Endometriosis - Annika Nourishing New Life

Endometriosis

Are your menstrual products toxic? 

, , , , , ,

Why are conventional menstrual products toxic?

Pesticide residues: Most tampons and pads contain cotton, but unless it is organic, that cotton is often treated with pesticides and herbicides, which can leave behind toxic residues. These chemicals can be absorbed by the delicate skin of the vaginal area, potentially affecting hormonal balance.

Bleaching chemicals: Many brands use chlorine bleaching to whiten their products, which can produce dioxins – a group of harmful chemicals linked to hormone disruption, immune system damage and reproductive issues.

Fragrances and dyes: Scented pads and tampons contain synthetic fragrances and dyes, which are made from a cocktail of chemicals that can trigger allergic reactions, skin irritation, and even disrupt vaginal pH balance.

Plastics and absorbent gels: Some pads contain plastic layers and super-absorbent gels that trap moisture. While this prevents leaks, it can also create a warm, humid environment that promotes bacterial growth and skin irritation. These materials may also contain endocrine-disrupting chemicals like phthalates and BPA. Phthalates are chemicals used to make plastics more flexible, but they can interfere with hormone function, potentially affecting reproductive health and leading to developmental issues. BPA (bisphenol A), also found in plastics, has been linked to hormone disruption, particularly oestrogen, which can have harmful effects on fertility and increase the risk of certain cancers.

Parabens are commonly used as preservatives in many personal care and hygiene products, including pads and tampons, to extend shelf life and prevent bacterial growth. These chemicals are easily absorbed through the skin, and as endocrine disruptors, parabens mimic oestrogen in the body. This can disrupt hormonal balance, leading to reproductive issues, early puberty, and increased risk of hormone-related cancers. Over time, cumulative exposure to parabens can increase the risk of these negative health effects.

Heavy metals: Harmful metals such as lead, arsenic and cadmium have been found in certain tampon brands. These metals can be present due to contamination during the manufacturing process, often in the cotton or other materials used. When absorbed by the body, these metals can accumulate over time and pose significant health risks. Lead and cadmium are linked to kidney damage, reproductive issues, and neurological problems, while arsenic is a known carcinogen. The presence of these metals in tampons raises concerns about long-term exposure and its potential to disrupt hormonal function, cause organ damage and increase the risk of certain cancers.

Toxic Shock Syndrome (TSS): Tampons, especially high-absorbency ones, create an environment that may encourage bacterial growth, increasing the risk of TSS – a rare but life-threatening condition caused by toxins released from certain bacteria when tampons are left in for too long.

Non-toxic menstrual product alternatives

Thankfully, there are many safer, eco-friendly options available. Here are some of the best non-toxic menstrual products and their benefits:

Organic cotton tampons and pads

Organic tampons and pads are made from 100% certified organic cotton, eliminating exposure to pesticides, herbicides, bleaching chemicals, fragrances, and dyes – making them a safer choice for sensitive skin. These products are also biodegradable, reducing environmental impact compared to conventional options. However, it is worth noting that some brands still use plastic applicators, which contribute to plastic waste. For an eco-friendlier choice, opt for cardboard or reusable applicators.

Menstrual cups

Menstrual cups are made from flexible, medical-grade silicone or rubber and are inserted into the vagina to collect rather than absorb menstrual fluid. Unlike tampons, they don’t interfere with the vagina’s natural moisture levels, reducing the risk of dryness and irritation. They provide leak-free protection for up to 12 hours, making them a convenient, cost-effective and eco-friendly option since they last for several years. Proper cleaning and sterilisation between cycles are essential to maintain hygiene. While they can be incredibly convenient, some users may find them less practical as do require some practice to insert and remove comfortably.

Period underwear

Period underwear is designed with absorbent layers that can hold menstrual fluid without the need for pads or tampons. They are comfortable, leak-proof and reusable, making them a sustainable choice. Ideal for light to moderate flow days or as backup protection, however, they do require frequent washing. When wearing them, they generally feel dry, as the absorbent layers wick moisture away from the skin, but you may feel some dampness if they reach their maximum capacity during heavier flows. While the initial investment can be high, having multiple pairs is recommended, and the long-term cost savings are significant.

