Vitamin and Mineral Supplementation

Nutritional supplements are great for patients with inflammatory bowel disease (IBD) who may need a bit of extra help preventing a nutritional deficiency.

Your healthcare providers may also recommend a vitamin and/or mineral supplementation plan if your tests show you already have a nutritional deficiency.

You may be able to get all your necessary vitamins and minerals from eating a well-balanced, nutrient-rich diet. But flares, severe symptoms, surgeries, and other complications may make it difficult for some patients with Crohn’s disease or ulcerative colitis to get enough nutrients from food alone.

Check with your doctor or other healthcare providers before taking any supplements, including over-the-counter medications, herbs, and other complementary therapies.

  • Some supplements can cause gastrointestinal symptoms, including nausea and diarrhea.

  • Check the labels on your supplements for lactose, artificial colors, sugar alcohols, or preservatives, all which can aggravate your IBD, especially when you are in a flare.

  • Most supplements should not be taken on an empty stomach.

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Vitamin and Mineral Supplementation in IBD Often times, when you have Crohn's disease or ulcerative colitis, you may need to take vitamins or minerals to prevent or make up for a nutritional deficiency. Watch and listen this video to learn more about common vitamin and mineral supplements for IBD patients.

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Common Supplements Recommended for IBD Patients

Your healthcare provider may recommend that you take vitamin or mineral supplements, especially if you are experiencing nutritional deficiencies. We can help you learn about supplements that are commonly recommended for IBD patients.

This information can help you learn which vitamins and minerals are important to maintain your nutrition, along with the various foods you may want to try as part of your IBD-friendly diet.

Your body is unique. What works for one patient, will not work for everyone. Check with your healthcare providers before starting any supplements, as you will need proper dosing.

 

Calcium

Calcium maintains your bones and teeth. It is recommended for all IBD patients, but it is especially necessary if you are on corticosteroids, have osteopenia (low bone density), or osteoporosis (weak bones). Calcium is most effective when its taken together with vitamin D.

Foods to consider:

  • Low-fat milk products, such as cheese, yogurt milk, and kefir — use lactose-free versions of these foods if you are lactose intolerant

  • Dark leafy greens

  • Tofu

  • Broccoli

  • Salmon with bones

  • Shrimp

  • Sardines

  • Foods marked as calcium fortified

 

Folic Acid

Folic acid helps your body produce and maintain new cells, and helps you process fats and carbohydrates. Some of the medications your doctor may prescribe to treat your IBD, including sulfasalazine and methotrexate, may interfere with the absorption of folic acid. Doctors often recommend that pregnant women, including women with IBD, take folic acid supplements to prevent birth defects.

Foods to consider:

  • Beef liver

  • Black-eyed peas

  • Fortified breakfast cereals

  • Rice

  • Vegetables such as Brussels sprouts, lettuce, asparagus, spinach, and dark leafy greens

  • Orange juice

  • Wheat germ

  • Kidney beans

  • Spaghetti

  • Avocado

 

Iron

Iron is a component of hemoglobin, which is found in red blood cells and carries oxygen throughout your body. Iron deficiency can lead to anemia, a blood disorder and a serious complication of IBD. Patients that are anemic don’t have enough red blood cells. Inflammation and blood loss from intestinal ulcers can both cause you to develop an iron deficiency.

Foods high in iron should be paired with a vitamin C rich food to enhance absorption. Foods high in vitamin C include bell peppers, broccoli, berries, citrus, and tomatoes. It’s important to have your iron levels tested before taking supplements because excess iron can be toxic to your liver.

Foods to consider:  

  • Iron-fortified cereals

  • Oysters

  • Beans such as white beans, lentils, kidney beans, and chickpeas

  • Beef and beef liver

  • Spinach

  • Tofu

  • Sardines

  • Canned and stewed tomatoes

 

Vitamin B12

Vitamin B12 helps keep the nerve and blood cells healthy and is absorbed into the last section of the ileum, which is located at the end of your small intestine. If you have been diagnosed with Crohn’s disease involving the ileum, or if you’ve had surgery to remove part or all of the ileum, you may have trouble absorbing enough B12 from food alone.

Vegetarians are also at risk for developing at vitamin B12 deficiency.

Foods to consider:

  • Clams

  • Trout

  • Tuna

  • Liver

  • Beef

  • Fortified cereals

  • Milk

 

Vitamin D

Vitamin D, which helps your body absorb calcium, is recommended for all patients with IBD as it may help control intestinal inflammation. Some studies have even shown less active IBD in people who have an adequate vitamin D level.

This vitamin is most effective when taken together with calcium. It especially important for people who have a calcium deficiency, who have osteopenia or osteoporosis, or who are taking corticosteroids, which can cause vitamin D resistance.

Foods to consider:

  • Salmon

  • Tuna

  • Cod liver oil

  • Sardines

  • Orange juice

  • Milk

  • Egg yolk

  • Fortified yogurt

  • Fortified cereals

 

Vitamins A, E, and K

These vitamins are essential for cell production and preventing cell damage, blood production, fighting infections, and bone health. Patients who have trouble absorbing fat may have low levels of these fat-soluble vitamins. Fat absorption problems in IBD patients may be due to significant small bowel inflammation, short bowel syndrome (SBS), or biliary tract blockage, as in primary sclerosing cholangitis.

Foods to consider:

Vitamin A

  • Carrots

  • Sweet potatoes

  • Spinach

  • Red peppers

  • Broccoli

  • Cantaloupe

  • Mangos

Vitamin E

  • Almonds

  • Peanuts

  • Sunflower oil

  • Sunflower seeds

  • Wheat germ oil  

Vitamin K

  • Collard greens

  • Spinach

  • Kale

  • Broccoli

  • Cauliflower

  • Turnip greens

  • Soybeans

  • Cabbage

  • Soybean oil

  • Okra

  • Pomegranate juice

 

Zinc

Zinc helps the body fight off invading bacteria and viruses. The level of zinc in your system can be affected by several symptoms of both Crohn’s disease and ulcerative colitis, including severe diarrhea, short bowel syndrome, and extensive disease in your small intestine. People on a vegetarian diet are also at risk for zinc deficiency.

Symptoms of zinc deficiency include a rash, changes in taste, smell, and sight, difficulty with wounds healing, and poor growth in children.

Foods to consider:

  • Oysters

  • Crab

  • Shellfish

  • Beef

  • Fortified grains

  • Whole grains

  • Pork

  • Poultry

  • Legumes

  • Bran

  • Nuts

  • Green peas

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