Vitamins that may be helpful
UC is linked to an increased risk of colon
cancer. Studies have found that people with UC who take folic acid supplements or who have high blood levels
of folic acid have a reduced risk of colon cancer compared with people who have UC and do not
take folic acid supplements.17 18 19 Although these
associations do not prove that folic acid was responsible for the reduction in risk, this
vitamin has been shown to prevent experimentally induced colon cancer in animals.20
Moreover, low blood folic acid levels have been found in more than half of all people with
UC.21 People with UC who are taking the drug sulfasalazine, which inhibits the absorption of folic
acid,22 are at a particularly high risk of developing folic acid deficiency. Folic
acid supplementation may therefore be important for many people with UC. Since taking folic
acid may mask a vitamin B12 deficiency,
however, people with UC who wish to take folic acid over the long term should have their
vitamin B12 status assessed by a physician.
Alcohol consumption is known to promote folic acid deficiency and has also been linked to
an increased risk of colon cancer.23 People with UC should, therefore, keep alcohol
intake to a minimum.
Preliminary24 and double-blind trials25 26 27
have found that fish oil supplementation
reduces inflammation, decreases the need for anti-inflammatory drugs, and promotes normal
weight gain in people with UC. However, fish oil has not always been effective in clinical
trials for UC.28 Amounts used in successful clinical trials provided 3.2 grams of
EPA and 2.2 grams of DHA per day—the two
important fatty acids found in fish oil.
A fatty acid called butyrate, which is synthesized by intestinal bacteria, serves as fuel
for the cells that line the small intestine. Administration of butyrate by enema has produced
marked improvement in people with UC in most,29 30 31
32 33 34 but not all,35 preliminary trials. Butyrate
taken by mouth is not likely to be beneficial, as sufficient quantities do not reach the colon
by this route. Although butyrate enemas are not widely available, they can be obtained by
prescription through a compounding pharmacy, which prepares customized prescription
medications to meet individual patient needs.
In a preliminary trial, 6 of 13 people with ulcerative colitis went into remission after
taking 200 mg per day of DHEA for eight
weeks.36 This large amount of DHEA has the potential to cause adverse side effects
and should only be used under the supervision of a doctor.
In preliminary37 and double-blind38 trials, a probiotic supplement (in this case, a
non-disease-causing strain of Escherichia coli) was effective at maintaining
remission in people with UC. In a double-blind trial, a combination probiotic supplement
containing Lactobacilli, Bifidobacteria, and a beneficial strain of Streptococcus has been
shown to prevent pouchitis, a common complication of surgery for UC.39 People with
chronic relapsing pouchitis received either 3 grams per day of the supplement or placebo for
nine months. Eighty-five percent of those who took the supplement had no further episodes of
pouchitis during the nine-month trial, whereas 100% of those receiving placebo had relapses
within four months. Preliminary evidence suggests that combination probiotic supplements may
be effective at preventing UC relapses as well.40
In a preliminary trial, people with UC significantly improved on a sugar-free, low-allergen diet with additional nutritional
supplementation that included a
multivitamin-mineral supplement (2–6 tablets per day); a fish oil supplement (400 mg per day); borage oil (400 mg per day); flaxseed oil (400 mg per day); and a probiotic formula
containing Lactobacillus acidophilus
and other species of beneficial bacteria.41 Some participants received slight
variations of this regimen. Since so many different supplements were given and since the trial
was not controlled, it is not possible to say which, if any, of the nutrients was responsible
for the improvement observed by the researchers.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
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