalvo [00:02:24]:

Send me a DM or comment on the YouTube video if you’re watching there. And I can have people on to talk about this, but. And share kind of, like, my journey with it. But I’m obsessed now, and I never thought I would be, but my whole goal in life, basically, is to not have to wear makeup. And no matter how old I am, what happens, anything like that, long history with acne, feeling very self conscious with my skin and appearance, things like that. I’m like, you know what I mean? My skin’s gotten a lot better, obviously, but moving forward, it’s like, as you start to age, I got two little kids running a business, busy, and it’s definitely aged me a little bit. And I’m like, oh, no, I want to make this as smooth as possible, so let me know if you want to learn more about that, and that’s it. So if my face is red, don’t worry about it.

Amanda Montalvo [00:03:07]:

But I just can’t wear makeup. I refuse. So I’m going to talk about first mineral shifts in pregnancy, like, things that are to be expected, that are physiologically normal during this time. And the first one is copper. I get a lot of questions around copper shifts in pregnancy, and mostly, if a mom gets her labs done during pregnancy, that’s when she’ll ask me, oh, my gosh, my copper was elevated. How do I get that down? I’m like, we don’t want to get your copper down because it’s very normal and healthy for copper levels to increase during pregnancy, and ceruloplasmin will, too. That’s the. That’s the bioavailable form of copper.

Amanda Montalvo [00:03:45]:

I’m gonna. I’m gonna link a lot of episodes that I’ve done to this one, because in order for me to kind of COVID everything, I can’t get incredibly in depth on topics I’ve already covered. So if you’re new here, I think you’ll get the gist. But if you’re like, I want to learn more about copper and what’s, what bioavailable means versus non bioavailable. There is a copper deep dive episode that I’m going to link. Same thing. I’m going to talk about iron because that’s a huge. That’s probably the mineral I’ll get the most questions about in pregnancy.

Amanda Montalvo [00:04:12]:

And I have iron deep dives as well that I will link, so everything will be linked up. I’ve gotten very nerdy on a lot of minerals, but I think you’ll be able to grab what you need to from this episode. But ceruloplasmin is a blood measurement that you can compare to your copper levels, and that is just a bioavailable form. That means that you can, your body can actually use it to take action, especially on things like iron and the iron recycling system in the body. And so you can do blood measurements for copper and ceruloplasmin. You will see both levels increase during pregnancy, and that is because the increases in estrogen lead to increases in copper. And it’s very, very normal. It’s.

Amanda Montalvo [00:04:51]:

They will typically continue to increase as well. When you’re not pregnant, copper is often ideal. Copper levels in the blood serum are around 90 to 115 micrograms. So that’s like, typically, ideally, where we’re starting, they can get up to 261 once a woman is 40 weeks pregnant. I have seen it happen earlier as well, and there can definitely be some issues if someone has copper imbalances going into pregnancy. But for the most part, just know copper is going to increase, it’s going to ebb and flow, and there’s even more of a demand for it in pregnancy because your iron requirements go up, which is what we’ll kind of dig into next. But it’s natural. It’s something that we want to happen.

Amanda Montalvo [00:05:35]:

It’s important for mom’s health, baby’s health. And then in the third trimester, mom does a huge download of nutrients, specifically copper and iron, to the baby. And so that causes shifts in copper levels and iron levels. Some women will see their copper levels kind of go down quickly if they’re monitoring that throughout pregnancy. Some will see them go way up. And it’s all technically normal as long as, like, you’re good in every other way, but you’re gonna see mineral shifts and copper is gonna ebb and flow while you’re pregnant. Same thing with iron. The main thing that can be an issue with copper, and I’ve talked about this before, is so it increases, increases, increases, it will peak, and then sometimes it’ll drop a little bit in the third trimester, sometimes it will not.

Amanda Montalvo [00:06:19]:

And that either one is normal and healthy. But then from there, you want, it can take like, two months to go back down to those 90 to 115 levels postpartum, and the high copper levels postpartum for some women can contribute to postpartum depression. So it’s not. Copper is not the only nutrient to contribute to this. And I. I’m going to link to some research articles on copper and postpartum depression, and I think it’s so great that they’re taking a mineral approach and they’re thinking about, like, how does this shift in copper affect mental health postpartum? And I think that’s awesome. I’m just like, there are definitely other minerals that are also going to play a role. Like, low iron can play a role.

Amanda Montalvo [00:07:06]:

Low copper, not just high copper and then low zinc and low magnesium. They have not looked at things like low sodium and potassium or low iodine. And I’m like, that’s going to affect thyroid function, which has a huge impact on mental health. So I don’t think it’s ever just one thing. But as far as, like, what we have for the research right now, at least, what I found in the work that I’ve done is that it’s often this elevated level of copper that stays high if it stays high for too long. Maybe you have some copper imbalances, maybe there’s some deficiencies, or maybe there’s a lot of inflammation that can also drive up copper sometimes, and that can lead to issues with mental health status postpartum. So just something to be mindful of. I tend to, if I have a woman that has a history of mental health issues already, like, maybe it’s depression, maybe it’s anxiety.

Amanda Montalvo [00:07:57]:

Honestly, even things like ADHD. I do hair testing throughout pregnancy. I recommend doing it before, at least once during, typically towards, like, no earlier than second trimester and, like, towards the end of pregnancy so that we can get an idea of, like, what’s going on with your minerals and is there anything we can kind of prepare for? I also like to arm them with things that you can do to help rebalance copper. Like, vitamin C is awesome, especially if you can get a whole food version, like Camu. Camu powder works for most people. You can also just get it straight from food. But that can really help balance out copper. Getting enough vitamin A is key.

