Many of the side effects of medications may be the result of nutritional deficiencies caused by the drug. Many people know that taking oral contraceptives increases your risk of cardiovascular disease and stroke, but have never thought about why this occurs. What many people don’t know is that taking birth control pills could also cause disruptions in the body’s biochemical processes that are associated with thyroid and adrenal dysfunction, depression, anxiety, and insomnia.
There are two groups of oral birth control available. The first is a combination of estrogen and progesterone, and the second type is continuous oral progesterone, or injected. There is not a lot of information about nutritional depletions from the second type, but they are also known to increase the risk of cardiovascular disease and stroke. The terms monophasic, biphasic, and triphasic on the medications just refer to the ratios of estrogen and progesterone in the formula.
The raised levels of progesterone and estrogen send a signal that stops the release of follicle stimulating hormone (FSH) and lutienizing hormone (LH) necessary for a normal menstrual cycle with ovulation and for pregnancy to occur. So how does this increase the risk of developing vascular diseases such as pulmonary embolism, thrombophlebitis, cardiovascular disease (CVD), stroke, and heart attack?
The depletion of nutrients begins with the excess estrogen in the body which increases the activity of inflammatory steroid hormones called prostaglandins and produces an inflammatory response throughout the body. The body then must use B vitamins to fight the inflammation. The problem is that B vitamins are needed elsewhere, for a multitude of other biochemical processes by the body, including the creation of other important substances. There aren’t enough B vitamins left to adequately perform these tasks, and this also interferes with the GI tract’s ability to absorb nutrients.
Nutrients that can become depleted by birth control pills include magnesium, folic acid, vitamin B2, vitamin B3, vitamin B6, vitamin B12, vitamin C, tryptophan, tyrosine, and zinc. The body’s inability to absorb these nutrients can cause a cascade of altered physiologic processes that can negatively affect certain organ system’s ability to function properly.
High amounts of oxidative stress increase the release of “stress hormone” cortisol from the adrenal glands. Over time, this can lead to adrenal fatigue and decrease the body’s ability to cope with stress. This is why chronic stress and lack of restful sleep are often associated with weight gain. Overtime adrenal fatigue causes a weakened immune system, and can lead to the development of chronic illness, such as cardiovascular disease. B vitamins are strong protectors of the cardiovascular system and the adrenal glands.
B6 is used to form compounds (Schiff bases) that act as co-enzymes for many reactions. It synthesizes precursors for blood-forming elements, and it also helps create complexes (cytochromes) needed for the liver to carry out detoxification. It helps rid the body of homocysteine, high levels of which are associated with cardiovascular disease and stroke. Homocysteine acts as a free radical and damages the lining of the blood vessels and the cardiovascular system. B6 also regulates the production of DNA and RNA, as well the production and regulation of neurotransmitters epinephrine, norepinephrine, serotonin, and dopamine, necessary for a healthy state of mind.
One study performed on women between the ages of 20-25 found that after 2 1/2 years on oral contraceptives they had significantly reduced levels of vitamin B6. They also found that even after coming off of the medication, becoming pregnant, and giving birth, they had lowered concentration of B6 in their breast milk, and the children born to them were also deficient in B6. This indicates that women should supplement with a B-complex vitamin for an extended time, perhaps up to a year, after coming off of birth control.
B2 is a precursor for compounds necessary for several processes in the body, but is most notable for its role in energy production (it creates co-factors for oxidative phosphorylation and the electron transport chain). It also contributes to forming complexes necessary for liver detoxification. It helps form a powerful antioxidant (reduced glutathione) that protects against damaging oxidative stress from free-radicals and reduces plasma homocysteine. This antioxidant preserves the function of the endothelial cells lining the blood vessels. When these tissues are injured they are unable to secrete the substances needed for the blood vessels to relax, and the risk of hypertension and stroke is increased. B2 is also needed to create cofactors necessary for the formation of B6, B12, and folic acid, which are all also used to help clear the body of homocysteine.
Magnesium plays an important role in cardiovascular disease and diabetes. Low levels of magnesium in the diet have been shown to increase blood pressure, which can results in hypertension over time. Magnesium, along with B12 and folic acid, are involved in the reaction which converts harmful cardiovascular disease-promoting homocysteine into an antioxidant (SAMe) that promotes emotional wellbeing, reduces oxidative stress, and helps maintain cardiovascular function. In the absence of B12 and folic acid, the conversion stops with homocysteine and its levels increase in the body. In addition to helping convert harmful homocysteine into an antioxidant, B12 also ensures carbohydrates, proteins and fats are properly digested and the nutrients absorbed.
