Why people with Crohn’s explore alternatives to biologics
If you’re on Humira, Remicade, Stelara, Skyrizi or Entyvio, or have been told you might need one, you’re not alone in wondering what else is out there. Many people living with Crohn’s look for natural ways to support their gut health, whether that means adding to their current care, planning for the future, or simply feeling more in control.
This page explains the most common reasons people explore alternatives. It also maps the natural therapies people turn to against the same pathways conventional medications target.
Common reasons people look further
Response can fade over time
Many people find a biologic works well at first and then becomes less effective. A review of 2,236 patients found the annual risk of losing response to infliximab (Remicade) was about 13% per patient-year.
Side-effect concerns
TNF blockers such as Humira and Remicade carry FDA boxed warnings for serious infections and certain cancers. Understandably, many people want to know what else can support them.
Cost and access
Biologics are among the most expensive medications available, often costing tens of thousands of dollars a year before insurance, with prior authorisations and coverage battles along the way.
Injections and infusions
Regular self-injections or clinic infusions shape daily life. Many people want to feel more in control of their own health routine.
A whole-person approach
Crohn’s touches nutrition, energy, stress and the microbiome. People increasingly look for approaches that support the whole body, not a single pathway.
Supporting gut health alongside conventional care
Each conventional medication works on a specific inflammatory pathway. Here are the natural therapies people explore for support on those same pathways, plus two that no approved Crohn’s drug addresses directly.
TNF-α & NF-κB signalling
Conventional: Humira (adalimumab), Remicade (infliximab)
Wormwood is the only botanical shown to lower serum TNF-α directly in Crohn’s patients. Curcumin and andrographis work upstream on NF-κB, the switch that controls TNF-α production.
IL-12 / IL-23 & the inflammasome
Conventional: Stelara (ustekinumab), Skyrizi (risankizumab)
Gut-focused action
Conventional: Entyvio (vedolizumab)
Entyvio was designed to act on the gut specifically. EGCG and berberine are both poorly absorbed, so they stay concentrated in the gut too.
Leukotrienes (5-lipoxygenase)
Conventional: No approved Crohn’s medication targets this pathway directly
Boswellia’s AKBA directly inhibits 5-lipoxygenase. That makes it a way to add a different kind of support rather than duplicate what a medication already does.
Steroid-sparing support
Conventional: Prednisone (corticosteroids)
In a double-blind study, people taking wormwood tapered their steroids under medical supervision while their symptoms kept improving.
Gut-lining repair & barrier health
Conventional: No approved Crohn’s medication acts primarily here
Zinc helped normalise intestinal permeability in a Crohn’s study. NAG and BPC-157 are studied for supporting the gut’s own repair processes.
Natural options by research stage
From the most clinically studied to the newest emerging therapies.
| Therapy | Research stage | Studies reviewed |
|---|---|---|
| Andrographis paniculata (HMPL-004) The “king of bitters” — the only botanical taken into a Phase III IBD programme, with results comparable to mesalazine in ulcerative colitis. | Clinically studied | 2 |
| Curcumin (Turmeric) Turmeric’s golden compound supports a healthy inflammation response and is the most-researched botanical in inflammatory bowel disease. | Mixed results | 3 |
| Boswellia serrata Indian frankincense resin that targets a distinctive inflammatory pathway and performed on par with mesalazine in an active-Crohn’s trial. | Mixed results | 2 |
| CBD-Rich Cannabis CBD-rich cannabis significantly improved symptoms and quality of life in randomised Crohn’s trials. | Mixed results | 2 |
| Wormwood (Artemisia absinthium) A traditional digestive bitter that showed striking results in two Crohn’s studies, including measurable reductions in TNF-α. | Early clinical | 2 |
| Low-Dose Naltrexone (LDN) An off-label, low-dose use of an established medication that has shown promising results in Crohn’s trials and has a devoted patient following. | Early clinical | 3 |
| Omega-3 Fatty Acids (EPA/DHA) Essential fatty acids that feed your body’s inflammation-resolving pathways. Promising early Crohn’s results; larger trials were mixed. | Mixed results | 3 |
| Probiotics (VSL#3, E. coli Nissle, S. boulardii) Beneficial bacteria that help rebalance the gut microbiome. Standout results in pouchitis and ulcerative colitis; Crohn’s results are still emerging. | Mixed results | 3 |
| BPC-157 A healing peptide derived from gastric juice, with remarkable research on gut-lining repair, anastomosis healing and fistula closure. | Emerging | 3 |
| N-Acetyl Glucosamine A building block of the protective mucus layer that lines your gut. A pediatric pilot study reported striking improvements in hard-to-treat IBD. | Emerging | 1 |
| Berberine A golden plant alkaloid from traditional Chinese and Ayurvedic medicine that supports gut barrier integrity and a balanced microbiome. | Emerging | 1 |
| Quercetin A flavonoid found in onions, apples and capers that supports healthy inflammasome activity and gut barrier function. | Emerging | 2 |
| EGCG / Green Tea Extract Green tea’s key polyphenol, which stays concentrated in the gut and showed encouraging results in an ulcerative colitis pilot. | Emerging | 2 |
Talking to your gastroenterologist
The best results come from a care team that knows everything you’re doing. These steps make that conversation easier and more productive.