Amanda Montalvo [00:08:35]:

So some. It’s a. If they need it in like, a supplement form. I like cod liver oil. Cause it’s whole food based. I don’t like synthetic retinol palmitate. It’s just I. I get very nervous with the liver and things like that.

Amanda Montalvo [00:08:47]:

And so I prefer to get that cod liver oil version of retinol. I I don’t recommend plant foods as that vitamin a source. Cause you have to then convert that. And a lot of people have genetic snips that prevent them from converting all of it and only convert a small amount. So getting that retinol, that active version, is very powerful. So working on those two things, and then, you know, if this person already had elevated copper, I would not recommend something like beef liver. And we would utilize working on other whole foods, cod liver oil to get vitamin a, whole food, vitamin c, things like that to balance that out. And I also absolutely love Taurine, because taurine can help convert that excess copper to ceruloplasmindhenne.

Amanda Montalvo [00:09:28]:

Because a lot of the times, if we have excess copper and then we don’t have adequate levels of ceruloplasmin, it means that we just have this bio unavailable copper that we can’t really use because it’s not in that active form. So those are things that I like to consider if someone has that health history. Want to arm people with postpartum, because it’s like, you don’t want to have to test when they’re in the middle of this chaos and just, like, stress, you know, you want to be like, okay, here, this is. We know what your labs were before. This is how you’re feeling. This is likely what’s happening. Let’s take some action and see if we can help. And then supporting progesterone during that time can also be very helpful.

Amanda Montalvo [00:10:02]:

Obviously, even if you’re not cycling, there’s some pretty cool research around bio identical progesterone and postpartum depression as well. So those would be all things I would have someone armed with ahead of time, just in case, to support themselves. Postpartum. I also love. I’ve talked about this in my postpartum episode, but milk Moon herbs, they’re nervous system based, and so they have different blends. But, like, the no worries blend, I tell every mom now, I’m like, please get this blend for your postpartum. It’s phenomenal. It works.

Amanda Montalvo [00:10:31]:

It really does calm your nervous system. And they have a. They have like, a. Oh, my gosh. Cloud nine is what it’s called. They have very cute names for all their blends, and that can, like, help support the baby blues. Like, normal post baby blues, probably not. Postpartum depression, you’d still want to have, like, an understanding of everything else, like mineral imbalances, progesterone, like I talked about, but that could help in general for, like, more acute mood stuff, but copper shifts it shifts in good ways, it can shift in bad ways, and, like, that’s how I would consider supporting it.

Amanda Montalvo [00:11:01]:

The other big mineral shift is iron, and this is the one that I probably get the most questions about. Basically, we are going to have iron levels decrease naturally throughout pregnancy. It’s very natural. Typically, this is being monitored via hemoglobin levels most often. I have started to see mostly midwives. Not even all home birth midwives, even just like, a typical midwife in a hospital, are starting to look at other iron stats. This is like a kind of theme we’ve seen with a lot of our clients. And I’m like, oh, she’s actually not just measuring hemoglobin.

Amanda Montalvo [00:11:34]:

This is amazing because it’s so much more than just hemoglobin when it comes to iron status. Right. If you’ve listened to my iron deep dives or, you know, seen any of my content around iron before, then you know that iron is much more complex. And we have a whole iron recycling system in the body that requires copper and vitamin A and magnesium in order to function properly. If we have a lot of stress or inflammation that will affect our iron recycling system, and a lot of the times, that’s coming from, like, mental, emotional, physical stress, and also, like, things like stress and inflammation within the gut. So iron is not just like, it’s not an easy, like, oh, you have low iron, let’s take iron. It’s like, okay, where’s the breakdown happening? Is it actually iron? Do you need more copper and vitamin a, too? Are those deficient? And iron is deficient? Or maybe just copper and vitamin a? And then the other big piece I often see is there’s just a true absorption issue in the gut, because the amount of inflammation and maybe a history of, like, infections or gut issues, things like that. And so then it’s like, okay, well, you can support all the copper and vitamin a and iron you want, but if absorption isn’t great, then none of the levels are going to improve.

Amanda Montalvo [00:12:41]:

So we always want to try to put our investigator hat on when we’re thinking of, why are my iron levels not optimal, whether it’s during pregnancy or not, but during pregnancy, it’s typically measured via hemoglobin. It’s gonna shift. It’s normal. Cause hemoglobin production stays the same, but your blood volume increases. So blood volume increasing really significantly in the third trimester. But since hemoglobin production stays the same, overall hemoglobin is going to look lower. And that is accepted. That is a generally accepted idea.

Amanda Montalvo [00:13:15]:

Even within conventional medicine, but there’s, they’re cut off. And, like, even if it’s like, it depends on the doctor or the midwife, the ob, whoever you’re working with. But everyone’s got, like, a different cutoff. Like, and I’ll talk about, like, the deficiency, true deficiencies and stuff like that, but it’s accepted, but sometimes it’s not honored, you know, oh, we know that your hemoglobin is going to increase, but we still want you to supplement with iron anyway. So this is why it’s so important to educate yourself so you can advocate for yourself. And again, like, if it were no big deal to just take iron, I think it wouldn’t be a problem. I’ve just worked with so many women that it’s like, minerals work synergistically. If you take iron, your zinc, it’s probably going to go down.

