Keeping up the Nutrients

One of the things that worried me the most when I was diagnosed with FM was how to avoid high fructose foods while still having a balanced and healthy diet, and this is something that I still struggle with. As previously mentioned, since my FM diagnosis, I have struggled to maintain a healthy diet. Within in a year of the diagnosis, I had gained quite a bit of weight, and I am still struggling to keep my weight under control. While I am by no means obese, I am nevertheless heavier than I have ever been and have had trouble fitting into some of my clothes, so I am not happy about this! I have heard that some medications taken for IBD such as Prednisone can cause weight gain, however this is not the case for me, as I do not take this medication.

I have therefore concluded that the reason for my weight gain must have been the changes in my diet. After my FM diagnosis, I changed to a very simple diet, avoiding as many high fructose foods as possible. Because wheat is a significant problem food for me, but was also a large part of my diet previously, I was eating a lot of pasta and bread made with rice flour and potato flour, which meant that my diet was very high in carbohydrates, hence my weight gain. My diet was clearly very unhealthy, and I felt horrible. I have decided that to help with the weight issue, I need to work on having a more balanced diet and do more exercise, but I still worry that I am not getting the nutrients I need, as I still need to avoid a lot of foods.

MY STRUGGLES WITH IRON

Since I was about 8 years old, I have struggled to keep up my iron levels - although thankfully never quite bad enough to be classified as anaemic. Because of this, I have often struggled in the past with fatigue and dizzy spells. I was initially told that the best way to manage this was through my diet, for example eating more red meat. However, I found out when doing a routine blood test a couple of months ago that my iron levels have decreased since my FM diagnosis. As a result, for the first time, I am now taking iron supplements. I was initially concerned that the supplements would have a negative effect on my bowel, as this can be a common side effect, but this does not seem to be a problem, and I am now taking the supplements three times a week.

MY STRUGGLES WITH VITAMIN D

About three years ago, also through having a routine blood test, I found out that my Vitamin D levels were quite low, and was told by my GP to start taking vitamin D supplements. For the first six months or so, I took the supplements three times a day, and then reduced my dosage to once a day. I have now been told that my vitamin D levels are slightly over the average recommended level, so I have reduced my dosage further to three times a week (I usually take them with my iron supplements). I was initially told that my vitamin D levels were likely low due to not enough sun exposure, which made sense because I do consciously avoid being in the sun for too long, as I have very fair skin and some history of skin cancer in my family.

NUTRIENT DEFICIENCIES AND IBD

Disclaimer: I am not a nutritionist or doctor. The below comments are based on my own research, and are only meant to be used as a guide. Consult your doctor or nutritionist to help identify the best treatment options for you.

According to several studies, it is very common for people with IBD to have problems with nutrient deficiency. There are three main reasons for this: decreased intake of nutrients due to dietary limitations, difficulties absorbing nutrients due to inflammation of the bowel, and nutrient loss due to diarrhoea and bleeding. You can read more about these causes here and here. As a result, I am starting to wonder whether my iron and vitamin D deficiencies are also related to my IBD.

Vitamin D deficiency is quite common in people with IBD according to this recent study. The main reasons for this are that dietary fat, which is necessary for the body to absorb vitamin D, is poorly absorbed when the bowel is inflamed. Additionally, some medications can interfere with the body’s ability to absorb calcium, which is necessary for the body’s ability to use vitamin D. Studies have also shown that there is a link between the development and treatment of IBD, as vitamin D can impact the body’s digestive processes and immune system, in that symptoms often improve with increased vitamin D intake.

Iron deficiency and anaemia are also very common in people with IBD – around 36-76% more common than those without IBD according to this 2013 study. The main reasons for this are decreased dietary intake of iron, blood loss and malabsorption. Iron deficiency can of course make things more difficult for people with IBD, as common symptoms of iron deficiency and anaemia include dizziness, fatigue, headaches, loss of appetite and disrupted sleep.

For similar reasons, it is also common for people with IBD to have deficiencies in calcium, folic acid, vitamin B-12, and magnesium. You can read more about these here and here.

Apart from generally keeping healthy, there are some nutrients that can help to improve IBD symptoms. For UC in particular, the following nutrients can help with symptoms: iron and B vitamins can help with fatigue and memory, potassium can reduce stomach cramps, and magnesium can reduce diarrhoea. 

Do you have any tips for managing nutrient deficiencies and a healthy diet? Please comment below.