Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide

Table 1

Micronutrient deficiencies in IBD.

Micronutrient	Physiopathology	Main symptoms of deficiency	Diagnosis
Iron	Chronic blood loss; Impaired iron metabolism; Inadequate intake	Anemia, fatigue, sleeping disorders, restless legs syndrome, attention deficit, discontentment, agitation, and female infertility	Transferrin sat <16% and serum ferritin <30 ng/mL
Calcium	Inadequate dietary intake; Decreased intestinal/renal absorption	Decreased bone density, hyperparathyroidism, hypertension, and muscle spasm	Bone density scan; Serum calcium < 8.5 mg/dl
Selenium	Not fully understood	Cardiomyopathy and cartilage degeneration	Serum selenium <70 μg/L
Zinc	Chronic diarrhea; Malabsorption	Poor wound healing	Serum zinc <75 μg/mL
Magnesium	Chronic diarrhea; Inadequate dietary intake	Fatigue	Serum magnesium <1.41 mEq/L
Vitamin B9	Inadequate dietary intake; Malabsorption; Medications (MTX)	Megaloblastic anemia, modestly increased risk of colonic dysplasia, and hyperhomocysteinemia	Serum folate < 2.5 ng/mL
Vitamin B12	History of ileal/ileocolonic resection	Megaloblastic anemia and peripheral neuropathy	Serum B12 < 200 pg/mL
Vitamin D	Inadequate dietary intake; Malabsorption	Abnormal bone metabolism	Serum 25OHD (<15 ng/mL deficiency, <20 ng/mL insufficiency, and >30 ng/mL optimum)
Vitamin A	Inadequate dietary intake; Malabsorption	Poor wound healing, night blindness, and xeropthalmia	Serum retinol <30 μg/dL
Vitamin K	Inadequate dietary intake; Malabsorption; Use of antibiotics	Abnormal bone metabolism	Serum phylloquinone <1.1 ng/mL; PT/INR