Speaker 1: Welcome to the Kick Your Expert led podcast, helping you
Speaker 1: explore and learn everything about gettingant, pregnancy, birth, and becoming
Speaker 1: a parent.
Speaker 2: On the podcast and our online pregnancy program grow My Baby,
Speaker 2: we share my experience of helping more than four thousand
Speaker 2: babies to.
Speaker 1: Be born, and our experience of running a women's health
Speaker 1: clinic and parenting for boys.
Speaker 2: We're here to help everyone to feel empowered in pregnancy
Speaker 2: and birth with real life, practical information.
Speaker 1: Welcome everyone. I'm Bridgid Maloney and.
Speaker 2: I'm obstetrician Dr Patrick Maloney.
Speaker 1: And today we're talking about a universal symptom. While I
Speaker 1: think it's universal, people feel so fatigued in pregnancy and
Speaker 1: it's universal. Good, And they say, why am I always
Speaker 1: so tired?
Speaker 2: Oh? Tired? Good?
Speaker 1: All right, I want to start with Pat. Why is
Speaker 1: something like fatigue so easily dismissed in pregnancy?
Speaker 2: Well, I think that people just know that pregnant women
Speaker 2: are tired, so it's easy to say, well, you're pregnant.
Speaker 2: There you go, that's the new normal. That's the way
Speaker 2: it is. And I think we need a better framework
Speaker 2: than that. We probably need to be saying right, oh, well,
Speaker 2: hang on a minute, let's make sure that there's nothing
Speaker 2: else wrong with you. Yeah, and then if it is
Speaker 2: just pregnancy fatigue, how can we help manage that in
Speaker 2: a way that's constructive and helps the people around you
Speaker 2: help you in the way that they can ye.
Speaker 1: So in this episode, we're going to go through the
Speaker 1: different stages of pregnancy and link the fatigue around those
Speaker 1: different stages and what might be happening.
Speaker 2: For you.
Speaker 1: How often do people come in and say, look, I
Speaker 1: am just so tired.
Speaker 2: Well, I think that it's nearly universal in the first trimester,
Speaker 2: and people expect the noise you're in volmiting because we
Speaker 2: all know about that, But that doesn't happen to everybody.
Speaker 2: Most people get a bit, some people get tons, and
Speaker 2: a few lucky people get nun but everyone is tired, yeah,
Speaker 2: almost without exception.
Speaker 1: And it's a bit shocking, isn't it that it happens
Speaker 1: so soon as soon as you find out you're pregnant.
Speaker 1: Pretty much, it's just like a switch goes on and
Speaker 1: you go poop.
Speaker 2: Well, it's how some people find out they are pregnant.
Speaker 2: They go, I've never felt this died in my life.
Speaker 1: Yeah, And I just want to describe that tideness for me,
Speaker 1: and that was really like I had been hit by
Speaker 1: a truck. Yeah, Like it was just that very much
Speaker 1: bone weary, tired, where I felt like I couldn't really
Speaker 1: even lift my arms up and.
Speaker 2: Just walk like it.
Speaker 1: And it wasn't the whole pregnancy, but just right at
Speaker 1: the start, that's how I felt.
Speaker 2: Yeah. Yeah, So this is thought to be related to
Speaker 2: higher levels of progesterone. And there's a a progesterone of
Speaker 2: pregnancy called pregnantanolone, which is quite active within our neurological system,
Speaker 2: and it's part of the brain's inhibitory pathway. So there
Speaker 2: are some things that fire us up and some things
Speaker 2: that settle us down. And progesterone in early pregnancy is
Speaker 2: calming and sedating and helps calm down excess firing of
Speaker 2: our brains in our nervous of our brain and nervous system,
Speaker 2: and it makes you sleeping.
Speaker 1: I don't expect you to know the answer to this,
Speaker 1: but from an evolution perspective, you think that that's really dangerous.
Speaker 2: I don't know what it's for.
