Table of ContentsView AllTable of ContentsTop SupplementsOther OptionsWhy You Feel Sick and TiredFood vs. SupplementsWork With a Provider
Table of ContentsView All
View All
Table of Contents
Top Supplements
Other Options
Why You Feel Sick and Tired
Food vs. Supplements
Work With a Provider
People with Crohn’s disease are at an increased risk of certain nutrient deficiencies. Factors such as food avoidance,inflammationof the gastrointestinal (GI) tract, and medical treatments can improve nutrient absorption.
Supplements can help you obtain the vitamins and minerals you can’t get from food alone. While some deficiencies are common in Crohn’s disease, needs can vary from person to person. Your healthcare provider can help you find supplements based on your symptoms, blood tests, and current treatment plan.
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1. Folic Acid
Folic acid deficiencies in Crohn’s disease can often be attributed to the fact that some medications used to treat the disease, includingAzulfidine(sulfasalazine)andTrexall (methotrexate), may interfere with the normal absorption of this nutrient. In addition, it is common for people with Crohn’s to avoid certain foods, such as fresh fruits and vegetables, which are the main sources of folic acid.
A folic acid supplement may help treat some of the following symptoms of this type of deficiency:
Evidence-Based Benefits of Folic Acid and How to Get Enough
2. Calcium
Calciumis an essential nutrient and the most abundant mineral in the body. About 99% of calcium is stored in teeth and bones, making it a key factor in maintaining body strength and preventingosteoporosis(loss of bone mass and bone mineral density). Calcium also supports healthy circulation, hormones, nerve, and muscle health.
Since the body does not produce calcium, you have to get it through foods such as dairy products, dark green leafy vegetables, certain fish, and calcium-fortified foods and beverages. Despite their diets, research indicates that calcium levels are generally lower in people with Crohn’s disease than in those who do not have the disease.
Calcium is absorbed in thesmall intestine, where Crohn’s disease typically attacks. Inflammation andbowel resection(removal of a damaged portion of the bowel) can make it harder to absorb calcium in your intestines.
Corticosteroids, such asprednisone, which are often used to treat Crohn’s disease, tend to reduce calcium absorption in the intestines and increase your risk of osteoporosis. In addition, people with Crohn’s disease may avoid rich dairy foods due tolactose intoleranceor because these foods may worsen Crohn’s disease symptoms.
Your healthcare provider may advise calcium supplements to treat symptoms ofhypocalcemia(calcium deficiency), which can include:
Calcium Citrate vs. Calcium Carbonate: Which to Take?
3. Iron
Ironis a mineral you can only get through your diet. It is necessary for human growth and development. It is used to producehemoglobin, a protein in red blood cells that carries oxygen from your lungs to other body parts. Iron also plays a key role in maintaining healthybone marrow, muscles, organ function, and some hormones.
Iron deficiency in Crohn’s disease can lead to a substantial decrease in quality of life. It ranks as a leading cause of hospitalization for people with this disease. Iron supplementation may be advised to treat any of the following symptoms:
What Are The Health Benefits of Iron Supplements?
4. Vitamin B12
Vitamin B12(cobalamin) is a water-soluble vitamin, and you must regularly supply the vitamin through foods you eat or supplements. Vitamin B12 helps in the formation of healthyred blood cells, the maintenance of yourcentral nervous system, and the production ofDNA. It is present in foods of animal origin, which include fish, poultry, meat, eggs, and dairy products. Some cereals and yeast are fortified with vitamin B12.
Your healthcare provider may advise B12 supplementation to address the following symptoms of Vitamin B12 deficiency:
Vitamin B12 and IBD
5. Vitamin D
Your body can make vitamin D when exposed to sunlight. However, immunosuppressive therapies used to treat Crohn’s disease, such as Imuran (azathioprine) and Humira (adalimumab), can increase the risk ofskin cancer. Therefore, people taking these medications are advised to usesunscreen,which prevents UVB synthesis of vitamin D.
Vitamin D is important for people with calcium deficiency,osteopenia, or osteoporosis. In addition,vitamin D supplementsmay be advised for anyone with Crohn’s disease who is taking corticosteroids since these drugs cause vitamin D resistance.
