The Five
Curcumin
Curcumin is the yellow pigment of turmeric root and the most-studied plant compound in inflammatory bowel disease. It has randomized trials in ulcerative colitis, a…
Evidence 5/5Andrew 5/5
THE COMPLETE GUIDE · NOW ONLINE
100Supplements
for IBD.
The evidence. The mechanisms. The exact products.
Explore supplements, herbs, probiotics and nutrients for life with IBD.
CROHN’S DISEASEULCERATIVE COLITISINDETERMINATE COLITISMICROSCOPIC COLITIS
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The supplement library.
100 supplements
Evidence and Andrew’s opinion are scored separately.
The Five
Quercetin
Quercetin is the workhorse flavonoid of the plant kingdom and one of the most-studied antioxidants in existence, in cells and in animals. In people with IBD, it has…
Evidence 2/5Andrew 5/5
The Five
Omega-3 EPA/DHA
The two long-chain omega-3 fatty acids from cold-water fish are the most-consumed anti-inflammatory supplement in the world and one of the most-trialed in IBD, and…
Evidence 4/5Andrew 4/5
The Five
Serum-derived bovine immunoglobulins
A concentrated preparation of antibodies (mostly immunoglobulin G) purified from the blood plasma of cattle, not from milk or colostrum, which is why it is…
Evidence 3/5Andrew 4/5
The Five
Vitamin D3
Vitamin D is less a vitamin than the precursor to a hormone, and its receptor is found on nearly every immune cell in the gut. Deficiency and insufficiency are…
Evidence 4/5Andrew 5/5
Anti-Inflammatories
Bilberry / anthocyanins
Anthocyanins from European blueberry. In a Zurich open-label study, six weeks of an anthocyanin-rich bilberry preparation put 63% of mild-to-moderate UC patients…
Evidence 3/5Andrew 5/5
Anti-Inflammatories
Boswellia serrata
Frankincense resin; its boswellic acids inhibit 5-lipoxygenase, the leukotriene arm of inflammation that curcumin and omega-3 don't touch. Two 2001 trials found it…
Evidence 3/5Andrew 3/5
Anti-Inflammatories
Andrographis paniculata
A double-blind trial found the standardized extract HMPL-004 comparable to mesalazine in active UC; a 224-patient placebo-controlled trial then found 60% response…
Evidence 4/5Andrew —/5
Read entry →No product selected
Anti-Inflammatories
Green tea / EGCG
EGCG, the principal catechin. In a small double-blind pilot (n = 19), 400 to 800 mg/day of purified EGCG for 56 days produced a 67% response rate versus 0% on…
Evidence 3/5Andrew 4/5
Anti-Inflammatories
Ginger
In a 12-week randomized trial in mild-to-moderate UC, 2,000 mg/day of dried ginger lowered the oxidative-stress marker MDA and improved disease-activity scores…
Evidence 4/5Andrew 4/5
Anti-Inflammatories
Resveratrol
trans-Resveratrol from Japanese knotweed. A randomized UC trial found lower inflammatory markers and better quality-of-life scores over six weeks. Only 40 mg per…
Evidence 4/5Andrew 5/5
Anti-Inflammatories
Mastic gum
Chios mastic resin: a small Greek open-label Crohn's study reported lower CRP and IL-6 over four weeks, it reduced colitis in a rat model, and a clinical trial of a…
Evidence 3/5Andrew —/5
Anti-Inflammatories
Melatonin
Not just a sleep hormone, the gut makes far more melatonin than the pineal gland, and it acts on the gut wall directly. A randomized UC trial found melatonin as an…
Evidence 4/5Andrew 2/5
Anti-Inflammatories
Palmitoylethanolamide (PEA)
Randomized data in IBS and chronic pain; calms mast cells and glia. No IBD trials and no clean single-ingredient product.
