By Stephanie Greunke, MS, RD

The information in this post is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Always consult your healthcare provider to determine the appropriateness of the information for your own situation, or if you have any questions regarding conception, pregnancy, or your prenatal treatment plan. Have a question for our team? Click here to e-mail us.

You’ve made the decision to start trying for baby by ditching your hormonal birth control and allowing your body to reset and get pregnant. This is a great first step, but it’s not the only step I’d like you to consider when it comes to preparing for baby.

Not planning a pregnancy, but choosing to get off the pill for other reasons? Either way, the goal is to get your body to a healthy, hormonally balanced state. In order to do so we need to replenish nutrients the birth control pill depleted, remove excess synthetic estrogen by supporting liver health, and repair your gut.

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Waiting for your cycle to return

You may have gone off the pill expecting a quick return of your period. Unfortunately, that’s not always the case. While many women regain their cycles within three months of stopping the pill, it can take some women much longer. This is something I personally experienced. At the time, there were few people talking this issue, but now it’s being discussed by professionals like Dr. Jolene Brighten, ND.  If it takes longer than three months for your period to return, it’s generally recommended to take a pregnancy test and then consult your provider.

Click to listen to my interview with Dr. Brighten, where we discuss post-birth control syndrome.

If you’re looking to conceive, this delay can be incredibly frustrating. You may feel like this is out of your control, but remember, there’s always something you can do to feel empowered during difficult seasons. We’ve got your back! Regardless of how long it takes, it’s important to set your body up for success post-birth control so you have the best chance of regaining your cycle, reducing common symptoms experienced as a result of taking the pill, and feeling your best.

Working with your healthcare provider

After coming off the pill, I’d recommend working with a functional medicine provider who can order specific lab work to identify nutrients that may have been depleted, check your gut health, thyroid, and adrenals, and even perform a comprehensive reproductive hormone test like the Dutch test to identify any areas of concern and develop a customized plan. Conventional providers may not know about these tests, but it doesn’t hurt to ask or even seek another opinion.

Research shows that oral contraceptives deplete important nutrients including folate, vitamin B2, B6, B12, vitamin C and E, magnesium, selenium, and zinc. Vitamin D levels are also shown to drop by as much as 20% after stopping the pill. These nutrients play key roles in preconception health, pregnancy, and postpartum, so we want to make sure we replete these nutrients soon after or ideally while taking the pill to set yourself up for success. Let’s dive into some of the nutrients that may have been depleted, and how you can address these possible deficiencies.

