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Crohn's Disease Forum » Diet, Fitness, and Supplements » Are you getting your necessary vitamins and minerals? No.


 
03-23-2013, 04:04 PM   #1
David
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Are you getting your necessary vitamins and minerals? No.

I realize my discussion of vitamins and minerals probably gets old after awhile. But the fact is, if you're reading this and have Crohn's disease, you're very likely deficient in various vitamins and minerals and it is negatively affecting your disease status and overall health. I go so far as to say that I believe when the day comes where they figure out the cause of Crohn's disease, magnesium deficiency will be part of that equation.

I was reading an interesting paper today, Origins and evolution of the Western diet: health implications for the 21st century. In it, they had data regarding how many people don't get the RDA for specific vitamins and minerals. Here is the table:



That data is from 1994-1996 and I have little doubt it is worse today. And the thing is, if you have active inflammation, diarrhea, vomiting, on specific medications, and/or resection of intestine, it's going to be even harder for you to get those vitamins and minerals.

Taking a multivitamin just isn't going to do it. I implore each of you to focus your diet towards getting sufficient vitamins and minerals. For most of us, that requires DRASTIC changes in dietary habit and substantial personal education. Or start juicing veggies like there's no tomorrow.
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03-23-2013, 04:17 PM   #2
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I agree 100% with David. If not for this forum and David's dogged research into this I doubt I would have given much of this a second thought, apart from the obvious like B12.

I now have my children checked for deficiencies and we are supplementing as needed. If I can do anything humanely possible to keep my kids in remission then I will and I truly do believe that diet and supplementing plays a role in doing just that. They have both had ileocaecal resections so think that for them it will require life long vigilance to keep things the vitamin/mineral balance in check.

Dusty.
03-23-2013, 05:20 PM   #3
LittleChloe
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Thanks David, that's our much needed motivation to get the juicer dusted off.
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Last edited by LittleChloe; 03-23-2013 at 07:00 PM.
03-24-2013, 06:47 AM   #4
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Hi David,

Why is it that you say vitamin pills don't work as well as food? Also would you say that the vitamins in meal replacement drinks such as Ensure, Fortisip, etc. are also inferior to those in food?

I'm just curious. I love most fruit and veg, but I don't eat large quanitities because I need to gain weight and have no appetite, so I don't want to fill up on low calorie food. I also can't stomach much fibre. But last time I had blood taken I wasn't deficient in anything.
03-24-2013, 09:25 AM   #5
David
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If you want to take a multivitamin, that's fine, I don't have a big problem with that. What I'm saying is it often lulls people into a false sense of security. For example, as that paper above suggests, more than 60% of people don't get enough magnesium in their diet and are thus going to be deficient. If you have Crohn's, not only do you probably fall in that 60%, but your inflammation, diarrhea, vomiting, and/or resection also greatly reduces absorption and increases loss. If you check out your multivitamin, it has between 50mg and 100mg of magnesium. Yet, as this paper suggests, 600mg of supplemental magnesium is suggested for people who are deficient. Now, if you take 600mg of supplemental magnesium in one pop, there's a chance it is going to give you diarrhea as it has a laxative effect whereas that doesn't happen with food-based magnesium. But the point here is, you can be taking a multi and still very much be deficient in magnesium. Same goes for other vitamins and minerals.

I believe the primary reason why enteral nutrition and juicing work so well is because you're getting the vitamins and minerals you need. And by the way, juicing removes the fiber.

What vitamin and minerals were you tested for and what were the specific levels? "Normal" often is not and it's important to get the actual numbers.
03-24-2013, 12:15 PM   #6
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I'm having a little bit of an issue buying the right supplements at the right levels and not buying ones that interfere with each other. I was using a cod liver oil supplement with vitamin A+D until I read that this was pretty much pointless.

I was going to buy a plain old D3 5,000iu supplement, but of course you then need other supplements for that to work. However, while that seems like generally accepted knowledge, everything else I read is pretty conflicting. I don't seem to be able to get the recommended D3 plus supplement in England. What i'm really struggling with is that there seems to be 2 billion different combination's at different levels that don't compliment. Could someone offer me some advice?