Evidence 2/5Andrew —/5
Read entry →No product selected
Anti-Inflammatories
N-acetylcysteine (NAC)
N-acetylcysteine, the rate-limiting precursor to glutathione, and a mucolytic that thins mucus. A Spanish pilot RCT (n = 37) added 800 mg/day of NAC to mesalamine…
Evidence 3/5Andrew 3/5
Anti-Inflammatories
Glutathione (liposomal)
The body's master antioxidant: the tripeptide every cell makes to quench oxidative stress, detoxify, and recycle vitamins C and E, and it is measurably depleted in…
Evidence 2/5Andrew 3/5
Anti-Inflammatories
Alpha-lipoic acid
A mitochondrial antioxidant that regenerates glutathione and vitamins C and E. Case-level IBD data only; deep evidence in diabetic neuropathy. Also present in the…
Evidence 2/5Andrew 3/5
Anti-Inflammatories
CoQ10
The electron-transport cofactor. Mitochondrial dysfunction is a real feature of IBD epithelium, and CoQ10 is depleted by statins. Note: the O.N.E. multivitamin…
Evidence 2/5Andrew 3/5
Anti-Inflammatories
Rutin
Converted to quercetin by colonic bacteria and protective in colitis models. Buckwheat and citrus are rich food sources; no product needed.Reference 65
Evidence 1/5Andrew —/5
Read entry →No product selected
Anti-Inflammatories
Sulforaphane
Nrf2 activator; protective in colitis models, human data in other conditions. Thorne's extract standardizes glucoraphanin, the precursor.Reference 66
Evidence 1/5Andrew —/5
Anti-Inflammatories
Reishi
Triterpenes and beta-glucans with immunomodulatory activity in lab and animal studies. Host Defense products are mycelium grown on rice, not fruiting-body…
Evidence 1/5Andrew —/5
Anti-Inflammatories
Turkey tail
PSK/PSP polysaccharides; a small human study found turkey tail increased Bifidobacterium and Lactobacillus. Mycelium-on-rice product.
Evidence 2/5Andrew —/5
Anti-Inflammatories
Lion's mane
Erinacines and hericenones; improvement in a mouse UC model. A 2024 Italian retrospective study found a lion's-mane-based multi-compound add-on (with berberine,…
Evidence 3/5Andrew —/5
Anti-Inflammatories
Cordyceps
Cordycepin; anti-inflammatory in animal models. Mycelium-on-rice product.
Evidence 1/5Andrew —/5
Anti-Inflammatories
Maitake
D-fraction beta-glucan; immunomodulatory in animal models. Includes fruiting body.
Evidence 1/5Andrew —/5
Anti-Inflammatories
Shiitake
Lentinan; preclinical only. No standalone product; eat the mushroom.
Evidence 1/5Andrew —/5
Read entry →No product selected
Anti-Inflammatories
Milk thistle
An Iranian double-blind trial (n = 80, UC in remission) found 140 mg/day of silymarin for six months raised hemoglobin, lowered ESR, and kept 35 of 38 in remission…
Evidence 4/5Andrew —/5
Anti-Inflammatories
Cat's claw
Traditional anti-inflammatory; NF-kB inhibition in the lab; no IBD trials and no clean product.