Reusable cloth pads

Reusable cloth pads are made from layers of organic cotton or bamboo and can be washed and reused for years. They are free from synthetic materials and harmful chemicals, breathable and comfortable, helping to reduce irritation in the intimate area. Environmentally friendly and cost-effective, they offer long-term savings. However, they need to be washed after each use, which requires effort, and may not be as convenient for travel or on-the-go use.

How to support your Heart Health 

, , , , , ,

How to support your Heart Health

What is cardiovascular disease?

Cardiovascular disease is an umbrella term for a collection of conditions relating to the heart, blood vessels and circulation. These include high blood pressure, heart attacks, strokes, angina (when blood supply to the heart is restricted) and congestive heart failure (a condition that affects the pumping power of your heart).

What are the risks of cardiovascular disease?

  • High blood pressure
  • Diabetes and poor blood sugar regulation
  • Smoking
  • Poor diet and nutritional deficiencies
  • Being overweight or obese
  • Drinking excessive alcohol and caffeine
  • Being inactive and lack of exercise
  • Chronic stress
  • Family history – your risk may increase if close blood relatives experienced early heart disease
  • Having more than one risk factor means your overall risk of CVD is much higher.

What are the signs of an unhealthy heart?

  • Shortness of breath, coughing or wheezing
  • Dizziness, fainting or loss of consciousness
  • Nausea, vomiting, sweating
  • Chest pain (with or without exertion) – pressure, tightness or squeezing in the centre of chest
  • Pain in the abdomen, legs, arms, back, neck or jaw
  • An overwhelming sense of anxiety (like a panic attack)
  • Being unable to lift limbs or numbness to limbs
  • Drooping of one side of the face or an inability to smile
  • Confusion

How to improve heart health

Stop smoking as it causes irreparable damage to your lungs and blood vessels. The toxic chemicals in cigarettes can thicken your blood, increasing the formation of plaques and clots in your veins and arteries which could lead to blockages. Cigarettes also contain carbon monoxide which reduces oxygen availability in the body.

Avoid alcohol and caffeine. Aside from causing acidity and inflammation in the body, both substances increase your heart rate and blood pressure. Caffeine can also cause palpitations and reduce blood flow in the arteries as it blocks the hormone which keeps your arteries wide open.

Manage your stress by making time for relaxation and self-care. When you get stressed, your body releases the hormones cortisol and adrenaline. Both these stress hormones are involved in heart rate and blood pressure regulation. Chronic stress increases your risk of high blood pressure, strokes, and heart attacks.

Exercise daily as it’s essential for cardiovascular health. Doing a combination of cardio training (walking, running, swimming, aerobic-style fitness) and weight-bearing exercises helps strengthen your muscles, including your heart muscle. It also improves circulation and your heart’s ability to pump blood and move oxygen into your cells more efficiently. Exercise also helps with blood sugar regulation, weight management and reducing stress levels.

Improve your diet and optimise your nutrient intake: Cut out high-sugar foods, refined carbohydrates (breads, pasta, pastries, biscuits, pies, pizzas, cereals), fried foods, junk food, trans fats (margarine, cooking oils like rapeseed and vegetable oil, baked goods), pasteurised dairy products, deli meats (salami, ham, chorizo) and red meat as these foods contribute to poor cardiovascular health. Eat a diet that is rich in vegetables, fruit, quality protein (lentils, beans, peas, nuts), healthy fats (avocado, nut butters, seeds) and wholegrains (quinoa, millet, buckwheat, wholegrain rice).

Replace table salt with rock salt, natural sea salt or a plant salt. Table salt is toxic to the body and it causes blood pressure to rise and can increase the risk of cardiovascular disease, especially heart attacks and strokes.

