The nutrients you consume play a crucial role in maintaining your tissues, promoting cell growth, and supporting smooth metabolism. Your gut is the primary way your body absorbs the nutrients it needs to function well. However, with Crohn’s disease, having flares, inflammatory bowel disease (IBD)-related complications, or even taking some medications can interfere with your nutritional absorption.
If you have Crohn’s disease, there are a few key supplements you may want to consider taking if you have a nutritional deficiency. Before taking any new vitamins, it’s important to talk with your doctor. If needed, they can refer you to a registered dietitian.
Crohn’s disease can make it more difficult for the body to absorb certain nutrients for several reasons:
- Inflammation in the digestive tract that occurs during flares can disrupt your body’s ability to absorb vitamins and minerals.
- Medications for Crohn’s disease may increase the likelihood of certain nutrient deficiencies (consult your doctor about any potential medication interactions).
- Surgery to remove part of the digestive tract can reduce the body’s capacity to absorb nutrients.
Many people with IBD take supplemental vitamins and minerals along with their daily diet to manage nutritional deficiencies. A 2022 research overview highlights older studies indicating that about 50% of people with IBD try complementary and alternative treatment, including supplements.
Get tested for nutrient deficiency
The best way to find out if you’re nutrient-deficient is to ask your doctor if you can get your levels of key nutrients tested. This will provide a baseline for you and your healthcare team, allowing you to create a plan and determine next steps.
You can get all of these vitamins by eating a diet rich in nutrient-dense whole foods. However, if you’re experiencing malnutrition as a result of Crohn’s disease and your current diet isn’t meeting your nutritional needs, the following supplements may help. Before taking anything new, speak with your doctor for a personalized recommendation.
People with Crohn’s disease are more likely to have osteoporosis due to IBD symptoms and medication side effects. Osteopenia is a loss of bone density, which, if left untreated,
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.
A 2021 review of studies cites older research suggesting that among people with IBD, 22% to 77% have osteopenia and 17% to 41% have osteoporosis. Because of this, you may want to consider taking a calcium supplement, which is essential for maintaining bone health.
If you’re taking corticosteroid medications, it’s especially important to make sure you’re getting enough calcium. Corticosteroids are linked to long-term complications, which include osteopenia and osteoporosis.
Vitamin D is also an important supplement to take, as it works together with calcium to maintain bone health.
Foods that contain
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include:
- seafood like shrimp, sardines, and salmon with bones
- low fat dairy products such as yogurt, milk, and kefir
- tofu
- dark leafy greens like kale and spinach
- broccoli
- calcium-fortified foods (check the label to learn which foods these are)
Some medications for Crohn’s disease, including sulfasalazine (Azulfidine) and methotrexate (Trexall/Otrexup/Rasuvo),
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the absorption of folic acid.
Folic acid plays a crucial role in metabolism and the formation of new cells.
Foods that
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include:
- leafy greens, including Brussels sprouts, spinach, and asparagus
- rice
- fortified products, like some breakfast cereals
- kidney beans and black-eyed peas
avocado
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The synthetic form is called folate, which is often used in folic acid-fortified foods and supplements.
Experts often recommend that people with Crohn’s disease take vitamin D in addition to calcium to support bone health and help prevent osteoporosis. It’s also thought to help reduce inflammation in the intestines.
Foods that
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include:
- fatty fish, including salmon, tuna, and mackerel
- cod liver oil
- milk, as well as soy, almond, and oat milk
- eggs
- fortified products, such as certain types of orange juice, milk products, and cereals
People with IBD often can become deficient in iron because of inflammation and intestinal ulcers, which cause blood loss and anemia.
If you’re taking iron supplements, make sure to have your iron levels tested regularly because too much iron can be toxic. In addition to taking iron supplements, you can eat foods that contain vitamin C, such as
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to increase iron absorption.
Foods that
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include:
- oysters
- spinach
- tofu
- beans
- fortified products, like some cereals
This vitamin is absorbed in the ileum, a part of the small intestine. People who have inflammation in this part of the body, or have had surgery on this part of their digestive tract, will likely have difficulty absorbing vitamin B12 from eating food alone. If this is the case, it’s a good idea to take vitamin B12 supplements.
However,
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, including:
- clams
- trout
- fish
- ground beef or beef liver
- milk
- fortified nutritional yeast
Vitamins A, E, and K help produce and maintain cells, fight off infection, and play a role in bone health. They’re fat-soluble, meaning they enter your body with the absorption of fat. However, some people with Crohn’s disease may have fat absorption issues, which may prevent them from getting enough of these vitamins.
Foods high in vitamin A include:
- spinach
- broccoli
- carrots
- sweet potatoes
- pumpkin
- mango
- red bell peppers
Research suggests that vitamin E has anti-inflammatory properties and can help reduce inflammation in the colon. It can be
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:
- almonds
- peanuts
- sunflower seeds and sunflower oil
- broccoli
- kiwis
- raw tomatoes
- peanut butter
Studies suggest that vitamin K can reduce gut inflammation and oxidative stress, which helps protect the gut.
Foods that contain vitamin K include:
Some symptoms of Crohn’s disease, such as severe diarrhea, can affect zinc levels in the body.
Foods that contain zinc include:
- seafood, including oysters and shellfish like crab and lobsters
- red meat
- poultry
- whole grains and bran
- beans
- nuts
Other supplements that might help
Additional supplements that may benefit people with Crohn’s disease include:
- Omega-3 fatty acids: These compounds, found in fatty fish like salmon, are known to reduce inflammation, among other health benefits. Studies have shown that omega-3 fatty acids may help reduce certain symptomsof Crohn’s disease. However, further research is needed.
- Curcumin: This compound is found in the spice called turmeric and has been found to have anti-inflammatory, antioxidant, and immune-regulating properties. It can also help with gut microbiota. Curcumin is generally considered safe when used in cooking. However, it can interact with specific medications like antiplatelet drugs, blood thinners, and medications that affect blood sugar levels.
Speak with your doctor before taking any supplements. Consider bringing a list of the supplements you’re interested in to your appointment, as well as a list of all the medications and supplements you’re already taking. This should include over-the-counter medications, as well as herbal or other natural supplements.
If you’re taking medication for Crohn’s disease, keep taking these even if you start taking supplements or natural remedies. These cannot replace medication, but your doctor may recommend supplements or natural remedies in addition to your current treatment.
Some supplements might make symptoms worse
One important reason why it’s important to speak with your doctor before starting supplements is that some can actually make Crohn’s disease symptoms worse, especially if you’re already experiencing a flare.
A few supplements can cause gastrointestinal symptoms, including stomach pain, diarrhea, or constipation.
Additives in some supplements can also cause digestive discomfort if you have Crohn’s disease, even in small amounts, so check the label for them. Examples include:
Eating a balanced diet can benefit your physical health and if you have Crohn’s disease, can also help manage symptoms. However, complications from the condition can cause nutritional deficiencies.
If this is the case, talk with your doctor about how to ensure you’re getting all the essential vitamins and minerals. During your appointment, your doctor can help you develop a personalized approach to your nutrition.
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