Crohn's disease and supplements

Sometimes, a good diet simply isn't enough to correct a nutritional deficiency caused by Crohn’s disease (CD). You may have difficulty eating enough to meet your body’s caloric needs, or you may be lacking in particular vitamins and minerals. If you're suffering an intense flare-up of symptoms, you may not feel like eating.

Furthermore, damage to the gut, as well as certain medications for CD, mean that nutrients may not be well absorbed by the body.

This may make you feel unwell, weak and lacking in energy. It can make your symptoms worse and your medications less effective. Poor nutrition is particularly dangerous in children, whose growth may be affected.

In these cases, nutritional supplements may be called for. Your doctor can recommend multivitamins or other supplements to correct these lacks.

A person with CD is more likely to have specific nutritional deficiencies:

• Vitamin B12 – especially after surgery on the small intestine. You can obtain B12 supplements in the form of tablets, injections or sprays.

• Surgery can also affect your body’s ability to absorb fats; this lowers the absorption of vitamins A, E and K. Supplements of these vitamins are also available.

• People with CD often have low levels of vitamin D, which helps your body absorb calcium. A daily vitamin D supplement can help.

• Certain medications, e.g. sulfasalazine and methotrexate, can reduce folic acid levels. A daily folate supplement may be recommended (especially if you are pregnant, as folate is necessary for foetal development).

• If you suffer from anaemia due to internal bleeding, an iron supplement is an effective remedy. This is available in the form of tablets, liquids or infusions.

• Many people with long-term CD develop weak bones and osteopenia ( thinning of the bones) or ultimately osteoporosis (bone loss). This may be due to low levels of vitamin K, which helps to bind calcium in bones, and vitamin D, which helps bones absorb calcium.

• Furthermore, if you are lactose intolerant, you will not get calcium from dairy products. These problems can be averted by taking a daily calcium supplement.

• Daily supplements can also raise levels of potassium, magnesium and zinc, all nutrients that can be low in people with CD.

Depending on your situation and symptoms, some of the following might also be useful:

• A fibre supplement, such as psyllium powder or methylcellulose. This may relieve mild diarrhoea.

• The hormone DHEA (dehydroepiandrosterone), which some studies have shown is safe and possibly beneficial for short-term use.

• Various other studies have suggested that N-acetyl glucosamine, melatonin and omega-3 fatty acids are all substances that might be beneficial for people with CD. However, further studies are required to confirm this.

Remember, always talk to your doctor before starting a course of dietary supplements; get advice that is appropriate for your particular situation and symptoms.

Source: Crohn’s and Colitis Foundation of America (www.ccfa.org)
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