Increase your antioxidant levels through diet and supplementation. Antioxidants such as vitamins C, E and A, CoQ10, beta-carotene and bioflavonoids protect your blood vessels from the damage caused by plaques (fatty deposits). Fruit and vegetables contain an abundance of antioxidants.

Keep your weight in check and lose weight if obesity is an issue. Obesity can cause your blood pressure to rise, plaques to form in your arteries and increase your risk of heart disease. By eating the right foods, eliminating bad dietary habits, and doing regular exercise, your weight should naturally come down.

Stay hydrated by drinking sufficient fluids including filtered water and herbal teas. When your body is dehydrated, your blood volume decreases which means your heart has to beat faster to keep blood circulating. As a result, both your heart rate and blood pressure also rise.

Add herbs and spices to your food to improve circulation and support heart health including cayenne, ginger, garlic, turmeric, cinnamon, and coriander. These aromatics can help reduce inflammation, prevent blood clots, promote blood flow, and maintain blood pressure in the body.

Heavy flow and endometriosis

, , , , , ,

Heavy bleeding is defined as producing over 80mL of blood per cycle and may also manifest as the following:

▫️Having a flow that soaks through 1 or more pads or tampons every hour for several hours

▫️Having to double up on pads to control bleeding

▫️Needing to change pads or tampons overnight

▫️Having menstrual periods lasting longer than 7 days

▫️Having large blood clots

▫️Having a flow that keeps you from doing things you would normally do

Many things can cause heavy bleeding. Endometriosis is one of them.

Iron deficiency is common in endometriosis. Since iron is carried by the red blood cells, bleeding during menstruation leads to loss of iron. As your body attempts to make up for this loss, iron is pulled from stores within the body leading to a heavier bleed and increased risk for iron-deficiency anaemia.

Some people with endometriosis (and adenomyosis) produce more prostaglandins, a pro-inflammatory chemical responsible for the period. Prostaglandins can cause abnormally aggressive contractions that contribute to heavy bleeding.

Endometriosis alters the balance between oestrogenic and progesterone in some people, which is related to heavy bleeding as oestrogen builds the uterine lining and can cause the growth of things like polyps or fibroids (which also contribute to heavier bleeds).

3 Tips for heavy flow and endo

1. Get enough iron daily – low iron can contribute to a heavier flow. Iron is also needed for the CYP enzymes that support oestrogen metabolism. Consume eggs, legumes, wholegrains and grass-fed meat.

2. Get enough omega-3s – Prostaglandins cause uterine contractions that may result in heavier flow. Omega-3s like those found in oily fish, flaxseeds, eggs and walnuts can offer an abundance of prostaglandin formation.

3. Support proper oestrogen metabolism – Elevated oestrogen, or poor oestrogen metabolism causes growth of the endometrial lining (i.e. heavy flow). I usually recommend a DUTCH test to get a clearer picture of oestrogen metabolism.

Gut health and endometriosis

, , , , , , ,

Gut health and endometriosis

Key reasons why keeping your gut healthy is so important?

Weight management

Firmicuates, a classification of bacteria, are able to extract more calories from food, meaning if you have an overabundance, you may be storing fat, even if you’re not overeating. Fat tissue can be a source of inflammation with endo, as it can produce oestrogen. This in turn can contribute to more serve symptoms of endometriosis.

Mental health

Beneficial gut bacteria produce butyrate, which reduces anxiety and depression. Fermentation of some foods (high in sugar diet or high refined carbohydrate diet) result in the release of toxins and chemicals that make you feel foggy, groggy and fatigued – symptoms we don’t want to be indemnifying with endometriosis.

Protection

Having a healthy gut maintains a heath pH. Having a healthy pH prevents an overgrowth of toxin-producing bacteria that can be a source of inflammation (and pain) in endometriosis.

Healthy Hormones

An imbalance in the gut, common with low fibre diets and constipation, favours the reactivation of beta-glucuronidase. This is an enzyme that reactivates oestrogen otherwise destined for removal through the stools. Since oestrogen is a source of inflammation and can contribute to prefoliation of endometriosis, we want to be eliminating oestrogen as much as possible through daily stools.

