Drug-induced nutrient depletion

drospirenone, ethinyl estradiol, levomefolate & Nutrient Depletion

Also searched as Beyaz. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.

7Nutrient associations
Insignificant DepletionHighest rating
The bottom line

drospirenone, ethinyl estradiol, levomefolate has been associated with depletion of THIAMINE, VITAMIN B12, VITAMIN B6 and VITAMIN C and 3 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take drospirenone, ethinyl estradiol, levomefolate long-term, worth raising with your pharmacist or healthcare provider.

Take more than one medication? Open the checker with drospirenone, ethinyl estradiol, levomefolate pre-loaded and add the rest to see overlapping nutrient signals.

The evidence

Reported nutrient depletions with drospirenone, ethinyl estradiol, levomefolate

Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.

THIAMINE

Insignificant Depletion

CONTRACEPTIVE DRUGS

Theoretically, contraceptive drugs might reduce thiamine absorption; however, this is not likely to be clinically significant.
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Taking drospirenone, ethinyl estradiol, levomefolate? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Some research found a slight drop in thiamine-related enzyme activity in people taking oral contraceptives, which suggested a possible link to mild thiamine reduction, but other studies found no difference at all. Given that the evidence is mixed and the rating here is insignificant, most people taking this pill do not need a thiamine supplement. If you have concerns or eat a very limited diet, a quick chat with your pharmacist or doctor can put your mind at ease.

What Vitamin B1 (thiamine) does & food sources

Thiamine helps convert food into energy and is essential for nerve and heart function.

Common food sources:

  • Whole grains and fortified cereals
  • Pork
  • Beans and lentils
  • Nuts and seeds

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask about thiamine if you take an associated medication (for example, a long-term loop diuretic in heart failure) and have symptoms like fatigue or worsening heart failure control — this is an area your care team can weigh.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Thiamine is water-soluble and generally low-risk, but supplementing to treat a suspected problem should still be clinician-guided so the real cause is not missed.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Learn more about this nutrient: Thiamine — uses, safety & interactions

References (4)
  1. Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
  2. Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
  3. Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
  4. Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.

VITAMIN B12

Insignificant Depletion

CONTRACEPTIVE DRUGS

Oral contraceptives might reduce levels of vitamin B12; however, research is conflicting.

The data regarding the effects of oral contraceptives on vitamin B12 serum levels are conflicting. Some studies have found reduced serum levels in oral contraceptive users, but others have found no effect despite use of oral contraceptives for up to 6 months. When reduced serum levels are detected, vitamin B12 absorption, urinary excretion, tissue and erythrocyte levels, methylmalonic acid levels, and homocysteine are normal. When oral contraceptive use is stopped, normalization of vitamin B12 levels usually occurs. It's suggested that oral contraceptives reduce production of transcobalamin I, the protein which transports vitamin B12 in the blood. Thus, more of the vitamin is available for tissue uptake and serum levels may be reduced. Vitamin B12 supplements don't seem to increase serum levels of vitamin B12. Lower vitamin B12 serum levels seen with oral contraceptives probably aren't clinically significant.
Taking drospirenone, ethinyl estradiol, levomefolate? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Vitamin B12 is something your nerves and red blood cells depend on to work properly. This combination birth control pill may shift how B12 is carried through the bloodstream, which can cause measured levels in a blood test to look a bit lower, but the research is honestly mixed and many studies show no change at all. Importantly, when lower readings do show up, the B12 that matters inside your tissues appears to stay normal, and levels typically return to baseline once the pill is stopped. This is rated insignificant, so most people taking this medication have nothing to worry about, but mention it to your pharmacist or doctor if you ever have concerns.

What Vitamin B12 does & food sources

Vitamin B12 supports red blood cell formation, nerve function, and DNA synthesis.

Common food sources:

  • Meat, poultry, and fish
  • Eggs and dairy products
  • Fortified cereals and nutritional yeast

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

If you take an associated medication long-term, ask your healthcare provider whether checking a vitamin B12 level (sometimes with methylmalonic acid) is appropriate — especially if you notice fatigue, numbness, tingling, or memory changes.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

B12 status is easy to check and low levels are usually straightforward to address, so testing before supplementing is often the sensible order. High-dose folic acid can mask a B12 deficiency, which is one reason B12 and folate questions are best sorted out together with your provider.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: B12 deficiency can look like other conditions — do not self-diagnose from symptoms alone.

