Could these vitamins, minerals, and other nutrients help you manage ulcerative colitis and your overall health?
Eating healthy is key to feeling healthy. But when you’re struggling with the abdominal cramping and pain of an ulcerative colitis flare-up, making nutritious choices isn’t always that simple.
If you limit the foods you consume to try to prevent flare-ups, your diet may be lacking certain nutrients. During a flare-up, loss of appetite, diarrhea, and an interference with the absorption of nutrients may also lead to deficiencies. Furthermore, some common medications for ulcerative colitis can deplete your vitamin and mineral levels, says Amar Naik, MD, an assistant professor and gastroenterologist at Loyola Medicine in Maywood, Ill. These factors leave many people with ulcerative colitis searching for a magic bullet to make up the difference.
“Nutritional supplements can play a role in helping you feel better and managing your symptoms,” says Kristi King, MPH, RDN, LD, senior dietitian at Texas Children’s Hospital in Houston and a spokeswoman for the Academy of Nutrition and Dietetics. However, it’s very important to work with your doctor or a nutritionist before changing your diet or trying herbal remedies for ulcerative colitis. Nutritional management and herb use are more likely to be helpful for ulcerative colitis when used in conjunction with traditional medication, she explains.
4 Big Nutritional Deficiencies to Watch Out For
People with ulcerative colitis need to be aware of the following nutrients and the potential for deficiency:
1. Vitamin D. Vitamin D deficiency is fairly common in people with ulcerative colitis, says Razvan Arsenescu, MD, PhD, an associate professor of gastroenterology, hepatology, and nutrition, and the director of the Inflammatory Bowel Disease Program at Ohio State University’s Wexner Medical Center in Columbus. Inflammation may prevent you from absorbing vitamin D from your food, he explains. Skipping dairy products, like vitamin D-fortified milk, to prevent diarrhea can also leave you short. The problem: You need D to keep your bones strong and to metabolize calcium.
What’s more, vitamin D may help protect against certain types of colon cancer, according to a study published online in January 2015 in the journal Gut. The connection between colon cancer and vitamin D needs much more research, but Dr. Arsenescu says this finding is noteworthy because ulcerative colitis increases your risk of colon cancer. Ask your doctor whether you should take vitamin D supplements.
2. Calcium. Your calcium count could be low if you’re lactose-intolerant or if you’re taking a medication that interferes with calcium absorption, such as corticosteroids, King says. “You may need to take calcium supplements to be sure you’re meeting your daily requirement,” she adds. Calcium is also important for the health of your bones, so talk to your doctor.
3. B vitamins. B vitamins are important for cell health and for making DNA and other genetic material, according to the National Institutes of Health. You may be deficient in B12 if you’ve had surgery involving your small bowel — if so, you could need monthly injections to correct this deficiency, according to the Crohn’s & Colitis Foundation of America (CCFA). And you may need folate, or folic acid, if you’re taking sulfasalazine, which can keep you from absorbing this other B vitamin properly, the CCFA explains. Too little folate can leave you feeling weak and fatigued. To help you meet your needs, folate supplements are an option, as are fortified cereals, King says.
4. Iron. Heavy bleeding due to ulcerative colitis can cause you to lose a lot of iron, Dr. Naik says. He explains that you need iron for red blood cells to carry oxygen throughout the body. An iron deficiency can leave you feeling fatigued and bring on other symptoms, such as heart palpitations. Get tested for iron deficiency, and, if needed, follow your doctor’s recommendations for an iron supplement.
Other Nutritional Supplements to Consider
According to a 2012 review of research, there are no clear-cut answers about herbal remedies for ulcerative colitis. For now, only a handful of complementary therapies show some potential merit, including:
- Omega-3 fatty acids. They may help reduce inflammation associated with ulcerative colitis, but the amount of omega-3s you need is unclear. “I tell patients it’s not going to hurt them to increase omega-3 fatty acids from fish or canola oil,” King says. Omega-3s are also available in supplement form.
- Turmeric. “This spice is potentially beneficial as an anti-inflammatory and is fairly well-tolerated,” Naik says. Research published in the journal Food & Function in 2012 suggests that curcumin, an active ingredient in turmeric, may reduce the inflammation of ulcerative colitis. But the findings are limited because they are based on animal studies and small observational studies in humans. You can add turmeric to soups, stews, chicken dishes, rice, vegetables, or roasted potatoes.
- Probiotics. In 2012,Italian researchers concluded in the Journal of Gastroenterology and Hepatology Research that VSL#3, a highly concentrated cocktail of probiotics, has been shown to be effective in the prevention of pouchitis onset and relapses. Pouchitis is the inflammation of the lining of the pouch created when people with ulcerative colitis have their colon removed. VSL#3 is available in capsule form, but other forms of probiotics — which are good-for-the-gut bacteria — can be found in yogurt and kefir.
- Chamomile and other herbs. Researchers continue to look for promising herbal alternatives. A small study published in 2013 in Alimentary Pharmacology & Therapeutics suggested that an herbal preparation of myrrh, chamomile extract, and coffee charcoal may be helpful in reducing relapse in patients with inactive ulcerative colitis. However, much more research is needed to confirm this finding.
Always Discuss What You Take With Your Doctor
It’s very important that you take a team-based approach to your diet and supplements, Naik says. Before considering any supplement, ask your doctor, “How do I know if it’s working? And will it interfere with my ulcerative colitis medications?” And remember: While some herbs and nutrients can make you feel better, they will not prevent flares or cure your disease, Naik says.