Amanda Montalvo [00:13:59]:

You know what else is really important for pregnancy? Zinc. Health of the mom, health of the baby. That’s also really important for postpartum mental health, thyroid function. So it’s just that it, like, so I get a lot of, like, why can’t someone just take iron? And I’m like, they could, but it. It’s just so important to keep in mind that it’s not just taking iron. It does. Although it’s a mineral and you can buy it over the counter, it does have an effect on our health overall and our mineral status, which can affect all the different systems in our body. So I’ve just seen a lot of issues with women postpartum that have taken iron, especially if they have history of gut issues, because they’re like, that can feed pathogens and bacteria can fuel inflammation.

Amanda Montalvo [00:14:38]:

So it’s not that we never take it. I do have clients that take, like, a whole food source of iron if they truly need it, whether they are pregnant or not. But I think it’s important to know, like, what’s normal, what is expected, and then what could actually be a true concern. The other reason that in the third trimester that that iron, that hemoglobin level is going to decrease is because of that transfer that I talked about previously with copper and ironization going to the baby. So the baby’s going to get a huge amount of iron and copper in that third trimester. That will lead to a decrease in hemoglobin that is normal and expected. But if we already have a deficiency in one of those areas, or maybe vitamin a levels are low, which a lot of women, it’s like, I think it’s a third of women of reproductive age are entering pregnancy with low vitamin A levels. It wouldn’t be shocking if that was an issue for someone that can make hemoglobin diphtheregh too low.

Amanda Montalvo [00:15:32]:

And that is a concern. And that is. I would consider that a true deficiency. We just want to understand where it’s coming from, because, again, iron recycling system is not just as straightforward like most mineral things. Not just as straightforward as, like, low iron. Need more iron. You want to look at? Okay. Do you need more iron rich foods in your diet? That is very common.

Amanda Montalvo [00:15:52]:

Red meat. It’s like, we cannot be afraid of red meat, especially if you are getting a high quality source. I get all my meat from wild pastures. It’s not an ad, but I would love for it to be. I spend a lot of money with wild pastures. We get 99% of our meat from them, and the quality is just unmatched. If I had a farm I could go to locally, I would, but we don’t. Where we live, I’d have to drive an hour and a half.

Amanda Montalvo [00:16:15]:

And I’m just not in a place to do that right now with a baby and a toddler and a busy schedule and a husband who’s gone a lot. So we don’t do that. If you have a local farm, you could. If you’re like me, they are a good option to consider. It ends up being like $9.99 a pound on average, which you can. You’re getting all different cuts of meat. So all I’m saying, again, not an ad, I don’t have an affiliate code. It’s just, it can be to me, for us, it is worth it.

Amanda Montalvo [00:16:42]:

But even I still think if you cannot get grass fed, pasture raised meat, meat is still healthy for us. And I know a lot of people don’t agree with that, but it’s still incredibly nutrient dense. And if you’re looking for an iron source, the best way to get it is from food. So something like beef liver or beef liver is an okay option. But like any. Any red meat is going to be an amazing option. Even things like chicken liver, oysters are a great source of iron. Sardines give us a decent amount of iron, venison, things like that.

Amanda Montalvo [00:17:12]:

But, like, red meat gives us a lot. And then chicken liver is probably the highest. So you can absolutely get more from food. And I would say that’s like, the first thing I go towards is I’m like, what is your diet like? Are you getting iron in your diet? And then did you have a deficiency going into pregnancy. Very important to know. And then how is your digestion? Do you have a history of digestive issues, symptoms, bloating, gut health issues, ib’s, anything like that, infections, because all of those can affect our ability to break down the food, absorb the food. If there’s a lot of inflammation in the gut, you’re probably not absorbing those nutrients well. And then that’s when you have to take a different approach.

Amanda Montalvo [00:17:52]:

Yes, you can add more iron in your diet, but you probably also need to support your digestion. Maybe it’s apple cider vinegar, maybe it’s pregnancy friendly digestive bitters, like the calm tummy bitters from urban moonshine. Maybe it’s digestive enzymes, you know, it just depends on the person and. But those could all be strategies used to help reduce inflammation in the gut, support the breakdown, absorption of that iron. I also love lactoferrin. It’s one of my favorite supplements to utilize for women that are actually have low iron levels, especially if they have gut health concerns, because that lactoferrin will increase the absorption of iron in the intestinal cells, which will then help that iron get into the system and then the body. You still need copper and vitamin a and ceruloplasmin to get it into the iron recycling system and using it in the body. But that first step is crucial.

Amanda Montalvo [00:18:43]:

So if that is not happening for someone because of their health history, then I think definitely focusing on digestion and possibly something like lactoferrin could be helpful. You don’t have to take a lactoferrin supplement. Make sure you talk to your doctor. If you have a history of hemochromatosis, do not take it. If you have a history of pcos, talk with your doctor to make sure your iron is actually low, because pcos, you’re more likely to have high iron. So that’s something to consider as well. But if you truly have low iron, lactoferrin can be very helpful. You could also try to get it from a whole food form like colostrum.

Amanda Montalvo [00:19:17]:

That is something you could consider. Like you can get like a powdered colostrum. You can get a supplement colostrum that will have some lactoferrin in it. It just cannot be too heavily processed. It needs to be processed very carefully. Otherwise that lactoferrin gets, that protein gets denatured. So I would. I like to have people do whey protein if they can.

