06/26/2011 08:40 pm ET Updated Aug 26, 2011

The Nutritional Cost of Birth Control Pills

Scientific researchers have known for years that the birth control pill depletes nutrients, but to what extent have women been told this information and guided to supplements that will supply what's lost?

Browsing in a used book shop, I found a copy of the "Drug-Induced Nutrient Depletion Handbook," by pharmacist Ross Pelton and his colleagues. (A revised and updated edition will appear next year. Meanwhile, Pelton has a chart and much other free information on his website.)

"Many drugs deplete nutrients," explains Pelton, "but oral contraceptives are the worst." The depletions may increase a woman's risk of: depression, a weakened immune system, heart disease, cancer, and having a child with birth defects.

Pelton is not arguing that pharmaceuticals are useless. (He's a pharmacist.) He's saying that people taking prescription medicine should also ingest supplements to deal with side effects, which may otherwise cause great and possibly irreparable harm. "An ounce of prevention is worth not a pound of cure," he says, "but a ton."

The good news is that women can remedy these depletions easily, at a reasonable cost, if they are told what to do. Much of the scientific research on the nutritional costs of oral contraceptives goes back a third of a century or more. There has been plenty of time for data to get from scientists through doctors to women, but to what extent are women routinely counseled that the pill may deplete vitamin B-6, folic acid, and a list of other nutrients? Do we even know?

Way back in 1979 Smiciklas-Wright and a colleague at Yale did a questionnaire study about beliefs about nutrition among counselors at Planned Parenthood Centers. They found that, back then, only 65 per cent of the counselors were even aware of possible interrelationships between specific nutrients and oral contraceptives, and of these, only about half considered this issue "significant."

If only a small minority of counselors who specialized in dealing with young sexually active women regarded the link as significant, what about general practitioners? Today, of women who come to a doctor for a prescription for the pill, how many learn about the nutritional cost; and of these, how many actually take the necessary supplements? iciklas-Wright

Is this disconnect a systemic problem? Apart from small print in ads and the "Physicians' Desk Reference," big pharma has no incentive to say that its products may cause harm. To what extent do pharmacists, apart from a small group, act as counselors about nutritional costs? There have been random articles in the popular press and on dense government websites about folic acid and B-6 and other nutrients, but is it responsible to prescribe or dispense the pill without supplying clear information about the necessary supplements? (Or as Pelton would say, many other prescription drugs as well.)

Recently, Pelton appeared on my TV program to talk about the subject of his book. "If you think of women who are taking birth control pills," he explained, "and things like [vitamins] B-6, B-12, and folic acid are depleted, these are all critical to metabolize a compound called homocysteine." So what's the problem? "If you have elevated homocysteine, you have advanced cardiovascular disease risk, but there are no symptoms," Pelton said, "so woman can go for years not knowing they have a problem until they have a heart attack or stroke."

EDITOR'S NOTE: The link between elevated homocysteine and cardiovascular disease risk is uncertain. Studies show that nutrients that lower homocysteine do not lower cardiovascular disease event rates.