Magnesium regulates calcium channels and the electrical stability of the cells, plays a role in nerve conduction, relaxes the blood vessels to reduce blood pressure, and improves insulin sensitivity and the body’s ability to cope with increased blood sugar. Any insulin resistance, even in the absence of type II diabetes, is associated with hypertension because it increases the activity of the sympathetic nervous system, so it is especially important to maintain stable blood sugar and reduce your intake of refined sugar, simple grains and starches when taking birth control pills.
Vitamin C deficiency contributes to cardiovascular disease because it is needed to create collagen to repair the vascular lining from damage and prevent atherosclerosis. It also acts as an antioxidant and reduces free radicals. Tyrosine is an amino acid that is needed for proper adrenal and thyroid function. Low levels of tyrosine lead to low levels of thyroid hormones needed for the metabolism of proteins, carbohydrates, and fats, leading to an increase in circulating cholesterol and triglycerides, contributing to cardiovascular disease and stroke. Weight gain, fatigue, and depression are conditions that can result from hypothyroidism, and are also associated with cardiovascular disease.
Tryptophan is an amino acid that is used to form vitamin B3 as well as the neurotransmitter serotonin. Serotonin is responsible for overall emotional wellbeing. Reduced serotonin levels are highly associated with depression and anxiety, and because serotonin is a precursor for melatonin, insomnia as well.
Low levels of serotonin in the blood are interpreted by the brain as a hypoglycemic state, so it causes carbohydrate cravings in the hypothalamus and may lead to obesity, binge eating, or bulimia, which put even more stress on the cardiovascular system. This state also promotes the absorption of unhealthy types of cholesterol because tryptophan is necessary to form vitamin B3 as well as serotonin. Vitamin B3 increases the levels of healthy cholesterol while reducing the harmful forms of cholesterol in the body.
Melatonin regulates circadian rhythms and also acts as an antioxidant. When it gets dark, melatonin is what tells your body to stop releasing the neurotransmitters that keep you alert and allow you to relax (this is why melatonin as a sleep aid only works if you remove all artificial light shortly before going to bed). With reduced melatonin, it is harder to achieve restful sleep, and the body is unable to cope with the day’s oxidative stress during sleep as effectively as it should, thus perpetuating this condition of widespread inflammation and oxidative stress on the body that began with the introduction of excess estrogen and progesterone.
These drugs, while convenient, cause disruptions in metabolism, hormone and neurotransmitter production, and the cardiovascular system through multiple avenues. 5 years of oral contraceptive use significantly increases the risk of cardiovascular disease and clot formation leading to stroke. In addition, there is five times greater risk of developing Parkinson’s disease among those who have taken oral contraceptives when they were younger because the stress on the nervous system leads to degeneration of the neurons. This is not to say that any other forms of birth control are safe (except for good old condoms!), only that this is what research is available. Injections and many IUDs also use estrogen and progesterone, and the IUDs that don’t have their own sets of side effects. Oral contraceptives should not be a long-term solution to prevent pregnancy. Nutritional supplementation should be considered with their use and for some time after discontinuing use, and every step must be taken to reduce lifestyle risk factors such as improper diet and smoking.
Resources:
Martin, Brett R and Richardson, Daniel L “The effects of oral contraceptive induced nutrition depletions and its consequences.(Report)”. Original Internist. 18.2 2011-06-01. 45(11).
Dr. Brett Martin, D.C. Health Consequences of Oral Contraceptives and their Nutrient Depletions. Sept 21, 2001. Podcast
Related Supplements:
Homocysteine Supreme – This formula contains the nutrients described above, B2, B6, B12, Folic acid, zinc, and magnesium, as well other synergistic nutrients necessary for controlling homocysteine levels and decreasing cardiovascular risk, and for performing biochemical reactions needed for detoxification, joint and cartilage repair, and brain health.
B-Supreme – A powerful B vitamin combination formula
Additional resources:
Planned Parenthood: Birth Control Options – The diaphragm, sponge, and cervical cap are birth control options for women that do not put any hormones or release continuous chemicals into your body.