Amanda Montalvo [00:19:36]:

Paleo Valley. I know they also, they’re the people that make wild pastures. I’m like a walking paleobaliad but they have a whey protein that has colostrum in it. And the way they have a very low heat way of processing the whey protein. And so nothing gets denatured. And you can tell because if you mix it with too hot of a liquid, it all. So it’s incredibly high quality. I love it.

Amanda Montalvo [00:19:59]:

It mixes well with things. So we have a lot of our clients do that if they can tolerate whey protein. And we’re like, yeah, we don’t want to go too supplement heavy. Like, we want to be cautious, but we still want them to get support. So that’s like one that you could consider too. If you’re like, okay, I think that I have this digestive health history, this history of inflammation, gut issues. If you can tolerate whey, that would be the route I would take. If you cannot, you could just do lactoferrin or colostrum supplement.

Amanda Montalvo [00:20:23]:

And then the other areas you wanna consider is, do I have low copper, do I have low vitamin a? So you could test your hair or blood work for copper. Vitamin a levels you wanna test in your blood work, you wanna look at retinol. So that could be something that you consider as well as far as, like, what is a deficiency? What is it? When it comes to hemoglobin levels in pregnancy, non pregnant women is 12.5 to 13.5 milligrams per deciliter is considered optimal for the first half of pregnancy. It’s the same 12.5 to 13.5. I do see some women dip below that 12.5 in that second trimester. I would still consider that normal. But if you’re starting off pregnancy with lower levels than the 12.5, then that’s a little indicator of, hey, maybe my iron status isn’t quite optimal. And this is something that I want to pay attention to because as I go throughout pregnancy, it will continue to get lower.

Amanda Montalvo [00:21:16]:

Improving our thyroid health can be complex, right? It’s so much more than just knowing, am I making enough thyroid hormone? We really need to zoom out and look at the full process and picture and understand, okay, how is the signaling from my brain going? Is my thyroid getting the signal to make more thyroid hormone? And then you have to think about, is there anything my thyroid might need that it’s not getting to produce that thyroid hormone? Maybe there’s a nutrient deficiency, maybe there’s too much inflammation or stress. Then we want to think about, can it convert it? Right. That’s the next big step. And that’s typically impacted by stress, inflammation and nutrient deficiencies. As well, and then finally we have to realize, can it get inside the cells? And this is where minerals come in big time. So zooming out, understanding your full picture is so critical for thyroid health. This is why I created my free functional thyroid series. That is a six part video series.

Amanda Montalvo [00:22:10]:

It’s a mini course. I’m really proud of it. It gives you a ton of information and it’s going to help you figure out what is the root cause of your thyroid issue. Where in the process is it breaking down for you. I even go through lab tests and teach you how to understand what your lab tests mean and what you might want to optimize based on your results. So make sure you check it out. You can go to the description of this podcast and get the link to join for free. And then in the second half of pregnancy, the levels vary.

Amanda Montalvo [00:22:41]:

So I went through the root cause protocol training many years ago now, and what I learned in that training is that that’s where I learned all about the iron recycling system. Truly, I’m so grateful for it because it’s so important. And while we have known about the iron recycling system for a while, no one really talks about it. And I feel like in conventional and functional medicine, it’s just like, eh, it’s too complicated. We’re not going to try this. We can’t just like ignore all of this because we think it’s hard to explain. We just have to figure out how to teach it to someone. And I know with the women that I work with and in my community, they’re very diligent in learning things, and even if they don’t understand it right away, like, they will continue to try to learn and figure it out.

Amanda Montalvo [00:23:18]:

So I’d rather just explain to you guys what’s going on. So when it comes to like, and I know some people want like a black or white answer, but not really like that with iron, but they recommend 8.5 to 9.5 is optimal in the second half of pregnancy. I’ve been doing this all for a long time. I think that that is, I personally don’t really like to see it below nine, and if it’s below 8.5, I’m like, that’s low. And I also think that we can’t just only look at that number, because if someone started their pregnancy and say their hemoglobin was 13.5 and then all of a sudden it was 8.5 in the second half, I’d be like, that’s a really big jump. Like, that’s a little concerning for me, and I would probably get into more of, like, what have you been eating? Let’s talk about that. Let’s get into, like, are you eating enough red meat? How is your digestion been? How have your bowel movements been? Have you had any illnesses during this time? Because, you know, pregnant women do get sick, and that can 100% affect your iron status as well. So it’s just, it’s more complex than like, oh, if you’re this range, you’re good.

Amanda Montalvo [00:24:22]:

If you’re this range, you’re totally fine. Because the concern is a lot like, there’s some research that shows if your hemoglobin is too low, you have an increased risk of hemorrhaging. And then there’s others research that says that that’s actually not the case in that 8.5 to 9.5 hemoglobin during the second half of pregnancy is normal. And because of how estrogen and blood volume shift, and you’re not gonna. It doesn’t increase your risk of hemorrhaging. Again, I’m going to base it on the person because I think that’s what matters most. We have to keep medicine, like functional medicine, conventional medicine, whatever it is, individualized to the person. You can’t just go off lab values.