My understanding is that I need:
[email protected],000iu (to start with)
Magnesium Citrate (250?)
Zinc (?)

Is that everything?
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03-24-2013, 03:22 PM   #7
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I take Animal Pak and attempt to eat a diverse diet. Animal Pak is a pretty Hefty set of pills to choke down, but I can really notice the differenece since I started back on it. I compared Animal Pak Nurtuinal facts to Davids list and it has over RDA on everything, but Iron which it contains 0.

Vit and Mineral supplements are even more confusing when a drug like Humira says Vits and Herbs may interfer with it's effectiveness and I can't find which ones in specific anywhere.
03-24-2013, 04:33 PM   #8
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You are right on point, David. Great info! Thanks & keep banging that drum as more & more people are listening and getting healthier because of you!
03-25-2013, 08:17 AM   #9
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Something to throw out there - there are thought to be anti-nutrients in some foods that block the absorption of minerals, and additionally interfere with vitamin D's use in the body. One problematic chemical is phytic acid. Phytic acid is found naturally in grains, beans, and nuts. If eating these foods, I've read there are ways to prepare them so that the phylic acid is reduced or removed, allowing the nutrients to easily be absorbed.

As an example:

"Magnesium and Insulin Sensitivity"

Snippet from Dr. Guyenet's writing:

...Speaking of nutritious diets, how does one get magnesium? Good sources include halibut, leafy greens, chocolate and nuts. Bone broths are also an excellent source of highly absorbable magnesium. Whole grains and beans are also fairly good sources, while refined grains lack most of the magnesium in the whole grain. Organic foods, particularly artisanally produced foods from a farmer's market, are richer in magnesium because they grow on better soil and often use older varieties that are more nutritious.

The problem with seeds such as grains, beans and nuts is that they also contain phytic acid which prevents the absorption of magnesium and other minerals (16). Healthy non-industrial societies that relied on grains took great care in their preparation: they soaked them, often fermented them, and also frequently removed a portion of the bran before cooking (17). These steps all served to reduce the level of phytic acid and other anti-nutrients. I've posted a method for effectively reducing the amount of phytic acid in brown rice (18). Beans should ideally be soaked for 24 hours before cooking, preferably in warm water....
The rest of the article can be seen at:

http://wholehealthsource.blogspot.co...nsitivity.html
03-25-2013, 03:09 PM   #10
Cat-a-Tonic
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David, you mentioned juicing like there's no tomorrow. Anything specific you'd recommend juicing? I just got a new juicer and have been using it regularly, but I'd like to put the right things into it. Vitamin-wise and juicing-wise, which veggies pack the best bang for the buck? And as Beach and Jam noted, some things just don't work together as far as absorption, etc. I think I should tag Gianni here to get his opinion on this too. I know to avoid grapefruit because it can affect digestion/absorption of certain medications (such as Entocort - they always told me "no grapefruit and no grapefruit juice!" when I was on it). But other than that, I really just throw whatever I've got into my juicer (yesterday it was spinach, kale, green bell pepper, and oranges for sweetness - sounds like a weird combo and it smelled strongly of kale but tasted mild and wasn't bad at all).
03-25-2013, 09:30 PM   #11
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I appreciate all the information about health and vitamins we're possibly lacking in because of our disease. I'm getting a blood test this week to check my vitamin levels and specially asked my doctor for iron (I've been deficient), D, B12, Folic Acid. I hope it includes more! Anyway, I'm on a new kick of eating more fish, especially salmon, halibut and cod and looked up the nutrients of Halibut and found the following which looks good health-wise. I'm sure most know about the need for Omega 3 essential fatty acids and how we get way too many of Omega 6. Omega 3 (like in Fish Oil capsules or Flax Seed Oil) is especially good for inflammation.


