You can eat your fruits and veggies, exercise regularly, and take the occasional gummy vitamin—but that may not be enough to reach optimal health if you’re currently on a hormonal birth control pill. One of the lesser-known side effects of the Pill is it’s ability to cause deficiencies in essential vitamins and minerals like vitamin B6, magnesium, vitamin b12, folic acid, vitamin C, and zinc, among others. With immune health being of critical importance these days, why aren’t more women aware of this side effect?
“The science is there, but it’s certainly not new,” says Dr. Charis Chambers, a Board-certified OBGYN who is known as The Period Doctor. “I mean, this has been written about and discussed since the ’70s.” She notes that B vitamins are “particularly important for women of reproductive years,” and in addition to preventing anemia, they also play a key role in the “normal development of a fetus.” Some of the key vitamins and minerals birth control pills deplete—like vitamin c, for example— can lead to an increase in oxidative stress, triggering a potential cascade of negative effects. Especially since birth control is something women take for years, sometimes decades.
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So why does birth control impact your bioavailability of these nutrients? The science points to a variety of causes, all of which Dr. Jolene Brighten, a nutritional biochemist and naturopathic physician, covers in her book Beyond The Pill. Hormonal contraception impacts so many processes, Brighten explains, from how your liver functions to your gut permeability (and even who you’re attracted to). But both Brighten and Chambers agree that it’s largely the Pill’s impact on your liver function that’s to blame. “The human body is so complex,” says Chambers. “It’s mostly because these hormones are affecting your liver, which affects how everything is metabolized to your body.”
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All this isn’t to say that birth control is bad—for many women, it’s essential and life-saving. It’s just worth noting that in addition to preventing pregnancy and quelling symptoms of PCOS, hormonal pills can also impact your nutritional health.
Chambers stresses that just because a vitamin or mineral shows up as low on a blood test doesn’t mean it automatically correlates to any serious health issues. “How am I helping you by letting you know, hey, that’s a little low? It doesn’t equal that you would have depression, it doesn’t equal that you would be anemic. It doesn’t even equal greater birth defects,” says Chambers. To understand your health is to look at the big picture.
So why isn’t this decades-old side effect more commonly discussed? Chambers explains that the reason doctors don’t usually tell their patients about this risk is because their time with you is quick, and they’d rather let you know about more serious complications like strokes and blood clots. “We have limited time and I want I don’t want to get so lost in the weeds that I miss an opportunity to help you reach your life goals, which is planning your life and your family,” she says. If you want to optimise your nutritional health, don’t be afraid to discuss any concerns with your doctor.
This begs the question: while you’re still on the Pill, how can you optimise your nutrition outside of a balanced diet? Some supplement brands are currently selling capsules designed specifically for women on the Pill to fill in the gaps, though critics say they’re not well-rounded enough. Brighten and Chambers both agree that all women of child-bearing age, whether they’re on birth control pills or not, should be taking a prenatal or women’s multivitamin, which will cover all of your nutritional bases.
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“If you’re concerned about the nutrient depletions happening, get on a multivitamin or prenatal, but it’s not urgent right now for you to get b12 tested,” adds Brighten. Chambers also cautions against taking extreme measures to course-correct your nutrition at-home. “It doesn’t mean you should be like loading up on just B complex vitamins or chugging magnesium, or anything extreme,” she says.
In the age of COVID-19, it’s tempting to think more is better when it comes to immune-boosting and anti-inflammatory vitamins and minerals like vitamin C and zinc. That’s not the case. Other than taking a daily vitamin supplement, Brighten advises to only rush to a doctor if you’re exhibiting serious, life-threatening symptoms like difficulty breathing or chest pain that could indicate either a COVID infection or blood clot. “Will taking a multivitamin or prenatal prevent you from getting COVID? Absolutely not. Can you out-eat your way from contracting COVID? No,” says Brighten, who publicly battled the disease earlier this year. “So [supplements are] not a treatment and not a cure, and it’s not going to prevent it. But it is something that my doctors have said to me multiple times: if I had not had the diet and lifestyle that I did, I probably would have died from COVID.”
This story originally appeared on Harper’s BAZAAR US.