Amanda Montalvo [00:24:59]:

People aren’t a lab value, you know, so that is something. I don’t have, like, a perfect range. I just have, like, this is what, this is what some schools of thought say, 8.5 to 9.5 second half. Conventional medicine says, really, realistically, it’s like 10.5 to 11.5 in the second half of pregnancy. But I have seen plenty of women that have a hemoglobin of ten or like 9.89.5, and they’re perfectly healthy, they’re eating well, they have no signs or symptoms of iron deficiency. And so in that case, it’s like, okay, your iron levels are likely fine. And then when we look at their health history, they do have a history of maybe, like, estrogen dominant symptoms. And it’s like your estrogen could just be more elevated and negatively impacting the iron levels, which obviously isn’t great, but maybe it’s like, maybe we work on liver support.

Amanda Montalvo [00:25:53]:

I wouldn’t jump immediately to iron supplementation, even whole food base for them. I’d really trying to be strategizing. What does your body need, based on your history? Is it more iron from food? Is it digestive support? Is it liver support? Because we store a lot of iron in our liver, and so if they already have this history of estrogen dominics, maybe their liver is just extremely taxed right now, things like that. So there’s no perfect, like, protocol that I have if your iron levels are low. But I hope that gives you some areas that, like, you may want to investigate and things just to think about and talk about with your provider. So how much iron do we actually need during pregnancy? The RDA for iron in pregnancy is 27 milligrams daily, which is one and a half times more than the typical RDA for non pregnant women, which is 18 milligrams. For menstruating women. It decreases during menopause because obviously you’re not bleeding and losing blood every month.

Amanda Montalvo [00:26:45]:

But our bodies do require more iron during pregnancy because of this increase in red blood cell production, the growth of the placenta and the growth of the baby. Those all require iron. So I’m not saying we don’t need more. We just. We just want to be a little more thoughtful than like, oh, you just need iron. Cause it’s like, well, what if you actually need vitamin a? That means your baby needs vitamin a, too. How do you think we’re also vitamin a deficient? It’s not just from our diets. We inherit our nutritional status from our parents as well.

Amanda Montalvo [00:27:13]:

So just something to think about as far as, like, how do we support levels? I already went through, like, the cod liver oil strategy, you could, the lactoferrin or whey protein strategy, supporting digestion, things like that. I also love blood building herbs during pregnancy and postpartum. I talked about how I use a lot of these postpartum to support milk supply, but things like nettles, dandelion, burdock root, yellow doc, and alfalfa, these are all great to support your blood building capabilities. And they do all contain small amounts of iron as well. So those are ones that I like to incorporate for clients. And this could even just be like, you drink nettle tea throughout pregnancy. You know, you. You don’t have to get, like, a blend, but, like, nettles, dandelion, things like that.

Amanda Montalvo [00:27:58]:

If you have liver concerns, I would say, like, let’s incorporate dandelion because that could be very supportive for your liver as well. If you have histamine allergy stuff, let’s focus on nettles because that can also help with histamine issues. So, I mean, there’s many different ways you could approach it, but it’s, to me, the blood building herbs are, they don’t harm anything. They’re not going to lead to any big imbalances, but they can be supportive. So no matter what approach you take, if you’re like, I kind of just want to do something more, then you could consider those. A lot of them support digestion too, so that could be something that you consider. And as far as, like, whole food iron supplements, if you’re like, I really need to take an iron supplement, like, what do I take? That’s when I would say beef spleen is a great one that has a lot of iron that can get your whole daily requirement, like 27 milligrams in like one serving. And then from ancestral supplements, I think perfect supplements has a beef spleen as well.

Amanda Montalvo [00:28:51]:

And then ancestral supplements has a supplement called blood vitality that’s a very iron rich one as well. So those are the ones I typically recommend. But if your levels don’t increase with those, the question is, what else is going on? So don’t hesitate to investigate. If you’re in the masterminerals course and you’re like, I don’t know what to do, my levels are not increasing. Please comment because I would love to support you and help you figure out what’s going on. Okay, so those are the first two. I did not think I was going to spend that much time on copper and iron, so I’m going to go a little faster through the rest. If you’re in my Patreon, you’re gonna get all the notes from the episode anyway.

Amanda Montalvo [00:29:29]:

So if I don’t get to absolutely everything, you can still read through the notes in my PDF that I always post with the episode. If you’re like, what is your patreon? It’s just a podcast, Patreon. I do bonus episodes there. We do Q and A’s. It’s very fun. Everyone there is so nice and just like gracious and kind and so if you’re, if you wanna, I always have the link in the show notes. It’s just patreon.com hormonehealingrd. But I do always post my notes for the episode because I’m a very visual person and I have to have everything, like, organized and written out.

Amanda Montalvo [00:29:59]:

So the minerals that I want to just cover quickly. As far as, like, ones, I often get questioned about calcium. I mean, I get so many questions about, do I need a calcium supplement in pregnancy? And I’m like, it really depends. So the RDA for calcium doesn’t change during pregnancy. It’s one of the few minerals that does not change, and that is because we have a biological mechanism that naturally increases our absorption of calcium in the gut. So basically, what happens is we release more our vitamin D levels. The active vitamin D, the 125 vitamin D increase during the first trimester and it’ll peak during the third trimester. But it even starts even in the first trimester, and that increases calcium absorption in the gut.

