You Might Not Want to Mix These 5 Things With Birth Control


These things might be messing with the effectiveness
of your birth control and you have no idea. Hormone-based birth control includes things
like IUDs, rings, patches, and the widely used pill, which is what we’ll focus on
this episode. It comes in different forms but the ones you
probably know are combined oral contraceptives, which use a combination of estrogens, like
ethinylestradiol, and a progestogen, like progesterone. But there are things out there that will mess
with those hormones, meaning SURPRISE BABY, or dangerous side effects. So, if you’re on the pill, what should steer
clear of? At some point maybe you heard that eating
grapefruit or drinking grapefruit juice could make the pill less effective. Truth is, grapefruit juice can affect hormone
levels, but there’s no evidence that it increases your chances of getting pregnant. So, in a study done with menopausal women
grapefruit juice was shown to increase the ethinylestradiol in their system. Normally ethinylestradiol is broken down by
enzymes in your body called cytochrome P450 3A4–quite a mouthful–but grapefruit contains
organic compounds called furanocoumarins that block their activity, and this causes ethinylestradiol
to build up. When you’re on the pill you’re already
introducing more ethinylestradiol into your system. So, there are some claims that combining grapefruit
juice with the pill can make you feel sick or nauseous. Because the amount of that CYP3A4 enzyme in
one person’s intestine may not be the same as in someone else’s, these side-effects
are definitely not a “one-size-fits-all” thing and more research needs to be done before
any big claims are made. So activated charcoal is pretty hip these
days–you’ve probably seen it advertised in toothpastes, face masks, maybe some soaps,
but now it’s even making its way into stuff we eat, marketed as a “detoxer.” Activated charcoal is a form of carbon that
has been super-heated to create tiny, tiny pores that increase its surface area. By a lot. The surface area of one gram of activated
charcoal can cover an area greater than 3,000 square meters–over half of an American football
field. These tiny pores make activated charcoal an
incredible adsorber–meaning tons of different compounds will stick to it. And it actually has some legitimate uses,
like in the early stages of a drug overdose, because it can adsorb a range of drugs, keeping
someone’s stomach from absorbing them. But all that activated charcoal in your detox
smoothie is (a) probably just adsorbing pureed peach and (b) unless you’re literally having
an overdose, there are no toxins in your gut that need to be de…toxed. So if you’re drinking activated charcoal
it might keep that birth control from getting into your blood. Although there isn’t yet /direct evidence
for this, we at Reactions ask: why put yourself at risk for a silly health fad? St. John’s Wort isn’t FDA approved, but
in the US, it’s an over the counter supplement that people use to treat depression and, in
other parts of the world, it’s widely prescribed. St. John’s Wort is made up of many different
compounds, but the compound thought to act as an antidepressant is hyperforin. Hyperforin blocks reuptake of “feel good”
neurotransmitters like dopamine and serotonin, keeping that “happy” buzz going, but it
also increases the activity of CYP3A4–the same enzyme that grapefruit decreases the
activity of. So opposite to grapefruit, St. John’s Wort
clears estrogens from your system. This stimulates follicle growth and ovulation,
which increases your risk of getting pregnant. Let’s call it what it really is: a laxative. In recent years social media has been flooded
with detox tea promotions by celebrities and “influencers.” But here’s what’s up: they’re selling
you a serious case of diarrhea, and what you’re losing is water weight. These teas usually contain sennosides, often
just referred to as senna. Why senna works so well as a laxative is not
totally clear but it’s thought to both increase contraction and fluid secretion in your large
intestine. Diarrhea can cause a whole range of things
like dehydration, nausea, and fever, and…can keep you from absorbing hormones in the pill. If you’ve had diarrhea for more than a 24
hour period don’t count on your birth control being effective. Also… go to the hospital. And, finally, smoking. It is well established that smoking ups your
likelihood of having a stroke, and that increased likelihood is associated with a bunch of things
that make your blood clot, including fibrinogen. Fibrinogen is a clotting protein, and when
it’s acted on by an enzyme called thrombin, it polymerizes–forming a larger molecule
that works with other cells in your immune system to create a clot. The more clotting there is the more likely
you are to have a stroke. A combination of the pill and smoking is hypothesized
to put a woman at greater risk for stroke, because on its own the pill has been shown
to ever-so-slightly increase your risk. That being said, that increase is incredibly
small because the incidence of stroke in reproductive-age women is already very, very, low–around 1
in 100,000. So unless stroke is common in your family,
it’s a risk that shouldn’t keep you up at night. Although this list is a good place to start,
other things like certain antibiotics, and anti-seizure meds can mess with your oral
contraceptives. Remember — we’re a YouTube channel, not
a doctor — so go talk to yours to make sure you’re not putting yourself, or the effectiveness
of your birth control, at risk. See ya next week.

14 thoughts on “You Might Not Want to Mix These 5 Things With Birth Control

  1. Grapefruit juice def increases the efficacy of birth control, but also increases it's side effects. If you already have trouble managing side effects from BC, stay away from grapefruit juice, but otherwise you're fine 🙂
    ((Grapefruit juice also has interactions w/ other medications, so watch out for that too))

    Edit: commentary on the rest of the vid
    -yeah, activated charcoal can absolutely absorb your BC pill and prevent it from helping you, but the quantities of carbon in a specialty smoothie probably won't have much of an effect.

    -yeah, I'd avoid St John's Wart, the enzyme inhibition is no joke, and can affect many other medications as well.

    -detox teas are probably fine if you need the laxative effect, but you're right, they don't actually detox you. I've never found them to be particularly effective though, so i don't think they'd present much of a problem in conjunction with birth control, unless you have an extreme sensitivity to them.

    -and definitely, smoking while taking birth control significantly increases your risk of heart attack and stroke. This is the leading cause of death in women. Just don't do it.

    Thanks to the Reactions team for going over the mechanisms through which these interactions happen within the body. Absolutely love the channel 🙂

  2. 1.) grapefruit
    2.) activated charcoal
    3.) St. John’s wort (holistic antidepressant)
    4.) “detox tea” (laxatives)
    5.) smoking

  3. CYP450 is an enzyme encoded by CYP2D6. There are people out there who are CYP2D6 poor metabolizes and also altrarapid metabolizers. I happen to be a CYP2D6 pooe metabolizer, meaning I can’t metabolize CYP2D6 substrates properly, such as Opioids and most SSRIs and TCAs among other things like beta blockers, Benadryl, some plants, and so on. More than 25% of medication on the market are cyp2d6 substrates.

    It’s pretty important to get a GeneSite test to see how well your body metabolizes medication so you’re not doing any harm and to make sure your medication is being effective.

    Personalized medication is the future. You can immediately weed out medication that won’t be effective for you and save yourself the grief.

  4. I have an arm implant for bc, not a woman though, I’m a trans guy. Idk how much the pill translates to the implant though

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