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Note: The resources listed in this guide are not intended to be fully systematic or complete, nor does inclusion here imply any endorsement or recommendation by The University of Maryland or the Center for Integrative Medicine. The University of Maryland and the Center for Integrative Medicine make no warranties, express or implied, about the value or utility for any purpose of the information and resources contained herein.

Birth control medications - monophasic, biphasic, and triphasic preparations

Selected Medications:

Ethinyl Estradiol and Desogestrel
- Apri
- Desogen
- Mircette
- Ortho-Cept
Ethinyl Estradiol and Levonorgestrel
- Alesse
- Levlen
- Levlite
- Levora
- Nordette
- PREVEN
- Tri-Levlen
- Triphasil
Ethinyl Estradiol and Norethindrone
- Brevicon
- Estrostep 21
- Estrostep Fe
- Femhrt
- Genora 0.5/35
- Genora 1/35
- Jenest-28
- Loestrin
- Modicon
- Nelova 0.5/35E
- Nelova 10/11
- Norethin 1/35E
- Norinyl 1+35
- Ortho-Novum 1/35
- Ortho-Novum 10/11
- Ortho-Novum 7/7/7
- Ovcon 35
- Ovcon 50
- Tri-Norinyl
Ethinyl Estradiol and Norgestimate
- Ortho Tri-Cyclen
- Ortho-Cyclen
- Ortho-Prefest

Depletions:

Magnesium

Magnesium deficiency affects calcium and vitamin D levels in the body and may be associated with muscle cramps, heart irregularities, high blood pressure, diabetes, and osteoporosis (bone loss).

Vitamin B2 (Riboflavin)

Symptoms of vitamin B2 deficiency may include cracks at the corners of the mouth, inflammation of the skin, growth retardation, and impaired wound healing.

Vitamin B6 (Pyridoxine)

Symptoms of vitamin B6 deficiency may include weakness, nervousness, insomnia, mental confusion, irritability, and anemia. Long term low levels of this nutrient may also increase the risk of heart disease, as well as colon and prostate cancers.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, birth defects, and colon cancer.

Vitamin B12 (Cobalamin)

Obvious symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.

Vitamin C (Ascorbic Acid)

Vitamin C deficiency may include bruising, fever, anemia, emotional changes, swollen and bleeding gums, fatigue, lethargy, jaundice (yellowing of the skin and eyes), increased susceptibility to infections, slow wound healing, and swelling of the lower limbs. Severe deficiency leads to scurvy, a disorder that affects muscles and bones and is potentially fatal. However, scurvy is rare these days because of the wide availability of vitamin C from dietary sources.

Zinc

Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, growth retardation, hair loss, skin changes, diarrhea, and increased susceptibility to infection.

Editorial Note:

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle, as well as the length of time you have been taking the medication. Please consult your health care provider; he or she can best assess and address your individual health care needs and determine if you are at risk for nutrient depletions from these medications, as well as others not listed here.

Reviewed last on: 5/10/2010
Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.

Supporting Research

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Bermond P. Therapy of side effects of oral contraceptive agents with vitamin B6. Acta Vitaminol Enzymol. 1982;4(1-2):45-54.

Bierwirth J, Ulbricht KU, Schmidt RE, Witte T. Association of common variable immunodeficiency with vitamin B(6) deficiency. Eur J Clin Nutr. 2007; [Epub ahead of print].

Cashman K, Flynn A. Optimal nutrition: calcium, magnesium and phosphorus. Proc Nutr Soc. 1999;58:477-487.

Chiang EP, Smith DE, Selhub J, Dallal G, Wang YC, Roubenoff R. Inflammation causes tissue-specific depletion of vitamin B6. Arthritis Res Ther. 2005;7(6):R1254-62.

Fox C, Ramsoomair D, Carter C. Magnesium: its proven and potential clinical significance.South Med J. 2001;94(12):1195-201.

Green TJ, Houghton LA, Donovan U, et al. Oral contraceptives did not affect biochemical folate indexes and homocysteine concentrations in adolescent females. J Am Diet Assoc. 1998;98:49-55.

Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S Suppl):1344S-1349S.

Hjelt K, Brynskov J, Hippe E, Lundstrom P, Munck O. Oral contraceptives and the cobalamin (vitamin B12) metabolism. Acta Obstet Gynecol Scand. 1985;64(1):59-63.

Li Y, Schellhorn HE. New developments and novel therapeutic perspectives for vitamin C. J Nutr. 2007;137(10):2171-84.

Morris MS, Picciano MF, Jacques PF, Sellnub J. Plasma pyridoxal 5-phosphate in US Population: the National Health and Nutrition Examination Survey, 2003-2004. Am J Clin Nutr. 2008;87(5):1446-54.

Nielsen FH, Milne DB, Klevay LM, Gallagher S, Johnson L. Dietary magnesium deficiency induces heart rhythm changes, impairs glucose tolerance, and decreases serum cholesterol in post menopausal women. J Am Coll Nutr. 2007;26(2):121-32.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.;2001:459-471.

Powers HJ. Current knowledge concerning optimum nutritional status of riboflavin, niacin and pyridoxine. Proc Nutr Soc. 1999;58(2):435-440.

Rivers JM. Oral contraceptives and ascorbic acid. Am J Clin Nutr. 1975;28(5):550-554.

Rodríguez-Morán M, Guerrero-Romero F. Serum magnesium and C-reactive protein levels. Arch Dis Child. 2007; [Epub ahead of print].

Seelig MS. Increased need for magnesium with the use of combined oestrogen and calcium for osteoporosis treatment. Magnes Res. 1990;3(3):197-215.

Shojania AM. Oral contraceptives: effect of folate and vitamin B12 metabolism. Can Med Assoc J. 1982;126(3):244-247.

Spinneker A, Sola R, Lemmen V, Castillo MJ, Pietrzik K, González-Gross M. Vitamin B6 status, deficiency and its consequences--an overview. Nutr Hosp. 2007;22(1):7-24.

Stanton MF, Lowenstein FW. Serum magnesium in women during pregnancy, while taking contraceptives, and after menopause. J Am Coll Nutr. 1987;6(4):313-319.

Thompson J. Vitamins, minerals and supplements: overview of vitamin C (5). Community Pract. 2007;80(1):35-6.

Tubek S, Grzanka P, Tubek I. Role of Zinc in Hemostasis: A Review. Biol Trace Elem Res. 2007; [Epub ahead of print].

Webb JL. Nutritional effects of oral contraceptive use: a review. J Reprod Med. 1980;25(4):150-156.

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