Amanda Montalvo [00:30:42]:

It’s also, you know, kind of activating for your immune system. So I don’t typically recommend calcium supplements. What I will say is do a hair test. That is like, the best way to know, do I need more calcium? I always do one, like, I’ve done it like right before be conceived or like early in the first trimester. And then I usually do one halfway through or more towards, like, beginning of the third trimester, depending on, like, what your capacity is. What do you have capacity to change during that time? But before or during the first trimester is so ideal because then when you’re kind of questioning, like, what prenatal do I need, what supplements do I need? You’ll know because you have a test that shows you. But calcium is a great one to look at on there because for some women, a lot of times you, you increase to a fast metabolic type during pregnancy and you will need more calcium. And you can absolutely get that from food sources.

Amanda Montalvo [00:31:35]:

You know, you can get it from dairy, obviously, but you can also get it from things like sardines, salmon, cooked greens, like collard greens have a lot of calcium. Kale, casein protein powder has a ton of calcium. It’s like a supplement, basically. And then eggshell powder is one that I love. Forefront health makes one if you don’t want to make your own. And it is perfect. It’s like a nice thin powder. It’s really hard to make your own and have it come out like that.

Amanda Montalvo [00:32:00]:

I love theirs. Highly recommend it. The jar lasts a long time unless, you know, depending how much you’re taking. But that is one that I’ve utilized during pregnancy and postpartum breastfeeding, because you give a lot of calcium to the baby while you’re pregnant, but you give a lot of calcium to the baby while you’re breastfeeding as well. This is where it can potentially impact bone health. But then once you’re done breastfeeding, typically your bone density restores to what it was previously. But during pregnancy, usually you can give the baby 50 milligrams a day during the second trimester and then 250 milligrams a day during the third trimester. And while you’re breastfeeding, I mean, it can go up to 1000 milligrams a day, just straight to the baby.

Amanda Montalvo [00:32:40]:

It’s crazy. So that is one where I would say it really depends on your calcium status going into pregnancy. I know some women just automatically take one. I wouldn’t necessarily recommend that because if you don’t need it, you don’t want too much calcium. And ideally you get like a food form. But the easiest way is, like, through food. Eggshell powder, casein protein. If you can tolerate it, that will give you a lot of calcium.

Amanda Montalvo [00:33:04]:

But test your levels. Test, don’t guess if you can. And then iodine. I love iodine. We have a whole iodine series coming because it’s one of my favorite minerals. It’s had a huge impact on my life. Life. And it’s impacted.

Amanda Montalvo [00:33:17]:

Some of the nutritionists that work for me have utilized it personally. A lot of our clients have utilized it. It’s not for everyone. I will say that it’s kind of like one of those things where it’s like, if it works for you, it’s amazing and life changing, and if it doesn’t, it’s not great or you saw, like, no change. But usually that’s more related to stress. So it’s either like really good or really bad. But iodine is very important during pregnancy. And it’s one of those minerals that I’m like, I would love for most people to work up to being able to tolerate a low dose of iodine.

Amanda Montalvo [00:33:47]:

It’s important for the production of thyroid hormones for mom, for baby, then their future thyroid function. It also regulates the development of the baby’s brain and nervous system, which is something, obviously all of us want to support. And our iodine needs to increase during pregnancy and breastfeeding. And a lot of prenatals now have the RDA for iodine, which I believe is like 250 or 260 micrograms daily. So it jumps like it almost doubles while you’re. No, it does. It more than doubles while you’re pregnant versus not for rdas. And that it’s so important for the baby’s brain development.

Amanda Montalvo [00:34:22]:

And there’s actually studies on that. I’ll link in the show notes, as always. They’re always in the show notes, and you can get them on my blog because I have so many things that I link that I can’t put it in the show notes for everything. It’s always like on the blog post that goes with the podcast episode. And if you ever can’t find it, just email contactormonehealingrd.com and we can help you. But there are some cool studies that show iodine supplementation can lead to higher iqs and then unfortunately, deficiencies in iodine can lead to lower iqs and cognitive impairment and in some babies, congenital anomalies. It’s really important for mom and baby, though. It’s, it’s not just like one or the other, and it’s one that.

Amanda Montalvo [00:35:00]:

I do also think that we need to take carry with us into breastfeeding as well, and not just like the first six months of the first year. It’s like however long you breastfeed because you never really know unless you’re pumping how much you are giving your baby. And like, there’s going to be times where ebbs and flows. Sometimes you’re like, oh, they’re not eating that much, but it’s like they’re older, they’re getting more in one sitting. So when in doubt, if you’re pregnant postpartum nursing, even if you’re not nursing postpartum, I would still take it for, I would say like a year for most people, because you are trying to replenish from growing a baby for nine months. And during that time of replenishment, you’re also taking care of a baby and maybe you have other kids, other responsibilities, other life things, so it doesn’t hurt. And then as far as, like some signs of deficiency, here’s the thing, I don’t think you should just wait for signs of deficiency to take iodine or like many minerals. Like, we’re not waiting for signs of magnesium deficiency to take magnesium.

Amanda Montalvo [00:35:57]:

Right. Most people just widely accept that magnesium is very important. We use a lot of it up when we’re dealing with stress. It’s beneficial. I look at iodine like that, not in excessive amounts, but in smaller doses on a regular basis, either from food or from a little. A little help from supplementation, depending on the person, is incredibly supportive for our health. But especially if you have a history of like brittle nails, cold hands and feet, constipation, hair loss, depression, dry or scaly skin, or like puffy skin, edema, fluorid retention, headaches. If you, if you’re struggling with things like reflux, impaired mental function, irregular cycles, muscle cramps is another sign, muscle weakness too, not recovering well from exercise, poor memory, and then things like weight gain or just like, I guess like weight loss, resistance would be like a good way to put it.

