Can certain vitamins and supplements help Crohn's or colitis?

Sep 23 2014 - 7:26pm
Do vitamins or certain supplements help with Crohn's disease and colitis?

Can certain supplements help manage Crohn's disease and ulcerative colitis? There is promising research about some vitamins and supplements that are worth noting. Here is what you should know if you are diagnosed with IBD about supplements that could help or potentially harm.

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If you have been diagnosed with Crohn's disease your doctor might recommend you supplement with certain vitamins and minerals. Some vitamins or supplements are more important than others for anyone diagnosed with a type of inflammatory bowel disorder (IBD) that might also include ulcerative colitis.

Amino acids

L-glutamine has even been proposed as a treatment for Crohn's disease because it can help with symptom control, but may be best combined with the amino acid arginine.

The reason glutamine and arginine might be important is because they help calm harmful chemicals known as cytokines. Glutamine and arginine also reduces the expression of TNf-alpha, which is what medications such as Humira are designed for.

The amino acids also modulate the immune system.

One study, published in 2008 in the Journal of Nutrition, looked at biopsies from Crohn's disease patients given the amino acids, leading to the suggestion that they should also be considered as a part of liquid, or enteral therapy.

The amino acids were also found to alter gene pathways that go awry and implicated for Crohn's disease.

No studies have shown glutamine alone benefits Crohn's disease. The authors of the mentioned study found some benefit, but combined with arginine the effect was most significant.

It's important to note that the study was small. As is often the case, larger studies may not confirm the finding.

You can also get too much glutamine that ultimately converts to arginine and then helps produces nitric oxide (NO). Nitric oxide can actually damage the gut. Too much glutamine, given to rats in one study also increased harmful cytokines and inflammation, making it difficult to recommend glutamine.

Probiotics

Research is continually exploring how to make gut bacteria more 'friendly' to help treat Crohn's disease. What causes so-called bad bacteria to predominate in the gut in patients with IBD isn't yet fully understood.

One probiotic that could help manage Crohn's disease and ulcerative colitis is Saccharomyces boulardii (Sb). Specifically, the bacteria could help with diarrhea that is a constant concern for people with IBD.

One study showed the probiotic, combined with mesalamine helped prevent Crohn's symptom relapse.

Lactobacillus GG has been shown to boost immune response in a small study. The probiotic also improved health of the lining of the intestines.

Zinc

Zinc is a natural mineral that is found in the environment and our bodies. It is important for healing and is specifically used by the body to repair damaged cells in the intestines.

Drugs used for treating Crohn's disease including sulfasalazine can cause zinc levels to decline, meaning you may need a supplement.

Though zinc is not a cure for Crohn's symptoms, if your levels are low you're likely to have more problems with inflammation and intestinal healing. Ask your doctor if you need a supplement.

It's important to know you can also get too much zinc that can suppress the immune system. Zinc is an immune system booster, but only in the right amounts.

Omega-3 fatty acids

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It makes sense to try to eat food that contain omega-3 fatty acids because they are anti-inflammatory. Omega-3s are especially found in fish and fish-oil supplements. Studies however are mixed about whether fish oil can help with Crohn's disease.

Some foods promote inflammation. such as processed and red meats, though some people with IBD tolerate certain foods much better than others. Whether you can eat red meat without experiencing a Crohn's flare may depend on many factors. Still, there is much evidence that red meat, especially the processed kind, can lead to a variety of diseases.

Earlier this year I interviewed Dr. Barry Sears, creator of the Zone diet. Dr. Sears also noted there are not consistent studies showing fish oil benefits for Crohn's disease, but in his opinion it may be because the dosing was too low.

The best way to know if you are getting the right amount of fish oil to help manage IBD is by having a blood test known as an AA/EPA ratio.

Taking anti-inflammatory fish oil could eventually mean fewer medications for Crohn's treatment,Sears said.

“In summary, by following an anti-inflammatory diet like the Zone Diet coupled with high levels of omega-3 fatty acids and polyphenols can work at the molecular level to enhance the actions of currently used drugs suggesting that the levels of drugs can be significantly reduced since the molecular targets of both are the same."

You would want to speak with your doctor about any supplements you wish to try for Crohns disease or ulcerative colitis. Fish oil intake may need to be as high as 5 to 10 grams a day, according to Dr. Sears.

Turmeric

Taking a turmeric supplement or cooking with the Indian spice is a natural way to help quell inflammation. Studies showing that curcumin, the bioactive ingredient in turmeric, could help Crohn's and UC are encouraging, but unfortunately curcumin is poorly absorbed.

Most studies use a non-commercial form of curcumin that can't be purchased. Piperine that is the main ingredient in pepper is shown to help increase turmeric absorption.

Multi-vitamin

Taking a multi-vitamin is generally recommended if you have Crohn's or colitis. IBD can interfere with absorption of nutrients. Check with your doctor about which multi-vitamin that should also contain minerals might be right for you.

There is still much we don't know about supplements that can help with Crohn's and colitis. Some studies show benefit from taking fish oil, glutamine and arginine and zinc, but too much of any supplement can lead to worsening symptoms and may not work for everyone.

Resources:
Crohns.net
University of Maryland Medical Center

MayoClinic.org

References:

Plein K, Hotz J. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn’s disease with special respect to chronic diarrhea -- a pilot study. Z Gastroenterol 1993;31:129-134.

Plein K, Hotz J. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn’s disease with special respect to chronic diarrhea -- a pilot study. Z Gastroenterol 1993;31:129-134.

PubMed
"Curcumin for inflammatory bowel disease: A review of human studies"

"N-3 polyunsaturated fatty acid diet therapy for patients with inflammatory bowel disease"
Inflamm Bowel Dis. 2010 Oct;16(10):1696-707. doi: 10.1002/ibd.21251.
Uchiyama K, et al.

"Dietary conjugated linoleic acid and n-3 polyunsaturated fatty acids in inflammatory bowel disease"
Curr Opin Clin Nutr Metab Care. 2010 Sep;13(5):569-73. doi: 10.1097/MCO.0b013e32833b648e.
Bassaganya-Riera J, Hontecillas R.

Image credit: Pixabay

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