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Aftera
Depletes
Prolonged use of Aftera can impact 7 essential nutrients.
Vitamin B1
Studies suggest a potential for mild thiamine (vitamin B1) deficiency with long-term use of Oral Contraceptives (OCs). One finding showed that red blood cell activity of an enzyme dependent on thiamine (transketolase) decreased during OC treatment. This decrease indicates that the cells might not have enough thiamine to function optimally, suggesting a mild thiamine deficiency induced by the contraceptives. Supplementation with thiamine (vitamin B1) should be considered for women using OCs.
Replace with Vitamin B1 Thiamine (10 mg)
Research: Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception. 1975 Feb;11(2):151-4. doi:...
Zinc
Studies suggest that oral contraceptives (OCs) may contribute to zinc deficiency. Research has shown a significant decrease in serum zinc levels, the zinc circulating in the blood, in women taking OCs. This decrease is thought to be due to potential changes in how the body absorbs, excretes, or utilizes zinc within tissues. Due to its vital role in many bodily functions, ensuring sufficient zinc intake through supplementation should be considered for women on birth control pills.
Replace with Zinc Bisglycinate (12.5 mg)
Research: Fallah S, Sani FV, Firoozrai M. Effect of contraceptive pill on the selenium and zinc status of healthy subjects....
Folic Acid
Women using oral contraceptives (OCs) for extended periods may experience a decrease in their folate levels. Studies suggest that OC use might lower blood folate levels by up to 40%. This depletion can be a concern because folate plays a crucial role in red blood cell production. One research finding highlights a case where a patient developed anemia and nerve problems (polyneuropathy) after stopping vitamin B12 therapy, suggesting that folate deficiency might have been the main underlying issue. Supplementation of folate should be considered during oral contraceptive use.
Replace with Folate (0.2mg as L-5-Methylfolate) (0.34 DFE)
Research: Shikh EV, Makhova AA, Chemeris AV, Tormyshov IA. [Iatrogenic deficits of micronutrients]. Vopr Pitan. 2021;90(4):53-63....
Vitamin E
When using oral contraceptives (OCs), the body might experience increased oxidative stress due to hormonal changes. Vitamin E, a potent antioxidant, could potentially help counteract this stress and promote cellular health. Research shows that combining vitamin E with vitamin C supplementation might be even more beneficial. Studies like one where Group C received both vitamins showed a significant increase in the activity of enzymes (GPx and GR) crucial for antioxidant defense, along with a reduction in markers of oxidative damage (plasma MDA levels). This suggests that a combined approach with vitamins E and C might offer enhanced protection against cellular stress for women using OCs.
Replace with Natural Vitamin E d-alpha-tocopherol + mixed tocopherols (33 mg)
Research: Zal F, Mostafavi-Pour Z, Amini F, Heidari A. Effect of vitamin E and C supplements on lipid peroxidation and GSH-dependent...
Vitamin B2
Women using Oral Contraceptives (OCs) may benefit from including vitamin B2 (riboflavin) in their regimen. Vitamin B2 plays a critical role in activating other B vitamins, like folic acid and B6, which are essential for various bodily functions. Studies have shown that women on OCs have lower levels of active vitamin B2, as measured by the activity of an enzyme dependent on it (glutathione reductase). These reduced levels might be linked to migraines, a frequent side effect of OCs that can sometimes lead women to discontinue the medication. By ensuring adequate B2 intake, women on OCs may potentially experience reduced migraine frequency and benefit from the proper activation of other B vitamins.
Replace with Vitamin B2 Riboflavin (10 mg)
Research: Zencirci B. Comparison of the effects of dietary factors in the management and prophylaxis of migraine. J Pain Res. 2010 Jul...
Tyrosine
Women using oral contraceptives (OCs) may experience mood changes, including depression. Research suggests a potential link between these emotional shifts and a decrease in brain levels of the neurotransmitter norepinephrine (noradrenaline). This decrease could be related to reduced availability of its precursor molecule, tyrosine, in the brain. Studies have shown a significant decline in tyrosine levels in women on OCs. One study found that the area under the curve (AUC) in plasma for tyrosine in OC users were 43% of control levels. Tyrosine supplementation could potentially help regulate mood and improve emotional well-being while taking OCs.
