Inflammatory bowel disease (IBD) is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

IBD is an autoimmune condition where part of the digestive tract becomes inflamed and ulcerated marked with sores. There is emerging data that Vitamin D supplementation may lengthen the remission in IBD.

According to a review published earlier this month in Frontiers in Immunology, researchers investigated the therapeutic effects of micronutrient supplementation in IBD.

Growing evidence suggests that micronutrient status may have an impact on the course of IBD, however, micronutrient deficiencies are often overlooked in the treatment of IBD patients.

There have been numerous studies on micronutrient supplementation including vitamin D and iron, but the current research is preliminary for other vitamins and minerals. This review investigated the adjunctive therapeutic effects of micronutrient supplementation in IBD. Vitamin D supplementation in patients with IBD reduces inflammation and the risk of clinical relapse, improves responsiveness to anti-TNF therapy, prevents upper respiratory

tract infections in winter and spring and may have a positive effect on mental health.

Vitamin D supplementation should be based on body weight and to reach a certain vitamin D level. The main objective of iron supplementation is to correct iron deficiency and IDA. I would recommend a more bioavailable form like a ferrous glycinate that will not cause gastrointestinal side effects or compete with nutrient absorption.

Patients with IBS are also susceptible to deficiencies of other vitamins and minerals, such as vitamins B, K, A, C, and E, as well as zinc and selenium, due to impaired intestinal absorption, and restricted dietary intake. Supplementation of these micronutrients has also shown some benefits. For example, high-dose oral thiamine improves chronic fatigue in patients with quiescent IBD. Vitamin A supplementation can further reduce inflammation and promote mucosal healing. In addition, vitamin C, vitamin E, and selenium have all been shown to reduce oxidative stress.

In this review, the research team investigates calcium, magnesium, and manganese. Calcium is closely related to osteoporosis in IBD patients, so it is important to pay attention to the serum calcium level in the group of patients treated with steroids. Magnesium levels may affect sleep as well as psychological status and animal models suggest that manganese is essential for the maintenance of intestinal homeostasis

This review summarizes the adjunctive therapeutic effects of micronutrient supplementation in IBD, but supplementation should be personalized in patients with IBD based upon testing.

Source: Wu Y, Liu, Dong W. Adjunctive therapeutic effects of micronutrient supplementation in inflammatory bowel disease. Front Immunol. 2023 Apr 3;14:1143123.

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