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Low Zinc and Crohn's

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Crohn's Disease
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Posted 7/31/2009 7:17 PM (GMT 0)
Well, well, well...the doc tested my daughter's zinc and sure enough, she got a call today saying it was low and that she needed to take supplements of 25 mg daily. (She currently gets about a third of that in the single SCD multivitamin.) 

As the following link shows, research showing Crohn's patients tend to be low in zinc has been kicking around since at least 1977.

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=198059&Ausgabe=242382&ProduktNr=223838&filename=198059.pdf

Posted 8/1/2009 3:44 AM (GMT 0)
Zinc is absorbed via the same pathway as non-heme iron and they compete for access to that pathway (along with copper). If she is deficient in zinc, maybe she is deficient in iron and copper too? If she is taking both a zinc supplement and an iron supplement, she should take them at different meals to avoid the overloading of the absorption pathway. I have heard that calcium also interferes with iron absorption too, but I think that it is calcium carbonate that interferes - the iron carbonate that forms is not absorbed and the alkalinity caused by calcium carbonate also forms insoluble iron compounds. Zinc is best absorbed as zinc citrate.
Posted 8/1/2009 10:21 PM (GMT 0)

Yes, she is iron deficient and vitamin D deficient, too. Taking even the low dosage of 25mg iron can, I found out, interfere with zinc absorption for up to 4 hours. 

She aleady gets about 7 mg of zinc in her SCD multivitamin at lunch. And starting yesterday, she is taking another 22.5 mg of zinc picolinate at dinner. So we will have to see whether this helps.

I'm sure the Entocort interferes with D absorption, and suspect it of causing other deficiencies, too, so am hoping the LDN will allow her to taper off at least temporarily.

Posted 8/2/2009 4:46 AM (GMT 0)
I don't know about endocort and vitamin D, but inflammation of the small intestine or ileum will interfere with absorption of oil soluble vitamins and B12. Maybe sublingual B12 would be something to try?

If she takes zinc at lunch and at dinner, does she take her iron at breakfast then? I want to say that the actual compound in the supplements is important. It sounds like you have a handle on this, but there are important drawbacks to common forms of some supplements. Iron should not be Ferrous Sulphate. It is irritating and poorly absorbed. Ferrous citrate or ferrous fumarate/maleate/ or other organically bound form is better. They form chelates and are better absorbed and more stable (less damaging to tissues).

Calcium carbonate is another common supplement ingredient that is a bad idea. It neutralizes stomach acid and in the absence of an acidic environment, several other minerals (iron, zinc, copper and others) precipitate out as hydroxides and are poorly absorbed. Taking it with meals can reduce your stomach acidity to a level where the stomach digestive enzymes don't work (they work in a very restricted range of pH and temperature). This means undigested food passes into your small intestine where bacteria consume it. This causes bacterial growth (or overgrowth) and generates gas. It may also slow peristalsis as the bacteria feed. If the bacteria trigger your immune system, it will cause diarrhea.
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