Speaker 1: Like, you know, if you're in a tribe back in
Speaker 1: the day and all of a sudden you had all
Speaker 1: these sort of symptoms where you're really fatigued and stuff
Speaker 1: like you're a bit screwed.
Speaker 2: Yet on the African planes, it right, pick up all
Speaker 2: the pregnant where we're move to where the food's at,
Speaker 2: but they're too tired to come with us.
Speaker 1: Yeah, and you would think that, like, you know, back
Speaker 1: so at that early stage, some people like you said,
Speaker 1: the fatigue is the thing that makes them think am
Speaker 1: I pregnant? Yeah? But back in the day, would they
Speaker 1: put two and two together.
Speaker 2: I think that there are some of the physiological changes
Speaker 2: in pregnancy, the normal things that happened that that that
Speaker 2: you can see the point of it. But getting bone
Speaker 2: tied in the first time messages seems a bit cruel,
Speaker 2: A bit cruel, Yeah, especially if you're also horribly nauseator. Yeah.
Speaker 1: Yeah, and also not told anyone. So you're trying to
Speaker 1: go about your normal day, You're going to work, you're
Speaker 1: feeling like you needed to crawl under your desk and
Speaker 1: have a little nap, or you're doing an active job
Speaker 1: like you're a nurse or a teacher, on your feet
Speaker 1: all the time, Like I don't. It's I was lucky
Speaker 1: in my pregnancies where I could just sort of like
Speaker 1: zone out a little bit at a desk, but if
Speaker 1: I was in an active role, that would have been
Speaker 1: really challenging for sure. Right, So we've got first trimester
Speaker 1: pregnancy fatigue with progester owne issues. But I did see
Speaker 1: on Insta that your metabolism increases fifteen to twenty percent
Speaker 1: during pregnancy, and this is thought that's one reason why
Speaker 1: people get tired. But I thought fifteen to twenty percent
Speaker 1: for real, Like, I think we need to fact check that.
Speaker 2: Good well done, especially if it came from Insta. Yeah,
Speaker 2: so I think it's true that there are significantly increased
Speaker 2: metabolic demands when you're pregnant. So metabolic demand is just
Speaker 2: the energy required for your body to do all the
Speaker 2: things that it's doing. It's making a whole new person.
Speaker 2: But I don't think that your metabolism magically and at
Speaker 2: all times is able to is able to have a
Speaker 2: big uptick, big up to can pump that out in
Speaker 2: the way that it's needed. And perhaps that's where some
Speaker 2: of the deficit and the titness comes from.
Speaker 1: Yeah, and if some people put that like this was
Speaker 1: on a very well known birth educator's post, so if
Speaker 1: they put that together with okay, well, if my metabolism
Speaker 1: has increased fifteen to twenty percent, that means I do
Speaker 1: have to eat more. But that's not true really either.
Speaker 1: It's your calories. Additional calories do increase a little bit,
Speaker 1: but not to the point where you have to be
Speaker 1: eating fifteen to twenty percent more.
Speaker 2: Not at the start. No, no, So I always Metaiblism
Speaker 2: is a complex thing and it's not just fuel in
Speaker 2: one end and performance out the other. So in the
Speaker 2: first trimester, there's there's no increased caloric intake required, which
Speaker 2: is hand, isn't it, because you don't feel like eating anywhere. Yeah. Yeah,
Speaker 2: That's why I feel very very comfortable saying to people
Speaker 2: if you if you're horribly nauseated, eat fruit, eat fruit,
Speaker 2: tingles and salt and viniar chips and water, because that'll
Speaker 2: get some calories in, some water in and you'll get
Speaker 2: through the day. But it's not like you need to
Speaker 2: be eating tons of extra stuff follow that's it to
Speaker 2: have a healthy first trimester, And then there is you
Speaker 2: do need to be getting some extra calories in and
Speaker 2: the second and third t because you'll look at that,
Speaker 2: you know, the in the third trimester. The start of
Speaker 2: the third trimester that the baby's all formed but not
Speaker 2: very big, and then so the whole rest of the
Speaker 2: time is just all getting bigger. Yeah, now the ends
Speaker 2: you do, that's coming from somewhere, all right. Pad.
