DR. WALKER

5 most common vitamins/mineral deficiencies in Crohn’s disease.

Crohn’s disease is classed as an inflammatory bowel disease (IBD) as it causes chronic inflammation that can affect any part of the digestive system, but is most commonly seen in the small intestine and the first part of the large intestine. It often results in vitamin and mineral deficiencies as its disease process reduces appetite and affects the normal absorption of nutrients that typically occurs in the intestines. Advanced disease cases often require surgical removal of part (resection) or all (colectomy) of the colon, which can cause further problems with mineral and vitamin deficiencies.

The most common deficiencies seen in cases of Crohn’s disease, along with their related symptoms and complications are:

• Vitamin B12: This is the most common deficiency in patients with Crohn’s disease. It is especially prevalent in patients who have undergone removal of part or all of the colon as part of the management of this condition. In severe cases, it can cause numbness and tingling in the limbs as well as nerve damage.

• Iron: Rectal bleeding is a symptom of Crohn’s disease. This results in blood loss during bowel movements, which along with reduced absorption of iron in the intestine causes iron deficiency. Anaemia can arise as a result, which will cause fatigue and shortness of breath. Iron deficiency can also cause weakness, loss of concentration, difficulties with memory, increased susceptibility to infections, and reduced cold tolerance.

• Calcium: Patients with Crohn’s disease are often treated with steroids which are known to decrease absorption of calcium. These patients are also more likely to be lactose intolerant and so must avoid high calcium foods like dairy, that in combination with reduced absorption of calcium can result in weak muscles, bone fractures, irregular heart rhythm, decreased bone density, and osteoporosis.

• Vitamin D: This is a common deficiency in patients with Crohn’s disease and is a result of malabsorption of fat. It can result in dysfunction of the immune system and weakened bones. Vitamin D deficiency can also worse calcium deficiencies as it is necessary for the proper absorption of calcium.

• Folate: Another deficiency that is caused by the treatment of Crohn’s disease. Patients prescribed for methotrexate or sulfasalazine will have reduced metabolism of folate. This can cause inflammation of the skin or dialysis.

References:

1- Kerr, M. (2018, August 16). Nutritional Deficiencies and Crohn’s Disease. Healthline.
2- Richards, L. (2021, July 21). What to know about Crohn’s disease and nutritional deficiencies. MedicalNewsToday.
3- Sassi, K., MD. (2019, May 23). 5 Vitamins and Minerals You Need to Make Sure You’re Getting Enough of if You Have Crohn’s Disease. EverydayHealth.Com.