During flares of your Crohn’s disease, you may not be able to eat much healthy food. That means your body won’t be getting enough healthy nutrition. When you don’t get enough of certain vitamins and minerals, your doctor might say you have a deficiency. Supplements can help. And your doctor can tell you which ones you need, based on how Crohn’s affects your body and which drugs you take.
Crohn’s and Your Body
Your condition can make you feel sick and tired because you can’t eat the right foods. It may affect how your medication works, too, and it can stop kids from growing normally.
You may not get enough nutrients because:
Your gut is inflamed or damaged. It’s hard to absorb carbohydrates, fats, water, and vitamins and minerals. Surgery for Crohn’s can also cause this problem if too much of your small intestine is removed.
You don’t want to eat. This can happen because of pain, diarrhea, anxiety, and changes in taste.
You take prescription medication for Crohn’s. Some drugs make it harder to absorb nutrients.
You’re bleeding inside your body. The damage to your intestines can cause blood loss over time. This could lower your iron levels and lead to anemia.
Nutrients You May Miss
With Crohn’s, you’re more likely to have lower levels of:
1. Vitamin B12
If you have inflammation or have had surgery in the lower part of your small intestine, you may not absorb enough of this. Your doctor may prescribe shots or pills
Food sources of vitamin B12
- Beef: Beef liver, ground beef, top sirloin
- Dairy: Cheese, low-fat milk, yogurt,
- Fish and seafood: Clams, haddock, salmon, trout, tuna
- Poultry: Chicken
2. Folic Acid
Some Crohn’s drugs, like methotrexate and sulfasalazine, lower your body’s levels of folic acid. Your doctor may have you take a folate supplement.
Food sources of folate and folic acid:
- Beef: Beef liver, ground beef
- Fish and seafood: Dungeness crab, halibut
- Fruit: Banana, cantaloupe, papaya
- Poultry: Chicken
- Veggies: Asparagus, avocado, black-eyed peas, broccoli, Brussels sprouts, green peas, kidney beans, mustard greens, spinach, turnip greens
Steroids for Crohn’s disease can weaken your bones. If your body can’t digest milk or milk products, you’re even more likely to be short on calcium. Your doctor may tell you to take supplements to keep your bones strong and prevent other problems
Food sources of calcium:
- Dairy: Cheese, cottage cheese, ice cream, milk, sour cream, yogurt
- Fish: Salmon, sardines
- Veggies: Bok choy, broccoli, kale, turnip greens
4. Vitamin D
It helps your body absorb calcium for strong bones, but people with Crohn’s disease often don’t have enough. Your doctor may tell you to take a daily supplement.
Food sources of vitamin D:
- Cereal: Vitamin D fortified
- Dairy: Milk (nonfat, reduced-fat and whole — vitamin D fortified), Swiss cheese
- Fish: salmon, sardines, swordfish, tuna
- Meat: Liver
- Orange juice: Vitamin D fortified
5. Vitamins A, E, and K
Surgery on your intestines can make it hard for your body to absorb fats. That lowers your levels of these vitamins.
- Food sources of vitamin A
- Fruit: Apricots, cantaloupe, mangos
- Fish and poultry: Chicken, herring, Sockeye salmon, tuna
- Dairy: Ice cream, fat-free or skim milk with vitamin A, ricotta cheese, yogurt
- Veggies: Baked beans, black-eyed peas, carrots, spinach, summer squash, sweet peppers, sweet potatoes
Food sources of vitamin E
- Fruit: Kiwi, mango
- Nuts and nut butter: peanuts, almonds, hazelnuts, peanut butter
- Oils: corn oil, safflower oil, soybean oil, sunflower oil, wheat germ oil
- Veggies: broccoli, spinach, tomato
Food sources of vitamin K
- Beef and pork: Ground beef, ham
- Dairy: 2% milk, cheddar cheese, mozzarella cheese
- Fruit: Blueberries, grapes, pomegranate
- Fish, seafood, and poultry: Chicken breast, chicken liver, shrimp, sockeye salmon
- Veggies: Broccoli, carrots, collards, edamame, figs, kale, okra, spinach, turnip greens
Inflammation from your Crohn’s may keep your body from using iron as well as it should. And blood loss from ulcers may cause you to lose iron. In either case, your doctor may tell you to take iron tablets, liquid, or infusions.
Food sources of iron
- Dairy: Cheddar cheese, cottage cheese, milk
- Fish, seafood, and poultry: Chicken, oysters, sardines, turkey
- Fruits: Cantaloupe, raisins
- Nuts: Cashews, pistachios
- Veggies: Broccoli, chickpeas, green peas, kidney beans, lentils, mushrooms, potatoes, rice, spinach, tomatoes, white beans
7. Potassium, magnesium, and zinc
Your doctor may suggest a daily supplement to raise your levels.
