But, why? We could put the blame on several mechanisms, and really, most of the theories have merit. Messing with a complex endocrine function in our bodies has consequences, that much is obvious to us.
What I wanted to do today is focus on one particular angle. B vitamins. And B vitamins means methylation. B vitamins, especially B6, B9, and B12, basically run the methylation cycle. Now, you can find a lot of articles on the internet about methylation, epigenetics, nutrigenomics, etc. So I'm not going to move into the detailed, technical stuff. I want to keep this simple and easy to digest because I think the B vitamin angle is being completely overlooked, and this means women are falling through the cracks. To add to the offense, B vitamins are beneficial for hundreds of reasons, fairly inexpensive compared to other medical treatments, and can prevent or heal all kinds of conditions. So the idea that women are suffering with chronic complaints such as depression, anemia, neurological symptoms, fatigue, etc, and no one is saying a word about the B vitamin connection really "chaps my ass" as my husband would say.
Hormonal contraceptives (birth control) and hormonal replacement therapy (HRTs, often used for infertility or menopause complaints) can drain your B vitamin storage. That's the long and short of it. I'm not saying that using these products will always cause severe deficiency. It's simply an overlooked factor that can add to a woman's individual burden, creating a nutritional cascade.
Are you familiar with The Business of Being Born? Remember in the movie when they discuss how the woman is given pitocin, then given an epidural for the pain, and then the heart beat dips, so she's rushed off to a c-section? They called that a birth cascade. I like to talk about nutritional cascades on my blog, and taking birth control can be a factor in a nutritional cascade as it encourages the body to drain B vitamins. A similar situation happens during real pregnancy, too, so as to provide nutrients to the fetus. Depletion can also occur after birth in order to create nutritious milk for breastfeeding.
To make matters worse, most women are heavily encouraged to take synthetic folic acid and other unconverted B vitamins such as cyanocobalamin when trying to conceive, during pregnancy, and while breastfeeding. These low quality vitamins are difficult for the body to use, but they attach to the receptors, clogging them. Think of it as the same annoying situation of trying to get onto the internet in your teen years but hearing that dreadful dial tone instead because someone was on the phone. The body is stuck with low quality vitamins and that makes it harder to absorb anything else such as from any healthy foods the woman is eating.
When you pause to think about the chain of events in a woman's childbearing years, the cascade is obvious. A woman begins her childbearing years using birth control, which begins to slowly but steadily deplete her nutritional stores. She stops taking them momentarily because she's ready to conceive. She probably stops them only 1 or 2 cycles before conceiving unless she's experiencing fertility challenges. That means she goes from one depletion to the next.
During pregnancy, her body drains all available resources to the fetus. She obediently takes her low quality prenatal vitamins every day, clogging up the receptors and limiting the amount of nutrition her body can absorb. Then she gives birth and is exposed to some medications that can deplete B vitamins even more, such as anesthesia. She also likely takes pain medications during the birth or right afterwards, and they are almost always the kind that damage the liver. This is important because liver health is connected to methylation and hormonal balance.
Finally, she's determined to breastfeed, which is another slow and steady depletion as the body scavenges for any nutritional stores available to transfer through the milk to the baby. She takes a prenatal or women's multivitamin while breastfeeding, which causes more clogging.
Then six weeks after birth, she goes in for a check up that almost all childbearing women are familiar with: the birth control check up. That's what it is unless she has a very Catholic doctor or very natural midwife. She goes onto birth control 6 weeks after birth, while breastfeeding a baby and taking low quality vitamins. That means she has now hit the magical moment where she has assumed multiple burdens at the same time.
Do you know when Post Partum Depression (PPD) is most commonly diagnosed? The 3 month mark. Yep. She goes in for birth control at the 2 month mark and within one cycle, she's back in the clinic for depression.
Is it any wonder now that the cascade has been laid out here? How much burden can one hard working mom take before beginning to struggle?
If women were given full, informed consent about methylation health, the burden of various childbearing choices, and the risks and downsides of low quality vitamins, they could potentially prevent this cascade. A focus on bioavailable nutrition during the tough moments might really be just enough to help.
Even more concerning is the fact that B vitamin depletion is transferred to the child. If the mom doesn't have enough B vitamins, the child won't. Either due to exclusively breastfeeding, or due to using formula since formula contains the same low quality vitamins that clog up the receptors. B vitamin depletion in children often takes on many forms and is also easily overlooked or misdiagnosed. As an example, here is one article that discusses the issue of B12 deficiency misdiagnosed as autism:
"The signs and symptoms of pediatric B12 deficiency frequently mimic those of autism spectrum disorders. Both autistic and brain-injured B12- deficient children have obsessive-compulsive behaviors and difficulty with speech, language, writing, and comprehension. B12 deficiency can also cause aloofness and withdrawal. Sadly, very few children presenting with autistic symptoms receive adequate testing for B12 deficiency. Infants and young children are often misdiagnosed. Irritability or gastric symptoms of B12 deficiency can be easily mistaken for colic or gastroenteritis. The apathetic or dull infant can be mistaken for an “easy” or “good” baby, and “late walkers” or “late talkers” can be considered variants of normal development. "So as you continue to hear about birth control and the depression link in the upcoming weeks, please take a few moments out of your day to spread the word to other women about the B Vitamin Cascade. Encourage your friends and family to research B vitamins, methylation health, and the differences between converted and unconverted B vitamins. If you've become aware of a potential B vitamin deficiency, make sure you are looking at higher quality supplements with converted forms, and that you're working with someone who is knowledgeable about methylation challenges. Health officials, the CDC, doctors, even midwives and nurses are not speaking up about this issue enough yet. And in the meantime, PPD, PPA, and PPP remain common diagnoses in our country, with thousands of women receiving a diagnosis every year.
The stigma of mental illness is still strong in our society, and it's often amplified for women struggling with a diagnosis alongside childbearing. Women often grapple with feelings of inferiority, of being defective, of not being good enough at motherhood. What an empowering and enlightening moment, for a woman to realize that sometimes, these issues are most likely not due to some inner defect or failure, but rather a mere level of nutrition at key points during her childbearing years. This can also encourage other women to develop a true level of empathy, as they begin to recognize that the difference between their mental health and the mental struggles of their sisters might merely be a lab value. And with the change of a value, with their own vitamin cascade, they, too, could end up struggling.
We can talk about this topic with our sisters and start to get ahead of this cascade right here, right now.
Below are some various medical studies and articles that help to create a rough picture of the connections to this cascade:
Pediatric Vitamin B12 Deficiency: When Autism Isn't Autism
How Birth Control Pills Affect Your Nutritional Needs
Mood disorder with mixed, psychotic features due to vitamin B12 deficiency
Chronic psychosis associated with vitamin B12 deficiency
Vitamin B12 Deficiency Manifested as Psychosis Without Anemia
Treatment of depression: time to consider folic acid and vitamin B12
Related posts on my blog:
MTHFR and alcohol
Is folic acid the only and best choice?