While a vitamin D deficiency is usually asymptomatic (having few or no symptoms), severe and prolonged deficiency can cause the following symptoms:
What Is Vitamin D Deficiency?
6. Vitamins A, E, and K
Vitamin A,vitamin E, andvitamin Kare fat-soluble vitamins that you need to produce cells, prevent cell damage, and produce blood. These vitamins also fight infections and maintain bone health.
You must ingest these vitamins since your body doesn’t produce them. You can find them in the following foods:
People with trouble absorbing fat may have low levels of these fat-soluble vitamins. Fat absorption problems in people with Crohn’s disease may be due to significant small bowel inflammation and/or missing or removing portions of the jejunum and ileum.
Your healthcare provider may advise supplementation to treat symptoms of these deficiencies:
Vitamin A:
Vitamin E:
Vitamin K:
Vitamins and Minerals for Eye Health
7. Potassium, Magnesium, and Zinc
Potassium, magnesium, andzincareelectrolytes. These nutrients regulate muscle contractions and keep you hydrated. They also control the function of your nervous system and balance yourpH levels(the measure of acidity and alkalinity of a substance).
Your healthcare provider may advise taking potassium, magnesium, orzinc supplementsif you have any of the following symptoms of an electrolyte deficiency:
What Causes Electrolyte Imbalance and How to Treat It
8. Potassium
Potassiumis an electrolyte that helps your nerves function and muscles contract. It also helps your heartbeat remain regular and moves nutrients into cells and waste products out of cells. Potassium can also offset some ofsodium’sharmful effects on your blood pressure.
Potassium-rich foods include bananas, sweet potatoes, tomatoes, carrots, cucumbers, dairy products, fish, and leafy greens. People with Crohn’s disease have an increased risk of potassium deficiency (hypokalemia) when they experience common disease symptoms of chronicvomiting and diarrhea. The risk of potassium deficiency increases with the use of corticosteroids such as prednisone.
You may benefit from potassium supplements if you have any of the following symptoms of a potassium deficiency:
Symptoms of Low Potassium (Hypokalemia)
Liquid SupplementsIf you have a poor appetite or solid foods are intolerable, your healthcare provider may advise that you consume one of the following liquid supplements formulated for people with Crohn’s disease:EnLive!LipisorbModulen IBDOptimentalPeptamen or Peptamen Junior for kidsPeptamen 1.5SubdueVivonex
Liquid Supplements
If you have a poor appetite or solid foods are intolerable, your healthcare provider may advise that you consume one of the following liquid supplements formulated for people with Crohn’s disease:EnLive!LipisorbModulen IBDOptimentalPeptamen or Peptamen Junior for kidsPeptamen 1.5SubdueVivonex
If you have a poor appetite or solid foods are intolerable, your healthcare provider may advise that you consume one of the following liquid supplements formulated for people with Crohn’s disease:
Other Supplements That May Help
Other dietary supplements may also be effective in improving disease activity and preventing malnutrition. While these interventions have potential value in treating Crohn’s disease symptoms, further research on their potential applications and outcomes:
The 13 Best Probiotic Supplements for Gut Health, According to an RD
Why Crohn’s Can Make You Feel Sick and Tired
It’s not uncommon to feel sick and tired if you have Crohn’s disease, especially during periods offlare-ups(active disease). Research indicates that about 70% of people with active Crohn’s disease have fatigue during a flare-up. These feelings also affect about 40% of people in remission (minor or inactive symptoms).
When you have sufficient levels of vitamins and nutrients, their biochemical properties support normal physical and emotional function. However, nutritional deficiencies can interfere with these processes and deprive your body of the energy it needs to sustain itself.
This can impact bodily functions ranging from energy production to immune function. As a result, taking the right nutritional supplements can often become a key aspect of Crohn’s disease self-care.
Nutritional deficiencies can lead to the following symptoms that can make you feel chronically “sick and tired,” at any time in your Crohn’s disease course:
Nutritional deficiencies can also affect how prescribed medications for Crohn’s disease and other conditions work. Vitamin and mineral deficiencies can cause changes in your gastrointestinal tract, affecting the way your body absorbs and metabolizes a drug.
