Are there vitamins to avoid with diverticulitis?

In this article:

• Vitamins and diverticulitis
• Vitamins to avoid
• Vitamins to prioritize
• Other considerations
• When to see your doctor

In this article

• Vitamins and diverticulitis
• Vitamins to avoid
• Vitamins to prioritize
• Other considerations
• When to see your doctor

If you’re one of the millions of people with diverticulitis, you already know that taking control of your diet is key to managing your condition. You might think that taking vitamins will boost your overall health, but certain supplements could actually make your symptoms even worse. 

There are four vitamins you should take with caution if you have diverticulitis, and a handful of tips you can implement to mitigate the risk of a flare-up.

How certain vitamins can worsen diverticulitis

You can’t talk about diverticulitis without talking about the colon. A healthy colon wall is smooth. Occasionally, the colon develops a small, irregular pouch that bulges. This pouch is called a diverticulum (multiple pouches are diverticula). The bowel wall can have weak spots in the wall of the large intestine. Risk factors for developing diverticuli are chronic constipation and increasing age. Chronic constipation stresses those weak spots and causes outpouching of the bowel and bulges.  

Many people are asymptomatic and have these pouches without issues (a condition known as diverticulosis or diverticular disease), and they only know of their condition after they have a colonic imaging study with dye or after a colonoscopy. In fact, roughly 30% of people older than 50 have it. However, when the diverticula become inflamed, diverticulitis develops. This can lead to nausea, fevers, bloating, severe abdominal pain, constipation, and diarrhea. Some people experience acute bouts of diverticulitis, while others have it chronically. 

Vitamins may not necessarily worsen diverticulitis, but rather, they can lead to additional gastrointestinal issues, and nobody wants to deal with that. Certain vitamins and supplements are linked to GI disturbances, and they can adversely affect you in the following ways:

• Affecting your microbiome: Certain vitamins are great for your microbiome, but if taken in excess, they can shift the balance of good versus bad bacteria in your gut.
• Increased inflammation: Some supplements, such as iron, may increase inflammation in your GI tract and cause digestive issues.
• Changes in bowel movements: Some vitamins are linked to poor bowel motility, and constipation can cause stool to get stuck in the outpouchings called diverticula, leading to increased pain.
• Changes in pH: High dosages of certain vitamins can lead to an alteration in your gut’s pH balance, resulting in more inflammation and can even result in infection.

If you are prone to diverticulitis, then you already have a sensitive gut. Being mindful of what you put in your body—or how much of something you put in your body—can prevent you from experiencing additional adverse symptoms. 

Vitamins to approach with caution if you have diverticulitis

“At this point, no vitamin has been documented in clinical trials to directly worsen diverticulitis,” says Erika Gray, Pharm.D., founder and chief medical officer at ToolBox Genomics.com.  

Oddly enough, the very vitamins that can be beneficial for you can also be very harmful for you when taken at high dosages. The following supplements should be used with caution before, during, and after diverticulitis attacks:

1. Iron supplements

Taking an iron supplement, specifically ferrous sulfate, puts you at a significantly higher risk of having GI issues, including constipation. When you’re constipated, your bowel movements could become stuck in the diverticula, and some experts believe that this issue could lead to the inflammation and infection that causes diverticulitis. 

If you experience diverticulitis and need an iron supplement as well, consult with your healthcare provider about the appropriate dosage. You may also explore an alternative, like intravenous supplementation, which may bypass the gut altogether. 

2. Vitamin C

Vitamin C is great for your microbiome because it can boost the good bacteria and suppress the bad bacteria. However, you can take too much of a good thing.

“Taking high doses of vitamin C can cause stomach discomfort or loose stools,” warns Ashley Kitchens, RDN, registered dietitian and owner of Plant Centered Nutrition in Durham, North Carolina. If your body can’t absorb all of the vitamin C you take, your intestines pull in more water. In turn, this exacerbates symptoms like diarrhea for those with diverticulitis. The recommended daily dose of vitamin C for adults is 90 to 120 milligrams (mg), with excess amounts ranging from 400 to 2,000 mg.

3. Fat-soluble vitamins A, D, E, and K 

Proceed with caution here. Vitamins A, D, E, and K are known as the “fat-soluble” vitamins, which means they need dietary fats in order for your body to absorb them. Unlike water-soluble vitamins, which your body eventually excretes in urine, fat-soluble vitamins can accumulate, potentially leading to toxicity. They can be especially problematic for people with diverticulitis because of the vitamins’ effects on the GI system.

“Taking high doses of fat-soluble vitamins A, D, E, and K can upset your gut microbiome,” says Kitchens. “Very high doses of vitamin A have been shown to increase inflammation. Because vitamin D increases calcium absorption, taking very high doses can contribute to constipation in some people.”

The Mayo Clinic recommends the following doses:

• 6 to 15 mg of vitamin A
• 600 IU of vitamin D 
• 8 to 10 mg of vitamin E
• 90 to 120 mcg of vitamin K (this is the recommended daily intake, which most people get from their diets)

4. Magnesium

Magnesium is fantastic for sleep, your immune system, and—lo and behold—your gut! Some experts even recommend low doses of magnesium citrate as a laxative for those with diverticulitis. 