Evidence 1/5Andrew —/5
Read entry →No product selected
Microbiome Nourishing
Akkermansia muciniphila
The mucin-layer resident most consistently depleted in IBD, now available as a single-strain product for the first time. No IBD intervention trials yet, this is a…
Evidence 1/5Andrew 4/5
Microbiome Nourishing
Saccharomyces boulardii
A probiotic yeast, not a bacterium, so antibiotics don't kill it. A small Italian trial (n = 32) found relapse in 6% of Crohn's patients on mesalamine plus S.…
Evidence 3/5Andrew 4/5
Microbiome Nourishing
Spore-based probiotics
Not recommended (Andrew's position). Spore-forming Bacillus strains with IBS data. Spores germinate unpredictably and Andrew has seen flares follow them. No…
Evidence 2/5Andrew —/5
Read entry →No product selected
Microbiome Nourishing
Multi-strain Lactobacillus / Bifidobacterium
The one multi-strain product I'll put my name on: seven Lactobacillus and Bifidobacterium strains, 50 billion CFU, dairy- and soy-free. I'm not a big believer in…
Evidence 3/5Andrew 3/5
Microbiome Nourishing
Lactobacillus reuteri
In an Italian RCT (n = 40), eight weeks of L. reuteri ATCC 55730 enemas added to mesalazine cut children's Mayo scores from 8.6 to 3.2 (placebo unchanged), with…
Evidence 4/5Andrew —/5
Read entry →No product selected
Microbiome Nourishing
Lactobacillus plantarum 299v
Lactobacillus plantarum 299v is one of the best-characterized single probiotic strains: human-origin, acid- and bile-tolerant, and studied in randomized IBS trials…
Evidence 2/5Andrew 3/5
Microbiome Nourishing
Psyllium
A Spanish multicenter RCT (GETECCU, 1999) found Plantago ovata seed as effective as mesalamine for maintaining UC remission, and the combination best. Start small;…
Evidence 4/5Andrew —/5
Microbiome Nourishing
Partially hydrolyzed guar gum
Partially hydrolyzed guar gum: a low-gas soluble fiber with randomized IBS data and good short-chain-fatty-acid production.Reference 82
Evidence 2/5Andrew —/5
Microbiome Nourishing
Inulin / FOS
Oligofructose-enriched inulin (Synergy 1) lowered fecal calprotectin over four weeks in an acute-UC pilot and was well tolerated; a 2023 Cochrane review finds the…
Evidence 3/5Andrew —/5
Microbiome Nourishing
Galacto-oligosaccharides (GOS)
Galacto-oligosaccharides are strongly bifidogenic with randomized IBS data. This product pairs GOS with beta-glucan (D-15). Contains milk and fish.Reference 85
Evidence 2/5Andrew —/5
Microbiome Nourishing
Resistant starch
A food, not a supplement: cooked-and-cooled potatoes, rice, green bananas. The most direct way to feed butyrate producers.Reference 86
Evidence 2/5Andrew —/5
Read entry →No product selected
Microbiome Nourishing
Larch arabinogalactan
Larch arabinogalactan is a prebiotic with immune-modulating data in adjacent conditions. No product matched.
Evidence 2/5Andrew —/5
Read entry →No product selected
Microbiome Nourishing
Acacia gum
Acacia is among the best-tolerated soluble fibers, with randomized IBS data. No clean single-ingredient product on Fullscript.Reference 87
Evidence 2/5Andrew —/5
Read entry →No product selected
Microbiome Nourishing
Lactoferrin
Iron-binding whey protein with antimicrobial and immunomodulatory activity; human data in other conditions. Contains milk.
Evidence 2/5Andrew —/5
Microbiome Nourishing
Beta-glucan
Yeast and oat beta-glucans train innate immunity and feed the microbiome; adjacent human data. Covered inside the Galactomune product.
Evidence 2/5Andrew —/5
Read entry →No product selected
Microbiome Modulating
Berberine
The one antimicrobial botanical with real IBD evidence, and more of it than I expected: a 2024 meta-analysis pooled ten randomized trials (952 patients, mostly from…
Evidence 5/5Andrew 2/5
Microbiome Modulating
Oregano oil
Emulsified, sustained-release oregano oil, the form matters because raw oregano oil is harsh on the stomach. No IBD trials; this is here for the SIBO overlap that…
Evidence 1/5Andrew 2/5
Microbiome Modulating
Garlic / allicin
Allicin is a broad antimicrobial in the lab; no IBD trials. Cook with it instead.
Evidence 1/5Andrew —/5
Read entry →No product selected
Microbiome Modulating
Wormwood (Artemisia)
In a 10-week double-blind trial (n = 40), Crohn's patients tapering steroids stayed in remission on a wormwood blend (65%) while most placebo patients relapsed; a…
Evidence 4/5Andrew 3/5
Microbiome Modulating
Thyme oil
Thymol is antimicrobial in the lab; no IBD trials and no product.
Evidence 1/5Andrew —/5
Read entry →No product selected
Microbiome Modulating
Olive leaf extract
Oleuropein; antimicrobial and antioxidant in the lab; no IBD trials.
Evidence 1/5Andrew —/5
Read entry →No product selected
Microbiome Modulating
Caprylic acid / monolaurin
Medium-chain fatty acids with antifungal activity in the lab; no IBD trials.