Food sources of potassium
- Dairy: Cheese, soymilk, yogurt
- Fruits: Apple, apricot, banana, cantaloupe, prunes, raisins
- Beef: Sirloin
- Fish, seafood, and poultry: Chicken, salmon, tuna,
- Oil: Canola, corn, olive
- Veggies: Acorn squash, asparagus broccoli, kidney beans, potato, soybeans, spinach, tomato
Food sources of magnesium
- Dairy: Part-skim mozzarella, soymilk, yogurt
- Fruits: Apple, banana, raisins
- Nuts: Almonds, cashews, peanuts, peanut butter
- Beef: Ground beef
- Fish, seafood, and poultry: Chicken, halibut, salmon
- Dairy: Milk, yogurt
- Veggies: Avocado, black beans, broccoli, carrots, edamame, kidney beans, potato, spinach
Food sources of zinc
- Beef and pork: Beef chuck roast, pork chop
- Dairy: Cheddar cheese, mozzarella cheese, low-fat or nonfat milk, Swiss cheese, yogurt
- Fish, seafood, and poultry: crab, dark meat chicken, flounder, lobster, oysters, sole
- Nuts: Almonds, cashews
- Veggies: Baked beans, chickpeas, green peas, kidney beans
Foods or Supplements?
Almost any diet expert will tell you it’s better to get vitamins and minerals from foods than from a pill. But if you have Crohn’s disease, damage to parts of your intestines makes it harder to absorb or get enough of the nutrients you need. Certain healthy foods, like high-fiber nuts and seeds, may trigger symptoms.
Crohn’s — especially when it’s active — can make your body work harder, too. So you may need more calories and nutrients than other people. In these cases, supplements can help fill the gaps.
Work With Your Doctor
Don’t make the supplements decision by yourself. Talk to your doctor first. While they can help you be better nourished, some can affect the way your Crohn’s drugs work or make your symptoms worse.
Your doctor may want to test your levels of iron, vitamin D, vitamin B12, and other vitamins and minerals. What you need may also depend on where the damage is in your intestines.
Together, you can decide which supplements could help you feel better.
SUPPLEMENT VITAMIN B12
Health benefits of vitamin B12
B12 plays a crucial role in the body’s formation of red blood cells and neurological functioning. Therefore, it can boost overall health in a variety of ways and here are five of them:
1. Helps form red blood cells
Red blood cells carry oxygen from our lungs to tissues throughout our body. They also carry carbon dioxide — a toxic by-product of cell functioning — from those tissues back to the lungs where it’s then expelled.
“Vitamin B12 participates in the production of red blood cells,” says Vikram Tarugu, MD, a gastroenterologist and CEO of Detox of South Florida. “If the rates of vitamin B12 are too poor, red blood cell output is impaired, inducing megaloblastic anemia.”
Megaloblastic anemia refers to anemia — a lack of red blood cells — specifically caused by lack of B12. It “causes symptoms like fatigue, difficulty concentrating, clumsiness, and dry skin,” says Megan Wong, a registered dietitian at AlgaeCal, a company providing information on bone health.
While there are other reasons a person may develop anemia, such as excessive bleeding or low iron, maintaining healthy levels of vitamin B12 is one way to prevent it.
2. Might prevent dementia
Another benefit of vitamin B12 is that it can slow brain atrophy in the elderly. Brain atrophy means an overall shrinkage in brain volume and also a loss of neurons, which can cause diseases like Parkinson’s and Alzheimer’s making it difficult to function independently in society.
A 2008 study published by the American Academy of Neurology with 107 participants over 61-years-old, found that the brain volume lost over five years was greater for people with lower B12 levels in the blood.
“Vitamin B12 is crucial for a well-functioning brain and nervous system. Its role in the brain is so important that research suggests vitamin B12 might play a role in preventing dementia,” says Wong.
However, there’s no evidence that B12 supplements improve memory loss in those who are already suffering from Alzheimer’s disease.
3. May improve mood and symptoms of depression
There is still debate over the extent of its impact, but research has shown a connection between vitamin B12 deficiency and neuropsychiatric manifestations. These include depression, obsessive compulsive disorder (OCD), and mood swings.
“Vitamin B12 is required for serotonin development, which is a chemical that controls mood,” says Tarugu. This link has led researchers to encourage vitamin B12 supplements as part of treatment plans for those with depression.
For example, in a study of 199 depressed individuals, 100% of those treated with antidepressants as well as injected vitamin B12 improved by at least 20%. Only 69% of people treated with antidepressants and not B12 reported similar improvements.
4. May prevent birth defects
People who are pregnant have a higher recommended dose of vitamin B12. That’s because the compound may help prevent severe birth defects like partial paralysis and an undeveloped skull. “Adequate amounts of vitamin B12 are important for a successful pregnancy,” says Tarugu.
If someone with low levels of B12 becomes pregnant, they have a greater chance of giving birth to a child with neural tube defect. This class of birth defects includes anencephaly, a fatal condition where the baby’s brain and skull are severely underdeveloped. Along with maintaining proper vitamin B12 levels, taking folic acid before and after conception can decrease the chances of a baby having neural tube defects.
5. Supports healthy hair, skin, and nails
“However, if your [B12] levels are already adequate, consuming a supplement probably won’t boost your health in those regions,” he says.
