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Acemannan, aloe vera's primary polysaccharide, was studied in an exploratory clinical pilot in inflammatory bowel disease including Crohn's disease. Animal studies demonstrate aloe vera extract significantly reduces colonic inflammation markers (TNF-α, IL-6, nitric oxide) and improves histopathology in TNBS-induced colitis models.

B. longum has been studied as an adjunctive therapy in inflammatory bowel disease including Crohn's disease. Clinical trials and a 2021 review in the Journal of Immunology Research summarize evidence that B. longum can reduce IBD symptoms and intestinal inflammation, with lower fecal B. longum abundance consistently found in IBD patients compared to healthy controls.

Crohn's disease affecting the terminal ileum directly impairs bile salt reabsorption via ASBT downregulation or surgical resection, resulting in bile acid diarrhea. The first reported dysfunctional ASBT mutation was identified in a Crohn's disease patient. Bile acid diarrhea and SIBO both mimic and complicate Crohn's symptom assessment, with clinical impact confirmed in human studies.

Boswellia (Boswellia serrata) resin contains boswellic acids that reduce intestinal inflammation by inhibiting 5-lipoxygenase. It is identified in double-blind RCTs specifically for Crohn's disease, showing comparable efficacy to mesalamine for active CD in one trial. A larger maintenance trial found it safe but not superior to placebo for remission maintenance.

Boswellic acids, the active constituents of Boswellia serrata resin, inhibit 5-lipoxygenase and reduce leukotriene-driven intestinal inflammation. A double-blind RCT found Boswellia as effective as mesalamine for active Crohn's disease. A subsequent 108-patient 52-week placebo-controlled trial confirmed good tolerability but did not demonstrate superiority for maintaining CD remission.

Oral butyrate has been evaluated in Crohn's disease in small human trials. A PubMed-indexed study administered 4 g/day enteric-coated butyrate to 13 patients with mild-to-moderate ileocolonic Crohn's disease for 8 weeks with colonoscopic evaluation. A 2025 randomized IBD study included 60 Crohn's disease patients alongside UC patients receiving oral butyrate adjunct. Evidence is limited and mixed; tributyrin-specific Crohn's trials do not yet exist.

Butyric acid (butyrate) is the primary energy source for colonocytes and plays a key role in intestinal barrier integrity and mucosal immune regulation. ConsumerLab.com notes clinical evidence for butyrate supplementation in Crohn's disease. Reduced colonic butyrate production due to gut microbiome dysbiosis is a documented feature of CD pathogenesis.

Calcium deficiency is well-documented in Crohn's disease, driven by malabsorption, avoidance of dairy, and corticosteroid-induced bone loss. Calcium supplementation combined with vitamin D is recommended by gastroenterologists and the Crohn's & Colitis Foundation to prevent osteoporosis and maintain bone health in CD.

Bovine colostrum has been investigated in Crohn's disease specifically for its ability to reduce intestinal permeability, a key pathogenic factor. Animal models using TNBS-induced colitis (which mimics Crohn's) show protective effects. A registered double-blind RCT has been conducted examining colostrum for increased intestinal permeability in Crohn's patients.

Curcumin (the principal polyphenol in turmeric/Curcuma longa) has been evaluated in multiple RCTs and a 2024 meta-analysis of 13 placebo-controlled RCTs in IBD including Crohn's disease. It inhibits NF-κB and suppresses TNF-α and IL-6. A pilot study showed clinical improvement as add-on therapy in five CD patients. Evidence is strongest for UC but CD-specific signals are promising.

DHA is a major omega-3 component of fish oil studied alongside EPA for Crohn's disease. It serves as a precursor to pro-resolving mediators (resolvins, protectins). RCT evidence (EPIC trials, JAMA 2008) found no significant benefit for remission maintenance, though DHA bioavailability in CD patients is documented in a crossover RCT.

Intestinal mucosal DAO activity is significantly reduced in inflamed Crohn's disease tissue compared to healthy margins, and serum DAO is investigated as a biomarker of disease activity and intestinal barrier integrity. DAO is not used as a treatment for Crohn's disease but serves as a marker of enterocyte damage and mucosal integrity.

EPA is the primary anti-inflammatory omega-3 in fish oil studied for Crohn's disease. Large RCTs (EPIC trials, JAMA 2008) found no significant benefit for CD remission maintenance. A double-blind crossover RCT confirmed significant serum EPA increases in CD patients with supplementation but no significant effect on inflammatory markers CRP or fecal calprotectin.

Fish oil (omega-3 fatty acids EPA and DHA) has been extensively studied in Crohn's disease. A 1996 NEJM RCT found enteric-coated fish oil reduced CD relapse; however, the 2008 JAMA EPIC trials (two large RCTs) found no significant benefit for remission maintenance. A Cochrane review confirmed no consistent benefit. Fish oil is still included in CD nutritional management for anti-inflammatory support.