Learn more about this nutrient: Vitamin B12 — uses, safety & interactions

References (8)
  1. Hielt K, Brynskov J, Hippe E, et al. Oral contraceptives and the cobalamin (vitamin B12) metabolism. Acta Obstet Gynecol Scand 1985;64:59-63.
  2. Shojania AM. Oral contraceptives: effect on folate and vitamin B12 metabolism. Can Med Assoc J 1982;126:244-7.
  3. Mooij PN, Thomas CM, Doesburg WH, Eskes TK. Multivitamin supplementation in oral contraceptive users. Contraception 1991;44:277-88. PubMed
  4. Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
  5. Prasad AS, Lei KY, Moghissi KS, et al. Effect of oral contraceptives on nutrients. III. Vitamins B6, B12 and folic acid. Am J Obstet Gynecol 1976;125:1063-9. PubMed
  6. Grace E, Emans SJ, Drum DE. Hematologic abnormalities in adolescents who take oral contraceptive pills. J Pediatrics 1982;101:771-4. PubMed
  7. Barone C, Bartoloni C, Ghirlanda G, Gentiloni N. Megaloblastic anemia due to folic acid deficiency after oral contraceptives. Haematologica 1979;64:190-5.
  8. Gardyn J, Mittelman M, Zlotnik J, et al. Oral contraceptives can cause falsely low vitamin B12 levels. Acta Haematol 2000;104:22-4.

VITAMIN B6

Insignificant Depletion

ESTROGENS

Estrogens might reduce blood levels of vitamin B6. However, low doses are unlikely to have a clinically meaningful effect.

Estrogens can interfere with vitamin B6 metabolism. Reduced plasma pyridoxal phosphate levels may occur with oral contraceptives and estrogen replacement therapy. It is suggested that low vitamin B6 levels contribute to depression, lethargy, and fatigue sometimes associated with oral contraceptives. But there is not reliable evidence that vitamin B6 supplements prevent or treat these symptoms. Also, there is some evidence that with low-dose estrogen contraceptives, levels return to normal despite continued therapy. In general, use of oral contraceptives or postmenopausal estrogens does not necessitate vitamin B6 supplementation. For information on foods that are rich in vitamin B6, see our chart.
Taking drospirenone, ethinyl estradiol, levomefolate? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Vitamin B6 is something your body uses for brain chemistry, energy, and building proteins, so it touches quite a few everyday functions. The estrogen component of this pill can interfere with how your body processes B6, which may nudge blood levels a little lower than usual. That said, the doses of estrogen in modern low-dose contraceptives like this one are small enough that any change is generally considered insignificant for most people. Most women taking this pill do not need a B6 supplement, but if you have questions or notice unusual fatigue or mood changes, it is worth bringing up with your pharmacist or doctor.

What Vitamin B6 does & food sources

Vitamin B6 is involved in protein metabolism, neurotransmitter production, and red blood cell formation.

Common food sources:

  • Poultry and fish
  • Potatoes and starchy vegetables
  • Bananas
  • Fortified cereals

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

With some medications (for example, isoniazid), B6 is intentionally co-prescribed — follow your prescriber's plan. Otherwise, ask whether testing or supplementation is appropriate if you have symptoms like numbness or tingling.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Paradoxically, long-term high-dose B6 can itself cause nerve symptoms — this is a nutrient where more is definitely not better.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Avoid high-dose B6 without medical guidance; sustained high intakes can cause neuropathy.

Learn more about this nutrient: Vitamin B6 — uses, safety & interactions

References (6)
  1. Matsui MS, Rozovski SJ. Drug-nutrient interaction. Clin Ther 1982;4:423-40.
  2. Prasad AS, Lei KY, Moghissi KS, et al. Effect of oral contraceptives on nutrients. III. Vitamins B6, B12 and folic acid. Am J Obstet Gynecol 1976;125:1063-9. PubMed
  3. Butterworth CE. Interactions of nutrients with oral contraceptives and other drugs J Am Diet Assoc 1973;62:510-4.. DOI
  4. Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
  5. Haspels AA, Bennink HJ, Schreurs WH. Disturbance of tryptophan metabolism and its correction during oestrogen treatment in postmenopausal women. Maturitas 1978;1:15-20. . PubMed
  6. van der Vange N, van der Berg H, Kloosterboer HJ, Haspels AA. Effects of seven low-dose combined contraceptives on vitamin B6 status. Contraception 1989;40:377-84.. PubMed

VITAMIN C

Insignificant Depletion

ESTROGENS

Estrogens might reduce levels of vitamin C.