Speaker 1: So the next reason that this particular post said that
Speaker 1: people feel fatigued in first trimester was because the immune
Speaker 1: system had kicked in, and that feeling that the immune
Speaker 1: system was working in overtime sort of left your feeling
Speaker 1: like you had a mild cold all the time and
Speaker 1: that was increasing your tightness.
Speaker 2: That does not sound applausible to me at all. I
Speaker 2: think that your immune system definitely changes when you're pregnant.
Speaker 2: There are a number of important changes that your immune
Speaker 2: system needs to undergo, mostly so you don't reject your
Speaker 2: own baby, because the babies inside you it's half paternally derived,
Speaker 2: and it's and it's and so your immune system does
Speaker 2: function a bit differently, and if you look at some
Speaker 2: diseases with immune basis, they'll often function very differently. So
Speaker 2: people with say x ME, will often get better temporarily.
Speaker 2: Autoimmune conditions like a room toiter arthritis loopers asthma will
Speaker 2: often get temporarily better and then worse again afterwards. Thoroiditis,
Speaker 2: and these are due to changes in the way the
Speaker 2: immune system functions while you're pregnant. I'm not sure what
Speaker 2: the connection is with tiredness though, I don't I don't.
Speaker 2: I don't really see that, all right. I doubt that's accurate.
Speaker 2: I think I think that the immune system functions differently.
Speaker 2: I don't think that makes you tired.
Speaker 1: Okay, what about building more blood volume?
Speaker 2: Yeah, again, that's a thing. I'm not sure if it's
Speaker 2: related to tiredness. Definitely, you've built a lot more blood volume,
Speaker 2: so the blood volume increases significantly. It's got to fill
Speaker 2: up the placenta. And when you're pregnant, the physiological changes
Speaker 2: are very impressive. The cardiac changes are very impressive. So
Speaker 2: your rum heart rate is higher. The thing called stroke volume,
Speaker 2: which is how much your blood pumps out with each pump,
Speaker 2: is much higher, and there's a lot going along going
Speaker 2: on in your circulatory system. The exact relationship to tiredness,
Speaker 2: I'm not sure.
Speaker 1: I suppose, I don't know. Maybe they were positing that
Speaker 1: it's because your body is producing or making all this
Speaker 1: extra blood volume.
Speaker 2: Well, yes, I think, I mean, I think the most
Speaker 2: plausible connection to tiredness would be a hormonal one. Yeah, yeah,
Speaker 2: these other things are happening, doesn't mean to make it tired.
Speaker 2: I might be splitting hairs here, but it's but some
Speaker 2: of the stuff you read about pregnancy from non expert
Speaker 2: sources has a sort of a pseudo scientific face plausibility
Speaker 2: that actually is not under there's no there's no actual
Speaker 2: data or convincing mechanism of action behind it. So if
Speaker 2: you say your body's doing all these things and therefore
Speaker 2: you're tired, it's like, well, yeah, maybe, but I want
Speaker 2: to hear I want to know more. I want to
Speaker 2: hear more. How is that making me tie?
Speaker 1: It's so interesting, and you know, maybe we are sort
Speaker 1: of going down a rabbit hole a little bit. But
Speaker 1: if people are interested in this, go back and listen
Speaker 1: to our episode that we did on experts on social Media,
Speaker 1: you know, where we talked about if someone can say
Speaker 1: it really confidently and with certainly certainty, and people feel like,
Speaker 1: oh good, this person is in control. They know that
Speaker 1: you are tired in first tromester because you're doing X
Speaker 1: y Z. You know that that sort of gives people
Speaker 1: sense of calm in that. But you know, good, I'm
Speaker 1: glad that I've fact checked all those things with you.
Speaker 1: So you think in first trimester it's mainly progesterone, I
Speaker 1: think so.
