During flares of your Crohn’s disease, you may not be able to eat much healthy food. That means your body won’t be getting enough healthy nutrition. When you don’t get enough of certain vitamins and minerals, your doctor might say you have a deficiency. Supplements can help. And your doctor can tell you which ones you need, based on how Crohn's affects your body and which drugs you take.
Crohn’s and Your Body
Your condition can make you feel sick and tired because you can’t eat the right foods. It may affect how your medication works, too, and it can stop kids from growing normally.
You may not get enough nutrients because:
Your gut is inflamed or damaged. It's hard to absorb carbohydrates, fats, water, and vitamins and minerals. Surgery for Crohn's can also cause this problem if too much of your small intestine is removed.
You don’t want to eat. This can happen because of pain, diarrhea, anxiety, and changes in taste.
You take prescription medication for Crohn’s. Some drugs make it harder to absorb nutrients.
You’re bleeding inside your body. The damage to your intestines can cause blood loss over time. This could lower your iron levels and lead to anemia.
Nutrients You May Miss
With Crohn's, you’re more likely to have lower levels of:
1. Vitamin B12
If you have inflammation or have had surgery in the lower part of your small intestine, you may not absorb enough of this. Your doctor may prescribe shots or pills.
Food sources of vitamin B12
- Beef: Beef liver, ground beef, top sirloin
- Dairy: Cheese, low-fat milk, yogurt,
- Fish and seafood: Clams, haddock, salmon, trout, tuna
- Poultry: Chicken
2. Folic Acid
Some Crohn's drugs, like methotrexate and sulfasalazine, lower your body’s levels of folic acid. Your doctor may have you take a folate supplement.
Food sources of folate and folic acid:
- Beef: Beef liver, ground beef
- Fish and seafood: Dungeness crab, halibut
- Fruit: Banana, cantaloupe, papaya
- Poultry: Chicken
- Veggies: Asparagus, avocado, black eyed peas, broccoli, Brussels sprouts, green peas, kidney beans, mustard greens, spinach, turnip greens
3. Calcium
Steroids for Crohn's disease can weaken your bones. If your body can't digest milk or milk products, you're even more likely to be short on calcium. Your doctor may tell you to take supplements to keep your bones strong and prevent other problems.
Food sources of calcium:
- Dairy: Cheese, cottage cheese, ice cream, milk, sour cream, yogurt
- Fish: Salmon, sardines
- Veggies: Bok choy, broccoli, kale, turnip greens
4. Vitamin D
It helps your body absorb calcium for strong bones, but people with Crohn's disease often don’t have enough. Your doctor may tell you to take a daily supplement.
Food sources of vitamin D:
- Cereal: Vitamin D fortified
- Dairy: Milk (nonfat, reduced-fat and whole -- vitamin D fortified), Swiss cheese
- Fish: salmon, sardines, swordfish, tuna
- Meat: Liver
- Orange juice: Vitamin D fortified
5. Vitamins A, E, and K
Surgery on your intestines can make it hard for your body to absorb fats. That lowers your levels of these vitamins.
Food sources of vitamin A
- Eggs
- Fruit: Apricots, cantaloupe, mangos
- Fish and poultry: Chicken, herring, Sockeye salmon, tuna
- Dairy: Ice cream, fat-free or skim milk with vitamin A, ricotta cheese, yogurt
- Veggies: Baked beans, black-eyed peas, carrots, spinach, summer squash, sweet peppers, sweet potatoes
Food sources of vitamin E
- Fruit: Kiwi, mango
- Nuts and nut butters: peanuts, almonds, hazelnuts, peanut butter
- Oils: corn oil, safflower oil, soybean oil, sunflower oil, wheat germ oil
- Veggies: broccoli, spinach, tomato
Food sources of vitamin K
- Beef and pork: Ground beef, ham
- Dairy: 2% milk, cheddar cheese, mozzarella cheese
- Fruit: Blueberries, grapes, pomegranate
- Fish, seafood, and poultry: Chicken breast, chicken liver, shrimp, sockeye salmon
- Veggies: Broccoli, carrots, collards, edamame, figs, kale, okra, spinach, turnip greens
6. Iron
Inflammation from your Crohn’s may keep your body from using iron as well as it should. And blood loss from ulcers may cause you to lose iron. In either case, your doctor may tell you to take iron tablets, liquid, or infusions.