Some common reasons that you may develop a nutritional deficiency with Crohn’s disease are:
How Crohn’s Disease Is Treated
Foods or Supplements: Which Is Better?
Generally, consuming a diet of healthy foods is the best way to meet your nutritional needs. When compared to supplements, the complexity of foods means they often provide trace elements that are not present in a supplement.
As a result, you’re likely to get better nutrition from foods, including essentialfiberto manage constipation and prevent other diseases. Foods can also contain additional protective substances such as phytochemicals andantioxidants, which provide benefits in preventing heart disease,cancer,diabetes, and other diseases.
However, having Crohn’s disease may interfere with your ability to consistently consume a healthy diet. Even when you’re able to eat the right foods, the effects of Crohn’s disease may prevent your body from properly absorbing the amounts of nutrients your body needs. In these cases, your healthcare provider may advise taking supplements to help offset the effects of specific vitamin or mineral deficiencies to maintain proper nutrition.
Work With Your Healthcare Provider
Since Crohn’s disease affects everyone differently, there is not one vitamin or combination of vitamins in particular that is advised for everyone. Before starting on a new vitamin or supplement, it’s important to work with your healthcare provider to determine the best course of action. Factors such as your diet, disease severity, prescribed medications, and the impact of other health conditions can affect which vitamins and supplements are right for you.
While vitamins and supplements may seem harmless, some can worsen Crohn’s symptoms, like nausea or diarrhea. They can also interact with medications you may be taking for Crohn’s disease or other conditions.
Your healthcare provider can help you identify nutritional deficiencies and ways to correct them without interfering with your treatment plan. They can also advise a Crohn’s disease diet that may help meet your needs. If vitamins or supplements are necessary, your healthcare provider can advise the proper dosage to help you achieve the intended benefits.
Summary
While most people can get the vitamins and minerals they need from eating a healthy diet, doing so can be hard for someone with Crohn’s disease. Getting nutrients from food alone can be a challenge when you’re dealing with flares, severe symptoms, and the results of GI surgery, which are common in Crohn’s disease.
While supplements can help correct nutritional deficiencies, everyone’s needs are unique. Consult your healthcare provider before starting any new supplement. While they may seem like healthy choices, supplements may present new symptoms or change the way certain drugs work. With the proper guidance, you can maintain healthy nutrition safely without having new problems.
33 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Crohn’s and Colitis Foundation.Vitamin and mineral supplementation.U.S. Centers for Disease Control and Prevention.About folic acid.Ratajczak AE, Szymczak-Tomczak A, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I.Does folic acid protect patients with inflammatory bowel disease from complications?Nutrients. 2021;13(11):4036. doi:10.3390/nu13114036Portsmouth Regional Hospital.Folic acid deficiency symptoms: Should you talk with your doctor?United States Department of Agriculture.Eye on nutrition: calcium.American Journal of Managed Care (AJMC).Patients with Crohn’s disease report low calcium, magnesium intake.Kempinski R, Arabasz D, Neubauer K.Effects of milk and dairy on the risk and course of inflammatory bowel disease versus patients' dietary beliefs and practices: a systematic review.Nutrients. 2024;16(15):2555. doi:10.3390/nu16152555CARE Hospitals.How does calcium deficiency affect bone health?MedlinePlus.Iron.Mahadea D, Adamczewska E, Ratajczak AE, et al.Iron deficiency anemia in inflammatory bowel diseases-a narrative review.Nutrients. 