"Halibut are truly a nutrient-dense food. A very good source of high quality protein, halibut are rich in significant amounts of a variety of important nutrients including the minerals selenium, magnesium, phosphorus and potassium; the B vitamins B12, niacin, and B6; and perhaps most important, the beneficial omega-3 essential fatty acids. Essential fatty acids are so named because they are essential for our health but cannot be made by the body; they must therefore be obtained from foods. Cold-water fish like halibut are a rich source of the omega-3 essential fats, a form of essential fatty acids in which the standard American diet is sorely deficient. (The other form of essential fatty acids, the omega-6s, are plentiful in a variety of commonly consumed oils such as corn and safflower oil. In fact, the omega-6s are so plentiful in the typical American diet that too much omega-6 is consumed in proportion to omega-3s--an imbalance that promotes inflammation, thus contributing to virtually every chronic disease in which inflammation is a key component.)"

If anyone has a Trader Joes near them, I've been buying their fresh salmon with cous cous and frozen Halibut (breaded) and frozen Cod (breaded) and all three are delicious - with fresh lemon and a little tarter sauce.


Here are the nutrients and percent - high in B 12 and in Magnesium, David.


Nutrients in
Halibut
4.00 oz-wt (113.40 grams)
Nutrient%Daily Value

tryptophan106.2%

selenium75.8%

protein60.5%

vitamin B3 34.4%

phosphorus 32.3%

magnesium 30.3%

omega-3 fats 25.8%

vitamin B12 25.8%

vitamin B6 22.5%

potassium 18.6%

Calories (158)8%
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I seem to be in remission: I believe from the Asacol / Low Residue Diet / Probiotics and NO STRESS!
03-25-2013, 09:52 PM   #12
Sarah50
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If anyone is interested, here's a link to a great article on the immune system and which nutrients are needed and what foods to find them in:

"What Foods are Good for My Immune System?"

http://www.whfoods.com/genpage.php?tname=faq&dbid=24

This article includes an important section for us called, "Maintaining a healthy gastrointestinal barrier is essential for optimal immune function".

Here's a section from it. Apparently foods high in phosphatidylcholine or its precursor, choline, are particularly beneficial in supporting the gastrointestinal barrier. Very interesting. I clicked on the link for choline here and WOO HOO!! Milk chocolate and peanut butter are listed as foods with choline! Two of my favorite 'treats'!!!

"The foods you eat can provide support for this barrier or cause damage to it. For instance, alcohol consumption is known to irritate the gastric (stomach) mucosal barrier. Some drugs, for example, the non-steriodal anti-inflammatory drugs like aspirin and ibuprofen, also can harm this barrier. Many nutrients in the World�s Healthiest Foods help to support a healthy barrier. Foods that are high in phosphatidylcholine or its precursor, choline, are particularly beneficial in supporting a healthy gastrointestinal barrier since phosphatidylcholine is one of the components of the protective mucosa that lines your intestinal tract and provides the first barrier defense. Studies have shown that diets low in choline result in low levels of phosphatidylcholine."

Last edited by Sarah50; 03-25-2013 at 11:03 PM.
03-26-2013, 04:42 AM   #13
Beach bum
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I'm having a little bit of an issue buying the right supplements at the right levels and not buying ones that interfere with each other. I was using a cod liver oil supplement with vitamin A+D until I read that this was pretty much pointless

I have been taking a muti vit with iron and vit D spray first thing in the morning for ages , I have recently added an Omega 3 fish oil pill - is this not a good idea?
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Crohn's Diagnosed : 12/07/12
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Switching to : Azathioprine and started Infliximab 14/08/12
Juicing every morning.
Taking vitamin D spray
Multi vits & iron
And Probio 7 probiotic.
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Being given a "drugs rest" from Aza - 17/9/14
03-26-2013, 05:36 AM   #14
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Hi David,

Why is it that you say vitamin pills don't work as well as food? Also would you say that the vitamins in meal replacement drinks such as Ensure, Fortisip, etc. are also inferior to those in food?

I'm just curious. I love most fruit and veg, but I don't eat large quanitities because I need to gain weight and have no appetite, so I don't want to fill up on low calorie food. I also can't stomach much fibre. But last time I had blood taken I wasn't deficient in anything.
The problem with supplements is that the vitamins and minerals do not have the same bioavailability as the vitamins and minerals found in actual foods. This is why when one takes iron supplements for example, they have to take way more than the actual RDI because your body only absorbs a small amount of it.

