The Best Dietary Supplements for IBD

In addition to eating a nutritious diet, adding certain supplements to your wellness routine could help treat and prevent nutrient deficiencies, improve IBD-related symptoms, and benefit your overall health.

When you live with inflammatory bowel disease (IBD), a variety of factors can influence your symptoms and overall health. Maintaining a nutritious diet and taking certain supplements can make a big difference in disease activity and the way you feel.

Supplements can be helpful because people with IBD are more likely to have deficiencies in several vitamins and minerals. Plus, certain supplements can help protect your cells from oxidative damage and reduce inflammation, which tends to be high in people with IBD.

But before you take any supplements, it’s important to talk with your doctor. They may want you to have blood work done first to find out whether you have nutritional deficiencies and, if you do, to determine the right dosage of supplements for you.

If your doctor agrees, I believe the following are among the best dietary supplements that could help improve your overall health and IBD symptoms.

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B complex

People with IBD are more likely to be deficient in certain B vitamins, especially B12 and folate. Many factors contribute to this, including malabsorption (one of the hallmarks of IBD) and the use of nutrient-depleting medications such as methotrexate. Surgery and bacterial overgrowth can also be contributing factors.

People with Crohn’s disease are much more likely to be deficient in these B vitamins than people with ulcerative colitis (UC). In fact, more than 28% of people with Crohn’s have a folate deficiency, while only about 8% of people with UC do.

B vitamin deficiencies can lead to several health issues, such as increased heart disease risk, mood changes, and megaloblastic anemia.

This is why healthcare professionals recommend that people with Crohn’s and UC supplement with B vitamins to make sure they’re maintaining healthy levels of these essential nutrients.

Rather than taking a single B vitamin (such as B12), taking a B-complex supplement, which provides all eight B vitamins, can help you meet your daily vitamin needs and protect against deficiency.

Iron

If you’re living with IBD, it’s likely that you’re low in one or more minerals. Iron deficiency tops the list, affecting up to 81% of people with UC and 39% of people with Crohn’s.

Iron deficiency in people with IBD is caused by impaired iron absorption, inflammation, inadequate dietary intake, and more. Iron deficiency can make you feel awful, causing symptoms like fatigue, mood changes, cold intolerance, and shortness of breath.

Iron deficiency is usually treated with oral iron supplements. But in some cases, people with iron deficiency who cannot absorb iron from dietary supplements may need iron infusions, in which an iron solution is infused directly into a vein. Your doctor will recommend the best iron treatment based on your iron levels, health needs, and tolerance.

Several forms of iron are used in iron supplements, and some are better absorbed and less likely to cause side effects than others.

Some forms of iron, such as ferrous sulfate, may cause gastrointestinal (GI) side effects, including constipation, and aren’t as well absorbed as other types of iron.

Since you likely already experience GI symptoms due to IBD, you may want to choose bioavailable forms of iron that are easier to tolerate, such as iron bisglycinate chelate or heme iron polypeptides. Some studies also suggest that taking vitamin C along with your iron supplement may enhance iron absorption.

Magnesium

Studies show that up to 33% of people with Crohn’s disease have a magnesium deficiency.

This can negatively affect several aspects of health, including mental health, and can lead to symptoms and health complications such as anxiety, headaches, muscle cramps, and high blood pressure.

Taking a magnesium supplement can help you ensure that you’re getting enough of this essential mineral each day. Look for magnesium glycinate, a highly absorbable type of magnesium that’s less likely to cause GI side effects than other forms of magnesium, such as magnesium citrate.

Doses of magnesium vary, but the Tolerable Upper Intake Level (UL) — the maximum daily intake of a nutrient that is unlikely to cause harm — for magnesium supplements has been set at 350 milligrams (mg) per day since 1997. However, newer research suggests that higher doses are generally safe, so your doctor may recommend taking more.

Zinc

People with IBD sometimes take glucocorticoid medications, such as prednisone, for short-term treatment of flares. While these medications are effective for improving symptoms and reducing inflammation, they can reduce absorption of certain nutrients, including zinc.

IBD symptoms and side effects such as diarrhea, vomiting, and inadequate dietary intake can also contribute to low zinc levels.

Zinc is an essential mineral, which means your body needs it for many functions but cannot produce it, so you have to get it from food or supplements. Zinc plays important roles in immune function, wound healing, and protein synthesis, so it’s crucial for people with IBD to maintain healthy zinc levels.

Zinc comes in many forms, but some, such as zinc picolinate and zinc citrate, are better absorbed than other forms, like zinc oxide.

Most zinc supplements contain 15–30 mg of zinc per serving. The UL for zinc is set at 40 mg per day, so it’s best to avoid taking doses larger than 30 mg per day unless your doctor specifically recommends it.

Vitamin D

Vitamin D is one of the most common nutrient deficiencies in the world and is even more common in people with IBD. In fact, up to 70% of people with Crohn’s and up to 40% of people with UC have low levels of vitamin D.

Vitamin D is necessary for immune function, bone health, and the regulation of inflammation. The disease process of IBD contributes to low vitamin D levels, which can, in turn, increase IBD disease activity.

Doses of vitamin D vary, but people with a vitamin D deficiency (a vitamin D level lower than 20 nanograms per milliliter) often need very high doses of vitamin D to increase their levels. If you’re low or deficient in vitamin D, your doctor will recommend an appropriate dose for your needs.

Vitamin D works together with vitamin K in your body, which is why some experts recommend taking supplements containing both vitamins. Some research suggests that supplementing with vitamin D and vitamin K together may be more beneficial for promoting heart and bone health than supplementing with vitamin D alone.

Other supplements

In addition to taking the nutrients listed above, people with IBD may benefit from taking certain additional supplements that help regulate inflammation and improve digestive health, such as:

• Omega-3 fats: The omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have powerful anti-inflammatory effects. Research suggests that omega-3 supplements may help reduce disease activity, decrease inflammatory markers, and improve intestinal inflammation and overall quality of life in people with IBD.
• Probiotics: Some study results suggest that certain strains of probiotics, including Lactobacillus casei, may help improve inflammatory markers and certain symptoms, such as bloating, in people with IBD. However, more research is needed.
• Curcumin: Curcumin is the main polyphenol compound found in turmeric. Curcumin has strong antioxidant and anti-inflammatory properties. Though more research is needed, evidence suggests that supplementing with high doses of curcumin may be helpful for regulating inflammation and improving some symptoms in UC.

The takeaway

A doctor and a registered dietitian can help you develop the best supplement regimen for your specific needs, since not everyone with IBD needs or benefits from the same supplements.

In addition to adding supplements to your wellness routine, it’s important to focus on the quality of your overall eating habits, as supplements aren’t meant to take the place of a nutritious, well-rounded diet.

Eating protein-rich meals and snacks and making sure to include a variety of healthy foods in your diet is one of the best ways to care for your health and ensure that you’re getting the nutrients your body needs every day.