Food sources of iron
- Dairy: Cheddar cheese, cottage cheese, milk
- Fish, seafood, and poultry: Chicken, oysters, sardines, turkey
- Fruits: Cantaloupe, raisins
- Nuts: Cashews, pistachios
- Veggies: Broccoli, chickpeas, green peas, kidney beans, lentils, mushrooms, potatoes, rice, spinach, tomatoes, white beans
7. Potassium, magnesium, and zinc
Your doctor may suggest a daily supplement to raise your levels.
Food sources of potassium
- Dairy: Cheese, soymilk, yogurt
- Fruits: Apple, apricot, banana, cantaloupe, prunes, raisins
- Beef: Sirloin
- Fish, seafood, and poultry: Chicken, salmon, tuna,
- Oil: Canola, corn, olive
- Veggies: Acorn squash, asparagus broccoli, kidney beans, potato, soy beans, spinach, tomato
Food sources of magnesium
- Dairy: Part skim mozzarella, soymilk, yogurt
- Fruits: Apple, banana, raisins
- Nuts: Almonds, cashews, peanuts, peanut butter
- Beef: Ground beef
- Fish, seafood, and poultry: Chicken, halibut, salmon
- Dairy: Milk, yogurt
- Veggies: Avocado, black beans, broccoli, carrots, edamame, kidney beans, potato, spinach
Food sources of zinc
- Beef and pork: Beef chuck roast, pork chop
- Dairy: Cheddar cheese, mozzarella cheese, low-fat or nonfat milk, Swiss cheese, yogurt
- Fish, seafood, and poultry: crab, dark meat chicken, flounder, lobster, oysters, sole
- Nuts: Almonds, cashews
- Veggies: Baked beans, chickpeas, green peas, kidney beans
Foods or Supplements?
Almost any diet expert will tell you it's better to get vitamins and minerals from foods than from a pill. But if you have Crohn's disease, damage to parts of your intestines makes it harder to absorb or get enough of the nutrients you need. Certain healthy foods, like high-fiber nuts and seeds, may trigger symptoms.
Crohn's -- especially when it's active -- can make your body work harder, too. So you may need more calories and nutrients than other people. In these cases, supplements can help fill the gaps.
Work With Your Doctor
Don't make the supplements decision by yourself. Talk to your doctor first. While they can help you be better nourished, some can affect the way your Crohn's drugs work or make your symptoms worse.
Your doctor may want to test your levels of iron, vitamin D, vitamin B12, and other vitamins and minerals. What you need may also depend on where the damage is in your intestines.
Together, you can decide which supplements could help you feel better.
Show Sources
Photo Credit: Jon Larson / Getty Images
SOURCES:
ASPEN Nutrition Support Patient Education Manual: "Nutrition and Crohn's Disease."
Beth Israel Deaconess Medical Center: "What Are the Complications of Crohn's Disease?"
Crohn's and Colitis Foundation of America: "Complementary and Alternative Medicine (CAM)," "Diet and Nutrition," "Vitamin and Mineral Supplementation."
Medscape: "Vitamin D Intake Associated with Reduced Risk of Crohn's Disease."
National Digestive Diseases Information Clearinghouse: "Ulcerative Colitis."
National Institutes of Health: “Vitamin B12,” “Calcium,” “Folate,” “Iron,” “Magnesium,” “Potassium,” “Vitamin A,” “Vitamin D,” “Vitamin E,” “Vitamin K,” “Zinc.”
