How Birth Control Impacts Gut Health
If you’re a woman, you’ve probably had hormonal birth control recommended to you at some point in your life. If you’re like me, you may have taken it for over 10 years without knowing the side effects and consequences of such a commonly prescribed medication. Many women seek the guidance of their health providers with hormonal birth control being the only solution offered, but we are infrequently told how this medication prescribed to 75 million women annually in the US alone depletes us of several key nutrients essential for healthy hormone function and fertility and dessimates our gut health, further putting our body is a stressed state.
Hormonal birth control depletes the body of several key ingredients important for fertility to include B vitamins, vitamin C, selenium, zinc and magnesium. It seems a bit counterintuitive that a product intended to better help women choose when they conceive and avoid conception also may be at the root cause of why they struggle to conceive later in life when coming off birth control.
B vitamins
Hormonal birth control depletes the body of several B vitamins to include riboflavin, folate, B12, and B6. B vitamins are essential for the normal function of cells and nerves, but also for liver function and the detoxification of estrogen (both endogenous and exogenous - produced by us and provided by external sources).
Methylation, one of the key metabolic pathways for the detoxification of estrogen, is reliant on B vitamins for support. Without adequate vitamin B consumption in combination with the depletion caused by hormonal birth control, many women are deficient and struggle to detoxify from the synthetic estrogens being introduced in their birth control, leading to the recirculation of estrogen and the development of estrogen dominance, which results in painful and heavy periods, breast tenderness, and PMS.
Zinc
Zinc is an important mineral essential for nearly 100 enzymatic processes in the body and plays a role in creation of DNA, growth of cells, building proteins, healing damaged tissue, and supporting a healthy immune system. Zinc is also a cofactor for the production of stomach acid, and is therefore critical for the chemical digestion of foods to avoid intestinal inflammation, leaky gut, and the development of both gut pathogens and food sensitivities.
When it is depleted due to hormonal birth control use, it’s not uncommon to see a deterioration in immune function, trouble healing wounds quickly, poor nail quality (to include white spots on fingernails and brittle nails), and declines in digestive function.
Selenium
Selenium is a trace mineral that plays a role in the production of DNA, protects against cell damage and infections, and is a key mineral for thyroid function. Keeping in mind that hormones do not function within a bubble and all of our endocrine glands communicate with one another. This means that when sex hormones are effectively shut off through the use of homronal birth control, the thyroid can be effected and this is further exacerbated by the depletion of selenium which is key for healthy thyroid function.
Magnesium
Magnesium is one of our key minerals important for over 300 enzymatic processes in the body and supports muscle and nerve function and energy production most notably. It is depleted with hormonal birth control use and impacts the adrenal glands indirectly as magnesium is utilized when the body is under stress. As the sex hormones are affected and a stress response takes place through both the depletion of nutrients, hormonal shifts, and impact to the gut (as we’ll soon discuss), magnesium is burned through at higher rates, leaving many women severely deficient.
So how does all of this relate to your digestive health? Many of the key nutrients depleted via hormonal birth control use plays an important role in digestive function, preventing infections throughout the digestive system, and the absorption of food. Research also shows strong connections between intestinal diseases and the use of hormonal birth control.
Digestive Dysfunction
Stomach acid is composed primarily of water, iron, B vitamins and zinc - several of which are depleted by hormonal birth control as you now know. As stomach acid levels lower, the digestive system struggles to chemically digest food.
In the stomach, this can lead to the potential for bacterial infections such as helicobacter pylori to overgrow as it is normally kept at bay via adequate stomach acid. When stomach acidity is low, food may also remain in the stomach for long durations of time as the stomach attempts to produce more gastric juice to aid in digestion, which can result in churning, a heavy feeling in the stomach, excessive hiccuping/burping, acid reflux, or heartburn and indigestion.
At some point, the food moves into the intestinal tract whether it has been fully digested chemically or not and undigested food particles create inflammation in the GI tract contributing to intestinal permeability over time. When food is not chemically digested properly, it is not broken down to the molecules that are able to be absorbed into the bloodstream. This means that despite having a perfect diet, if you are not producing adequate stomach acid to break down your food, it is unlikely you are absorbing the vitamins and nutrients you’re consuming.
