Woman coming in wants to prep herself for getting pregnant—35, birth control since 16. A few months ago, she went off birth control, experienced very bad acne, and so she went back on. Says the acne was the reason she went on when she was 16. This is a very common story of course, and I’m sure many of you have seen this lots of times. Done comprehensive blood. She looks pretty good outside of some functional iron deficiency, lack of protein in her diet, possible HCl, and electrolyte imbalances. Advised Paleo reset and then hormone testing. What tests do you suggest, and should they be done when on birth control or at some point went off the pills? I want to prep well before she goes off BCs so she can have less symptoms and then regulate her conception.

Chris Kresser: Yes. Definitely like a DUTCH test what are you going to be learning about shortly after hormones and then also serum hormone testing through Esoterix, which is I think owned by LabCorp is what we use for serum hormone testing. Those can both be complementary and helpful. I think I’ve written an article, if you search for “Kresser post birth control syndrome,” there’s a blog post there that was written actually by one of my RDs Laura Schoenfeld, Five Tips For Treating Post Birth Control Syndrome. It’s actually on the Kresser Institute blog as well as the Chris Kresser blog. You should have no trouble finding it, and then I did a podcast a while back, How To Recover From Long Term Use of Birth Control Pills, so definitely check those out.

In short, the key is once she gets off birth control there’s going to be a period of things getting worse. It’s pretty hard to avoid that because the birth control pills affect the endogenous production of hormones obviously in an adverse way, and it takes a while for the body to bounce back from that. Some of the things that can be helpful is very clean diet, nutrient dense, making sure that blood sugar is regulated, definitely correcting the iron deficiency because that’s going to affect hormone regulation. Paleo reset, like you said, is a good recommendation. Botanicals can be really helpful. Since you’re an acupuncturist, Adam, you might be familiar with Evergreen Herbs. Evergreen has some formulas that you might also already be familiar with called Blossom—Blossom 1, 2, 3 and 4. They’re designed to be used at different at the four different phases of the menstrual cycle. Blossom 1 may take during menstruation, Blossom 2 follicular, Blossom three ovulation, and Blossom 4 luteal phase. I found them to be extremely helpful in helping women to regulate the cycles and also for pre-conception. We’ll be getting a little bit more into hormones, but not a lot in this course. That’s going to be the next step. But also addressing HPA axis is super important for a woman who’s been on birth control as a way of helping to regulate sex hormone production. We’ll be talking about that in the HPA unit shortly. I would do the DUTCH and serum hormone testing maybe two or three weeks after going off BC. I don’t see a lot of value of doing it on BC because it’s not going to give you really any actionable information. It’s just going to tell you what her hormones look like while she’s on BC, but when she gets off, after two or three weeks then you’re going to see where things are, and that’s going to be helpful in guiding your work.