Immunity

If the GALT – a communication system between the gut, nervous system, and immune system – is impacted by things like inflammation, this too impacts immunity. A dysfunctional immune system can result in serve and unpredictable symptoms of endometriosis.

Barrier Maintenance

A healthy gut prevents a leaky gut. When leaky gut occurs due to dysbiosis, gut inflammation, or stress, large molecules can enter the general circulation and promote an immune reaction. This in turn may contribute further to the immune system dysfunction we already experience with endometriosis, and intensify symptoms of autoimmunity, or results in the development of an auto-immune condition.

Is Birth Control Messing with Your Nutrition?

, , , , , , ,

Oral contraceptives are prescribed beyond preventing pregnancy, for reasons such as
  • To regulate menstrual cycles
  • Provide some relief for pain during menstruation
  • Acne
  • Ovarian cyst prevention.
  • PMS and PMDD relief
  • Endometriosis management
  • Menstrual migraine relief

However, there are many drawbacks of the contraceptive pill which may be affecting your future fertility. In this blog I am going to focus on nutrition depletion.

Research has demonstrated the use of oral contraceptives may be significantly affecting bodily levels of many essential vitamins and minerals. 1-5

Here are 5 essential nutrients commonly depleted by the pill

• Magnesium

• Zinc

• Folic acid

• Vitamin B12

• Vitamin E

Magnesium

The pill and oestrogen therapy has demonstrated a depletion in serum magnesium levels, causing a potential deficiency of this essential mineral. 6,7 This is concerning for most females in where dietary magnesium intake is already low, not to mention a 21st century lifestyle that quickly uses up magnesium stores such as poor sleep, high-intensity exercise, chronic stress, and high intake of caffeine, sugar, and processed foods. 7-12

Magnesium has many benefits which have been supported by research such as supporting energy, sleep, mood, and hormone balance. Given the body’s widespread need for magnesium, low dietary intake in addition to the continual drain on the body’s stores, it is particularly concerning that the contraceptive pill may be depleting levels even further.

Furthermore, magnesium depletion alters the calcium to magnesium ratio which may affect blood coagulation.13 The deficiency in magnesium may contribute to the thromboembolic complications associated with oestrogens.6,7 Therefore, it is worth taking magnesium supplementation in addition to your diet when taking the oral contraceptive pill. 

Zinc

Lower plasma zinc levels have been observed in research dating as far back as 1968 14,15 in addition to more recent studies confirming this finding too. 16-20

Zinc is an essential trace element, used as a cofactor for more than 300 different enzymes, used in every cell, organ, bone, tissue, and fluid of the body.  Zinc is involved in immune and skin health and is important in supporting reproduction. The World Health Organisation (WHO), states the global prevalence of zinc deficiency is a surprising 31%.

The changes which occur as a result of increased oestrogen from the oral contraceptive pill may lower blood zinc levels and also increase the amount of zinc used by bodily tissues. 21-22 When these alterations occur, the need for dietary zinc increases. 20

Although not all research demonstrated a reduced level of zinc, the majority indicated that oral contraceptives, to include lower doses, have a negative effect on the nutritional status of this mineral. 16,20,23-31 Additionally, a decrease in zinc, selenium, phosphorus and magnesium in women taking oral contraceptives was found in a recent systematic review 32 which had been associated to the duration of contraceptive use.

Therefore, when oral contraception is recommended by your health professional, supplementing zinc may be useful and is best supplemented with copper due to both minerals being antagonists, which means they compete for binding sites in the body. Excess zinc can lead to a copper deficiency and vice versa.