Evidence 1/5Andrew —/5
Read entry →No product selected
Barrier Repair
L-glutamine
The primary fuel of the small-intestinal lining. Human trials are honest and unflattering: in Crohn's, oral glutamine improved intestinal permeability but no more…
Evidence 3/5Andrew 5/5
Barrier Repair
Butyrate
Butyric acid itself (not the sodium or calcium salt) in a sustained-release form designed to survive the small intestine and reach the colon, which is the entire…
Evidence 3/5Andrew 4/5
Barrier Repair
Creatine
Creatine monohydrate, the cheapest, best-studied supplement in existence, and the epithelium's ATP buffer. The gut-lining story is strong in cells and mice…
Evidence 1/5Andrew 4/5
Barrier Repair
Aloe vera (inner leaf)
Inner-leaf gel, not whole-leaf, which contains aloin, a laxative that irritates IBD guts. In a London double-blind trial (n = 44), 100 mL of aloe gel twice daily…
Evidence 3/5Andrew 3/5
Barrier Repair
Zinc carnosine
Andrew wants this one emphasized: a zinc-carnosine chelate that stays in contact with the gut lining, developed in Japan as an ulcer drug (polaprezinc). In a London…
Evidence 3/5Andrew —/5
Barrier Repair
N-acetylglucosamine (NAG)
The amino sugar the gut uses to build mucin, the mucus layer itself. In a London pilot, 8 of 12 children with severe, treatment-resistant IBD improved on NAG (oral,…
Evidence 3/5Andrew 3/5
Barrier Repair
Bovine colostrum
A small randomized trial of bovine colostrum enemas added to mesalazine in left-sided colitis improved symptom and histology scores over four weeks. Oral colostrum…
Evidence 4/5Andrew —/5
Barrier Repair
Phosphatidylcholine
The phospholipid that makes up most of the colonic mucus layer, and is measurably depleted in UC. A delayed-release PC (LT-02) had three positive Heidelberg trials…
Evidence 3/5Andrew 4/5
Barrier Repair
Collagen peptides
Glycine, proline and hydroxyproline, the raw materials for connective tissue and the gut lining. No IBD trials; it's here as a well-tolerated protein source that…
Evidence 1/5Andrew 4/5
Barrier Repair
Slippery elm
A demulcent, it coats. The mucilage soothes irritated lining on contact, and biopsy studies found antioxidant activity in UC tissue. One of the oldest gut remedies…
Evidence 2/5Andrew 3/5
Barrier Repair
Marshmallow root
Demulcent mucilage, traditional for irritated lining. Covered inside DGL Plus.
Evidence 1/5Andrew —/5
Read entry →No product selected
Barrier Repair
DGL licorice
Deglycyrrhizinated licorice protects mucosa without the blood-pressure effect of whole licorice. Note: some people find DGL irritating rather than soothing; if it…
Evidence 1/5Andrew —/5
Barrier Repair
Chamomile
Apigenin and bisabolol; spasmolytic and mildly anti-inflammatory. A German double-blind trial (n = 96) found a myrrh, chamomile and coffee-charcoal preparation…
Evidence 3/5Andrew —/5
Read entry →No product selected
Peptides
BPC-157
BPC-157 is a fifteen-amino-acid fragment of a protein found in gastric juice, with an enormous animal literature on mucosal, tendon and vascular repair, nearly all…
Evidence 1/5Andrew 4/5
Peptides
KPV
KPV is the three-amino-acid anti-inflammatory tail of alpha-MSH. It is taken up directly by inflamed intestinal epithelium through the PepT1 transporter, and in…
Evidence 1/5Andrew 3/5
Digestive Support & Enzymes
Peppermint oil (enteric-coated)
The only entry in this section with a real randomized-trial base: in IBS, a meta-analysis of seven placebo-controlled trials found enteric-coated peppermint oil…
Evidence 2/5Andrew 2/5
Digestive Support & Enzymes
Broad-spectrum digestive enzymes
Broad-spectrum plant enzymes, proteases, amylase, lipase, lactase, alpha-galactosidase and more. Exocrine pancreatic insufficiency is underdiagnosed in IBD, and…
Evidence 2/5Andrew 3/5
Digestive Support & Enzymes
Papain (papaya enzyme)
Papain from papaya plus bromelain, in a chewable-style tablet, the closest thing on Fullscript to the classic papaya enzyme. Gentle proteases taken with meals.
