I enjoy podcasts and when they are by actual medical or wellness professionals I do want to take note of the information and sometimes pass that information along. It’s important to remind ourselves, sometimes the authors are quoting older or less rigorous studies and sometimes when listening we can. Some studies used serum levels (the kind of tests when you get ‘routine’ blood work), other studies use tissue red blood cell levels which may differ from what you get in your serum tests and we don’t understand all the implications of those variances.
Earlier studies in the use of contraceptive pills discussed increases and decrease the physiologic levels of ten nutrients. While these were considered real findings, women with adequate diets were not instructed to take supplements. The newer research with modern low-dose pills continues to show that OCs can influence your nutritional status—some changes are mild, while others may be worth addressing.
Which Nutrients Are Affected?
Vitamin B6 (Pyridoxine):
OC use has been associated with lower levels of vitamin B6. Some women may notice mood changes like irritability or depression when deficient. Supplementing B6 can help improve symptoms for some users.
Vitamin B12 (Cobalamin):
Women on birth control often show reduced B12 levels, though the clinical impact is still unclear. Most of the studies on pub med are from the 1970s and 1980s when oral contraceptive hormonal strengths were much higher than today. Even with lower levels of B12, most women don’t develop full-blown deficiency, but it’s something to keep an eye on, especially for those with limited dietary intake of animal products. Vegans and those with GI malabsorption issues should be monitored more closely.
Folate (Vitamin B9):
Folate levels may also drop with OC use. Particularly in women with inability to methylate folate. This is especially important for women planning pregnancy, as low folate is linked to neural tube defects. Some modern birth control formulations now include folate to address this risk.
Vitamins C and E:
As antioxidants, these vitamins help protect against cellular damage. Some studies suggest that OCs can reduce their levels, potentially increasing oxidative stress over time.
Zinc, Magnesium, and Selenium:
These essential minerals may be lower in women taking OCs. They’re important for immunity, mood balance, and metabolic health. Dietary intake or supplementation may help if you’re low in these nutrients.
Copper Levels Elevate
Oral contraceptive (OC) use can lead to elevated serum copper levels, a condition known as hypercupremia. This effect is primarily attributed to estrogen-induced increases in ceruloplasmin, the main copper-carrying protein in the blood.
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A meta-analysis of 26 studies found that combined oral contraceptives (COCs) commonly raise serum copper to levels between 1.5 and 2.0 mg/L, exceeding typical reference ranges. Although these levels are not considered toxic, the long-term implications remain under investigation. PubMed+1ScienceDirect+1
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Influence of Progestin Type: Research indicates the type of progestin in OCs affects the degree of copper elevation. For instance, OCs containing antiandrogenic progestins drospirenone or desogestrel are associated with higher increases in serum copper compared to levonorgestrel. Nature
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Rapid Onset and Reversibility: Studies have shown serum copper levels rises significantly within 10 days of starting COCs and return to baseline within a few weeks after discontinuation. Fertstert
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Clinical Cases: There are documented cases where elevated serum copper levels due to OC use led to corneal copper deposits. These deposits diminished after stopping the contraceptives, highlighting the potential for reversibility.
What Does This Mean for You?
- Skin and Lip Health Can Be Affected:
- Supplements May Help: Taking a high-quality multivitamin or targeted supplements (especially if you’re vegetarian or have dietary restrictions) helps maintain optimal levels. But monitoring blood levels may be important
- Nutritional Strategies: A diet rich in leafy greens, whole grains, lean protein, and antioxidant-rich fruits can go a long way in supporting your nutrient needs while on birth control.
- Pregnancy Planning: If you’re transitioning off the pill to conceive, make sure your folate and B vitamin levels are optimized several months in advance.
- Talk to Your Provider: If you’re feeling fatigued, moody, or just not quite yourself, ask your healthcare provider about checking your nutrient levels. It might not be “just stress.”
The Bottom Line
Modern birth control pills are safe and effective, but they can impact your nutrient status. Understanding how they interact with your body helps you stay ahead of potential deficiencies and keep your health on track. With a thoughtful approach to diet and supplementation, most women can continue taking OCs with confidence and support their long-term well-being.