Addressing nutrient deficiencies with whole foods

  • Folate (vitamin B9): Folate is well known for its importance during pregnancy for supporting neural tube closure, neurological health, growth and development. In addition, low plasma or serum folate has been found in patients with recurrent mood disorders including depression. This is important to know so you can not only optimize your chances of conceiving, but also support your mental health through the process and well into motherhood.
    • What to do? Make sure you’re eating rich sources of folate like leafy green vegetables, broccoli, and asparagus every day and consider taking a prenatal that includes methylfolate (instead of folic acid).
  • Other B-vitamins (B2, B6, B12): Vitamins B6 and B12 support brain and nervous system health for you and your baby. B-vitamins are important for reducing homocysteine levels, which gives us the best chance of conceiving and having a healthy pregnancy. We also know that B12 levels are often deficient in pregnant women.  B6 can help ward off nausea associated with morning sickness and is often used clinically in combination with medication used to treat nausea/vomiting, so you’ll want to ensure adequate intake before conceiving. B-vitamins (including B12, B6, and B9) play an important role in supporting mental health and are often depleted postpartum. It’s not a bad idea to consider including rich sources of B-vitamins in your diet as a preventative measure.
    • What to do? Look for a prenatal with methylated forms of B-vitamins. If you’re up for it, consider consuming 3-4 oz of liver to more efficiently restore your body’s levels of these vitamins. Liver capsules, like the ones from Vital Proteins, can also help restore B12 levels. Not happening? Consume meat, fish, and poultry and consider taking a prenatal multivitamin to fill in the gaps. If tolerated, organic, grass-fed, full-fat yogurt can also be a rich source of B2. If you choose to include dairy, quality is important since we want to minimize exposure to hormones and environmental toxins.
  • Vitamin C and E: Hormonal birth control promotes inflammation and oxidative stress, so antioxidant-rich foods are a must to combat free radical damage. Unfortunately, two of our body’s key antioxidants, vitamin C and E, are known to be depleted as a result of birth control. This is an important consideration for preconception since free radicals can cause oxidative stress and DNA damage. We want to keep our cells as healthy as possible if we’re planning on conceiving (this goes for both partners!). Focusing on these nutrients now will promote immune system health, optimize iron levels (vitamin C helps your body absorb iron), and improve pregnancy outcomes.
    • What to do: Load your plate with fruits, vegetables, and healthy fats rich in vitamin C, E, and a host of other antioxidants. Great sources of vitamin C include citrus, bell peppers, strawberries, tomatoes, and broccoli. Vitamin E is found in healthy fats like nuts, seeds, and fatty fish. I enjoy adding camu camu powder (a rich source of vitamin C) along with sunflower or almond butter (rich sources of vitamin E) to smoothies for an extra boost.
  • Magnesium: Nearly half (likely more!) of Americans consume inadequate amounts of magnesium from food. We then add insult to injury with the pill, since it’s known to deplete stores of magnesium. This makes it essential to consider your current dietary intake and supplementation. Magnesium is required for hundreds of biochemical reactions within our cells. It’s important to replenish and ensure optimal magnesium levels before pregnancy to reduce the risk of pregnancy-related concerns like high blood pressure and other pesky complaints like restless leg syndrome and even nausea!
    • What to do: I love a food-based approach for most nutrients, but when it comes to magnesium it can be hard to restore levels using food alone. Foods rich in magnesium include leafy green vegetables, pumpkin, sunflower, and sesame seeds, Brazil nuts, avocados, and dark chocolate (not a hard sell). Talk to your provider about including a magnesium supplement. Some prenatals include magnesium, but it may not be enough to replenish levels.
  • Selenium: We can’t discount the importance of your thyroid and liver health when it comes to restoring your health post-birth control. Your liver is responsible for processing and helping to remove excess hormones (such as the high levels of synthetic estrogen from hormonal birth control) from your body. Your thyroid also needs to be good shape before conceiving since low levels increase the risk of infertility and miscarriage. Selenium supports thyroid and liver function and also helps your body bind and safely eliminate heavy metals—things you don’t want circulating in your bloodstream during pregnancy or while nursing.
    • What to do: Enjoy a variety of foods rich in selenium every day including wild-caught fish, oysters, Brazil nuts, organ meats, eggs, and other animal proteins (beef, poultry, lamb). Check to see if your prenatal also contains selenium to help replenish lost stores and work with your provider if you’re navigating an autoimmune thyroid condition as you may benefit from additional supplementation.
  • Zinc: Ensuring sufficient zinc is essential for reducing inflammation and free radical damage to cells, supporting fertility (in both partners) and promoting fetal growth and development. The pill depletes zinc, and deficiencies are common in the pregnant and postpartum population, making this nutrient one to keep on your radar. Zinc is another nutrient that’s been shown to affect maternal mental health and well-being.
    • What to do: Luckily, many of the foods listed above are also rich in zinc. Eggs, seafood, oysters, and red meat are great sources. And while you can find zinc in plant foods, animal forms are the most bioavailable sources. Check to see if zinc is in your multivitamin and ask your provider about additional supplementation.

In Summary

It may feel overwhelming, but just remember that small changes over time add up. Here are a few starting places:

  1. Consume a wide variety of leafy greens, cruciferous veggies, healthy fats, and animal protein/fish at most of your meals. Following the Whole30 template is a great place to start!
  2. Nourish your liver with foods such as beets, dandelion tea, and garlic. Reduce your intake of alcohol, added sugar, and refined/processed foods. Consider working with a functional medicine provider to do a therapeutic detox at least three months before conceiving.
  3. Consider taking a prenatal vitamin (here are some I like) that contains the nutrients listed above. You can order my favorites here.
  4. Work with your provider to run a micronutrient test to identify deficiencies and create a plan to replete lost stores.
  5. Consider adding a probiotic to support your gut health, and avoid foods that you know don’t work for your body. You may also need to address low stomach acid, infections, stress, and a variety of other factors to optimize your gut health.

For more information on optimal gut health, check out our post with Dr. Michael Ruscio, or my post on how you can work toward optimal gut health.


Stephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie has supported women locally and globally through her web-based private practice, RockYourHormones.com, and continues to do so in her role as Whole Mamas Program Manager.

 

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