If you do have a vitamin B12 deficiency, it may manifest as vitiligo — a condition in which the skin has discolored patches, slower hair growth, or skin hyperpigmentation. In this case, adding vitamin B12 to your diet or taking a supplement may improve the condition.
The amount of vitamin B12 a person needs steadily increases as they age.
“The best food sources [of B12] are meat, poultry, eggs, dairy, fish, and fortified cereals,” says Wong.
B12 can be supplemented in four ways, says Taylor Graber, MD, physician and owner of ASAP IVs, a mobile IV hydration and wellness company:
- Orally, through eating foods rich in vitamin B12
- Taking a B12 supplement
- Injected into the muscle
- Through an IV drip
As vitamin B12 is found naturally in animal-based food products, vegetarians and vegans may not get enough of it in their diet and require supplements. Medical conditions may also require a person to seek out additional amounts of the vitamin.
Vitamin B12 deficiency symptoms and causes
Between 1.5% and 15% of the general population is vitamin B12 deficient. Symptoms of vitamin B12 deficiency include megaloblastic anemia — in which abnormally sized or immature red blood cells are produced — weight loss, weakness, neurological changes like memory loss and depression, as well as fatigue.
Your small intestine helps absorb B12 with help from a substance secreted by the stomach known as intrinsic factor. This makes people with certain health conditions more susceptible to B12 deficiency.
“Without intrinsic factor, the free vitamin B12 in the digestive tract is unable to be absorbed,” says Graber. “Deficiencies of this glycoprotein, or a shortening of the small intestine where the B12 is absorbed, can lead to an inadequate amount of dietary vitamin B12.”
Vitamin B12 is a water-soluble vitamin meaning that your body only absorbs necessary amounts of B12, with the rest flushing out through your urine. That said, there can still be side effects of excess intake. These symptoms include headaches, anxiety, and nausea.
Vitamin supplements, such as B12, have previously been reported to interact with medicines and supplements, like colchicine and vitamin C supplements. Therefore, always consult your doctor before starting a new supplement or diet
Udo’s Choice® Ultimate Oil Blend
Great performance and good recovery practices go hand-in-hand. Trevor Woods reveals his ultimate tips for performing at your best.
The key to optimising your training response is mastering your recovery. There are two critical practices that must not be neglected – sleep and nutrition. If an athlete is not optimising these two ‘recovery pillars’, other accessory techniques will have minimal benefit.
Studies show getting the right quality and quantity of sleep leads to increased performance and mental well-being in athletes. It is also known that chronic sleep debt impairs performance, bothphysical and mental. How many hours do we need, this varies, but common advice is to aim for 8–10 hours per night? In addition to sleep duration, sleep quality and sleep phase also affect the regenerative qualities of sleep. Exercising late in the day can make it difficult to get a good night’s sleep, and following up an intense evening session with inadequate sleep is far from ideal. Athletes losing sleep after these evening sessions are advised to switch their intense training to the morning and focus evening training time on lower intensity activities such as yoga, stretching, and massage.
For athletes training 2-3 times per week, following a healthy daily nutrition plan focused on whole foods is generally sufficient for optimal recovery before the next training session. But for those training once per day or more, refuelling promptly for the next session is critical.
Refuelling appropriately on a consistent basis after workouts will restore muscle and liver glycogen stores, replace fluid and electrolytes lost in sweat, promote muscle repair and bolster the immune system.
Immediately on finishing a workout, start replacing fluid and electrolyte losses with a sodium containing drink or water plus sodium containing food. To restore muscle glycogen and promoteprotein synthesis, consume 0.8g per kg of body weight of carbohydrate and 0.2g per kg of body weight of protein within 30 minutes of finishing exercise.
A homemade smoothie is a good option using fruit, milk, natural yogurt and/or water, and the addition of Udo’s Choice Beyond Greens will give an additional nutrient boost of B12, iron, calcium and protein from rich green foods.
Additionally, antioxidants such as vitamin C and vitamin A, and microbiotics are good additions to a recovery drink or snack, so try adding some One Nutrition Spirulina, or Udo’s Choice Super 8. In the hours post-exercise continue your recovery by eating a healthy whole foods meal. This meal should contain a combination of carbohydrate, about 20g of protein and some healthy fat, a good source being Udo’s Choice Oil Blend. Use it as a dressing on salads or cooked vegetables. Athletes who optimise post exercise nutrition will perform better in training and accumulate more high qualitysessions than athletes skipping post-exercise recovery fuelling.
Trevor Woods is a qualifi ed exercise physiologist and experienced triathlete with multiple national titles along with World and European age-group medals in triathlon. He is also the current Masters M50 cyclocross national champion.
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Take two tablets one hour before bedtime. Food supplements are intended to supplement the diet, and should not be a substitute for a varied diet or healthy lifestyle. Do not exceed the stated dose.
Caution: Seek professional advice before using if you are pregnant, breastfeeding or suffer from allergies. Do not take Melissa Dream™ in combination with any antidepressants or sleep medications.
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