It can be hard to live with ulcerative colitis (UC), and you might wonder if supplements could help you stay healthy. While eating a balanced diet is always important, you might need extra nutrients because of your symptoms or medications.
Why could people with UC need supplements?
“People with UC are at a higher risk for nutrient deficiencies for a few different reasons,” said Brogan Taylor, a registered dietitian with Banner – University Medicine.
- Inflammation: UC causes inflammation in your digestive system. This can make it harder for you to absorb nutrients from your food.
- Symptoms: Diarrhea and loss of appetite can cause nutrient deficiencies.
- Medications: Taking steroids or sulfasalazine could lead to low levels of vitamin D or calcium.
Regular blood tests are key to spotting what you need. Supplements can help bridge gaps when you can’t get enough nutrients in your diet. Your health care provider or dietitian can recommend the best supplements based on your needs.
What supplements can help with UC deficiencies?
If you have UC, you might need to take supplements to get enough of these nutrients:
- Calcium and vitamin D: If you take steroids for a long time, you might have low levels of calcium and vitamin D, which are important for keeping your bones and immune system strong. “We recommend monitoring these levels and taking vitamin D and calcium if levels are low,” Taylor said. Dairy products (if they don’t cause symptoms like gas, bloating or loose stools) and fortified foods can help, but you might still need a supplement if your levels are low.
- Iron: “Iron deficiency is common with UC, due to poor absorption, blood loss from ulcerations or GI bleeding or medications that limit absorption,” Taylor said. Low iron levels can make you feel tired and weak. Gentle iron supplements, like iron bisglycinate, can be more gentle on your stomach than other types.
- Vitamin B12 and folate: “Folate and B12 levels can be low due to poor absorption caused by inflammation or medications that limit absorption,” Taylor said. You can get vitamin B12 from foods like fish, eggs, dairy and fortified cereals and folate in leafy green vegetables and fortified grains, nuts and seeds, but you may still need supplements.
- Zinc, magnesium and potassium: Levels of these minerals, which are important for immune health, wound healing, muscle function and stress, can be low due to diarrhea. Foods like pumpkin seeds, almonds, bananas and avocados can help you make sure you’re getting enough. “If you are having loose stools several times per day, make sure you discuss this with your gastroenterologist, since you may need to replace these nutrients,” Taylor said.
Gut health supplements for UC: What works and what doesn’t?
You may wonder whether these supplements can help with ulcerative colitis:
- Probiotics: “Research is still evolving when it comes to probiotics and UC. While there are a few brands of probiotics that are targeted for UC, we do not usually recommend that you start taking a probiotic, especially during a flare,” Taylor said. If you still have gas, bloating or irregular stool after inflammation has calmed down, talk to your health care provider about whether a probiotic supplement might help.
- Fiber: “Fiber can be controversial. It is important to adjust your intake of fiber when you are in a flare, but you can increase it when you’re not,” Taylor said. A dietitian can guide you on the amount and type of fiber that’s best and how to get that from food before considering supplements.
- Omega-3 fatty acids: “Omega-3s can help with UC because they help decrease inflammation,” Taylor said. “I would recommend you get omega-3s from sources like fatty fish a few times per week.” If you can’t get enough omega-3s in your diet, a supplement might be helpful.
- Curcumin (turmeric): “Many people ask if taking turmeric can help decrease inflammation. There is not evidence to support this claim,” Taylor said.
How can you safely take supplements?
Before starting supplements, it’s important to talk to your health care provider to find out what supplements you may need and to make sure they won’t interact with any other medications you’re taking.
“You want to make sure you are monitored so that you don’t end up with high levels of iron, vitamin D, B12 or other nutrients,” Taylor said.
Supplements aren’t regulated by the FDA the same way as medicines. Your provider can recommend reputable brands that are tested by independent organizations like NSF, USP or Informed Choice.
Diet comes first
Supplements should never replace a nutritious, balanced diet. If you have UC, working with a registered dietitian can help you create a meal plan that meets your needs.
“You should meet with a registered dietitian who is familiar with dietary modifications for UC. That way, you can make sure you are getting the nutrients you need and working on dietary modifications during flares and maintenance,” Taylor said.
The bottom line
When you have UC, you have unique nutritional needs. Regular blood tests and check-ups can help you and your health care provider figure out what supplements might be right for you. Always consult with your provider before adding anything new to your routine.
If you would like to learn more about getting the nutrients you need when you have ulcerative colitis, reach out to your dietitian or health care provider or an expert at Banner Health.
