Day 6 of IBD Awareness Week – Supplements with IBD

Yesterday was focused on practicing good nutritional habits with IBD. By design those habits should seem kinda simple and easy. We want to take that same approach towards supplements with IBD (if you choose to or need to include them in your overall health plan).

So focusing on good nutrition with IBD can lead many of us directly into the world of supplements¹. Books have been written on this topic alone so please understand my approach here is to help you get started with the basics.

My “starting five” supplements with IBD

CURCUMIN is a yellow-colored substance found in turmeric root. You might be more familiar with turmeric as the spice that gives many curries their bright-yellow color. Curcumin has been shown to decrease swelling (inflammation) and relieve occasional soreness.curcuminSupplemental curcumin can benefit you in several ways:

  • Helps maintain a healthy inflammatory response in various parts of the body*
  • Provides antioxidant support*
  • Provides support for joint, eye, GI tract, liver, prostate and nerve health*
  • Provides relief from occasional soreness*

MULTI – VITAMIN I choose to take this supplement because of the comprehensive vitamins and minerals provided. These two ideal multi-vitamin/mineral combinations support a high performance nutrition program.*multi-vitaminThe keystone of every nutritional product line is a multi-vitamin/mineral supplement. A multi-vitamin/mineral product is the starting point for every individual’s supplementation needs and therefore it should contain all of the essential nutrients.Because of the state of the current food supply and because very few individuals eat the recommended five daily servings of fruits and vegetables, nutrition experts agree that a multi-vitamin/mineral supplement should be taken daily. Even the Journal of the American Medical Association – not usually known as a supporter of nutritional supplements – suggests that everyone should take a multi-vitamin/mineral supplement (JAMA2002;287:3127-3129). A good multi-vitamin/mineral nutritional supplement could be considered “dietary insurance” to be certain all of the essential nutrients are being consumed on a daily basis. Even greater health benefits can be realized when a healthy diet is being eaten in addition to taking a multi-vitamin/mineral supplement.

  • Provides vitamin K2 to support calcium metabolism*
  • Includes the active, tissue-ready form of vitamin B12*
  • Chelated minerals provide for optimal absorption*
  • Provides Indena’s curcumin phytosome (Meriva®), which helps maintain the body’s normal inflammatory response in joints, muscles, and the gastrointestinal tract*
  • Also uses Indena’s green tea phytosome (GreenSelect®) to provide antioxidant and metabolic benefits*
  • Includes Relora®, a proprietary blend of plant extracts shown to curb late-night cravings, optimize cortisol and DHEA levels, aid in weight management, and support restful sleep

GLUTAMINE to promote healthy mucus membranes of the mouth and gastrointestinal tract*

I like the powder instead of the pills

  • Promotes gastrointestinal and immune health*
  • The powder form facilitates taking it in higher amounts
  • A necessary nutrient for wound healing*
  • Provides support for muscles after exercise or injury*
  • Helps maintain cellular hydration and metabolism*
  • Supports healthy nerve function*
  • Mixes easily in warm or cold liquids

PROBIOTIC The human intestinal tract contains trillions of bacteria that, in a healthy person, coexist with us in a beneficial, symbiotic relationship. They help digest food, produce vitamins, regulate the metabolism, and control a normal immune response. Probiotic bacteria promote a healthy intestinal environment by producing lactic acid and by secreting fatty acids that are helpful to the growth of other beneficial microorganisms.* probioticBacillus coagulans is a lactic acid-producing bacteria that represents a breakthrough in probiotic supplementation. This beneficial bacteria is dormant in the bottle, then reverts to a growing bacteria in the intestines.* Because of this, it resists being killed by stomach acid; in contrast, many Lactobacillus probiotics lose most or all of their potency before use and do not survive their trip through the stomach.*

FOLATE an essential B vitamin in its active, tissue-ready form. Folic acid must be converted to its active forms to be used by the body.* This is a multi-step biochemical process that occurs in the intestines and liver. In the presence of intestinal or liver dysfunction this conversion may not occur sufficiently enough to meet the body’s needs. Furthermore, up to 60-percent of the U.S. population may have a genetic enzyme defect that makes it difficult for them to convert folic acid into active 5-MTHF. For these individuals and many others, 5-MTHF supplementation may be a more effective method of folate repletion.*folateIn concert with vitamin B12, 5-MTHF functions as a methyl-group donor involved in the conversion of the amino acid homocysteine to methionine.* Methyl-group donation is vital to many biochemical conversion processes, including the synthesis of serotonin, melatonin, and DNA.*

Questions about supplements with IBD¹

Do patients with IBD absorb foods normally?

