If you limit the foods you consume to avoid flares, your diet may be lacking certain nutrients. During a flare-up, loss of appetite, diarrhea, and 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, Illinois. 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, RDN, a senior dietitian at Texas Children’s Hospital in Houston. However, it’s very important to work with your doctor or 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.
1. Vitamin D
Vitamin D deficiency is fairly common in people with ulcerative colitis, says Razvan Arsenescu, MD, PhD, a codirector of the Inflammatory Bowel Diseases Center at Morristown Medical Center in Morristown, New Jersey. A study published in March 2021 in Revista Médica de Chile found that 75 percent of participants with inflammatory bowel disease had either insufficient or poor vitamin D levels. Inflammation may prevent you from absorbing vitamin D from your food, Dr. Arsenescu 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 your mental health, according to a review published in October 2021 in Nutrients . Across all the studies analyzed, reviewers saw that vitamin D supplementation helped improve mood while reducing anxiety and depression.
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.
4. Iron
Heavy bleeding due to ulcerative colitis can cause you to lose a lot of iron, Dr. Naik says. 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 treating both ulcerative colitis and iron deficiency.
Nutritional Supplements to Consider for Ulcerative Colitis
The most recent clinical guidelines for the treatment of ulcerative colitis say there are no clear-cut answers about complementary therapies. For now, only a handful show some potential merit:
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.Curcumin “This spice is potentially beneficial as an anti-inflammatory and is fairly well-tolerated,” Naik says. Research published in January 2020 in the Annals of Gastroenterology found that curcumin, an active ingredient in tumeric, given alongside mesalamine therapy, was linked to a 3 times greater likelihood of benefit from the treatment. Despite the limited findings, curcumin does have anti-inflammatory properties that may help some patients. You can add turmeric to soups, stews, chicken dishes, rice, vegetables, or roasted potatoes.Probiotics The clinical guidelines for ulcerative colitis have looked at probiotics with skepticism, since their efficacy is not proven and not all strains sold in a supermarket are the same. However, technology and our understanding of gut bacteria has improved, paving the way for targeted probiotic supplements meant to be taken as complement to traditional medicine. A study published in October 2021 in the Journal of Clinical Medicine found that the unique formulation of a product called FEEDColon helped patients maintain remission. Other Herbs Researchers continue to look for promising herbal alternatives. A study published in December 2018 in the American Journal of Translational Research found that the menthol in peppermint helped improve ulcers and lower both oxidative stress and inflammation in rats. Other small studies have found 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 these findings.
Should I Discuss Supplements With My 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. Additional reporting by Jordan M. Davidson.
