This week, I wanted to chat about some of the most common nutritional deficiencies IBD patients face. Deficiencies are a common part of living with Crohn’s Disease and are often caused by malnutrition: in other words, our body not being able to absorb nutrients properly from our food.They can also be caused by taking certain medication (such as steroids) or lack of variation in the diet due to food restrictions.
Often people ask me about adrenal fatigue (more on this in this blog post), and my advice is to always get checked for potential deficiencies before looking at other pathways (such as adrenal fatigue).
Today, I wanted to talk about some of the most common deficiencies with IBD, their symptoms and how to resolve them. I have also shared the supplements I’ve personally tried for these deficiencies; which may be helpful!
1. Vitamin D
What is it? Vitamin D is nicknamed the ‘sunshine’ vitamin as our body synthesises it from the sun itself. We can get some vitamin D through our food (for example, by tucking into wild salmon and eggs) but it isn’t absorbable as through the sun.
Because of this, the NHS advises that almost all of us would benefit from supplementing this vitamin in the cold winter months.
Why do IBD patients suffer from deficiencies?
One reason, Vitamin D is a fat-soluble vitamin; meaning your digestive tract needs to be able to properly absorb fat to fully absorb vitamin D. If your gut is not able to digest fat adequately, it makes sense it might struggle with Vit D too.
We may also need more of this than others since Vitamin D also works to lower TNF in the body targeting inflammation. Therefore, it’s thought IBD patients might need more Vitamin D than others to manage inflammation levels.
Crohn’s Colitis UK suggests that IBD patients who are deficient in vitamin D (estimated at least 30% of us) need more steroids and have almost double the chance of surgery than IBD patients who aren’t deficient; suggesting it is linked to disease activity.
Learn more: Read my complete guide to Vitamin D and IBD.
Supplement it: I have tried many different vitamin D supplements so thought I’d share what has helped me.
I started out with Better You’s DLux 3000 vitamin D spray. I’ve spoken before how their transdermal sprays are great as they’re easier to digest than a tablet.
However, I found the large dosage to upset my stomach (especially when my levels were only slightly low) so I switched to Heath Spark Curcumin complex since it contained turmeric and vitamin D. However, the vitamin D is a much lower dose, so I think it depends on how deficient you are!
What is it? Vitamin B12 is an important vitamin that helps with many of our body’s functions. Without it, our body can product abnormally sized red blood cells; meaning they can’t carry blood around the body efficiently-this can lead to anaemia and extreme fatigue.
Why do patients suffer from deficiencies?
This vitamin is actually absorbed and synthesised in our terminal ileum. If there is disease activity in this area, patients may not be able to absorb the vitamin fully. This can also link to low levels of stomach acid which I have blogged about here.
Also, patients who have surgery are likely to not able to properly absorb Vitamin D and may need regular injections.
Supplement It: I’ve been lucky that I have never had low levels of Vitamin B12 myself, but if it’s severe; it is likely your doctor will offer you a B12 injection to quickly top of your levels. If it’s not severe, I would again recommend looking into Better You- they offer a B12 Oral Spray
What is it? Iron is arguably one of the most common nutritional deficiencies and one that I probably don’t need to explain to you. Iron is found in our red blood cells as haemoglobin; a substance that carries oxygen around the body. A lack of iron leads to anaemia-the symptoms of which include fatigue and shortness of breath.
Why do patients suffer from deficiencies? IBD Patients can lose blood through internal bleeding (even if you don’t notice it in your stools).
Supplement It: I have previously had an iron infusion as taking tablets does not agree with me. Now it is stable, I’ll regularly use Spatone iron water, which is a very gentle form of iron and much kinder to your digestion (but doesn’t contain as much as prescribed supplements). You can also get a version of with added vitamin C which can help your body absorb more of the iron.
What is it? Magnesium is an important electrolyte that helps with many things-such as supporting our muscles and energy levels. Magnesium deficiency is becoming more common as we drink less tap water (which contains it) and our soils aren’t as rich in it as they used to be. When we’re stressed, our magnesium levels can also be depleted.
Why do IBD patients suffer from deficiencies?
It’s thought the state of our gut plays a big role in how much magnesium we have as it is absorbed in the intestines and then transported through the blood to cells and tissues. In turn, those of us with chronic diarrhoea often have low levels of Magnesium too as if we are dehydrated and have constant diarrhoea, our electrolytes are often flushed out of the body: leaving us susceptible to both magnesium and potassium deficiency.
Read more: Read my complete guide to Magnesium deficiency and IBD.
Supplement it: I don’t use a supplement but I do sometimes add magnesium salts to my bath; which can be an effective way to top up your levels. I also asked my doctor to check my Magnesium levels.
What is it? Calcium is an important mineral which helps with strong bones and teeth (amongst many other functions).
Why do patients suffer from deficiencies? Lots of patients can have low levels of calcium due to steroid intake, which depletes the levels of this mineral. Low calcium levels are common with many autoimmune diseases due to malnutrition.
This is the only nutrient I haven’t tried supplementing myself because I am a rare Crohn’s entity who has not taken steroids. Often, your doctor will prescribe a supplement to take alongside steroid treatment.
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