Most often, yes. Patients who have inflammation only in the large intestine absorb food normally. People with Crohn’s disease may have problems with digestion if their disease involves the small intestine. They may eat enough food but cannot absorb it adequately. In fact, up to 40 percent of people with Crohn’s do not absorb carbohydrates properly. They may experience bloating, gaseousness, and diarrhea as well as a loss in important nutrients. Fat malabsorption is another problem in Crohn’s disease, affecting at least one-third of patients. At particular risk are people who have had terminal ileal resections.

The degree to which digestion is impaired depends on how much of the small intestine is diseased and whether any intestine has been removed during surgery. If only the last foot or two of the ileum is inflamed, the absorption of all nutrients except vitamin B-12 will probably be normal. If more than two or three feet of ileum is diseased, significant malabsorption of fat may occur. If the upper small intestine is also inflamed, the degree of malabsorption in Crohn’s disease is apt to be much worse, and deficiencies of many nutrients, minerals, and more vitamins are likely. Some IBD therapies — especially the 5-ASA medications (e.g., Asacol,® Pentasa®) — cause interference with the absorption of folate, which is essential in helping to prevent cancer and birth defects, so it should be taken in supplement form.

Should supplements be taken? If so, which ones?

Again, that depends on the extent and location of the disease. Vitamin B-12 is absorbed in the lower ileum—that means that people who have ileitis (Crohn’s disease that affects the ileum) or those who have undergone small bowel surgery may have a vitamin B-12 deficiency because they are unable to absorb enough of this vitamin from their diet or from oral supplements. To correct this deficiency—which can be determined by measuring the amount of this vitamin in the blood—a monthly intramuscular injection of vitamin B-12 may be required.

Folic acid (another B vitamin) deficiency is also quite common in patients who are on the drug sulfasalazine. For these patients, the recommended dietary allowance for a folate tablet is 1 mg daily, as a supplement. For most people with chronic IBD, it is worthwhile to take a multivitamin preparation regularly. If you suffer from maldigestion or have undergone intestinal surgery, other vitamins-particularly vitamin D-may be required. Affecting as many as 68 percent of people, vitamin D deficiency is one of the most common nutritional deficiencies seen in association with Crohn’s disease. Vitamin D is essential for good bone formation and for the metabolism of calcium.

The recommended dietary allowance for supplementation of this vitamin is in the range of 800 I.U./day, especially in the non-sunny areas of the country, and particularly for those with active disease. Together with vitamins A, E, and K, vitamin D is a fat-soluble vitamin; these tend to be less easily absorbed than water-soluble vitamins. Consequently, they may be absorbed better in liquid rather than pill form.

Are any minerals recommended?

In most IBD patients, there is no obvious lack of minerals. However, iron deficiency is fairly common in people with ulcerative colitis and Crohn’s colitis and less common in those with small intestine disease. It results from blood loss following inflammation and ulceration of the colon. Blood iron levels are easily measured, and if a deficiency is found (otherwise known as anemia), oral iron tablets or liquid may be given. The usual dose is between 8 to 27 mg, taken one to three times a day-depending on the extent of the deficiency and the patient’s tolerance. Oral iron turns the stool black, which can be mistaken for intestinal bleeding.   Other mineral deficiencies include potassium and magnesium. People may develop potassium deficiencies with diarrhea or vomiting, or as a result of prednisone therapy. Potassium supplements are available in tablet and other forms. Oral supplements of magnesium oxide may prove necessary for people who have magnesium deficiency caused by chronic diarrhea or extensive small intestinal disease, or those who have had substantial lengths of intestine removed through surgery.

Trace elements are nutrients that are absorbed in the body in minute quantities. Still, they are essential for some important biologic functions. Deficiencies in trace elements are noted in people with advanced Crohn’s disease-mainly those with poor nutritional intake and extensive small intestine disease.

¹Through my Precision Nutrition certifications I’m an affiliate member and earn a commission from Thorne Research. I’m also proud to use and offer their supplements to my friends and family members.
* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
* Information provided by article –

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