Folic acid

Studies have demonstrated a potential reduction in blood folate levels. 33-37. One recent systematic review and meta-analysis concluded, due to reduced blood folate concentrations associated with the use of oral contraceptives, it is necessary that women of a childbearing age to continue the use of folate supplementation whilst using the contraceptive pill. 38

Folic acid is necessary within the first 4 weeks of pregnancy in order to prevent neural tube defects. Due to the folate-depleting effects of the oral contraceptive, in 2012 there was the introduction of contraceptives that were fortified with folate to help reduce the risk of neural tube defects in pregnancies that occurred during use or shortly after the discontinuation of oral contraceptives.39,40

Some evidence has shown an increase in the rate of cervical dysplasia to cervical cancer progression and that folic acid may slow or reverse this dysplasia.41,42

Recent studies recommend all women of childbearing age taking the oral contraceptive pill should supplement with folic acid. It is recommended to take the body-ready form of 5-methyltetrahydrofolate (5-MTHF) of folic acid as some people are genetically less able to convert folic acid into this active form, and therefore is less effective. Supplementing with active 5-MTHF form of folic acid bypasses the need for conversion and therefore reassures folate stores are being replenished.

Vitamin B12

The depletion of vitamin B12 in women using oral contraceptives has been found in many studies, compared to non-users .20, 43-52 In addition to folic acid, low maternal B12 status is also considered to be a standalone risk factor for neural tube defects. 53

Vitamin B12 has many functions, such as

  • Supports the blood to carry oxygen
  • Essential for healthy nerves and DNA synthesis
  • Supports the elimination of toxins   

Animal products are a rich source of vitamin B12 and are the only vitamin that can’t be reliably supplied by a varied wholefood plant-based diet.

one recent systematic review demonstrated oral contraceptives have been found to deplete vitamin B12, therefore vitamin supplements might be beneficial when taking oral contraceptives.54.55

Vitamin E

Vitamin E has many positive health benefits, to include

  • Antioxidant
  • Healthy skin
  • Immune function support
  • Cardiovascular support

Research demonstrated that the oral contraceptive had increased markers of oxidative stress and decreased levels of vitamin E in the blood. A further study found a significant rise in the clotting activity of blood platelets when taking the oral contraceptive pill, naturally accompanying decreased blood levels of vitamin E. 56-58 Research found, supplementing with vitamin E increased vitamin E blood levels and had shown a decrease in the clotting activity of platelets.59

Daily supplementation may help to support improved levels of key nutrients

Research has shown that oral contraceptives can deplete blood levels of many essential vitamins and minerals, in addition to the above, therefore if you are required to take the oral contraceptive pill you may benefit from supplementing your diet with a daily multivitamin & mineral to support these possible negative effects.

References:

1. Theuer RC. Effect of Oral Contraceptive Agents on Vitamin and Mineral Needs: A Review. J Reprod Med. 1972; 8:13-9.

2. Berg G, Kohlmeier L, Brenner H. Effect of Oral Contraceptive Progestins on Serum Copper Concentration. Eur J Clin Nutr. 1998; 52:711-5.

3. Ghayour-Mobarhan M, Taylor A, New SA, Lamb DJ, Ferns GA. Determinants of Serum Copper, Zinc and Selenium in Healthy Subjects. Ann Clin Biochem. 2005; 42:364-75.

4. Tamura T, Picciano MF. Folate and Human Reproduction. Am J Clin Nutr 2006;83: 993-1016.

5. Prevention of Neural Tube Defects: Results of the Medical Research Council Vitamin Study. Mrc Vitamin Study Research Group. Lancet. 1991; 338:131-7.

6. Seelig MS. Increased need for magnesium with the use of combined oestrogen and calcium for osteoporosis treatment. Magnes Res 1990; 3:197-215

7. 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

8. Stanton MF, Lowenstein FW. Serum magnesium in women during pregnancy, while taking contraceptives, and after menopause. J Am Coll Nutr 1987; 6:313-9

9. Akinloye O, Adebayo T, Oguntibeju O, Oparinde D, Ogunyemi E. Effects of contraceptives on serum trace elements, calcium and phosphorus levels.West Indian Med J 2011; 60: 308-315.

