Oral Contraceptives (Birth Control Pill)
Common brand names: Lo Loestrin, Yaz, Yasmin, Ortho Tri-Cyclen
Five nutrients listed against this medication. The most severe is marked critical.
At a glance
One of the five is marked well documented. The other four carry their own evidence levels.
At a glance
- Vitamin B6 (P5P form)Critical · Well documented
- Folate (Methylfolate)Critical · Moderate evidence
- Vitamin B12Moderate · Moderate evidence
- MagnesiumModerate · Traditionally cited, limited evidence
- ZincModerate · Moderate evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Estrogen in OCP increases tryptophan metabolism via the kynurenine pathway, dramatically increasing B6 demand. B6 deficiency is the most consistent nutrient depletion in OCP users.
Common signs, Depression, anxiety, irritability, PMS worsening, nausea, elevated homocysteine An amino acid in the blood that rises when vitamin B12, folate or B6 are low.
Nutrition Reviews (1979): oral contraceptive users show altered tryptophan metabolism correctable by pyridoxine, consistent with an increased B6 requirement.
P5P 25–50 mg daily is a range in common use, not from a trial cited on this row. The cited paper estimated the B6 requirement of oral-contraceptive users; it did not compare P5P with pyridoxine, which is the form it studied.
Mechanism, OCPs reduce folate absorption and increase urinary folate excretion. Critical risk: women who become pregnant shortly after stopping OCPs may have depleted folate, the key nutrient preventing neural tube defects.
Common signs, Elevated homocysteine, neural tube defect risk if conception follows OCP cessation
Nutrition Reviews (2011): review of oral contraceptives and B vitamin status. The older folate findings came from higher-estrogen formulations; the review reports that current low-dose contraceptives have not been shown to lower folate status, while the effect on vitamin B6 does persist.
L-methylfolate 400–800 mcg daily is a range in common use, and continuing it for some months after stopping is common practice; neither figure is from a trial cited on this row. The cited paper reports folate, B6 and B12 status in oral-contraceptive users.
Mechanism, OCPs reduce B12 serum levels, likely via altered binding protein levels rather than malabsorption.
Common signs, Fatigue, mood changes, elevated homocysteine
Sütterlin et al. (Eur J Obstet Gynecol Reprod Biol, 2003; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 12593896): lower serum B12 in women using modern low-dose oral contraceptives (routine screening deemed unnecessary except with pre-existing deficiency).
Methylcobalamin 500–1,000 mcg daily is a range in common use, not from a trial cited on this row. The cited paper measured serum folate and B12 in women using a 20 microgram ethinyl estradiol pill and tested no repletion.
Mechanism, Estrogen increases magnesium uptake into red blood cells and bone, lowering serum magnesium.
Common signs, Muscle cramps, headache, PMS symptoms, sleep disturbance
Seelig (J Am Coll Nutr, 1993): a review of magnesium/estrogen interrelationships describing redistribution rather than loss. Primary human data are mixed and do not establish depletion.
Magnesium 200–300 mg at bedtime is a range in common use, not from a trial cited on this row. The cited work is a review of magnesium and estrogen across several conditions and tested no dose or form.
Mechanism, OCPs raise serum copper while lowering zinc. They have opposing effects on the zinc/copper ratio.
Common signs, Immune suppression, skin issues, hair loss, acne (zinc deficiency)
Prasad et al. (Am J Clin Nutr, 1975; PMID 1119434): plasma zinc significantly decreased and plasma copper increased in oral-contraceptive users.
Zinc bisglycinate was used at 15 mg daily. Additional copper supplementation is generally avoided in this setting.
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Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
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