Speaker 2: Yeah.
Speaker 1: And again we also talked about how you saying I
Speaker 1: think so, that's good science, Like without the data, you
Speaker 1: think so.
Speaker 2: Yeah, to the best of my knowledge, perhaps perhaps there
Speaker 2: isn't Perhaps no one knows for sure, but yeah, that
Speaker 2: is good science. Saying we don't know is a lot
Speaker 2: better than saying, here's something that sounds like it might
Speaker 2: be correct, and I will say it because it because
Speaker 2: I want to sound authoritative.
Speaker 1: Ye, all right, Pat. So the next thing is, I
Speaker 1: don't know if it's a myth or not, but mostly
Speaker 1: people say that they get their energy back in second trimester.
Speaker 2: Yeah, so that does tend to improve round about the
Speaker 2: time that the nausea and vomiting improve, about twelve weeks.
Speaker 2: And people will say, yeah, okay, fine, I'm back. I'm
Speaker 2: still not my old self, but I'm not that sort
Speaker 2: of deep bone tired that I was at ten or eleven weeks,
Speaker 2: and I've started to respond better to rest and can
Speaker 2: manage give or take my old day pre pregnancy day.
Speaker 1: All right, And what about for those people that you know,
Speaker 1: unfortunately don't say that they get any energy back and
Speaker 1: they have this ongoing fatigue. What are the things that
Speaker 1: you're looking for.
Speaker 2: Well, I think we just have to make sure that
Speaker 2: we're not dealing with someone who's tired completely for other reasons.
Speaker 2: So the two big ticket ones that we talk about
Speaker 2: a lot of hypothyroidism and iron deficiency anemia. So the
Speaker 2: hypothyroidism that it can be common in pregnancy, it can
Speaker 2: be subtle. Checking thyroid function is pretty easily done as
Speaker 2: a blood test. There are a number of sort of
Speaker 2: medical students style style examination findings that can indicate thorough disease,
Speaker 2: but they're often subtle, and in pregnancy, we want to
Speaker 2: pick them up long before the person's examination is abnormal,
Speaker 2: so we just do it by test. And iron deficiency
Speaker 2: and iron deficiency anemia is an interesting one. Everybody agrees
Speaker 2: that iron deficiency anemia i've got such the line that
Speaker 2: we're not making enough for blood cells and the hemoglobin
Speaker 2: is actually low, that that's a convincing form of tightness
Speaker 2: and should be treated. Not everybody agrees that iron deficiency
Speaker 2: with a normal hemoglobin is clinically significant, but most of
Speaker 2: us think that some people feel otherwise, but authoritative bodies,
Speaker 2: national Associations of Hematologists, red Cross, various blood experts nationally
Speaker 2: feel that iron deficiency in and of itself can be
Speaker 2: symptomatic even if the hemoglobin is still in the normal range.
Speaker 1: And is this where somebody might have low ferretin?
Speaker 2: Yeah, so the best, the most sort of useful measure
Speaker 2: on the iron test is called ferretin. And if we
Speaker 2: check the ferret and it's very low under thirty, especially,
Speaker 2: you know, especially if it's under twenty. You know, definitely
Speaker 2: if it's in single digits, that's likely to be symptomatic
Speaker 2: in the form of tiredness, decrease, exercise tolerance, sometimes lowered mood,
Speaker 2: even if the hemoglobin, which is all we used to check,
Speaker 2: is still up one hundred and twenty five and thirty.
Speaker 1: And if someone's having care where that practitioner is looking
Speaker 1: at their hemoglobin only and that hemoglobins, like, what can
Speaker 1: they do if they then still feel the same symptoms
Speaker 1: and still feel the fatigue, Can they ask to have
Speaker 1: their ferret and check for sure?