10. Hameed A, Majeed T, Rauf S, Ashraf M, Jalil M, Nasrullah M, Hussan A, Noreen R. Effect of oral and injectable contraceptives on serum calcium, magnesium and phosphorus in women. J Ayub Med Coll Abbottabad 2001; 13: 24-25.

11. Olatunbosun D, Adeniyi F, Adadevoh BK. Effect of oral contraceptives on Serum magnesium levels. Int J Fertil 1974; 19: 224-226.

12. Blum M, Kitai E, Ariel Y, Schnierer M, Bograd H. Oral contraceptive lowers serum magnesium. Harefuah 1991; 121: 363-364.

13. Cowan JA. Introduction to the biological chemistry of magnesium. ed. J.A. Cowan. New York. VCH;1995.

14. Halsted JA, Hackley BM, Smith JC, Jr. Plasma-zinc and copper in pregnancy and after oral contraceptives. Lancet 1968; 2: 278-279

15. King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987; 117: 217- 219

16. Prasad AS, Oberleas D, Moghissi KS, Stryker JC, Lei KY. Effect of Oral Contraceptive Agents on Nutrients: Ii. Vitamins. Am J Clin Nutr. 1975; 28:385-91.

17. Akinloye O, Adebayo T, Oguntibeju O, Oparinde D, Ogunyemi E. Effects of contraceptives on serum trace elements, calcium and phosphorus levels.West Indian Med J 2011; 60: 308-315.18. Briggs Mh, Briggs M, Austin J. Effects of steroid pharmaceuticals on plasma zinc. Nature 1971; 232: 480-481

19. Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980; 33: 267-271.

20. Fallah S, Sani Fv, Firoozrai M. Effect of contraceptive pill on the selenium and zinc status of healthy subjects. Contraception 2009; 80: 40-43.

21. King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987; 117: 217- 219

22. 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.

23. Tyrer LB. Nutrition and the pill. J Reprod Med 1984; 29:547-50.

24. Webb JL. Nutritional effects of oral contraceptive use: a review. J Reprod Med 1980; 25: 150-156.

25. Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980; 33: 267-271.

26. 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.

27. Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981; 34:1479-83

28. 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.

29. 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.

30. 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.

31. Thane, C W et al : Oral contraceptives and nutritional status in adolescent British girls. Nutrition Research, 2002, 22, 449-462

32. Dante G et al. Vitamin and mineral needs during the oral contraceptive therapy: a systematic review. Int J Reprod Contracept Obstet Gynecol. 2014 Mar;3(1):1-10

33. Trowbridge M, Jr., Wadsworth R, Moffitt E. Malabsorption associated with gluten enteropathy, do oral contraceptives interfere with folate metabolism? J Maine Med Assoc 1968; 59: 240-242.

34. Paton A. Oral contraceptives and folate deficiency. Lancet 1969; 1: 418.

35. Ryser J, Farquet J, Petite J. Megaloblastic anemia due to folic acid deficiency in a young woman on oral contraceptives. Acta Haematol 1971; 45: 319-324.

36. Whitehead N, Reyner F, Lindenbaum J. Megaloblastic changes in the cervical epithelium. Association with oral contraceptive therapy and reversal with folic acid. JAMA 1973; 226: 1421-1424

37. Shojania AM. Oral contraceptives: effect of folate and vitamin B12 metabolism. Can Med Assoc J 1982; 126: 244-247

38. Shere, Mahvash, et al. “Association between use of oral contraceptives and folate status: a systematic review and meta-analysis.” Journal of Obstetrics and Gynaecology Canada 37: 430-438.

39. Castano PM, Aydemir A, Sampson-Landers C, Lynen R. The folate status of reproductive-aged women in a randomised trial of a folate-fortified oral contraceptive: dietary and blood assessments. Public health nutrition. 2014 Jun;17(6):1375-83.

40. Fruzzetti, F. Beyaz P An oral contraceptive fortified with folate Women’s Health1 (Jan 2012): 13-9.

41. Butterworth CE, Hatch KD, Gore H, et al. Improvement in cervical dysplasia associated with folic acid therapy in users of oral contraceptives. Am J Clin Nutr 1982; 35:73-82.