Evidence on the effects of oral contraceptives and hormone replacement therapy on vitamin C levels is conflicting. It's suggested that estrogens can reduce vitamin C absorption or increase its breakdown, and that vitamin C stores are used to prevent oxidation of estrogens in tissue. This may only be clinically relevant in patients with very low intake of vitamin C. Supplements aren't necessary for people on estrogens who have an adequate dietary intake of vitamin C.
Taking drospirenone, ethinyl estradiol, levomefolate? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Vitamin C is something your body uses for immune defense, skin health, and protecting cells from damage. The estrogen component of this birth control pill may slightly affect how your body absorbs or breaks down vitamin C, and there is some thought that vitamin C gets used up helping to process estrogen in body tissues. That said, the research here is mixed, and for most people eating a reasonably balanced diet, this is not considered a meaningful concern. No supplement is recommended for this, but if you have questions about your diet or vitamin C intake, your pharmacist or doctor is a good person to ask.

What Vitamin C does & food sources

Vitamin C is an antioxidant that supports the immune system, collagen formation, and iron absorption.

Common food sources:

  • Citrus fruits
  • Bell peppers
  • Strawberries and kiwi
  • Broccoli and Brussels sprouts

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Frank vitamin C deficiency is uncommon with a varied diet. If your diet is limited and you take an associated medication, ask your provider whether your intake is adequate.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Vitamin C is water-soluble and generally low-risk at food-level intakes; very high supplemental doses can cause stomach upset and may not add benefit.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Learn more about this nutrient: Vitamin C — uses, safety & interactions

References (9)
  1. Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
  2. Briggs M, Briggs M. Vitamin C requirements and oral contraceptives. Nature 1972;238:277. PubMed
  3. Rivers JM. Oral contraceptives and ascorbic acid. Am J Clin Nutr 1975;28:550-4. PubMed
  4. Hudiburgh NK, Milner AN. Influence of oral contraceptives on ascorbic acid and triglyceride status. J Am Diet Assoc 1979;75:19-22. DOI
  5. Weininger J, King JC. Effect of oral contraceptives on ascorbic acid status of young women consuming a constant diet. Nutr Rep Int 1977;15:255-64.
  6. McLeroy VJ, Schendel HE. Influence of oral contraceptives on ascorbic acid concentrations in healthy, sexually mature women. Am J Clin Nutr 1973;26:191-6. PubMed
  7. Rivers JM, Devine MM. Plasma ascorbic acid concentrations and oral contraceptives. Am J Clin Nutr 1972;25:684-9. PubMed
  8. Kuo SM, Lin CP. 17Beta-estradiol inhibition of ascorbic acid accumulation in human intestinal Caco-2 cells. Eur J Pharmacol 1998;361:253-9.
  9. Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed

ZINC

Insignificant Depletion

ESTROGENS

Estrogens might reduce, or have no effect on, zinc levels.

Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Taking drospirenone, ethinyl estradiol, levomefolate? A supplement is not needed for most patients.
Dr. Brian Staiger, Pharm.D explains

Zinc helps power hundreds of enzymes in your body and supports immune function, wound healing, and cell growth. The estrogen in this pill may shift how zinc is distributed, possibly pulling more of it into body tissues for protein building rather than leaving it circulating in the blood. That said, studies on estrogens and zinc levels have gone back and forth, and there is no good evidence this pill flushes zinc out through the kidneys. Given the insignificant depletion rating here, most people taking this medication do not need to worry about zinc levels or consider a supplement, but feel free to bring it up with your pharmacist or doctor if you have concerns.

What Zinc does & food sources

Zinc supports immune function, wound healing, taste and smell, and many enzyme systems.

Common food sources:

  • Meat and shellfish (especially oysters)
  • Beans and lentils
  • Nuts and seeds
  • Whole grains

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask about zinc status if you take an associated medication long-term and notice slow wound healing, frequent infections, or taste changes — a clinician can decide whether testing or an empiric plan makes sense.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Zinc competes with copper for absorption — long-term, higher-dose zinc without medical guidance can cause copper deficiency. Zinc also binds some antibiotics in the gut, so dose timing matters.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Keep zinc doses moderate and time them away from interacting medications — ask your pharmacist.