Folic acid (vitamin B9) deficiency is common in Crohn's disease due to malabsorption and interference by medications including sulfasalazine and methotrexate. A PubMed study found serum folate significantly lower in CD patients than controls. Supplementation is recommended by gastroenterology authorities to support cell growth, reduce inflammatory homocysteine, and lower colorectal cancer risk.

In retrospective clinical studies, SBI (bovine serum IgG) has been used as adjunct nutritional support in Crohn's disease patients unresponsive to standard therapy, with reported symptom improvements. Animal colitis models also demonstrate SBI attenuates E. coli-associated colonic inflammation.

An early RCT by Gerhardt et al. showed a mean reduction of 90 points on the Crohn's Disease Activity Index (CDAI) for Boswellia vs. 53 for mesalamine. However, a subsequent larger double-blind RCT (Holtmeier et al., 2011; n=82) found no significant difference from placebo in remission maintenance at 52 weeks. Evidence is therefore mixed: promising for active disease induction but not maintenance.

Iron deficiency and iron deficiency anemia are among the most common complications of Crohn's disease, caused by chronic intestinal bleeding, malabsorption, and reduced intake. Iron supplementation (oral or intravenous) is a standard, universally recommended nutritional intervention in CD, endorsed by the Crohn's & Colitis Foundation and all major gastroenterology authorities.

Multiple RCTs and a Cochrane review have examined L-glutamine for Crohn's disease; results are mixed with no demonstrated benefit for induction of remission, but some trials show improved intestinal permeability and antioxidant status. Glutamine is consistently found to be safe in this population.

L. acidophilus has been investigated within multi-strain probiotic combinations for Crohn's disease (CD) in both preclinical and limited clinical contexts. Preclinical work in a SAMP1/YitFc mouse model of CD-like ileitis demonstrated that a combination including L. acidophilus and other strains reduced pathogen burden and modulated adaptive immune pathways. Human evidence is limited; L. acidophilus features in IBD probiotic protocols but robust dedicated CD RCTs are sparse. The strongest evidence for Lactobacillus genus interventions in IBD pertains to ulcerative colitis rather than Crohn's specifically.

A double-blind RCT (Bousvaros et al. 2005, Inflamm Bowel Dis) evaluated LGG versus placebo as adjunct to standard maintenance therapy in children with Crohn's disease. While LGG has anti-inflammatory effects in intestinal models and modulates gut microbiota, the clinical RCT in Crohn's disease did not demonstrate a significant therapeutic advantage over standard therapy alone.

Fecal lactoferrin is a validated biomarker with high sensitivity and specificity for detecting active Crohn's disease. As a therapeutic, lactoferrin's antimicrobial and immunomodulatory properties are under active investigation for IBD including Crohn's, though direct interventional RCT data remain limited.

Magnesium deficiency is prevalent in Crohn's disease, confirmed in a 2024 PRISMA-compliant systematic review of eight studies (453 CD patients). Serum magnesium was significantly lower in CD patients versus controls, correlated with elevated CRP (disease activity), and hypomagnesemia prevalence reached up to 50% in one study. Supplementation may improve CD management and remission.

Mastic gum (Pistacia lentiscus resin) was found superior to placebo for inducing remission in Crohn's disease in a pilot RCT, with significant reductions in CDAI, IL-6, CRP, and oxidative stress. Multiple systematic reviews of herbal IBD therapies specifically list mastic gum as having clinical evidence in CD.

In Crohn's disease, MCTs are used clinically as a more easily absorbed fat source when LCT malabsorption occurs due to mucosal inflammation, resection, or bile salt deficiency. MCT oil is incorporated into semi-elemental enteral formulas recommended for Crohn's management, and clinical nutrition guidance cites MCT as a practical caloric supplement when fat absorption is compromised.

N-acetyl-glucosamine (NAG) has very preliminary evidence for benefit in Crohn's disease; ConsumerLab.com notes reduced NAG levels in CD patients and some clinical signals though studies have been uncontrolled. A Johns Hopkins University/NIDDK-sponsored RCT (NCT07225998, 2025) is currently evaluating oral NAG specifically in Crohn's disease based on glycosylation defect mechanisms.

NAC has been examined in inflammatory bowel disease including Crohn's disease as an adjunctive antioxidant and anti-inflammatory agent. A 2024 PMC review identified Crohn's disease among conditions for which NAC may be beneficial. Clinical evidence is limited but involves measurable anti-inflammatory effects in IBD populations.

Omega-3 fatty acids (EPA and DHA from fish oil) have been extensively studied in Crohn's disease. Despite plausible anti-inflammatory mechanisms and documented bioavailability in CD patients, the 2008 JAMA EPIC trials and a Cochrane review found no significant benefit for remission maintenance. They remain listed by gastroenterology authorities for anti-inflammatory support in CD.

Potassium deficiency (hypokalemia) is a recognized complication of Crohn's disease caused by chronic diarrhea, vomiting, and intestinal fluid losses. WebMD and gastroenterology sources list potassium among the minerals commonly requiring supplementation in CD. It is essential for healthy muscle, cardiac, and cellular function.