Evidence 1/5Andrew 4/5
Digestive Support & Enzymes
Bromelain
Pineapple-stem protease. With food it digests protein; between meals it's absorbed and acts as an anti-inflammatory, with case reports in UC. 500 mg at 2,400 GDU, a…
Evidence 2/5Andrew 4/5
Digestive Support & Enzymes
Lactase
Secondary lactose intolerance is common in active small-bowel disease and often resolves in remission. No clean standalone product matched; the enzyme blend (H-02)…
Evidence 2/5Andrew —/5
Read entry →No product selected
Digestive Support & Enzymes
Alpha-galactosidase
Breaks down the oligosaccharides in legumes that cause gas. Included in the enzyme blend (H-02).
Evidence 2/5Andrew —/5
Read entry →No product selected
Digestive Support & Enzymes
Diamine oxidase (DAO)
Histamine-degrading enzymeReference 132
Evidence —/5Andrew —/5
Digestive Support & Enzymes
Betaine HCl
Gastric acid support; no IBD evidence and it conflicts with acid-suppressing medication. No product matched.
Evidence 1/5Andrew —/5
Read entry →No product selected
Amino Acids
Tryptophan
The one amino-acid product for the section: all essential amino acids in free form, including tryptophan, histidine and the sulfur amino acids that entries I-01…
Evidence 2/5Andrew 3/5
Amino Acids
Arginine
Nitric oxide precursor with wound-healing roles; preclinical colitis data only.
Evidence 1/5Andrew —/5
Read entry →No product selected
Amino Acids
Glycine
Anti-inflammatory and cytoprotective in animal models; abundant in collagen and bone broth (F-09).
Evidence 1/5Andrew —/5
Read entry →No product selected
Amino Acids
Sulfur amino acids
Cysteine and methionine feed glutathione synthesis; see NAC (C-10). Preclinical only. Caution: sulfur amino acids are converted by sulfate-reducing gut bacteria…
Evidence 1/5Andrew —/5
Read entry →No product selected
Amino Acids
Histidine
Depleted in Crohn's disease in observational studies; protective in colitis models.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Iron
Iron deficiency is the most common deficiency in IBD; European guidelines call for a blood count, ferritin and CRP every three months in active disease and every…
Evidence —/5Andrew 4/5
Vitamins & Minerals
Vitamin B12
Absorbed only in the terminal ileum, so ileal Crohn's and resection make deficiency likely. A Dutch RCT found extra B12 does not relieve fatigue in people who…
Evidence 3/5Andrew —/5
Vitamins & Minerals
Folate (B9)
Sulfasalazine and methotrexate both deplete folate; 5-MTHF is the active form. Safe alongside methotrexate for IBD.Reference 139
Evidence 3/5Andrew —/5
Vitamins & Minerals
Zinc
Lost in diarrhea; a Chicago cohort found zinc-deficient IBD patients had more hospitalizations, surgeries and complications, and that correcting zinc improved those…
Evidence 3/5Andrew —/5
Vitamins & Minerals
Magnesium
Magnesium glycinate, the form least likely to loosen stool, 120 mg of elemental magnesium per capsule with nothing else but the capsule and a trace of ascorbyl…
Evidence 3/5Andrew 4/5
Vitamins & Minerals
Vitamin A
Supports mucosal immunity and epithelial differentiation. Fat-soluble; watch total intake with the multivitamin.Reference 143
Evidence 2/5Andrew —/5
Vitamins & Minerals
Calcium
Bone loss is a common IBD complication, worsened by steroids. Citrate absorbs without stomach acid.Reference 144
Evidence 3/5Andrew —/5
Vitamins & Minerals
Thiamine (B1)
A Danish crossover RCT (n = 40) found four weeks of high-dose thiamine (600–1,800 mg/day, by weight and sex) cut fatigue scores by 4.5 points versus none on placebo…
Evidence 4/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Riboflavin (B2)
The Dutch RISE-UP study gave riboflavin to Crohn's patients and reported microbiome and oxidative-stress changes. In the multivitamin.Reference 148
Evidence 3/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Niacin (B3)