In the case of multivitamins, some vitamins or minerals conflict each other, I.e., they use the same transport chain for absorption and usually the body priorities one over the other. Calcium and iron are a good example. If you take both together, your body will absorb the calcium, but not the iron.

Vitamins that are added to foods, like ensure, are no different than the vitamins in supplements, they are not occurring naturally.
03-26-2013, 05:39 AM   #15
AlliRuns
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I take Animal Pak and attempt to eat a diverse diet. Animal Pak is a pretty Hefty set of pills to choke down, but I can really notice the differenece since I started back on it. I compared Animal Pak Nurtuinal facts to Davids list and it has over RDA on everything, but Iron which it contains 0.

Vit and Mineral supplements are even more confusing when a drug like Humira says Vits and Herbs may interfer with it's effectiveness and I can't find which ones in specific anywhere.
Is it the same things to avoid as Remicade maybe? I was told avoid Ginseng and echinacea.
03-26-2013, 06:44 AM   #16
Jam300
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I have been taking a muti vit with iron and vit D spray first thing in the morning for ages , I have recently added an Omega 3 fish oil pill - is this not a good idea?
Oh no, that's not what I meant apologies! I read that Vitamin A, in the state utilised in cod liver oil tablets isn't well used by the body (so you end up with too much) and can negate the Vitamin D absorbtion. That may be slightly off, but that was the jist I got from the article.

http://www.vitamindcouncil.org/news-...tamin-a-ratio/

In my case, I was using a Cod Liver Oil supplement, enhanced with Vitamins A + D. According to that article, that is pointless and potentially even harmful. Sorry to scare you Beach Bum, I should have explained better!
03-26-2013, 10:49 AM   #17
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Cod liver enhanced with A and D? Both occur naturally in Cod Liver Oil, to enhance it increases chances of toxicity.
03-26-2013, 10:53 AM   #18
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Oh that's ok no worries. It is all a bit of a mine field isn't it?
03-26-2013, 01:06 PM   #19
Jam300
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Cod liver enhanced with A and D? Both occur naturally in Cod Liver Oil, to enhance it increases chances of toxicity.
Yup, was nice finding that out after taking 60 or so one-a-day pills.
03-28-2013, 06:56 PM   #20
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David, you mentioned juicing like there's no tomorrow. Anything specific you'd recommend juicing? I just got a new juicer and have been using it regularly, but I'd like to put the right things into it. Vitamin-wise and juicing-wise, which veggies pack the best bang for the buck? And as Beach and Jam noted, some things just don't work together as far as absorption, etc. I think I should tag Gianni here to get his opinion on this too. I know to avoid grapefruit because it can affect digestion/absorption of certain medications (such as Entocort - they always told me "no grapefruit and no grapefruit juice!" when I was on it). But other than that, I really just throw whatever I've got into my juicer (yesterday it was spinach, kale, green bell pepper, and oranges for sweetness - sounds like a weird combo and it smelled strongly of kale but tasted mild and wasn't bad at all).
A fun thing to go by is to make sure you incorporate the different colors. What i mean by that is to make sure you dont always specifically juice only orange colored vegetables nor only green colored ones but to have a good mixture of the orange, green, purples, reds, etc etc. Many of the different colored veggies hold different vitamins and minerals the the other colors may be lacking in.

As for specific veggies i'll break it down color wise.

Orange- Sweet potatoes- basically like a large multivitamin with actual healthy percentages... just don't try to swallow it

Green: Kale, swiss chard.

Purple/red- red cabbage full of minerals.

yellow? Ginger, great mineral content.

anyways the specifics don't matter as much if you are ensuring you visit all the colors. But even still there may be some things that need some supplementing.

Gianni
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03-28-2013, 10:30 PM   #21
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I take Animal Pak and attempt to eat a diverse diet. Animal Pak is a pretty Hefty set of pills to choke down, but I can really notice the differenece since I started back on it. I compared Animal Pak Nurtuinal facts to Davids list and it has over RDA on everything, but Iron which it contains 0.