Amanda Montalvo [00:36:51]:

So those, those can all be signs. Honestly, our thyroid affects every system in the body, so that’s why when you look at a list of hypothyroid symptoms, it’s like, oh, it’s like, everything. And if you are someone that is hyperthyroid, iodine also can be very helpful. Do not take it blindly. Please work with a practitioner that is educated on using iodine. Most people will be like, no, you shouldn’t take iodine ever, especially if a thyroid concern, whether it’s hypo or hyper. But we utilize it with both in our practice. We’re just very careful with autoimmune conditions, specifically Hashimoto’s graves.

Amanda Montalvo [00:37:26]:

It’s like a lifesaver. It’s like an absolute lifesaver. Hashimoto’s. You have to be very careful when you have to work on other areas before you can utilize iodine. But it is. It can be very helpful in healing. If you’re like, I can’t work with a practitioner. Try to get it from food.

Amanda Montalvo [00:37:41]:

Seaweed is going to have the highest amount naturally. You can get some from dairy products, seafood. There’s a small amount in eggs. There’s a small amount in fruits and vegetables. So you’re likely getting some and then supplements. It’s like you have to take cofactors with iodine. So don’t you worry. I’m going to go through all this in the iodine series and talk about iodine utilizing iodine, things like that, because we’re already 40 minutes into this episode, so I’m not going to go through it all now, but I am going to cover that.

Amanda Montalvo [00:38:12]:

So if that interests you, make sure you listen to those episodes. But it is very important during pregnancy, and if you are taking a prenatal, I would just check, does it have iodine and how much? Because the RDA is going to be. Oh, it is 220 micrograms for breastfeeding or for pregnancy and 290 for breastfeeding. So, you know, is it in there? If not, then maybe you want to try to prioritize getting it from food. Okay. Zinc. I actually don’t get an overwhelming amount of questions about zinc and pregnancy. And I’m like, why? You know, I think it’s a very important mineral for pregnancy.

Amanda Montalvo [00:38:47]:

If zinc is deficient before we conceive, it can lead to poor placenta development, which is going to impact fetal development, increases the risk of miscarriage, can lead to low fetal weight, neural tube defects. All things that I’m like, these are a big deal, and these are definitely things that I know that women are dealing with, but I just don’t think there’s enough attention brought to the fact that zinc can impact these. Iron gets so much attention when it comes to, like, growth and development and then like folate is always focused on, right, heavily for neural tube defects, as it should be. But there are other nutrients that are involved in that as well. And when those are just areas that we want to consider. Also for egg quality, it’s really important for the development of the egg and making sure that it matures properly, which is going to affect our ability to conceive and maintain a pregnancy. So sinks are very important, one for men and women, for fertility, and one that we definitely want to focus on. It is very easy to get from food.

Amanda Montalvo [00:39:42]:

If you eat red meat regularly, I would. I like women to eat it every day. And I know everyone feels differently about that, but I think it’s an important one to eat every single day. You can get four to six milligrams of zinc in 3oz of beef. And the RDA during pregnancy is eleven milligrams per day. And then during breastfeeding it’s twelve milligrams. So if you can eat red meat, you can also get it in seafood, oysters, crab. There’s a good amount in pork.

Amanda Montalvo [00:40:11]:

Chickpeas are going to have some. It’s not as bioavailable because it’s not an animal food. Turkey, chicken, eggs have a small amount. Shrimp has some. It adds up like, there’s like a little bit in a lot of foods. So that’s like the other benefit of eating a mix of animals and plants, but definitely incorporating red meat and seafood into your diet on a regular basis. So zinc is a very important one. Low levels have been linked to postpartum depression along with the imbalances in copper.

Amanda Montalvo [00:40:37]:

It’s, it’s a big one. And it’s one of those where you’re kind of like, how do I know if I need to support it? Hair testing can help. If you can’t get a hair test, then what I think about is you have a history of inflammation and gut issues. Probably need some prioritizing rich foods if you do. Again, we have to be so careful with supplementation. If we take zinc, that could, that could lead to lower copper and iron. So it’s like sometimes you would just take the supplement because the benefits outweigh the cons. But if you are someone that is already pregnant and struggling with low iron, please be careful with zinc because it could potentially make it worse.

Amanda Montalvo [00:41:12]:

And then, you know, you’re, you’re just. Especially if you’re working with a provider that’s like, you need to have this level of hemoglobin if you want to do like a home birth or something. Just be smart and don’t overdo supplementation. Sodium is another really important one. We need enough sodium. Our needs do increase during pregnancy. This is a controversial one, because if some, some places are like, some studies are showing that you don’t, there are a lot of studies showing that you do. I think that you absolutely do need more sodium while you’re pregnant.

Amanda Montalvo [00:41:39]:

The issue is that a lot of women are not getting enough potassium, so they’re increasing sodium, not getting enough potassium. They can get fluid retention, a lot of unwanted symptoms. So we just want to be mindful of the fact that sodium and potassium work together. So if you only increase sodium, you get fluid retention. Your blood pressure might go up, but if you’re increasing sodium, but you’re also increasing potassium, and that’s like the next mineral we’ll get into, that can be a beautiful balance in a way to support your adrenal glands, your thyroid function and hormone use in the body. Blood sugar levels, sodium, potassium, are both really important for insulin sensitivity and getting glucose inside the cell, which supports healthy blood sugar levels. Both of them are just so important for avoiding complications in pregnancy. And then you’re going to need more postpartum, whether you’re breastfeeding or not, because like I said before, if you’re breastfeeding, it’s a huge demand on your body.

