Abstract
Because birth control pills are known to cause alterations in folate metabolism in adult women, this study's purpose was to determine if adolescents on birth control pills are at risk of developing anemia secondary to abnormal folate metabolism. 90 adolescents taking Brevicon or Norinyl 1/50 for longer than 6 months were compared to 90 non-pill users. Intake of folate was evaluated by a dietary history questionnaire. 14% of pill users and 8% of controls had low serum folates (< 3.0 ng/ml) (p>0.1). Low whole blood folates (<150 ng/ml) were seen in 32% of pill users, but in only 18% of controls. (p<0.1). However, controls were more likely to have low ferritins (<10 ng/ml) than pill users (21% v 11%; p<0.1), perhaps because of diminished menstrual flow on the pill. Of the low ferritin patients two-thirds had neither low hemoglobin (<12 g/dl) nor low MCV (<80 um3). No low cobalamins and no significant difference was noted in the Hgb, MCV, or polylobe count in either group. This study indicates that serum folate levels, whole blood folate levels and ferritins are frequently low in adolescents and are often not reflected by CBC's. Although pill use appears to increase slightly the risk of developing cellular folate deficiency, the pill appears to be protective against iron deficiency and is not associated with anemia.
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Grace, E., Emans, S., Drum, D. et al. 15 HEMATOLOGIC ABNORMALITIES IN ADOLESCENTS ON BIRTH CONTROL PILLS. Pediatr Res 15 (Suppl 4), 442 (1981). https://doi.org/10.1203/00006450-198104001-00024
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DOI: https://doi.org/10.1203/00006450-198104001-00024