Vitamin and Mineral Supplementation

Vitamin and Mineral Supplementation

Vitamin and Mineral Supplementation

Many patients with IBD take supplements to make up for or prevent a nutritional deficiency. Always consult with your healthcare provider prior to taking any supplements, and consider the following:

  • When possible, get your vitamins and minerals from foods rather than supplements.
  • Discuss all supplements, over-the-counter medications, herbs and complementary therapies with your doctor first!
  • Some supplements can cause gastrointestinal symptoms including nausea and diarrhea.
  • Check labels to see if supplements contain lactose, artificial colors, sugar alcohols, or preservatives.
  • Most supplements should NOT be taken on an empty stomach

Supplements and Recommended Foods that May be Needed for IBD Patients

*Always consult with your healthcare provider prior to taking any supplements and to receive personalized, recommended dosing.

Vitamin and Mineral Supplementation

Supplement CA

Calcium

Recommended for all IBD patients, but especially if you are on steroids or have known osteopenia (low bone density) or osteoporosis (weak bones). Calcium is most effective when taken together with Vitamin D.

Foods to consider: Low-fat milk products such as cheese, yogurt milk, kefir (if tolerated – lactose free versions available for all these if lactose intolerant), dark leafy greens, tofu, broccoli, salmon with bones, shrimp, sardines, and calcium fortified foods – aim for three servings per day.

Supplement Folic Acid

Folic Acid

Certain medications (sulfasalazine and methotrexate) may interfere with the absorption of folic acid. All pregnant women, including women with IBD, are also advised to take supplements to prevent birth defects.

Foods to consider: Beef liver, spinach, black-eyed peas, fortified breakfast cereals, rice, asparagus, spaghetti, brussels sprouts, lettuce, avocado, orange juice, wheat germ, kidney beans, and dark leafy greens

Supplement FE

Iron

Low iron can occur in IBD patients for two reasons: inflammation in the body causes it to use iron less efficiently and blood loss from intestinal ulcers. Iron deficiency can lead to anemia (disorder of the blood where there is not enough red blood cells). It is important to determine if a deficiency is present before taking iron supplements, as excess iron can be toxic to the liver.

Foods to consider:  Iron fortified cereals, oysters, white beans, beef, beef liver, lentils, spinach, tofu, kidney beans, chickpeas, sardines, and canned and stewed tomatoes. Foods high in iron should be paired with a Vitamin C rich food (bell peppers, broccoli, berries, citrus, and tomatoes) to enhance absorption.

To learn more about the signs and symptoms of anemia and to receive guidance on how to engage with your provider regarding testing and caring for anemia, watch the Anemia and IBD Webinar.

Knowing your iron levels is especially important for the IBD population as Iron Deficiency Anemia, or IDA, can affect 36-76 percent of people living with Crohn's disease or ulcerative colitis. Click here for more information on IDA.

 

Supplement B12

Vitamin B12

Vitamin B12 is absorbed into the last part of the ileum. People with Crohn’s disease involving the ileum or people who have had surgery to remove portions of the ileum, may have problems absorbing B12 from foods. Those on a vegetarian diet are at risk for Vitamin B12 deficiency.

Foods to consider: Clam, liver, fortified cereals, trout, tuna, beef, and milk

Supplement D

Vitamin D

Recommended for all IBD patients as Vitamin D may play an important role in intestinal inflammation, and in some studies, patients with an adequate Vitamin D level have less active IBD. Vitamin D is especially important in people who have calcium deficiency, have osteopenia/osteoporosis (low bone density/weak bones) or are on steroids (which causes Vitamin D resistance). Vitamin D is most effective when taken together with calcium.

Foods to consider: Salmon, tuna, orange juice, milk, sardines, egg yolk, cod liver oil, fortified yogurt, and fortified cereals

Supplement Mixed

Vitamins A, E, and K

Patients with trouble absorbing fat due to significant small bowel inflammation, short bowel syndrome, or biliary tract blockage (as in Primary Sclerosing Cholangitis) may have low levels of the fat-soluble Vitamins A, E, and K.

Foods to consider:

Vitamin A: Carrots, sweet potatoes, spinach, cantaloupe, red peppers, broccoli, and mangos

Vitamin E: Almonds, peanuts, wheat germ oil, sunflower oil, and sunflower seeds

Vitamin K: Collard greens, spinach, kale, broccoli, turnip greens, soybeans, cabbage, soybean oil, okra, pomegranate juice, and cauliflower

Supplement ZN

Zinc

Patients with severe diarrhea, extensive disease in their small intestine, short bowel syndrome, or those on a vegetarian diet are at risk for zinc deficiency. Symptoms of zinc deficiency include a rash, changes in taste, smell and sight, difficulty with wound healing, and poor growth in children.

Foods to consider: Oysters, beef, crab, fortified grains, pork, poultry, shellfish, legumes, bran, nuts, green peas, and whole grains