Intestinal Permeability
Studies show that the use of steroid hormones in oral contraceptives not only impact the beneficial gut flora but also negatively affect estrogen metabolism in the body and can contribute to weight-loss resistance. Use of birth control decreases the gut’s ability to metabolize estrogens, which can further contribute to an estrogen dominant state and leaves synthetic estrogens recirculating in the body.
The use of hormonal birth control has also been shown to increase the risk of inflammatory bowel disease by at least 50% to include Chron’s disease. It’s unclear why hormonal contraceptives would trigger an inflammatory condition but researchers believe it’s due to the impaired immune function, an imbalance gut microbiome and increased permeability that birth control contributes to.
Researchers have known since the late 1960’s that hormonal contraceptives are connected to intestinal inflammation. Oral consumption of hormones alters the permeability of the intestinal tract and this exposure to exogenous hormones (aka those produced outside of the body) creates a suboptimal environment for beneficial flora. This intestinal permeability is also known as leaky gut and allows for the normally tight junctions of the villi in the intestinal tract to become inflamed and more permeable. Under normal conditions, these junctions are highly selective about what is absorbed directly into the bloodstream, but as these junctions become “leaky” food particles, pathogens (bacteria, yeast, parasites), and toxins are able to move directly into the bloodstream where the immune system is left to fight them off.
Over time, these leaky junctions can contribute to elevated immune function as our white blood cells work hard to fight off these pathogens, toxins and foods perceived as foreign invaders. As this continues, the immune system can struggle to keep up with demands. For you, this may look like noticing that you get sick more frequently and may experience more bloating, gas, changes in bowel movements and new food sensitivities appearing.
Liver function
As we already discussed, the liver is directly impacted by the depletion of several key B vitamins in its efforts to detoxify estrogens in the body. Research also suggests oral contraceptives are both associated with several liver related complications to include hepatotoxicity, or damage to the liver caused by the use of medications, and cholestasis, or liver disease due to the reduction of bile flow.
Cholestasis due to estrogens appears to be related to inhibition of bilirubin and bile acid secretion related to effects of estrogens that modulate bile acid and bilirubin metabolism. The reduction of bile flow is an important consideration for the binding of toxins and hormones (both endogenous and exogenous) to be removed from the body effectively. Bile also plays an important role in digestive function through the emulsification of fatty acids to allow for their absorption. Without adequate bile blow, poor fat digestion occurs, bile can become viscous affecting the health of the gallbladder, and creating toxicity in the colon due to high fat content which can contribute to constipation. This further contributes to digestive dysfunction, intestinal inflammation and poor elimination of toxins as a whole through elimination pathways.
What You Can Do
If you’re concerned about your use of hormonal birth control and its effects on your nutrient status and digestive health, there are a couple keys things to consider implementing into your health regimen:
Incorporate B vitamins into your diet as much as possible. Beef liver is a great source of bioavailable B vitamins, but if you’d prefer a supplement, it’s important to get a product that contains all B vitamins to support a healthy balance. You can utilize a B complex that contains folate (not folic acid, as this is the synthetic version of folate) and methylated B vitamins which ensures that if your methylation pathway is struggling, you’ll still receive the support you need.
Get zinc in your diet. Zinc is found in animal meats (and so are B vitamins) and are most prominent in seafood, especially oysters. You can use either fresh or canned oysters, or if you’d prefer several oyster-based zinc supplements exist on the market.
Consider magnesium supplementation as it’s difficult to get adequate magnesium through diet alone due to poor soil quality translating to poor mineral levels in our modern produce. Be mindful of the type of magnesium you take. Magnesium citrate serves as a laxative. Magnesium glycinate is calming. Magnesium malate is energizing. All magnesium serves different functions so it’s important to find the right form of magnesium to serve your unique needs.
Support liver detoxification and functions. Dandelion tea, garlic, beets, and burdock all support healthy liver detoxification. This may or may not be sufficient support depending on the duration of your hormonal birth control use in addition to other factors that impact liver health.
Consider taking a deep dive into your digestive health. If you’re struggling with digestive issues due to the use of birth control, you’re noticing hormonal imbalances when attempting to come off of birth control, or you’d like guidance supporting your body as you get off birth control in preparation for conception, our team can help support you from every angle to support digestive health, screen for gut pathogens, and ensure your liver is functioning optimally to support hormonal balance for a healthy and comfortable pregnancy.