Replace with L-Tyrosine (200 mg)
Research: Møller, S.E., Maach-Møller, B., Olesen, M., Madsen, B.K., Madsen, P., & Fjalland, B. (1995). Tyrosine metabolism in users of...
Also Benefits From:
Selenium
Selenium is an essential mineral that plays a role in cell function, including protecting against cell damage and potentially supporting a healthy thyroid. Oral contraceptives (OCs) can impact nutrient levels in the body, and selenium is one such nutrient that might be depleted. Selenium offers potential benefits against cancer development, so maintaining adequate levels is important. While more research is needed, some studies suggest that OC users may have lower selenium levels. This highlights the potential importance of ensuring adequate selenium supplementation for women on birth control pills.
Research: Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med...
Health Impact
Aftera-induced nutrient depletion can lead to a range of health problems
Wernicke–Korsakoff Neurologic Changes
Reviews of thiamine deficiency disorders show that severe depletion causes Wernicke encephalopathy, with progression to Korsakoff psychosis if untreated, particularly in malnutrition, alcoholism and certain drug exposures.
Research: Smith TJ et al. Thiamine deficiency disorders: a clinical perspective. Ann N Y Acad Sci. 2021;1498(1):9-28.; Ott M et al....
Beriberi Neuropathy & Cardiac Failure
Case series and reviews document that thiamine deficiency presents with distal sensorimotor neuropathy and cardiomyopathy, which can often be rapidly reversible with repletion if identified early.
Research: Li S et al. Wernicke encephalopathy: a mini review of the clinical and imaging features. Neurol Sci. 2025;46(2):e12307376.;...
Weakened Immune Response
Classic dermatology and immunology literature shows that zinc deficiency causes lymphopenia and reduced immune capacity; more recent work links marginal deficiency to impaired inflammatory and anti-microbial responses.
Research: Fraker PJ et al. The dynamic link between the integrity of the immune system and zinc status. JAMA Dermatol....
Slow Skin & Wound Healing
Experimental and clinical studies demonstrate that zinc deficiency is associated with skin lesions, delayed wound closure and abnormal inflammatory responses, while zinc repletion can improve healing outcomes in selected populations.
Research: Lin PH, Sermersheim M et al. Zinc in wound healing modulation. Nutrients. 2017;9(1):16.; News-Medical. The role of zinc in...
High Homocysteine & Vascular Risk
Meta-analyses of randomized trials show that folic acid supplementation lowers homocysteine and modestly reduces stroke and overall cardiovascular disease risk in some populations, especially where baseline folate status is low, highlighting the adverse vascular profile of folate deficiency.
Research: Li Y et al. Folic acid supplementation and the risk of cardiovascular diseases: a meta-analysis of randomized controlled...
Folate-Related Megaloblastic Anemia
Hematology and nutrition reviews describe folate deficiency as a classic cause of megaloblastic anemia and mucosal abnormalities, frequently exacerbated by medications that antagonize folate metabolism.
Research: O’Leary F, Samman S. Vitamin B12 in health and disease. Nutrients. 2010;2(3):299-316. (discussion of folate and B12 in...
Neuropathy & Ataxia From Low E
Case series and reviews document that vitamin E deficiency, particularly in fat-malabsorption syndromes, can cause progressive sensory neuropathy and ataxia that may improve with high-dose replacement.
Research: Chan KH et al. Sensory axonopathy associated with vitamin E deficiency. Case Rep Neurol Med. 2021;2021:7971715.; Puri V et...
Side Effects
Common side effects of Aftera, some of which may be related to nutrient depletion
Review
Some common side effects of the emergency contraception pill Aftera may include:

1. Nausea
2. Vomiting
3. Abdominal pain
4. Fatigue
5. Headache
6. Dizziness
7. Breast tenderness
8. Irregular bleeding or spotting
9. Changes in menstrual cycle
10. Allergic reactions

It is important to note that these side effects are usually mild and temporary. However, if you experience severe or persistent side effects, it is recommended to seek medical attention. Additionally, Aftera does not protect against sexually transmitted infections (STIs) and should not be used as a regular form of contraception.
Get Support
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