S. boulardii has been evaluated in multiple clinical trials for Crohn's disease (CD), showing mixed results. An early small RCT found a marked reduction in relapse when combined with mesalamine, but a larger placebo-controlled trial (FLORABEST, n=165) failed to show benefit for relapse prevention. It improves intestinal permeability in CD patients in remission, and it is supported by mechanistic anti-inflammatory evidence.

An in vitro study using inflamed human colorectal biopsy tissue from IBD patients found slippery elm had dose-dependent antioxidant activity comparable to 5-aminosalicylate, the most potent herb tested. No human RCTs exist for Crohn's disease specifically. The PMC IBD review notes the findings as promising but requiring further study.

Human intestinal mucosal biopsies from Crohn's disease patients treated with resolvin D2 ex vivo show reduced pro-inflammatory cytokine production comparable to anti-TNFα therapy. Reduced SPM levels in Crohn's disease mucosa have been documented. SPMs represent a mechanistically rational non-immunosuppressive therapeutic approach.

S. thermophilus, as part of VSL#3, has been studied for preventing post-operative recurrence of Crohn's disease. While direct evidence for S. thermophilus alone in Crohn's is limited, VSL#3 has demonstrated efficacy in this context in controlled trials.

Artesunate, derived from A. annua, suppresses TNF-α and Th1/Th17 responses in TNBS colitis models—mechanisms central to Crohn's pathology. Johns Hopkins research explicitly proposed artesunate as a candidate therapy for Crohn's disease based on these experimental findings.

Tributyrin is a naturally occurring triglyceride prodrug of butyric acid that releases three butyrate molecules upon hydrolysis in the intestine. A US patent (USPTO 5569680) specifically covers treating inflammatory bowel disease including Crohn's disease with tributyrin. ConsumerLab.com lists tributyrin among butyrate forms with clinical evidence for CD.

Curcumin has been evaluated as adjunctive therapy in Crohn's disease (CD) with emerging clinical evidence from RCTs, though the evidence base is smaller than for ulcerative colitis. Preclinical data strongly support anti-inflammatory mechanisms relevant to CD pathophysiology. Two RCTs specifically in CD have been conducted.

Vitamin A deficiency is documented in Crohn's disease, particularly in severe disease with ileal involvement and fat malabsorption. Gastroenterology Advisor lists it among the key supplements for CD. It plays key roles in intestinal mucosal healing, epithelial integrity, and IgA-mediated mucosal immunity.

Vitamin B12 deficiency is a clinically recognized complication of Crohn's disease, particularly when the terminal ileum (the exclusive site of B12 absorption) is inflamed, surgically resected, or bypassed. Supplementation is routinely recommended by gastroenterologists and is a standard component of CD nutritional management, particularly in patients with ileal disease.

Folate (vitamin B9) deficiency is well-documented in Crohn's disease. A PubMed study confirmed serum folate significantly lower in CD patients versus controls. Supplementation reduces inflammatory homocysteine, supports immune–microbiota interactions, and is especially important for patients on methotrexate or sulfasalazine.

Vitamin D deficiency is highly prevalent in Crohn's disease and linked to disease severity and relapse risk. Gastroenterologists routinely recommend supplementation to correct deficiency, support bone health, and modulate intestinal immune function. Higher serum vitamin D levels correlate with improved remission rates in CD.

Vitamin D3 (cholecalciferol) is the preferred supplemental form of vitamin D for correcting the highly prevalent deficiency in Crohn's disease. A double-blind crossover RCT confirmed significantly raised serum vitamin D in CD patients with D3 supplementation. Clinical authorities rate it as having the strongest combined evidence (deficiency correction plus therapeutic benefit) among CD supplements.

Vitamin K deficiency is recognized in Crohn's disease due to fat malabsorption and intestinal surgery. Gastroenterology Advisor and WebMD list it among the fat-soluble vitamins that CD patients may need to supplement, particularly for bone health (activation of osteocalcin) and coagulation function.

Zinc deficiency is a well-documented complication of Crohn's disease, caused by chronic diarrhea, malabsorption, and extensive small bowel involvement. The Crohn's & Colitis Foundation and gastroenterology clinicians list zinc supplementation as an established nutritional intervention in CD. Low zinc levels are associated with impaired mucosal healing and immune dysfunction.

Cat's claw is listed among traditional indications for Crohn's disease and inflammatory bowel disease in multiple ethnobotanical and herbal medicine references. Its anti-inflammatory NF-κB inhibition is mechanistically relevant to Crohn's pathophysiology. No dedicated human clinical trials for Crohn's disease have been published.

Crohn's disease is listed as a traditional use of indigo in the EBSCO Research Starters monograph and is included in recent IBD animal-model meta-analyses of indigo naturalis. Human clinical evidence is, however, derived from UC studies; no dedicated Crohn's disease clinical trials exist.

Slippery elm is listed in herbalist and integrative medicine references as a traditional supportive remedy for Crohn's disease, primarily due to its demulcent properties and potential to soothe inflamed intestinal mucosa. No Crohn's-specific clinical trials have been conducted.