Crohn's disease affects about 120,000 people in Britain. It is a chronic inflammatory disease, which can affect the whole of the alimentary tract from mouth to anus. The most commonly affected sites are the lower part of the small intestine and the first part of the large intestine.
The damage the disease itself causes to the digestive tract as well as the damage done by surgery and medication used to treat it make it hard for the body to absorb nutrients. This means that sufferers should be aware of shortages in vitamins and minerals in their body and address it by dietary changes or supplementation.
Here are a list of 10 vitamins you may need if you have Crohn's disease:
Crohn's disease can cause bleeding in the intestines resulting in a loss of hemoglobin, which are red blood cells carrying lots of iron, and anemia which is a red blood cell deficiency.
Fatigue, headaches and pale skin are all signs of anemia. To address this deficiency, iron can be taken as a supplement, 8 to 27 milligrams one to three times a day is recommended.
Crohn's disease can damage the ileum, the lower part of the intestine required for vitamin B12 absorption. Sometimes portions of the ileum have to be surgically removed.
Symptoms of B12 deficiency include weakness, fatigue and light headedness. In severe cases it can damage nerves which in turn causes tingling or numbness in the fingers and toes and difficulty walking.
Depending on the level of deficiency, B12 supplementation may not be enough in which case a B12 injection will be needed from you GP.
Folic acid Folic acid is another B vitamin
and it is essential for forming new cells. Some drugs used to treat Crohn's can cause iron deficiencies so be aware of this side effect and supplement your diet daily with iron if required.
People suffering from Crohn's disease often have a calcium deficiency because their bodies cannot absorb the nutrient, this is compounded by the fact that lactose intolerance (an inability to digest calcium rich dairy foods) is extremely common. Treatment with corticosteroids also deplete the body of calcium as well as having persistent active inflammation.
This type of deficiency increases the risk of early onset osteoporosis, therefore Crohn's disease sufferers benefit from being on calcium and vitamin D supplementation to keep their bones strong.
Diarrhoea is a major feature of inflammatory bowel disease and is a defence mechanism of the body in response to inflammation and infection. Sufferers with excessive, watery diarrhea can find their bodies deprived of magnesium and potassium.
Magnesium is critical for a variety of body processes, including keeping the heart, muscles, and kidneys in good working order. Symptoms of a deficiency can include anxiety, difficulty sleeping, nausea and vomiting and restless legs syndrome.
Diarrhoea also depletes the body of it's zinc reserves especially if the bout is prolonged. While the deficiency is rare, it can cause loss of appetite and compromise the immune system.
Note, children with Crohn's are at a greater risk of zinc deficiency which can in turn result in slowed growth.
People whose lower intestines have been damaged or removed due to Crohn's disease may have difficulty absorbing vitamin A. More commonly, though, deficiencies may occur if Crohn's has resulted in any obstruction of the intestine. The ileum usually has a small population of bacteria but when the intestine is blocked fluid can stagnate, causing bacteria to flourish. Subsequently, the bacteria will compete for and consume vitamin A leading to a deficiency in the body.
A large proportion of Crohn's sufferers will have a vitamin D deficiency, often resulting in bone pain and muscle weakness.
A small study of 15 people conducted by researchers from Weill-Cornell Medical Centre in New York gave participants either a low dose (1,000 International Units) of the vitamin or a high dose (10,000IU), those given the high dose had less symptoms after six months.The researchers concluded:
"Our interim analysis suggests that supplementation with 10,000 IU of Vitamin D3 may be an effective adjunctive therapy for ameliorating symptoms in Crohn's disease patients."
The results were presented at the annual conference of the American College of Gastroenterology.
Crohn's disease affects about 120,000 people in Britain. Higher incidence rates are found in countries closer the poles, leading to the theory that lack of exposure to UV light - essential for our bodies to manufacture vitamin D - is a cause.
Vitamin D is difficult to obtain from food but can be obtained by way of a supplement. Dr. Nirmal Kaur, MD, medical director of the Inflammatory Bowel Disease Center, says "Every patient who has inflammatory bowel disease should have a vitamin D level checked at least annually and supplemented as needed."
Damage to the ileum makes it difficult for the body to absorb vitamin E, known for its antioxidant properties. Symptoms of vitamin E deficiency includes tingling and numbness in the fingers and toes (known as peripheral neuropathy) and muscle weakness.
Vitamin E can be found in nuts, seeds, vegetable oils, green leafy vegetables, and fortified cereals. But people with Crohn's may need water-soluble forms of vitamin E.
Like vitamins A, D, and E, vitamin K is a fat-soluble vitamin meaning it is less easily absorbed than water-soluble vitamins such as B and C. This makes people with Crohn's disease especially vulnerable to vitamin K (along with A, D, and E) deficiencies.
Vitamin K is essential for blood clotting and possibly also to maintain strong bones. You can find it in green leafy vegetables as well as in fish, liver, meat, and eggs.