Portrait of Melissa M Keenan, PhD
Author
Melissa M Keenan, PhD
Portrait of Lauren A Koenig
Reviewer
Lauren A Koenig, PhD

Your body needs certain nutrients from either your diet or your environment in order to function properly. When your lifestyle does not supply you with enough of a certain type of nutrient, you are considered to have a nutritional deficiency.

Since the late 1960’s, researchers have examined whether (hormonal) can cause nutritional deficiencies. In fact, this was quite a popular research topic in the 1970’s and 1980’s. So let’s hang on tight and dig into the recent data (aka with current pill formulations) of how and  if affects the availability of nutrients for your body.

The very basics of nutrition

Food and water provide the necessary nutrients we need to live. Your body breaks down food and water into the basic molecules that it needs to fuel its cells (which are the building blocks of your body). Nutrients are divided into the “macronutrients” of carbohydrates, proteins and fats and “micronutrients” of vitamins and minerals.1

A healthy, balanced diet should provide adequate nutrition to support a healthy body. Occasionally, there are certain nutrients that should be added to our diets depending on your health status and other factors.2

What is a nutritional deficiency?

Nutritional deficiency occurs when a person does not have the necessary amount of a macro- or micronutrient to support a healthy body. Nutritional deficiencies can be clinical (meaning a doctor can diagnose a patient, often due to symptoms) or subclinical (goes undetected or unnoticed).3 They can be difficult to diagnose and require blood tests to evaluate levels. For this piece, let’s focus on nutritional deficiencies of micronutrients, aka vitamins and minerals.

There are many vitamins and minerals that are considered essential:

Your body requires different amounts of each of these micronutrients and different times of life have different requirements as well.5

Micronutrient deficiencies are more likely to affect certain populations (pregnant and lactating, young, elderly, obese, or critically ill people), and do occur in “high income” countries such as the United States. Avoiding nutrient deficiencies is especially important for pregnant and lactating mothers, both for their own health and for the healthy development and growth of the fetus or baby.8

An estimated 31% of the US is at risk of a vitamin or anemia nutritional deficiency.9

How does affect nutrition or nutritional deficiencies?

It all comes down to your liver. Why? Your liver is the organ responsible for metabolizing your food (aka micronutrients), but also for metabolizing toxins and drugs (such as ). Therefore, your liver is where micronutrients and meet (theoretically speaking, anyway).

The question is: are these interactions leading to deficiencies in nutrients that can be harmful to those taking ?

As of now, there is limited current and reliable evidence to support the idea that oral contraceptives cause nutritional deficiencies – except when there are other on-going underlying health conditions.

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Does cause nutritional deficiencies?

A number of studies in the 1970’s and 1980’s looked at specific metabolic changes in people taking oral contraceptives. It is difficult to judge the validity of these papers as many are no longer accessible to understand the study details. Many were also studying early options that had much higher levels of hormones than those used today.

As we know, it is theoretically possible that there are metabolic changes when taking hormones since hormones both directly affect the liver and are metabolized by the liver. However, many of the rumors of causing nutrient deficiencies are rooted in these very outdated studies.

The one exception to this seems to be vitamin B6, which has been shown to be decreased with newer formulations.10 However, there remains controversy on whether the amount of B6 depletion is sustained during use and if it is a clinically meaningful decrease.11

 

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Otherwise, current research generally suggests that if you are healthy, eat a balanced diet, and do not take other drugs when you start hormonal birth control, then it shouldn’t cause nutritional deficiencies. In fact, this same logic was also proposed in 1977 when many studies were purporting the negative effects of at the time.12

Some drugs (including specific antibiotics) may pose safety risks depending on your medical history and the particular drug-drug interactions. If you are taking other medications in addition to oral contraceptives, we recommend checking with a healthcare provider before starting .

Although not all micronutrients are not studied in relation to , there is some information provided by single studies. It’s worth emphasizing that many of these results have not been replicated by multiple groups and/or were (very) small studies and/or were done many years ago, so more thorough recent research is definitely needed before making strong conclusions about their findings.

Minerals

Table of minerals and birth control's effect on them

Vitamins

Table of vitamins

Should you take extra vitamins when on ?

The research says that vitamins B6 and B12 may be decreased in oral contraceptive users. Yet, the impact of this level of decrease has not been studied and is not immediately known. Supplements of these vitamins are readily available.

Overall, if you eat a healthy diet, do not have underlying medical issues, and do not take other prescription medications, shouldn’t cause dangerous nutritional deficiencies. However, a multivitamin is generally a safe supplement to take and so, if it puts you at ease to take one while using hormonal birth control, that is a simple solution. If you still aren’t sure what is best for you, your medical provider is a good person to ask.

Conclusion

Most nutritional deficiencies can be avoided with a healthy, well-balanced, nutrient-dense diet and healthy habits (aka do not smoke, drink alcohol in moderation and avoid recreational drugs), including when taking . Specific health situations, most commonly pregnancy or lactation, have unique nutritional requirements and can necessitate extra vitamins.

We’re hopeful that more research will be done to better understand the benefits of birth control pills that contain extra vitamins such as folate,40-41 and iron.42 Maybe one day your multivitamin and could come in one pill?

Always consult your healthcare provider if you have concerns about your health.

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