Amanda Montalvo [00:42:34]:

We, you know, when you’re pregnant, you have the increase in fluids, fluid volume, so you need more. And that blood volume, you need more. And then postpartum, if you’re dealing with stress, everyone is good stress, bad stress doesn’t matter. You’re dealing with more. You need support. You’re nursing, you definitely need more. And it’s just like a really important way to be able to handle stress better and just, and make sure you are staying hydrated. So sodium potassium are huge, too.

Amanda Montalvo [00:43:00]:

Low sodium can lead to insulin resistance, that can cause issues in pregnancy, that can lead to gestational diabetes, it can contribute to preeclampsia. So we want to be very mindful of that. And then when it comes to potassium, that if you are struggling with blood, with blood pressure, which I do see a lot, and it’s, and sometimes it’s like stress related, sometimes it’s imbalances and minerals. Potassium is a amazing way to naturally bring your blood pressure down in a, it’s a very gentle way to do it. And so that’s one where it’s like, try to increase potassium rich foods for Patreon. You guys have that whole list. I’ll go through some of them now, like potatoes, sweet potatoes, tomatoes, parsnips, spinach, swiss chard, any green. I always say cook it because you’re not going to absorb as many minerals if it’s raw.

Amanda Montalvo [00:43:46]:

And then, of course, fruit, like mango. Beans are great sources. Black beans, chickpeas. Beets are phenomenal. They’re right up there with potatoes. They have a ton. I have had clients that have success with, like, a beet powder, too. Oh, my gosh.

Amanda Montalvo [00:44:00]:

Doctor Cowen, that that brand makes really, really high quality vegetable powders, all different kinds. I’ve linked to them before. I think I’m on my website. I can’t remember. I love them and they have like, a beet powder. And I will have some of my clients utilize that when they’re pregnant. If they have elevated blood pressure just to consistently get, like, a good dose of potassium, of course they’re drinking adrenal cocktails utilizing that. That’s going to give you sodium potassium, too.

Amanda Montalvo [00:44:29]:

But getting that extra boost on a daily basis can be great. There’s also studies around beats and high blood pressure in pregnancy, too. So that could be something that you want to consider. But getting enough sodium potassium is so important. It’s also very helpful for morning sickness. I think that some level of morning sickness is very normal. I know some people disagree with that. I think there’s some amount is normal, especially your first pregnancy.

Amanda Montalvo [00:44:53]:

Your body’s never done that before. Hormones are increasing. Hcg is surging, and that will lead to more nausea. The more hydrated you can be, the less nauseous you’re going to be. Doesn’t mean it’s going to take it all away. But that is when I’m like, please, like, maybe you put a little bit of salt under your tongue. You add a pinch of salt to your water throughout the day, drinking adrenal cocktails, eating potassium rich foods, when you can maybe incorporate beet powder if it’s appropriate for your health history. You don’t want to do it if you have low blood pressure, by the way, got to be careful, especially when I think about my, like, mass cell activation people and pots people, please be careful and make sure you’re having plenty, plenty of sodium.

Amanda Montalvo [00:45:31]:

I have two episodes on mcas pots and hypermobility that I did with Michelle Shapiro, so if you fall into that category, please listen to those or just like, you know, touch base with me on social media or something. But, yeah, so sodium potassium are very important. They’re going to support blood sugar, thyroid function, reduce nausea, make sure you’re hydrated, support that rising blood volume, all those things, and they’re. And they’re gonna. I get a lot of questions around, like, how do you avoid fluorid retention in pregnancy? And I’m like, you want to make sure you’re having a nice balance of sodium and potassium. Usually it’s adding more potassium in, but I’ve seen an overwhelming amount of women just not consuming enough sodium, and that’s having a huge impact as well. Protein intake is also critical for protein balance, which helps keep fluid in the right place. So making sure you’re eating enough protein as well, which I know can be challenging depending on how you’re feeling and your appetite and things like that.

Amanda Montalvo [00:46:23]:

But it really can help make a difference if nothing else is as well. So those are the major minerals that we want to focus on during. There’s obviously other minerals during pregnancy, but these are some of my big ones that I want people to just understand. Copper is going to increase. That’s normal. Iron is going to decrease. That is normal. I went through a lot of strategies on how to support that.

Amanda Montalvo [00:46:43]:

If you guys have any questions, obviously in Patreon, just leave them below. And everyone else, you can always touch base with me on social media. I hope this episode was helpful. I’ll cap it here. And then if you’re wanting to learn more about iodine, I am going to be doing that in the next couple episodes, so make sure you check in for that series. All right, that’s it, guys. I’ll see you in the next episode. Thank you for listening to this episode of the Ru Menstrual podcast.

Amanda Montalvo [00:47:07]:

If you want to support my work, please leave a review and let me know how you like the episode. This lets me know, like, what you guys want more of, less of. I read every single one and I appreciate them more than you know. If you want to keep learning, you can get access to the bonus episode and additional resources on patreon.com hormone healingrd. I’d love to have you in there. Thanks again, and I will see you in the next episode.

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

Master Your Minerals

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Hormone Healing RD