Supplements
*Before starting a supplement of any kind, talk to your health care professional to make sure it is appropriate for you and does not interfere with any medications.*
Everyone with IBD is different, and while I share what works for me you will need to talk to your doctor to make a plan and find what works for you and your needs.
If possible, it’s always better to get vitamins from food, but if you are deficient and needing a supplement to help be sure to take one that is third party verified. Vitamins are not like other ‘drugs’ regulated by the FDA so often there is no guarantee that what is on the label is actually in the bottle. However, if there is a third party certification sticker or a COA (Certificate of analysis) on the bottle it has been tested for purity. And 9 times out of 10 the vitamin company will put this on their bottle because it’s a valuable selling point.
There are some vitamins that can commonly be low for those with IBD. I get these checked at least twice a year. These include; Vitamin D, B12, and iron (ask for an iron panel with ferritin).
Below you can find some information about these vitamins and see my multivitamin with iron and my probiotic.
1. Vitamin D
Vitamin D plays a big role in the immune system response and can play a role in the development of autoimmune diseases. A shocking majority of Americans are vitamin D deficient. Vitamin D3 helps normal immune function and the absorption of calcium and phosphorus. You can also get Vitamin D from the sun! Try getting 15 minutes of sunlight a day. *check to make sure none of your medications require you to stay out of direct sunlight.*
2. B12
I highly recommend getting your B12 level checked if you can’t seem to shake your chronic fatigue. I have needed to get B12 shots in the past, and they made all the difference for my fatigue. Stabilizing this vitamin level was super helpful for me personally. I started with the B12 shots (done at my Dr.’s office) once every two weeks. We then were able to move to once a month when my level got closer to normal range. Once we reached a normal level I was able to take sublingual (dissolving under the tongue) tablets for a while. I have discontinued the use of them at my GI’s recommendation, but we check this level whenever we do bloodwork to make sure I don’t become deficient again.
3. Iron
Did you know that 50% of Crohn’s and Colitis patients develop iron deficiency, and 25% develop iron deficiency anemia as a result. Iron deficiency and anemia go hand in hand, but they are not always seen together. It is possible to have iron deficiency and not have developed anemia at that point in time. Iron deficiency is caused by lack of iron and red blood cells to carry oxygen to the body. This can cause severe fatigue, dizziness, chest pain, shortness of breath, cold fingers and toes, and strange cravings like dirt, clay, or ice. This deficiency is caused most commonly in IBD patients from loss of blood, as gastrointestinal bleeding generally marks active disease.
Iron deficiency can be identified with a simple blood test. Your physician can have a blood panel done that can test for hemoglobin, or they can have a blood test done that measures a substance known as ferritin which will show if you have iron deficiency. If you are not losing blood, but have the symptoms of iron deficiency your doctor can have a FOBT, or fecal occult blood test done. This will test for chemical evidence of blood, but may need to be done multiple times as blood may not be present in every sample given. Either way, the good news is that iron deficiency is easy to test for, and can be addressed with iron pills or iron IV drip. (If a lot of inflammation exists because of active disease, iron pills can add to this so discuss options accordingly with your doctor).
4. Probiotic
Most probiotics available to the public range from 10 to 100 billion bacteria per pill or serving. However, the one I take, which is made for those with UC, has 112.5 billion per capsule! Not everyone with IBD needs a probiotic. There are a few studies supporting the use of probiotics for UC, but not for Crohn’s so consult your doctor or RD (registered dietitian) to see what is best for you.