It's essential for women taking birth control pills to be aware of potential nutrient depletion. Oral contraceptives, commonly known as “the pill,” have been a staple of family planning for decades. As of 2017, over 5 million women in the US were using oral birth control and not always for reproductive reasons (1). In fact, doctors commonly prescribe hormone pills to teenage girls as means of managing acne, mood swings, or other complaints not related to sexual activity. What many women don’t realize is that the birth control pill can influence their nutritional status in impactful ways. Understanding any potential deficiencies that may arise for those who are taking, or have recently taken, hormonal birth control is essential for maintaining their overall health and well-being. In this article, we’ll discuss how birth control affects a woman’s nutrient status, which nutrients are depleted by the birth control pill, and how to counteract nutrient depletions. How Does Birth Control Affect A Woman’s Nutrient Status? Birth control pills work by introducing synthetic hormones, usually estrogen and progestin, into a woman's body. These mimic natural hormones produced by the ovaries and, as a result, prevent pregnancy (2). However, as no system in the body functions in a vacuum, artificial hormones can affect various physiological processes, which in turn affect how the body absorbs and utilizes certain nutrients. How Does Birth Control Affect The Body’s Absorption & Utilization Of Certain Nutrients? First, synthetic hormones can influence the gastrointestinal tract, potentially altering gastric acidity and digestive motility (3). These changes can impact the breakdown and absorption of nutrients in the stomach and intestines, with the possibility of creating an environment that is less conducive to optimal nutrient uptake. Second, synthetic hormones may have the potential to influence the composition and activity of the gut microbiome (4). Alterations in the gut microbiota can affect nutrient metabolism and absorption, leading to variations in the bioavailability of vitamins and minerals (5). Additionally, these hormones may interact with nutrient-binding proteins in the bloodstream, potentially impacting the transport of nutrients to various tissues and organs (6). Third, synthetic hormones can influence liver function, potentially affecting the metabolism and storage of nutrients before they are released into the bloodstream for use by the body as the liver plays a pivotal role in both hormone processing and nutrient distribution (7). This can lead to variations in the availability of essential nutrients. Finally, hormonal changes brought about by the use of synthetic hormones can disrupt nutrient metabolism and interactions, potentially affecting how the body regulates blood sugar levels, stores energy, and maintains nutrient balance (8). Key Nutrients Depleted By Birth Control Pills Oral contraceptives are known to deplete several key nutrients in the body (9). Here's a list of key nutrients depleted by birth control use: 1. B Vitamins Synthetic hormones can interfere with the body's ability to absorb and utilize B vitamins, particularly B2, B6, and B12. These vitamins are essential for various physiological processes, including energy metabolism, DNA synthesis, and the functioning of the nervous system. Reduced absorption of B vitamins can lead to deficiencies, which may cause symptoms like fatigue, anemia, and nerve-related issues. 2. Vitamin C Research has suggested that vitamin C levels may be lower in women on oral contraceptives. Vitamin C is essential for the immune system and overall health. 3. Folate The pill can interfere with the body's ability to absorb folate, a crucial nutrient for cell division and fetal development. 4. Magnesium Magnesium is a vital mineral involved in over 300 biochemical reactions within the body, including muscle and nerve function, blood glucose control, and blood pressure regulation. Some studies have found a link between magnesium deficiency and the use of birth control pills (10,11). 5. Coenzyme This coenzyme, also known as CoQ10, is vital for energy production within cells. Some studies have suggested that the pill can deplete CoQ10 levels. 6. Selenium Selenium is an essential mineral with antioxidant properties. Oral contraceptives may impact selenium levels in the body. 7. Zinc Zinc may be impacted by oral contraceptives. Zinc is an essential mineral that plays a role in immune function and wound healing. A Note About MTHFR & Birth Control An important consideration for women with MTHFR mutations who are contemplating the use of birth control pills is that they may already have lower levels of folate and certain B vitamins (12,13). This is because the MTHFR gene encodes an enzyme responsible for converting folic acid into its active form, methylfolate, which plays a vital role in numerous biochemical processes, including DNA synthesis and repair. Certain genetic variations in the MTHFR gene can result in reduced enzymatic activity, leading to decreased conversion of folic acid (14). As