Signals through GPR109A, the same receptor as butyrate, in colonic epithelium. In the multivitamin.Reference 149
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Selenium
Cofactor for glutathione peroxidase; often low in IBD.Reference 150
Evidence 2/5Andrew —/5
Vitamins & Minerals
Vitamin C
Buffered ascorbate powder with no other ingredients; the mineral load also helps constipation, and plain ascorbic acid loosens stool. Four options: PERQUE's…
Evidence 2/5Andrew —/5
Vitamins & Minerals
Vitamin E
Natural d-alpha tocopherol (400 IU, 260 mg) with 67 mg of the other tocopherols, the family of forms found in food, rather than a single synthetic form; in rapeseed…
Evidence 3/5Andrew 4/5
Vitamins & Minerals
Vitamin B6
Low in IBD and lowered further by inflammation. P5P is the active form.Reference 153
Evidence 2/5Andrew —/5
Vitamins & Minerals
Vitamin K2
Vitamin K deficiency is documented in Crohn's; K2 directs calcium to bone. Standalone MK-7; warfarin interaction.Reference 154
Evidence 2/5Andrew —/5
Vitamins & Minerals
Biotin (B7)
Biotin transport is altered in experimental colitis. In the multivitamin.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Pantothenic acid (B5)
Wound-healing roles; in the multivitamin.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Choline
Direct precursor to phosphatidylcholine (F-08). In the multivitamin.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Copper
Cofactor for SOD1; long-term zinc without copper depletes it. In the multivitamin.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Potassium
Lost in diarrhea; food first (bananas, potatoes, broth). Standalone capsules are capped at 99 mg and not worth linking.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Iodine
Thyroid function; in the multivitamin.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
Manganese
Cofactor for mitochondrial SOD2; in the multivitamin.
Evidence 1/5Andrew —/5
Read entry →No product selected
Vitamins & Minerals
The multivitamin
One capsule covers the thirteen essential vitamins plus zinc, selenium, iodine, manganese, choline, CoQ10 and alpha-lipoic acid, which means it overlaps with…
Evidence —/5Andrew 4/5
Sleep, Stress & Attention
Herbal sleep formula
An all-herbal formula built around passionflower, valerian, California poppy, skullcap and hops, with vervain, gotu kola and a trace of lavender, extracted into…
Evidence 2/5Andrew 4/5
Sleep, Stress & Attention
Bach flower remedy (Rescue Remedy)
Five flower essences (rock rose, clematis, impatiens, cherry plum, star of Bethlehem) in a grape-alcohol base, the formula Dr Edward Bach developed in England in…
Evidence 1/5Andrew 3/5
Sleep, Stress & Attention
L-theanine
The amino acid that makes green tea calming. L-theanine raises alpha-wave activity in the brain within an hour, and in randomized trials it reduced stress-related…
Evidence 2/5Andrew 5/5
Sleep, Stress & Attention
L-tyrosine
The amino acid the brain turns into dopamine and noradrenaline. In randomized studies, tyrosine preserves working memory and attention when the dopamine system is…
Evidence 2/5Andrew 4/5
Sleep, Stress & Attention
Phosphatidylserine
A phospholipid concentrated in cell membranes, and in the brain more than anywhere else. Phosphatidylserine has randomized trials for memory and attention in older…
Evidence 2/5Andrew 5/5
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Product selections are options to discuss with your care team. Andrew earns a commission on Fullscript purchases. US shipping only.
CONNECT THE DOTS
Understand the whole picture.
A NOTE FROM ANDREW
Every part of you
is in the room.
I have Crohn’s disease. I’m a health educator, a health coach, and the founder of Systema Health. I wrote this guide to put the supplements I believe in, the evidence, and the exact products in front of the people who need them.
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