Speaker 2: You can? You can definitely ask at a local doctor
Speaker 2: or in an antenatal visit. I feel like my iron
Speaker 2: might be low even though my emoglobin's okay, and if
Speaker 2: that iron was low, I would be interested in having
Speaker 2: that treated. Remember, the iron in your pregnancy multivitamin is
Speaker 2: about enough to keep you going where you are because
Speaker 2: the baby's stealing lots of your irons. So if your
Speaker 2: iron's a hundred and you take the iron in the
Speaker 2: in the antenatal multivitamin, then the baby will keep on stealing,
Speaker 2: but you're adding some so it's going to state about hundred.
Speaker 2: But if your iron's ten, the baby will keep on stealing.
Speaker 2: The iron in the multivite won't be enough. You'll remain deficient,
Speaker 2: so you need that plus extra, and extra would be
Speaker 2: to take an iron tablet in addition to the multivite,
Speaker 2: which is hard to do every day. They tend to
Speaker 2: cause constipation so much every second day. And if we
Speaker 2: can see that in that intake is exceeding output, so
Speaker 2: we're getting more in than the baby stealing, then it'll
Speaker 2: come back up. But if that's still not working, or
Speaker 2: if the deaf deficit is so profound that we don't
Speaker 2: think it's going to have a reasonable chance of working,
Speaker 2: then sometimes we'll skip the gut and go straight to
Speaker 2: the intravenous iron infusion.
Speaker 1: And is it anecdotal. Yes, it's anecdotal. But I'm noticing
Speaker 1: that we're having a lot of our patients have iron infusions.
Speaker 1: Do you think it's a it's a sort of growing issue.
Speaker 2: Yeah, I think a few. It's a it's an interesting question.
Speaker 2: I think a few things have happened at once. There's
Speaker 2: always been iron infusions. But when I was a junior doctor,
Speaker 2: it's pretty awful they have an iron infusion. It really hurt.
Speaker 2: You got to be super duper careful that the vein,
Speaker 2: you know, you have the vein really well canulated so
Speaker 2: none of it leaked out, But mostly it hurt the
Speaker 2: patient as the iron went up there vein, and it
Speaker 2: was painful. So they were in general given to people
Speaker 2: who had chemo, who are having chemo, who had you know,
Speaker 2: a profound uh profound iron deficiency, or perhaps who wouldn't
Speaker 2: who needs really needed a blood transfusion, but but but
Speaker 2: wouldn't consider one for whatever reason. So it was a
Speaker 2: bit of a last resort. But then they invented one
Speaker 2: that didn't hurt, so, you know, give or take, it's
Speaker 2: a very well tolerated form of iron. And then at
Speaker 2: the same time, I think being a vegetarian, certainly in
Speaker 2: Australia is more popular with women in the pregnancy age
Speaker 2: group than it used to be. So for for you know,
Speaker 2: ethical reasons. Some a lot, a lot of women in
Speaker 2: the pregnancy years are not meat eaters for ethical reasons
Speaker 2: or for religious preference, or for that just turns them off. Yeah,
Speaker 2: there's a weird phenomenon where you might need red meat
Speaker 2: in early pregnancy. But that's the last thing possibly say.
Speaker 1: It can't stand the smell of it even cooking. Yeah.
Speaker 2: Yeah, so that's another one of those things that seems counterintuitive.
Speaker 2: And but so you know, in that cohort of women,
Speaker 2: they are likely to come into the more likely than
Speaker 2: other groups in the community to come into the pregnancy
Speaker 2: owned a fishon in the first place. Remember, they've often
Speaker 2: been menstuating everything, trying to have a baby. So a
Speaker 2: bunch of other young women who had iron deficiency, they
Speaker 2: might be treating that by having a marina and not menstruating,
Speaker 2: or be on the pill and menstruating less. But the
Speaker 2: group trying to have a baby, maybe they've been trying
Speaker 2: for six months, have been having a proper natural period
Speaker 2: for six months, eating no meat, get pregnant checkered iron
Speaker 2: fish fascinating.
Speaker 1: So apart from are there any other symptoms that you
Speaker 1: would expect with someone that has an iron deficiency.