such, women with MTHFR gene mutations need to be extra aware of their nutritional status if they are currently taking, or have recently taken, birth control, especially if they plan to conceive. Curious about vitamin B12 deficiency? See: Vitamin B12 Deficiency In Kids & Adults Looking for foods rich in B12? See: What Foods Are High In Vitamin B12? Looking for dietary sources of zinc? See: 16 Good Dietary Sources of Zinc & Kid Approved Meals Maintaining Nutritional Balance To Counteract Nutrient Depletion It's essential for women taking birth control pills to be aware of potential nutrient depletion. While the pill is a valuable tool for family planning, it's not without its trade-offs. To counteract potential nutrient depletions, women on birth control should prioritize a balanced and nutrient-dense diet. Oftentimes, it is also necessary to incorporate supplements in order to mitigate any deficiencies. If you plan to stop taking birth control, it may be necessary to continue taking supplements for several months after discontinuing the pill to restore nutrient status. Working with a knowledgeable medical professional is recommended. For more information on supplement protocols, read: How To Create A Daily Supplement Protocol For Your Family Learn the ‘why’ behind getting nutrients from supplements vs food here: Is Getting Nutrients From Food Better Than Taking A Supplement? Summary While birth control pills have undeniably revolutionized family planning, it's essential to acknowledge their potential influence on nutrient levels in the body. Synthetic hormones can affect various physiological processes, which in turn affect how the body absorbs and utilizes certain nutrients, such as B vitamins, zinc, and folate. For women taking contraceptives, a proactive approach should include a balanced diet and, in many cases, nutrient supplementation. PRODUCTS MENTIONED IN THIS ARTICLE See Product See Product See Product See Product See Product See Product SHOP & EARN REWARDS. JOIN TODAY! References: Products - Data Briefs - Number 327 - December 2018. (2019, June 7). Www.cdc.gov. https://www.cdc.gov/nchs/products/databriefs/db327.htm Gebel Berg E. (2015). The Chemistry of the Pill. ACS central science, 1(1), 5–7. https://doi.org/10.1021/acscentsci.5b00066 Judkins, T. C., Dennis-Wall, J. C., Sims, S. M., Colee, J., & Langkamp-Henken, B. (2020). Stool frequency and form and gastrointestinal symptoms differ by day of the menstrual cycle in healthy adult women taking oral contraceptives: a prospective observational study. BMC women's health, 20(1), 136. https://doi.org/10.1186/s12905-020-01000-x Adlercreutz, H., Pulkkinen, M. O., Hämäläinen, E. K., & Korpela, J. T. (1984). Studies on the role of intestinal bacteria in metabolism of synthetic and natural steroid hormones. Journal of steroid biochemistry, 20(1), 217–229. https://doi.org/10.1016/0022-4731(84)90208-5 Krajmalnik-Brown, R., Ilhan, Z. E., Kang, D. W., & DiBaise, J. K. (2012). Effects of gut microbes on nutrient absorption and energy regulation. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 27(2), 201-214. https://doi.org/10.1177/0884533611436116 Human Metabolism, Energy, Nutrients | Learn Science at Scitable. (2010). Nature.com. https://www.nature.com/scitable/topicpage/nutrient-utilization-in-humans-metabolism-pathways-14234029/ LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Estrogens and Oral Contraceptives. [Updated 2020 May 28]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548539/ Tao, Z., & Cheng, Z. (2023). Hormonal regulation of metabolism-recent lessons learned from insulin and estrogen. Clinical science (London, England : 1979), 137(6), 415–434. https://doi.org/10.1042/CS20210519 Palmery, M., Saraceno, A., Vaiarelli, A., & Carlomagno, G. (2013). Oral contraceptives and changes in nutritional requirements. European review for medical and pharmacological sciences, 17(13), 1804–1813. Olatunbosun, D. A., Adeniyi, F. A., & Adadevoh, B. K. (1974). Effect of oral contraceptives on Serum magnesium levels. International journal of fertility, 19(4), 224–226. Hameed, A., Majeed, T., Rauf, S., Ashraf, M., Jalil, M. A., Nasrullah, M., Hussan, A., & Noreen, R. (2001). Effect of oral and injectable contraceptives on serum calcium, magnesium and phosphorus in women. Journal of Ayub Medical College, Abbottabad : JAMC, 13(3), 24–25. Tsang, B. L., Devine, O. J., Cordero, A. M., Marchetta, C. M., Mulinare, J., Mersereau, P., Guo, J., Qi, Y. P., Berry, R. J., Rosenthal, J., Crider, K. S., & Hamner, H. C. (2015). Assessing the association between the methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism and blood folate concentrations: a systematic review and meta-analysis of trials and observational studies. The American journal of clinical nutrition, 101(6), 1286–1294. https://doi.org/10.3945/ajcn.114.099994 Perishable. (2018, December 15). Importance of vitamin B12 and MTHFR. MTHFR Gene Support. https://mthfrgenesupport.com/2018/12/importance-of-vitamin-b12-and-mthfr/ MTHFR gene: MedlinePlus Genetics. (n.d.). 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