Learn more about this nutrient: Zinc — uses, safety & interactions

References (11)
  1. Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
  2. King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
  3. Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
  4. Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
  5. Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
  6. Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
  7. Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
  8. Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
  9. Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
  10. Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
  11. Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed

FOLIC ACID

Moderate Depletion

ESTROGENS

Estrogens might reduce serum folate levels and increase the risk of folate deficiency.

Reduced serum and red blood cell folate levels can occur with the use of conjugated estrogens (Premarin) or oral contraceptives, although this is unlikely with adequate dietary folate intake. There are rare reports of megaloblastic anemia associated with oral contraceptive use, usually in patients with other conditions contributing to folate deficiency. Possible mechanisms by which estrogens contribute to folate deficiency include reduced absorption of dietary folate, increased excretion, induction of liver enzymes, and increased protein binding of folate in serum. There is some evidence that oral contraceptives can increase the rate of progression of cervical dysplasia to cervical cancer, and that folic acid can slow or reverse this dysplasia. Advise patients taking oral contraceptives or other estrogens to maintain a good dietary intake of folate. Recommend supplements only for those with inadequate dietary intake or other conditions that contribute to folate deficiency, and for those diagnosed with, or at increased risk for, cervical dysplasia. For information on foods that are rich in folate, see our chart.
Taking drospirenone, ethinyl estradiol, levomefolate? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Folate, a B vitamin your body needs for healthy cell growth and DNA repair, can be affected by the estrogen in this pill. The estrogen component may reduce how well your gut absorbs folate from food, and may also nudge the liver to process it faster or bind it up in the blood where it becomes less usable. For most people eating a reasonably balanced diet this is not a crisis, but a moderate rating means it is worth paying attention to, especially if your diet is already low in folate-rich foods. Ask your pharmacist or doctor whether your current intake is enough or whether a separate folic acid supplement makes sense for you.

What Folic acid (folate) does & food sources

Folate is needed for cell division, red blood cell formation, and healthy fetal development.

Common food sources:

  • Leafy green vegetables
  • Beans, lentils, and peas
  • Fortified grains and cereals
  • Citrus fruits

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.

Learn more about this nutrient: Folic Acid — uses, safety & interactions

References (9)
  1. Matsui MS, Rozovski SJ. Drug-nutrient interaction. Clin Ther 1982;4:423-40.
  2. Prasad AS, Lei KY, Moghissi KS, et al. Effect of oral contraceptives on nutrients. III. Vitamins B6, B12 and folic acid. Am J Obstet Gynecol 1976;125:1063-9. PubMed
  3. Grace E, Emans SJ, Drum DE. Hematologic abnormalities in adolescents who take oral contraceptive pills. J Pediatrics 1982;101:771-4. PubMed
  4. Green TJ, Houghton LA, Donovan U, et al. Oral contraceptives did not affect biochemical folate indexes and homocysteine concentrations in adolescent females. J Am Diet Assoc 1998;98:49-55. PubMed
  5. Shojania AM. Oral contraceptives: effect on folate and vitamin B12 metabolism. Can Med Assoc J 1982;126:244-7.
  6. Mooij PN, Thomas CM, Doesburg WH, Eskes TK. Multivitamin supplementation in oral contraceptive users. Contraception 1991;44:277-88. PubMed
  7. Barone C, Bartoloni C, Ghirlanda G, Gentiloni N. Megaloblastic anemia due to folic acid deficiency after oral contraceptives. Haematologica 1979;64:190-5.
  8. Butterworth CE, Hatch KD, Gore H, Mueller H, Krumdieck CL. Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr 1982;35:73-82. PubMed
  9. Check WA. Folate for oral contraceptive users may reduce cervical cancer risk. J Am Med Assoc 1980;244:633-4. DOI

MAGNESIUM

Moderate Depletion

ESTROGENS

Estrogens reduce serum levels of magnesium by increasing its uptake into body tissues.

