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Laboratory evidence of nutritional deficiencies reported in adults with inflammatory bowel disease

Laboratory evidence of nutritional deficiencies reported in adults with inflammatory bowel disease
Deficiencies Percent
Common
Anemia 60 to 80
Iron deficiency 39 to 81
Vitamin D deficiency 75
Vitamin B12 deficiency* 20 to 60
Zinc deficiency 40 to 50
Calcium deficiency[1] 18 to 42
Hypoalbuminemia (primarily reflects inflammation) 25 to 80
Less commonΔ
Folic acid deficiency  
Magnesium deficiency  
Vitamin A deficiency  
Vitamin E deficiency  
Vitamin K deficiency  
Copper deficiency  
Vitamin C deficiency  
Vitamin B1 (thiamine) deficiency[2]  
Niacin deficiency  
The frequency of vitamin and mineral deficiencies in patients with inflammatory bowel disease varies widely, depending on the patient population and criteria used to define deficiency. In this table, deficiencies are listed as "less common" if they are typically reported in 10% or less of the population studied.
DXA: dual-energy x-ray absorptiometry.
* The frequency of vitamin B12 deficiency depends on extent of ileal involvement or ileal resection.
¶ Negative calcium balance as defined by bone mineral density T-score <–2.5 as measured by DXA.
Δ Cases reported but prevalence not described.
The prevalence of folic acid deficiency in this population varies widely in different reports. It appears to be uncommon in reports from the last decade, perhaps due to reduced use of sulfasalazine and/or higher levels of folate intake[3].
References:
  1. Bernstein CN, Leslie WD, Leboff MS. AGA Technical review on osteoporosis in gastrointestinal disorders. Gastroenterology 2003; 124:795.
  2. Hwang C, Ross V, Mahadevan U. Micronutrient deficiencies in inflammatory bowel disease: from A to zinc. Inflamm Bowel Dis 2012; 18:1961.
  3. Kulnigg S, Gasche C. Systematic review: managing anaemia in Crohn's disease. Aliment Pharmacol Ther 2006; 24:1507.
Adapted from: Perkal MF, Seashore JH. Nutrition and inflammatory bowel disease. Gastroenterol Clin N Am 1989; 18:567.
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