Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Oral contraceptives ("birth control pills") have been shown in multiple studies to affect the metabolism and blood levels of certain B vitamins, particularly folic acid (vitamin B9), vitamin B6, and vitamin B12. The mechanism involves altered absorption, increased excretion, and changes in hepatic metabolism. For example, women taking combination oral contraceptives have been found to have lower serum concentrations of vitamin B6 and B12 compared to non-users. There is also evidence that folate status can be diminished. Some of the side effects of oral contraceptives, such as mood changes, fatigue, or increased risk of neural tube defects in pregnancies that occur shortly after stopping the pill, may be partially related to these deficiencies.

Supplementation with B vitamins is sometimes recommended for women on oral contraceptives to help counter these potential deficiencies and associated side effects. Scientific reviews and clinical guidelines agree that the risk of significant deficiency is relatively low in well-nourished populations, but supplementation may be justified in those with marginal dietary intake or additional risk factors. The evidence for supplementation preventing or reducing specific side effects (like depression or low energy) is limited but suggestive, particularly for folate and B6. Therefore, the use of B vitamins for this purpose is based on both mechanistic understanding and observed biochemical changes, but direct clinical outcome evidence remains moderate.

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