Speaker 2: Well, the other symptoms are probably more related to iron
Speaker 2: deficiency anemia where it was sort of run out of iron.
Speaker 2: We're not making up for new red blood cells, and
Speaker 2: now the hemoglobin is actually low, so pale poor exercise
Speaker 2: tolerance can't walk up ill anymore. And occasionally we'll see
Speaker 2: this in a pregnant woman. It's much more common to
Speaker 2: see this in my job, in someone who comes in
Speaker 2: at forty seven forty eight with heavy menstrual bleeding from
Speaker 2: a big fire broad uterus and the GPS checked their
Speaker 2: hemoglobin and at seven where did it all go? Well,
Speaker 2: it just went a little bit more out each month
Speaker 2: than the woman could get in. Yeah, so she ate
Speaker 2: a bit of red meat but couldn't keep but was
Speaker 2: never catching up with how much she was losing through
Speaker 2: periods that had big clots or floods, and wake up
Speaker 2: in a puddle in the morning in bed and that
Speaker 2: incro mentally used up all the iron and then the
Speaker 2: hemoglobin start to fall. Our body's pretty good at adapting,
Speaker 2: so we just get a little you know, the oxygen.
Speaker 2: The hemoglobin carries oxygen from our lungs out to our body,
Speaker 2: and there's a thing called oxygen association curve where our
Speaker 2: body says, right, if they're not much hemoglobe will make
Speaker 2: it easier for the oxygen to leap off into the tissues,
Speaker 2: and so and so these all of these slight adjustments
Speaker 2: are made by our body as the iron gets lower
Speaker 2: and lower and the hemoglobin gets lower and lower. But
Speaker 2: then we get to a thing called slippery slope where
Speaker 2: we just can't managin it, manage it.
Speaker 1: I'm imagining all the thirty year olds that are listening
Speaker 1: to our podcasts and you say this happens when you're
Speaker 1: forty seven, forty eight, and they're like, no, something else
Speaker 1: I get to look forward to dear. All right, So
Speaker 1: you touched a little bit on mood. Much. Does mental
Speaker 1: health conditions impact on fatigue in pregnancy?
Speaker 2: Well? I think it's It works both ways, doesn't it.
Speaker 2: So if you've got a mental health issue that can
Speaker 2: manifest us fatigue, So people with depression feel tired, they
Speaker 2: feel uninterested in the things that used to get them
Speaker 2: fired up. There it's difficult to get out of bed
Speaker 2: in the morning. The day doesn't seem to hold the
Speaker 2: hold for them, the things that used to be worth
Speaker 2: getting out of bed for. And then it works in
Speaker 2: the other direction as well, in that if you are very,
Speaker 2: very tired, it makes any mental health issue you might
Speaker 2: have seem worse.
Speaker 1: And we are moving into third trimester now, and sometimes
Speaker 1: this fatigue comes back that you had in the first trimester.
Speaker 2: Yeah, why is that? Well, I think by then it's
Speaker 2: due to actual metabolic demand, an actual metabolic diffic deficits.
Speaker 2: So I think by then, your body's got a lot
Speaker 2: of work to do. That you're lugging around a three
Speaker 2: kilow baby and a and a and a placenta and
Speaker 2: all the extra water and then and the water around
Speaker 2: a baby, and then the water in your tissues and
Speaker 2: the and the and the swollen ankles, and then your
Speaker 2: brain is doing a lot of background work. It's processing,
Speaker 2: especially first baby, you're processing the mental load of the change.
Speaker 2: A lot of people find change tiring.
Speaker 1: I do, don't go there.
Speaker 2: Pat so they they So there's a lot going on
Speaker 2: and and and and that's a that's a different I think,
Speaker 2: a different form of tightness. That's that's not that's not
Speaker 2: home only driven like the first trimester one. It's it's
Speaker 2: it's literally like you're carrying around a big, heavy sack.
Speaker 1: Pat mentions the brain and the brain changes. If you're
Speaker 1: fascinated by that, go back and listen to our episode
Speaker 1: that we did with doctor Sarah Mackay, who's a neuroscientist.
