Oral contraceptives, commonly referred to as birth control pills, have been on the market for several decades and used by millions of adolescent girls and women. As with many other medications, birth control pill use depletes nutrients out of your body. These medications are often used for many years, putting a significant strain on your body. Women of all ages need to actively ensure replenishment of these nutrients that may be depleted during oral contraceptive use.

Current CDC statistics show that at least 12.6 percent of women age 15-49 use birth control pills for contraceptive use. Millions more women are prescribed birth control pills to reduce risk of ovarian and endometrial cancers and anemia related with menses. They are also used for acne, migraine headaches, facial hair growth, polycystic ovarian syndrome (PCOS) and menstrual related mood disorders in women of all ages.

Critical Nutrients Depleted

Birth control pills drain your body of several essential nutrients with ongoing use. Depleted nutrients include vitamins B2, B6, B12, folate, vitamin C, vitamin E, magnesium, selenium, and zinc. These nutrients provide hundreds of necessary actions for normal physiology. Any woman using these medications must absolutely be aware and actively replenish these vitamins and minerals.

Oral contraceptives affect how your body metabolizes dietary nutrients. They cause changes in absorption and tissue uptake. They may also release nutrients stored in internal organs into the blood stream. This latter effect may cause an increase of iron, copper, and vitamin A in the bloodstream. This does not always mean that your tissue reserves are adequate or in excess, but should be properly evaluated. For example, it was found that women who used oral contraceptives had higher blood levels of vitamin A, yet tissue stores were lower than non-users.

The consequences of inadequate nutritional reserves are far reaching. Here are some of the things impacted by each nutrient.

Vitamin B2

Vitamin B2, i.e. riboflavin helps other B vitamins, like thiamin (vitamin B1), to make energy from carbohydrates. Lack of riboflavin is linked with hair loss, anemia, cracks on the corner’s of the mouth and chapped lips, poor mood, dry skin w/ greasy scales, dizziness, eyes that are red, itchy, and burn, blurred vision, cataracts, tongue inflammation, impaired growth, headaches, and light sensitivity.

Adequate vitamin B2 insures proper thyroid function and improves reproductive health, aids in red blood cell production, and is critical for your brain and liver. Without vitamin B2, gut lining integrity and immune cell function is compromised. It also can lead to depleted levels of the master antioxidant – glutathione. In addition, neurological stress and impaired detoxification occurs without adequate vitamin B2. Depletion of vitamin B2 also impacts vitamin B6 metabolism.

Vitamin B6

Vitamin B6 is necessary for tryptophan to convert into serotonin and melatonin as well as dopamine metabolism. Research from several decades ago noted that “approximately 80% of all women using oral contraceptives for 6 months or more months experience abnormal tryptophan metabolism.” 

Vitamin B6 affects red blood cells as it is needed for formation and oxygenation. Insufficient levels affect nerves and brain function, which may lead to poor mood, irritability, confusion, nervousness, changes in brain electrical activity, sleep difficulties, nerve tingling and numbness, and unusually acute hearing. B6 insufficiency impairs homocysteine and methylation metabolism, which affects DNA synthesis and compromises cell repair. Balanced methylation is required for heart and circulatory health, cholesterol, blood pressure, blood sugar, thyroid, brain health and hundreds of other functions in your body.

Vitamin B6 affects skin health and acne, hair, nausea, joint changes, eye irritation, dizziness, facial oiliness, fatigue, sore tongue, diminished wound healing, morning sickness, PMS, poor growth, and weakness. Cracks at the corners of your mouth, swollen and sore tongue, peeling or chapped lips, canker sores, and weakened immune system may occur.

Vitamin B12

Vitamin B12 impacts many things including red blood cell formation and tissue oxygenation, mood, memory, growth and development, cognitive performance, balance and movement. Fatigue, shortness of breath, weakness, sluggish bowels, loss of appetite, and weight loss may occur with inadequate levels.

You need B12 for neurological function, DNA synthesis, fertility, mitochondrial function and energy production, methylation function, detoxification, and heart health. A decline in cognitive performance and brain shrinkage has been linked with inadequate vitamin B12. It is critical for growth and development of infants and children. This is especially important for normal neurological development in the unborn. Remember that there is still a small chance that you can get pregnant with oral contraceptive use.

