Although much attention has been focused on celiac disease as a cause of infertility and miscarriage, Crohn’s disease may also have an impact on fertility through multiple nutrient deficiencies, auto-immune factors and widespread inflammation and inflammatory cytokines.

Crohn’s disease is characterized by inflammation throughout the large and small intestines that can severely compromise nutrient absorption - especially folic acid - and produce inflammatory substances which may interfere with normal fertility.

Additionally, surgery which may be performed to remove portions of the intestines can result in scar tissue and adhesions within the pelvis which could also endanger fertility.

Remedying the nutrient deficiencies known to be associated with Crohn’s disease could be an important key to improving fertility in Crohn’s patients. Sub-lingual nutrients are available as sprays and drops that are absorbed through the mouth mucosa or under the tongue allowing any absorption problems in the gut to be by-passed. It is relatively easy to find sub-lingual folic acid, vitamin B12 and other nutrients such as vitamin-D sub-lingual spray.

Another strategy of interest is the use of low-dose-naltrexone, a drug which is being used successfully to treat both Crohn’s disease and infertility. This line of treatment may both improve fertility while lending stability to the digestive tract when other medications may be undesirable during pregnancy.

Taking care to follow and anti-inflammatory diet with plenty of fish oil, fruits and vegetables and other anti-inflammatory supplements could hold another key to conceiving successfully with Crohn’s.

So the question becomes what to supplement and how? This is really an individual matter as supplementation needs to take into account the person’s diet choices, current health and level of Crohn’s but there are some generalizations that can be made.

A number of studies have set out to measure the types of nutrient depletions that are prevalent in patients with Crohn’s. One such study (1) measured blood levels - and red blood cell levels - of nutrients in 24 patients and 24 healthy subjects discovered that patients with Crohn’s disease had comparatively far less vitamin A, E, B1, B2, B6 and folic acid, all important fertility nutrients.

Another similar study (2) analyzed nutrient levels in 279 Crohn’s patients and discovered that 85% were deficient in essential nutrients, especially iron, calcium and also - to a lesser degree - zinc, protein, B12 and folic acid.

Interestingly, another study (3) looked at nutrient levels of patients who had Crohn’s disease, but were in long-term remission. Even though their disease was not active their bone mineral levels were lower than average and their blood had significantly lower levels of: beta-carotene, vitamins C and E, selenium, magnesium, and zinc, and glutathione peroxidase, an important antioxidant.

A further study (4) of 137 Crohn’s patients also confirmed that many with the disease have lower levels of iron, vitamin B12, and folate, all critical fertility nutrients.

One important consequence of low levels of B-vitamins, specifically B6, B12 and folate is a tendency towards increased serum homocysteine levels. These B-vitamins are essential for proper ‘methylation‘ which is a very important process within the body and high homocysteine is a byproduct of poor methylation.

High homocysteine is not favorable for fertility and pregnancy and is associated with increased birth defects. It is important to check blood levels of homocysteine if you have Crohn’s disease and are trying to conceive, if homocysteine levels are high they can usually be reduced with therapeutic use of B12, B6 and folate.

Deficiency of folic acid is a special concern in Crohn’s disease given it’s protective power over healthy baby development. One study (5) set out to evaluate how adequately 100 patients with Crohn’s disease absorbed folic acid compared to 20 healthy controls. After administration of a set dose of folate blood levels sere assessed, results showed that only 75% of the Crohn’s patients had normal folic acid levels after taking the supplement, 9% showed virtually no discernible rise in folate levels at all.

A comprehensive list of the nutrients known to be deficient in people with Crohn’s provided by crohns.net include the following: vitamin A, Beta carotene, Vitamin D, Vitamin E, Vitamin K, Vitamin C, Vitamin B1, B2, B3, B12, Folic acid, biotin, calcium, magnesium, iron, zinc, selenium. Re-nourishing your body could hold the key to better fertility and a healthier pregnancy and baby.

This article is purely for educational and informational purposes and is not intended to substitute for medical diagnosis or treatment for which you should consult a physician.

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References:

Kuroki F, Iida M, Tominaga M, et al. Multiple vitamin status in Crohn’s disease. Dig Dis Sci 1993;38:1614-1618.
Rath HC, Caesar I, Roth M, Scholmerich J. Nutritional deficiencies and complications in chronic inflammatory bowel disease. Med Klin 1998;93:6-10.
Geerling BJ, Badart-Smook A, Stockbrugger RW, Brummer RJ. Comprehensive nutritional status in patients with long-standing Crohn disease currently in remission. Am J Clin Nutr 1998;67:919-926.
Imes S, Pinchbeck BR, Dinwoodie A, et al. Iron, folate, vitamin B-12, zinc, and copper status in out-patients with Crohn’s disease: effect of diet counseling. J Am Diet Assoc 1987;87:928-930.
Steger GG, Mader RM, Vogelsang H, et al. Folate absorption in Crohn’s disease. Digestion 1994;55:234-238.