Speaker 1: It's just really fascinating how the woman's brain is changing,
Speaker 1: particularly in the first pregnancy. Good, all right, what are
Speaker 1: some of the things people can do if they do
Speaker 1: feel this enormous fatigue.
Speaker 2: I think that it's worth reporting, So don't just how
Speaker 2: pregnant it's I'll be fine or no one cares. It's
Speaker 2: worth worth reporting because the akara would say, we'ld ask
Speaker 2: a few red flag type questions and then think, hang
Speaker 2: on a minute, perhaps we should be excluding organic disease,
Speaker 2: so let's make sure this isn't e deficiency, in deficiency,
Speaker 2: anemia or hypothyroidism in particular. And then if it's none
Speaker 2: of those things and it's just we're feeling very tight
Speaker 2: because we're pregnant, then we need to adapt. Adapt.
Speaker 1: And it's the same sort of I don't know, routine
Speaker 1: and hygiene that you would use if you want to
Speaker 1: look at your sleep patterns, how you're going to bed, like,
Speaker 1: what's your hydration, like, what's your stress level? Like like
Speaker 1: just because you're pregnant, those things don't disappear. You need
Speaker 1: all of those things. And I want to put in
Speaker 1: a big plug for exercise.
Speaker 2: Yeah, good point.
Speaker 1: And it's not just because I'm a recently converted exercise
Speaker 1: gym goer.
Speaker 2: When you least feel like is when you need the most,
Speaker 2: and it.
Speaker 1: Can be something as simple as a walk around the
Speaker 1: block like fresh air. It just it's a method of
Speaker 1: resetting exercise.
Speaker 2: Nobody ever went for a swiam or a walk around
Speaker 2: the block and wish they had. Let's say that is
Speaker 2: a very good point.
Speaker 1: All right, everyone, Yes, it is universal. Fatigue is something
Speaker 1: that is everybody on everybody's radar when they're pregnant. Hopefully
Speaker 1: some of those things that we've talked about today give
Speaker 1: you some tips to know where and you should maybe
Speaker 1: get that investigated further. And then you know, look at
Speaker 1: your patterns, what are you doing in your day, look
Speaker 1: at your exercise, your sleep routine, your hydration, and we
Speaker 1: wish you lots of luck.
Speaker 2: Good a lot of times it's sometimes this is one
Speaker 2: of those soldier on situations after important causes more important,
Speaker 2: more medical causes have been excluded. But you know, it is,
Speaker 2: it is. It is tough to tell the truth about
Speaker 2: this one. There is at the end of it all,
Speaker 2: when you when the placenter's out and you're no longer pregnant,
Speaker 2: those pregnancy related causes of feeling tired all the time
Speaker 2: do resolve, but unfortunately they're replaced by the demands of
Speaker 2: a newborn, and so that it's a false dawn at
Speaker 2: the end, and then there's a whole new set of
Speaker 2: adaptations needed to meet the next challenge.
Speaker 1: And even though I felt bone weary also at one
Speaker 1: point in the fourth fourth newborn phase, I still felt
Speaker 1: more physically able. So you can meet those challenges with
Speaker 1: a body that feels more physically able because you no
Speaker 1: longer actually different growing a baby internally, Yeah it is different.
Speaker 1: Good all right, everyone, keep growing those babies. You're doing
Speaker 1: a great job.
Speaker 2: Thanks for listening, everybody.
Speaker 1: Okay, bye for now. Hey, even though doctor Pat is
Speaker 1: well a doctor and we get lots of other doctors
Speaker 1: and other experts on our podcast, I just need to
Speaker 1: remind you that this podcast is for informational purposes only.
Speaker 1: We share lots of medical insights and experience, but everything
Speaker 1: we talk about is general in nature and may not
Speaker 1: apply to your specific situation. Please always consult with your
Speaker 1: own healthcare provider for your individual medical advice. When you
Speaker 1: grow your baby,