2021;13(11):4008. Published 2021 Nov 10. doi:10.3390/nu13114008National Institutes of Health Office of Dietary Supplements.Vitamin B12 fact sheet for health professionals.Gomollón F, Gargallo CJ, Muñoz JF, et al.Oral cyanocobalamin is effective in the treatment of vitamin B12 deficiency in Crohn’s disease.Nutrients. 2017;9(3):308. doi:10.3390/nu9030308Harvard Health Publishing Harvard Medical School.Vitamin B12 deficiency can be sneaky and harmful.National Institute of Health Office of Dietary Supplements.Vitamin D.Raftery T, O’Sullivan M.Optimal vitamin D levels in Crohn’s disease: a review.Proceedings of the Nutrition Society. 2015;74(1):56-66. doi:10.1017/S0029665114001591Yale Medicine.Vitamin D deficiency.Cleveland Clinic Health Essentials.Fat-soluble vitamins: what they are and how to get the most out of them.Merck Manual Consumer Version.Vitamin A deficiency.National Institutes of health Office of Dietary Supplements.Vitamin E.Merck Manual Consumer Version.Vitamin K deficiency.Cedars-Sinai.What are electrolytes?UPMC.Electrolyte deficiency disorders.MedlinePlus.Potassium.UCSF Health.Nutrition tips for inflammatory bowel disease.Mount Sinai.Crohn disease.Algieri F, Rodriguez-Nogales A, Rodriguez-Cabezas ME, Risco S, Ocete MA, Galvez J.Botanical drugs as an emerging strategy in inflammatory bowel disease: a review.Mediators Inflamm. 2015;2015:179616. doi:10.1155/2015/179616De Conno B, Pesce M, Chiurazzi M, et al.Nutraceuticals and diet supplements in Crohn’s disease: a general overview of the most promising approaches in the clinic.Foods. 2022;11(7):1044. doi:10.3390/foods11071044Crohn’s and Colitis UK.Fatigue.Relive Health.Signs you are nutrient or vitamin deficient.Rupa Health.Nutritional deficiencies in children: early detection and management through functional medicine.Merck Manual Professional Version.Nutrient-drug interactions.Oklahoma Medical Research Foundation (OMRF).Food vs. supplements: what’s the verdict?Yale New Haven Health.Taking your vitamins? Make sure to tell your doctor.
33 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Crohn’s and Colitis Foundation.Vitamin and mineral supplementation.U.S. Centers for Disease Control and Prevention.About folic acid.Ratajczak AE, Szymczak-Tomczak A, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I.Does folic acid protect patients with inflammatory bowel disease from complications?Nutrients. 2021;13(11):4036. doi:10.3390/nu13114036Portsmouth Regional Hospital.Folic acid deficiency symptoms: Should you talk with your doctor?United States Department of Agriculture.Eye on nutrition: calcium.American Journal of Managed Care (AJMC).Patients with Crohn’s disease report low calcium, magnesium intake.Kempinski R, Arabasz D, Neubauer K.Effects of milk and dairy on the risk and course of inflammatory bowel disease versus patients' dietary beliefs and practices: a systematic review.Nutrients. 2024;16(15):2555. doi:10.3390/nu16152555CARE Hospitals.How does calcium deficiency affect bone health?MedlinePlus.Iron.Mahadea D, Adamczewska E, Ratajczak AE, et al.Iron deficiency anemia in inflammatory bowel diseases-a narrative review.Nutrients. 2021;13(11):4008. Published 2021 Nov 10. doi:10.3390/nu13114008National Institutes of Health Office of Dietary Supplements.Vitamin B12 fact sheet for health professionals.Gomollón F, Gargallo CJ, Muñoz JF, et al.Oral cyanocobalamin is effective in the treatment of vitamin B12 deficiency in Crohn’s disease.Nutrients. 2017;9(3):308. doi:10.3390/nu9030308Harvard Health Publishing Harvard Medical School.Vitamin B12 deficiency can be sneaky and harmful.National Institute of Health Office of Dietary Supplements.Vitamin D.Raftery T, O’Sullivan M.Optimal vitamin D levels in Crohn’s disease: a review.Proceedings of the Nutrition Society. 2015;74(1):56-66. doi:10.1017/S0029665114001591Yale Medicine.Vitamin D deficiency.Cleveland Clinic Health Essentials.Fat-soluble vitamins: what they are and how to get the most out of them.Merck Manual Consumer Version.Vitamin A deficiency.National Institutes of health Office of Dietary Supplements.Vitamin E.Merck Manual Consumer Version.Vitamin K deficiency.Cedars-Sinai.What are electrolytes?UPMC.Electrolyte deficiency disorders.MedlinePlus.Potassium.UCSF Health.Nutrition tips for inflammatory bowel disease.Mount Sinai.Crohn disease.Algieri F, Rodriguez-Nogales A, Rodriguez-Cabezas ME, Risco S, Ocete MA, Galvez J.Botanical drugs as an emerging strategy in inflammatory bowel disease: a review.Mediators Inflamm. 