42. Check WA. Folate for oral contraceptive users may reduce cervical cancer risk. J Am Med Assoc 1980; 244:633-4.

43. Wilson SM, Bivins BN, Russell KA, Bailey LB. Oral Contraceptive Use: Impact on Folate, Vitamin B(6), and Vitamin B(1)(2) Status. Nutr Rev. 2011; 69:572-83.

44. Mooij PN, Thomas CM, Doesburg WH, Eskes TK. Multivitamin supplementation in oral contraceptive users. Contraception 1991; 44:277-88.

45. Lussana F, Zighetti Ml, Bucciarelli P, Cugno M, Cattane M. Blood levels of homocysteine, folate, vitamin B6 and B12 in women using oral contraceptives compared to non-users. Thromb Res 2003; 112: 37-41.

46. Shojania AM. Oral contraceptives: effect of folate and vitamin B12 metabolism. Can Med Assoc J 1982; 126: 244-247

47. Wertalik L, Metz E, Lobuglio A, Balcerzak S. Decreased Serum B 12 Levels With Oral Contraceptive Jama 1972; 221: 1371-1374.

48. Sutterlin M, Bussen S, Rieger L, Dietl J, Steck T. Serum Folate And Vitamin B12 Levels In Women Using Modern Oral Contraceptives (Oc) Containing 20 Microg Ethinyl Estradiol. Eur J Obstet Gynecol Reprod Biol 2003; 107: 57-61.

49. Riedel B, Bjorke Monsen A, Ueland P, Schneede J. Effects Of Oral Contraceptives And Hormone Replacement Therapy On Markers Of Cobalamin Status. Clin Chem 2005; 51: 778-781.

50. Shojania Am, Wylie B. The Effect Of Oral Contraceptives On Vitamin B12 Metabolism. Am J Obstet Gynecol 1979; 135: 129-134.

51. Veninga K S. Effects Of Oral Contraceptives On Vitamins B6, B12, C, And Folacin. J Nurse Midwifery 1984; 29: 386-390.

52. Hielt K, Brynskov J, Hippe E, et al. Oral contraceptives and the cobalamin (vitamin B12) metabolism. Acta Obstet Gynecol Scand 1985; 64:59-63.

53. Adams MJ Jr, Khoury MJ, Scanlon KS, Stevenson RE, Knight GJ, Haddow JE et al. Elevated Midtrimester Serum Methylmalonic Acid Levels as a Risk Factor for Neural Tube Defects. Teratology. 1995; 51:311-7.

54. Dante G et al. Vitamin and mineral needs during the oral contraceptive therapy: a systematic review. Int J Reprod Contracept Obstet Gynecol. 2014 Mar;3(1):1-10

55. Basnayake S, de Silva SV, Miller PC, Rogers S. A Trial of Daily Vitamin Supplementation as a Means of Reducing Oral Contraceptive Side Effects and Discontinuation in Sri Lanka. Contraception. 1983; 27:465-72

56. Aftergood L, Alfin-Slater R B. Oral contraceptivealpha- tocopherol interrelationships. Lipids 1974; 9: 91-96.

57. Akinsanya M, Adeniyi T, Ajayi G, Oyedele M. Effects of vitamin E and folic acid on some antioxidant enzymes activities of female Wistar rats administered combined oral contraceptives. African J Biochem Res 2010; 4: 238-242.

58. Brigg M. Letter: vitamin E status and oral contraceptives. Am J Clin Nutr 1975; 28: 436.

59. Renaud S, Ciavatti M, Perrot L, Berthezene F, Dargent D, Condamin P. Influence of vitamin E administration on platelet functions in hormonal contraceptive users. Contraception 1987; 36: 347-358.

Home
About Me
Shop Programmes
Functional Testing
Contact Me

Terms & Conditions
Data Protection
Cookie Policy

Annika Nourishing New Life © 2025 Design Marque

archive