Estrogens enhance magnesium uptake by soft tissues and bones, lowering serum levels. There appears to be an inverse relationship between estrogen levels and magnesium serum levels. Estrogen therapy, including the use of oral contraceptives, lowers serum magnesium levels and can cause hypomagnesemia, which may contribute to thromboembolic complications associated with estrogens. For information on foods that are rich in magnesium, see our chart.
Taking drospirenone, ethinyl estradiol, levomefolate? Monitor for depletion; a supplement is needed for some patients.
Dr. Brian Staiger, Pharm.D explains

Magnesium is a mineral your muscles, nerves, and heart rhythm all depend on, and the estrogen in this pill appears to redirect magnesium away from the bloodstream and into bones and soft tissues, which can leave circulating levels lower than they should be. This is a moderate concern, not a minor footnote, so long-term users are worth keeping an eye on. If you have been on this pill for a while and notice things like muscle cramps, fatigue, or irregular heartbeat, it is worth bringing up with your pharmacist or doctor to see whether your magnesium levels should be checked.

What Magnesium does & food sources

Magnesium is involved in muscle and nerve function, heart rhythm, blood sugar control, and bone health.

Common food sources:

  • Nuts and seeds (almonds, pumpkin seeds)
  • Whole grains
  • Leafy green vegetables
  • Beans and legumes

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

What to discuss with your clinician

Ask whether a magnesium level is worth checking if you take an associated medication long-term — particularly with symptoms like muscle cramps, twitching, or palpitations. Blood levels do not always reflect total body stores, which is worth discussing too.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Supplement considerations

Magnesium supplements come in many forms and can cause loose stools at higher doses. They can also bind some medications in the gut (certain antibiotics, thyroid medication), so timing matters — check with your pharmacist.

Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.

HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.

Caution: Magnesium supplementation can be risky in kidney disease, where magnesium can accumulate — always check with a clinician first if your kidney function is reduced.

Learn more about this nutrient: Magnesium — uses, safety & interactions

References (4)
  1. Seelig MS. Increased need for magnesium with the use of combined oestrogen and calcium for osteoporosis treatment. Magnes Res 1990;3:197-215..
  2. Seelig MS. Interrelationship of magnesium and estrogen in cardiovascular and bone disorders, eclampsia, migraine, and premenstrual syndrome. J Am Coll Nutr 1993;12:442-58.. PubMed
  3. Muneyyirci-Delale O, Nacharaju VL, Dalloul M, et al. Serum ionized magnesium and calcium in women after menopause: inverse relation of estrogen with ionized magnesium. Fertil Steril 1999;71:869-72.. PubMed
  4. Stanton MF, Lowenstein FW. Serum magnesium in women during pregnancy, while taking contraceptives, and after menopause. J Am Coll Nutr 1987;6:313-9.. PubMed
Important

This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.

Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.

© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
Understand the basics

What drug-induced nutrient depletion means

Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.

Association is not deficiency

An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.

Evidence varies by pair

Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.

When to ask about labs

If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.

Don't self-supplement blindly

Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.

Never stop a medication over this

These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.

Food first, usually

For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.

Common questions

drospirenone, ethinyl estradiol, levomefolate & nutrients: FAQs

Does drospirenone, ethinyl estradiol, levomefolate deplete THIAMINE?
drospirenone, ethinyl estradiol, levomefolate has been associated with lower THIAMINE levels in the clinical literature — see the evidence rating and details above. An association is not a guarantee: dose, duration, diet, and your own health all matter. If you take drospirenone, ethinyl estradiol, levomefolate long-term, ask your healthcare provider whether checking your THIAMINE status is appropriate.
Should I take a supplement because I take drospirenone, ethinyl estradiol, levomefolate?
Not automatically. The right first step is usually a conversation with your pharmacist or provider — they can weigh your dose and duration, decide whether testing makes sense, and recommend food-first strategies or a supplement if genuinely needed. Some supplements can interact with medications, so do not add one without checking.
Should I stop taking drospirenone, ethinyl estradiol, levomefolate?
No — never stop a prescribed medication because of a nutrient association. drospirenone, ethinyl estradiol, levomefolate is prescribed for good reasons, and nutrient considerations are usually manageable with monitoring or diet. Any change to your medication belongs in a conversation with your prescriber.
Where does this information come from?
The depletion records come from the Natural Medicines (Therapeutic Research Center) database — an evidence-graded clinical reference — and are displayed as published, with their citations. The plain-English context is written and reviewed by licensed HelloPharmacist pharmacists.

Questions about drospirenone, ethinyl estradiol, levomefolate and your nutrition?

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Sources

Sources & How We Checked

Nutrient depletion records for drospirenone, ethinyl estradiol, levomefolate are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.