2015;2015:179616. doi:10.1155/2015/179616De Conno B, Pesce M, Chiurazzi M, et al.Nutraceuticals and diet supplements in Crohn’s disease: a general overview of the most promising approaches in the clinic.Foods. 2022;11(7):1044. doi:10.3390/foods11071044Crohn’s and Colitis UK.Fatigue.Relive Health.Signs you are nutrient or vitamin deficient.Rupa Health.Nutritional deficiencies in children: early detection and management through functional medicine.Merck Manual Professional Version.Nutrient-drug interactions.Oklahoma Medical Research Foundation (OMRF).Food vs. supplements: what’s the verdict?Yale New Haven Health.Taking your vitamins? Make sure to tell your doctor.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Crohn’s and Colitis Foundation.Vitamin and mineral supplementation.U.S. Centers for Disease Control and Prevention.About folic acid.Ratajczak AE, Szymczak-Tomczak A, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I.Does folic acid protect patients with inflammatory bowel disease from complications?Nutrients. 2021;13(11):4036. doi:10.3390/nu13114036Portsmouth Regional Hospital.Folic acid deficiency symptoms: Should you talk with your doctor?United States Department of Agriculture.Eye on nutrition: calcium.American Journal of Managed Care (AJMC).Patients with Crohn’s disease report low calcium, magnesium intake.Kempinski R, Arabasz D, Neubauer K.Effects of milk and dairy on the risk and course of inflammatory bowel disease versus patients' dietary beliefs and practices: a systematic review.Nutrients. 2024;16(15):2555. doi:10.3390/nu16152555CARE Hospitals.How does calcium deficiency affect bone health?MedlinePlus.Iron.Mahadea D, Adamczewska E, Ratajczak AE, et al.Iron deficiency anemia in inflammatory bowel diseases-a narrative review.Nutrients. 2021;13(11):4008. Published 2021 Nov 10. doi:10.3390/nu13114008National Institutes of Health Office of Dietary Supplements.Vitamin B12 fact sheet for health professionals.Gomollón F, Gargallo CJ, Muñoz JF, et al.Oral cyanocobalamin is effective in the treatment of vitamin B12 deficiency in Crohn’s disease.Nutrients. 2017;9(3):308. doi:10.3390/nu9030308Harvard Health Publishing Harvard Medical School.Vitamin B12 deficiency can be sneaky and harmful.National Institute of Health Office of Dietary Supplements.Vitamin D.Raftery T, O’Sullivan M.Optimal vitamin D levels in Crohn’s disease: a review.Proceedings of the Nutrition Society. 2015;74(1):56-66. doi:10.1017/S0029665114001591Yale Medicine.Vitamin D deficiency.Cleveland Clinic Health Essentials.Fat-soluble vitamins: what they are and how to get the most out of them.Merck Manual Consumer Version.Vitamin A deficiency.National Institutes of health Office of Dietary Supplements.Vitamin E.Merck Manual Consumer Version.Vitamin K deficiency.Cedars-Sinai.What are electrolytes?UPMC.Electrolyte deficiency disorders.MedlinePlus.Potassium.UCSF Health.Nutrition tips for inflammatory bowel disease.Mount Sinai.Crohn disease.Algieri F, Rodriguez-Nogales A, Rodriguez-Cabezas ME, Risco S, Ocete MA, Galvez J.Botanical drugs as an emerging strategy in inflammatory bowel disease: a review.Mediators Inflamm. 2015;2015:179616. doi:10.1155/2015/179616De Conno B, Pesce M, Chiurazzi M, et al.Nutraceuticals and diet supplements in Crohn’s disease: a general overview of the most promising approaches in the clinic.Foods. 2022;11(7):1044. doi:10.3390/foods11071044Crohn’s and Colitis UK.Fatigue.Relive Health.Signs you are nutrient or vitamin deficient.Rupa Health.Nutritional deficiencies in children: early detection and management through functional medicine.Merck Manual Professional Version.Nutrient-drug interactions.Oklahoma Medical Research Foundation (OMRF).Food vs. supplements: what’s the verdict?Yale New Haven Health.Taking your vitamins? Make sure to tell your doctor.
