The Role of Zinc, Folic Acid, and Vitamin B12 in IB
These three nutrients deserve special mention since they are usually deficient in IBD patients.
Zinc Deficiency is a very well known complication of Crohn's disease. The causes are low dietary intake, poor absorption and excess losses through the stool. (1) Zinc deficiency occurs in approximately
45% (forty-five percent) of Crohn's disease patients. Common complications in Crohn's disease are directly related to the deficiency of zinc.
Poor healing of fissures and fistulas, skin lesions, decreased sexual development, growth retardation, retinal dysfunction, depressed immunity, and loss of appetite. The discouraging part is that many patients will not respond to oral or even intravenous zinc supplementation because of an apparent defect in tissue transport. Taking zinc supplements in the form of zinc picolinate may prove a better option, possibly improving both intestinal absorption and tissue transport. Picolinate is a zinc-binding molecule produced by the pancreas and appears to be better assimilated by the body.
Folic Acid Deficiency is quite common in IBD ranging in occurrence from 25% (twenty-five percent) to 64% (sixty-four percent) of IBD patients. (2-5) The culprit for this, in many cases, is the drug sulfasalazine. It is absolutely essential to correct folate deficiency since this deficiency further promotes malabsorption and diarrhea due to altered structure of intestinal mucosal cells. (6) These cells are turning over in three to four days and need a steady stream of folic acid.
Vitamin B12 is absorbed at the terminal ileum, the portion most commonly affected by Crohn's disease. A deficiency in vitamin B12 is also very common. Abnormal vitamin B12 absorption is found in 48% (forty-eight percent) of Crohn's disease patients. If the resection is 60-cm or less there might be a chance of adequate absorption. If however more than 60-cm are affected by inflammatory lesions or have been removed, monthly vitamin B12 in injections are recommended.
Next: Pancreatic Extracts and and Old Naturopathic Remedy
1. Fleming C.R. et al. Zinc Nutrition in Crohn's Disease. Dig Dis Sci 26 (1981):865-70
2. Rosenberg I.H., Bengoa J.M., Sitrin M.D. Nutritional Aspects of Inflammatory Bowel Disease. Ann Rev Nutr 5 (1985):463-84
3.Elsborg L., Larsen L. Folate Deficiency in Chronic Inflammatory Bowel Diseases. Scan J Gastroenterol 14 (1979):1019-24
4:Hellberg R., Hulten L., Bjorn-Rasmussen E. The Nutritional and Haematological Status Before and After Primary and Subsequent Resectional Procedures for Classical Crohn's Disease and Crohn's Colitis. Acta Chir Scand 148 (1982):453-60
5. Franklin J.L., Rosenberg I.H. Impaired Folic Acid Absorption in Inflammatory Bowel Disease: Effects of Salicylasosulfpyridine (Azulfidine). Gastroenterol 64 (1973):517-25
6. Carruthers L.B. Chronic Diarrhea Treated with Folic Acid. Lancet i (1946):849-50