Vit and Mineral supplements are even more confusing when a drug like Humira says Vits and Herbs may interfer with it's effectiveness and I can't find which ones in specific anywhere.
Yeah, and that's because Animal pak vitamins are primarily for men, and very few men (without digestive disorders) are anemic, and taking iron when you don't need it usually results in constipation, not to mention that most iron supplements contain nickel, which is one of the most common allergies.

Most vitamins formulated specifically for men do not contain iron.
03-29-2013, 12:30 AM   #22
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Ok, officially overwhelmed.

VIT D WAS 18 now taking 50,000per day by RX. Vit or b12 307 the low side of normal. My
Dr dosent want to treat it.

I have read a few dif places adults that low will feel the symptoms of low b.

What do I do now???


Lauren
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03-29-2013, 08:05 AM   #23
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Tots, with the B12, I'd suggest taking a sublingual form (say 200-250mcg) once a day for a month then get retested. If your B12 isn't significantly higher then that showcases you aren't properly absorbing B12 and are likely drawing down your liver stores. If your doctor doesn't want to properly treat it then, then get a new doctor. If your B12 IS significantly higher, then all is well.
03-29-2013, 09:28 AM   #24
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If you want to take a multivitamin, that's fine, I don't have a big problem with that. What I'm saying is it often lulls people into a false sense of security. For example, as that paper above suggests, more than 60% of people don't get enough magnesium in their diet and are thus going to be deficient. If you have Crohn's, not only do you probably fall in that 60%, but your inflammation, diarrhea, vomiting, and/or resection also greatly reduces absorption and increases loss. If you check out your multivitamin, it has between 50mg and 100mg of magnesium. Yet, as this paper suggests, 600mg of supplemental magnesium is suggested for people who are deficient. Now, if you take 600mg of supplemental magnesium in one pop, there's a chance it is going to give you diarrhea as it has a laxative effect whereas that doesn't happen with food-based magnesium. But the point here is, you can be taking a multi and still very much be deficient in magnesium. Same goes for other vitamins and minerals.

I believe the primary reason why enteral nutrition and juicing work so well is because you're getting the vitamins and minerals you need. And by the way, juicing removes the fiber.

What vitamin and minerals were you tested for and what were the specific levels? "Normal" often is not and it's important to get the actual numbers.
Hi, sorry it took me a while to respond - I had a brief hospital admission, but it's all fine now. This thread has grown a lot in the last few days!

I wasn't told the exact numbers, my GP simply told me they were all fine. I'd previously been deficient in vitamin D (I think because I use so much sun cream because I'm so fair skinned as much as any problem with diet) and a couple of other things I don't remember, and my GP said these were now back within the normal range and that everything else was still fine too.

I haven't been taking vitamin pills but have been having meal-replacement drinks (Ensure), mostly to help me gain weight rather than because they provide all the vitamins you need, but I think you're right about the "false sense of security" in that when I'm drinking them regularly I don't worry about how small my fruit and veg portions are because I know I'm getting everything from the drinks.
03-29-2013, 02:08 PM   #25
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My suggestion would be to get a copy of all your past vitamin and mineral levels and post the actual numbers here. "Fine" often is not.
03-29-2013, 02:11 PM   #26
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Hmmm, the problem with juicing and being on low fibre makes it pretty tricky! Any ideas?? She isn't really allowed much fruit or veg!
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03-29-2013, 02:13 PM   #27
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Juicing is low fiber.
03-29-2013, 02:14 PM   #28
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Juicing is low fiber.
OHHHH lol, cool need to look at that properly! Thanks
03-29-2013, 03:16 PM   #29
woops!
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Can anyone driect me to a thread with good juicing recipies please?
Thanks..
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03-29-2013, 03:33 PM   #30
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Can anyone driect me to a thread with good juicing recipies please?
Thanks..
Here you go.
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Crohn's Disease Forum » Diet, Fitness, and Supplements » Are you getting your necessary vitamins and minerals? No.
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