Crohn’s and Colitis Foundation.Vitamin and mineral supplementation.
U.S. Centers for Disease Control and Prevention.About folic acid.
Ratajczak AE, Szymczak-Tomczak A, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I.Does folic acid protect patients with inflammatory bowel disease from complications?Nutrients. 2021;13(11):4036. doi:10.3390/nu13114036
Portsmouth Regional Hospital.Folic acid deficiency symptoms: Should you talk with your doctor?
United States Department of Agriculture.Eye on nutrition: calcium.
American Journal of Managed Care (AJMC).Patients with Crohn’s disease report low calcium, magnesium intake.
Kempinski R, Arabasz D, Neubauer K.Effects of milk and dairy on the risk and course of inflammatory bowel disease versus patients' dietary beliefs and practices: a systematic review.Nutrients. 2024;16(15):2555. doi:10.3390/nu16152555
CARE Hospitals.How does calcium deficiency affect bone health?
MedlinePlus.Iron.
Mahadea D, Adamczewska E, Ratajczak AE, et al.Iron deficiency anemia in inflammatory bowel diseases-a narrative review.Nutrients. 2021;13(11):4008. Published 2021 Nov 10. doi:10.3390/nu13114008
National Institutes of Health Office of Dietary Supplements.Vitamin B12 fact sheet for health professionals.
Gomollón F, Gargallo CJ, Muñoz JF, et al.Oral cyanocobalamin is effective in the treatment of vitamin B12 deficiency in Crohn’s disease.Nutrients. 2017;9(3):308. doi:10.3390/nu9030308
Harvard Health Publishing Harvard Medical School.Vitamin B12 deficiency can be sneaky and harmful.
National Institute of Health Office of Dietary Supplements.Vitamin D.
Raftery T, O’Sullivan M.Optimal vitamin D levels in Crohn’s disease: a review.Proceedings of the Nutrition Society. 2015;74(1):56-66. doi:10.1017/S0029665114001591
Yale Medicine.Vitamin D deficiency.
Cleveland Clinic Health Essentials.Fat-soluble vitamins: what they are and how to get the most out of them.
Merck Manual Consumer Version.Vitamin A deficiency.
National Institutes of health Office of Dietary Supplements.Vitamin E.
Merck Manual Consumer Version.Vitamin K deficiency.
Cedars-Sinai.What are electrolytes?
UPMC.Electrolyte deficiency disorders.
MedlinePlus.Potassium.
UCSF Health.Nutrition tips for inflammatory bowel disease.
Mount Sinai.Crohn disease.
Algieri F, Rodriguez-Nogales A, Rodriguez-Cabezas ME, Risco S, Ocete MA, Galvez J.Botanical drugs as an emerging strategy in inflammatory bowel disease: a review.Mediators Inflamm. 2015;2015:179616. doi:10.1155/2015/179616
De Conno B, Pesce M, Chiurazzi M, et al.Nutraceuticals and diet supplements in Crohn’s disease: a general overview of the most promising approaches in the clinic.Foods. 2022;11(7):1044. doi:10.3390/foods11071044
Crohn’s and Colitis UK.Fatigue.
Relive Health.Signs you are nutrient or vitamin deficient.
Rupa Health.Nutritional deficiencies in children: early detection and management through functional medicine.
Merck Manual Professional Version.Nutrient-drug interactions.
Oklahoma Medical Research Foundation (OMRF).Food vs. supplements: what’s the verdict?
Yale New Haven Health.Taking your vitamins? Make sure to tell your doctor.
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