Vitamin B12 works directly with other B vitamins, like B2, B6, and folate, to manage homocysteine and methylation metabolism, which affects DNA synthesis and repair. Lack of these nutrients causes dysfunctional methylation that contributes to overall decline in health.

Vegetarians have a very high risk of vitamin B12 deficiency as the only natural source of vitamin B12 is from animal foods. Athletes, picky eaters, those with digestive disorders, gluten-intolerance, gastric-bypass, and elderly may have additional higher needs.

Folate

Folate is the preferred active form of folic acid, or vitamin B9. Folic acid is synthetic and poses metabolic stress, whereas folate is found in foods. You need folate for red blood cells, oxygenation and breathing, blood flow, immune cells, cell division, replication, and growth. It forms the building blocks of RNA and DNA that affects protein synthesis and genetic information in all cells. It is critical for healthy methylation with B6 and B12, etc.

You need folate to make the neurotransmitters dopamine, serotonin, and norepinephrine, thus it is essential for mood, cognitive health, bowel motility, stress tolerance, nerves, movement, sleep, blood pressure, and healthy brain aging. Folate helps you from getting stuck in negative behavior and rumination.

Folate is used by your body to help physical strength and energy production. It affects cellular management risk, cardiovascular and circulatory health, and cholesterol metabolism. Your teeth and gums, eyes, nerves, skin, bones, reproductive organs, liver and detoxification, gut, and immune system function all require folate.

Vitamin C

Widely known for its antioxidant and immune support, vitamin C is a “Jack of all trades” in nutrition. It helps recycle and spare other antioxidants protecting tissues throughout your body like the lens and retina of the eye, cell DNA, blood vessels, and cell membranes. It affects blood flow, red blood cells, platelets, bile acid, and cholesterol metabolism. It also helps iron absorption.

Vitamin C provides support for body structure and neurological function. It is required for collagen synthesis that affects your bones, teeth, skin, hair, nails, tendons, ligaments, and cartilage. Vitamin C supports and contributes to regulation of the neurotransmitters dopamine, norepinephrine, serotonin, GABA, glutamate, and acetylcholine.

Adrenal glands require 100 times more vitamin C than what is found in the blood. This makes vitamin C a workhorse nutrient essential for stress. The outer portion of the adrenal gland, i.e. the adrenal cortex, requires vitamin C to make cortisol, DHEA, and other adrenal cortex steroid hormones.

Vitamin C provides critical actions within the immune system. White blood cells such as neutrophils and macrophages, along with T-Cells, natural killer cells, and other cells within the immune system, depend on vitamin C to fight germs, make antibodies, and detoxify. Sufficient antibody production depends in part upon adequate vitamin C. This is important for natural immunity or in the use of vaccinations where many individuals fail to develop or retain antibodies.

Vitamin E

Vitamin E is a fat-soluble antioxidant well-known for cardiovascular support as it aids in protection and reduction of compounds from sticking to the inner lining of your blood vessels. It supports cholesterol metabolism and heart health. This versatile antioxidant also helps cell-signaling, gene expression, and immune function. Vitamin E works together with other essential fatty acids like omega-3 DHA and EPA to manage arachidonic acid metabolism, which affects inflammation levels.

Vitamin E as tocotrienols provides neuroprotection as it is an antiaging nutrient able to extend telomeres. It is also essential for healthy reproductive function and ovaries. 

Magnesium

Magnesium affects hundreds of processes in your body. Bones, heart, mitochondria, muscles, digestive tract, cell membranes, nerves, neurotransmitters, pancreas, teeth and gums, joints and cartilage all require magnesium for structure and function.

Magnesium helps keep calcium and sodium levels balanced in the body and supports potassium levels inside of cells. Magnesium, along with B2, B6, B12, folate, zinc and other nutrients, is needed by the mitochondria to make energy.

Magnesium is essential for DNA, RNA, protein synthesis, and keeping cellular function in working order. Magnesium plays a vital, essential role in glucose metabolism and insulin release. It is also vital for other endocrine tissues like the adrenals and thyroid. It is essential for the activation and use of calcium and vitamin D.