Where things get dicey is with how much and which type of magnesium you take. For example, too much magnesium citrate could cause diarrhea, worsening your symptoms. Magnesium glycinate may be the better option because it has milder effects on the colon. The recommended dosage of magnesium glycinate is between 400 to 420 milligrams for adults assigned male at birth, and 310 to 320 milligrams for adults assigned female at birth.

Vitamins that may actually help

If you’re looking for natural supplementation to help ease diverticulitis, there are several vitamins and minerals that may be beneficial for digestive health. Yes, these are the same vitamins that appear on our “proceed with caution” list, so make sure you’re paying attention to recommended dosages and getting medical advice from your healthcare provider. 

Vitamin D

Yes, this is also on our “vitamins to use with caution” list. But it’s important to note that vitamin D deficiency is linked to GI issues and increased risk of diverticulitis.

“The most documented vitamin for supporting diverticulitis is vitamin D due to its role in maintaining the immune system and intestinal lining,” Dr. Erika Gray explains. “Studies have shown that individuals with higher vitamin D levels are significantly less likely to require hospitalization for diverticulitis compared to those with lower vitamin D.”  Taking consistent Vitamin D3 1000 IU a day may be helpful in maintaining a normal Vitamin D level, which may decrease the risk of diverticulitis. 

Vitamin D coupons

Vitamins A, C, E, and K as antioxidants

Eating a diet rich in antioxidants may be key to managing your diverticulitis. Polyphenols, which are plant-based antioxidants, have been shown to reduce inflammation and protect the digestive system.

“Eating antioxidant-rich foods, like fruits and vegetables, or taking antioxidants (e.g.,  vitamins A, C, E, and K) can help reduce inflammation and create a stronger, more diverse microbiome,” says registered dietitian Ashley Kitchens. 

Vitamin A coupons, Vitamin C coupons, Vitamin E coupons, Vitamin K coupons

B vitamins

Many of the B vitamins, including niacin (vitamin B3) and vitamin B6, are often recommended for people with diverticulitis because they have anti-inflammatory effects. However, high dosages of the B vitamins could lead to the development of or worsen diverticulitis. Most American diets, if varied, provide enough B vitamins, although some people may need to supplement choline and vitamin B6. Strict vegetarians should also consider supplementing vitamin B12.

It’s best to speak with your healthcare provider if you are considering taking a B vitamin supplement to reap the health benefits and avoid unwanted side effects.

Vitamin B3 coupons, Vitamin B6 coupons, Vitamin B12 coupons

Fiber

Fiber isn’t a vitamin; it’s a carbohydrate. It’s available in a supplemental form, which is why we’re going to include it on our list. 

Fiber is great for your bowels, and research shows that eating a high-fiber diet can help prevent diverticulitis flare-ups. Aim for 25 to 35 grams of fiber a day. Keep in mind, however, that if you’re in a flare-up, you should limit your fiber intake to ease the strain on your system.

Fiber coupons

Probiotics

Anecdotally, some people have found probiotics beneficial for managing diverticular disease. These supplements are known for supporting healthy gut bacteria and reducing inflammation. However, one review notes that further research is needed before making a definitive conclusion on whether probiotics objectively help people with diverticulitis. Talk to your healthcare provider if you believe probiotics could be a good fit for you.

Probiotic coupons

Other dietary considerations for diverticulitis

There are a few other ways your diet can directly influence diverticulitis, for better or for worse. Experts make the distinction based on whether you’re in a flare-up or not.

During a diverticulitis flare-up

When you’re in the throes of a flare-up, Dr. Erika Gray recommends a few tips to allow your system to recover from diverticulitis:

• Start with a clear liquid diet and gradually work toward a low-fiber diet that includes foods such as eggs, fish, and rice.
• Minimize alcohol use.
• Minimize NSAIDs like ibuprofen as they irritate your intestines and increase the risk of diverticular complications. 
• Avoid red meat, processed meats, refined grains, and soda.
• Avoid legumes and dairy until the flare is over.

“After a flare, slowly reintroduce high fiber foods such as vegetables, fruits, and whole grains,” Dr. Gray says. “Stay hydrated and avoid eating processed meats, refined grains, and soda. Eating fermented foods such as yogurt can aid in the recovery process.”

Outside flare-ups

Ashley Kitchens, registered dietitian, suggests the following tips for a diverticulitis diet:

• Eat a plant-forward, high-fiber diet to help reduce the risk of future flare-ups and decrease inflammation in your colon. 
• Drink plenty of water to stay hydrated 
• Engage in physical activity to stimulate and keep regular bowel movements. Even walking helps!
• Recent studies have debunked the need to avoid seeds or popcorn unless you find they irritate you.

Some great food options for people prone to diverticulitis include lentils, legumes, whole grains, lean protein, and fruits and vegetables. 

When to talk to your healthcare provider

Clearly, there is some confusing information about diverticulitis and your diet. If you’re unsure how to supplement your diet, speak with a healthcare professional. This is especially true if you’re in the midst of a flare-up, when your system is at its most sensitive.