Oral Contraceptive and Macronutrients

What deficiencies should be considered?

Understanding the vitamin and mineral deficiencies that may occur is important since hair growth may rely on the maintenance of certain levels and loss of hair may occur from levels that are too low.

Many deficiencies have been studied. On average, women who use OCP's have slightly lower levels of B12, B6, zinc and magnesium than women who do not use OCP's. The most significant changes were for vitamin B12 and B6 with zinc, magnesium being only slightly affected. 
Many of these are "averages" or broad generalizations and may not apply to one specific person. For example, many women using oral contraceptives have fairly normal levels of all of these parameters. But when considered among the entire population, these trends are seen.

For example, B12 levels may be lowered by 100-150 points in women who use birth control. While low B12 levels are not clearly associated with hair loss (i.e. no good evidence), they are associated with many other health parameters. It is important to keep levels above 300 pg/ml and perhaps even 350 pg/mL.

Women using OCP's may have higher levels of other vitamins and minerals. Women who use birth control are more likely to have higher ferritin (iron) levels and less likely to be anemic. Women using oral contraceptives appear to have higher vitamin D levels than women who do not use OCP's.

The effect of every medication or supplement that a patient with hair loss uses needs to be carefully reviewed. Oral contraceptives may lower levels of some vitamins and minerals - the best evidence being for vitamin B12 and vitamin B6. Others appear to be only slightly affected.