Stress tension, irritability, melt downs and temper tantrums, noise sensitivity, teeth grinding, poor focus, restlessness, poor sleep, fatigue, twitchy muscles, moodiness, easily startled, jumpiness, and poor or stressed mood can indicate that more magnesium may be needed. Slow bowels, increased blood pressure, fast heart rate, and blood sugar dysregulation may also indicate a higher need for magnesium.

Selenium

Selenium is a trace mineral that profoundly impacts key organs like thyroid, heart, and brain along with tissue repair functions. The thyroid gland contains the highest amount of selenium, more than any other organ or tissue in the body per gram of tissue. Adequate selenium is absolutely essential to protection of the thyroid gland along with activation and tissue usage of thyroid hormone.

Selenium acts as an antioxidant that helps protect DNA repair, cell apoptosis/death. Adequate selenium levels within tissues are associated with reduced cell stress and healthier cells in lung, bladder, skin, thyroid, esophageal, stomach, colon, and other tissues.

Selenium helps protect cholesterol and cell membranes from oxidative stress, which in turn helps heart health and blood flow. It helps protect your brain and cognitive function against age-related decline. It supports coordination and motor speed, i.e. how fast and well you can move with dexterity and balance.

Zinc

Zinc is a trace mineral involved with hundreds of different actions in your body. It acts as the gate keeper for your immune system’s biological activity and is integral to immune homeostasis and defense.

Zinc affects energy production, gut barrier integrity, stomach acid production, blood sugar and pancreas, adrenals and thyroid, bones, oral and dental health, neurotransmitter production, nerves, and muscle activity. It is necessary for detoxification and your sense of hearing, vision, smell, taste, and touch and coordination. Several areas of your brain, especially the hippocampus, require zinc to help with memory formation, cognitive skills, and mood.

Proactive Steps

Depletion of any one of these nutrients has far reaching effects on your health. If a woman becomes pregnant while on oral contraceptives or stops the prescription and then becomes pregnant without adequate nutrient status, the nutrient deficits can have lifelong consequences for the child.

If you are currently or were recently taking birth control pills, you must replenish the depleted nutrients. It is also prudent to measure serum ferritin and serum iron, TIBC, and iron binding capacity to measure iron stores. Check serum folate, vitamin B12, and RBC levels of copper, zinc, and magnesium. Several of these nutrients are critical to homocysteine and methylation processes, so at least once per year check your homocysteine levels. You may also benefit from a methylation function test or a test that measures methylation SNPs.

Many oral contraceptive nutrient-depletion studies were done in the 1970’s and 80’s. Hormone amounts were considerably higher in the early prescriptions, more so than newer 2nd and 3rd generation oral contraceptives, and caused significant concerns. Newer medications are considered less of a concern. However, we have greater concerns today with diminished nutrient content in foods and more sugar and processed foods in the diet, increased toxins from plastics, herbicides, GMOs, EMFs, more autoimmune disorders, and higher stress levels than just a few decades ago that compete. The only way we can combat the combined risk of nutrients depleted by drugs, increased toxin load, and nutrient-poor diets is to be mindful and proactive. You do not have to experience the consequences listed above. If you or your daughters are on a medication like birth control pills, be diligent and proactive about nutritional fortification.

Additional resources

B Vitamin Deficiency: Are You at Risk? 

Are You Taking Folate or Folic Acid? Read This First 

Vitamin B12 Essential for Energy, Mood, and Overall Health 

Super Form of Vitamin B12 – Adenosylcobalamin 

Folate & Vitamin B12 for Cognitive Health and Stress

Vitamin C for Stress, Collagen, Immunity 

Insufficient Magnesium – Public Health Crisis Declared 

Vitamin D and Magnesium: Essential Partnership for Health 

Selenium’s Vital Role in Thyroid Hormone Function 

Tocotrienols Extend Telomeres and Turn Back the Clock 

The Best Form of Vitamin E for Health 

Zinc Essential for Immunity, Sense of Smell, and More  

Zinc: Do You Need More? 

Zinc, Alcohol Intake, and Thyroid Function 

MTHFR Gene Defects, Methylation, and Natural Support