- 1 Bring a written list of every supplement, dose and brand you take or are considering.
- 2 Ask specifically about interactions, especially with curcumin, berberine, CBD and Boswellia, which can affect how some medications are metabolised.
- 3 Ask for baseline tests (B12, vitamin D, ferritin, zinc, folate) so nutrient support is targeted.
- 4 Track your symptoms before and after adding something new, so you both have real data to discuss.
- 5 If you want to reduce or change medication, ask about a supervised plan. Never stop a biologic or taper steroids on your own.
Crohn’s medication glossary
A plain-language guide to the conventional medications mentioned across this site.
Humira (adalimumab)
Anti-TNF biologic
Neutralises tumour necrosis factor alpha (TNF-α), a master cytokine driving intestinal inflammation.
Self-injected. Widely used for moderate-to-severe Crohn’s disease and fistulising disease.
Remicade (infliximab)
Anti-TNF biologic
Chimeric monoclonal antibody against TNF-α, delivered by infusion.
The first biologic approved for Crohn’s disease; still a reference standard in trials.
Stelara (ustekinumab)
IL-12/23 inhibitor
Blocks the shared p40 subunit of interleukin-12 and interleukin-23.
Often used after anti-TNF failure.
Skyrizi (risankizumab)
IL-23 inhibitor
Selectively blocks the p19 subunit of interleukin-23.
A newer, more selective successor to the IL-12/23 class.
Entyvio (vedolizumab)
Gut-selective integrin blocker
Blocks α4β7 integrin, preventing lymphocyte trafficking into gut tissue.
Favoured where systemic immunosuppression is a concern.
Prednisone (prednisone / prednisolone)
Corticosteroid
Broad transcriptional suppression of inflammatory gene programmes.
Effective for inducing remission; not suitable for maintenance because of cumulative toxicity.
Azathioprine (azathioprine / 6-mercaptopurine)
Thiopurine immunomodulator
Purine antimetabolite that depletes activated lymphocytes.
Often the background therapy in supplement add-on trials.
Mesalamine (mesalazine / 5-ASA)
Aminosalicylate
Topically acting anti-inflammatory at the mucosal surface.
Modest effect in Crohn’s disease; the usual active comparator in herbal trials.
Sources
-
Loss of response and requirement of infliximab dose intensification in Crohn’s disease: a review
Gisbert JP, Panés J. · American Journal of Gastroenterology · 2009 · PMID 19174781
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Krebs S, Omer TN, Omer B. · Phytomedicine · 2010 · PMID 19962291
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Omer B, Krebs S, Omer H, Noor TO. · Phytomedicine · 2007 · PMID 17240130
Phase 2 — in development
Where traditional research stops, our community begins
Natural compounds can’t be patented, so they rarely get the multi-million-dollar trials that drugs receive. That leaves people with Crohn’s without answers to the questions that matter most: what actually helps, at what dose, and for whom? Our Community Symptom Tracker will crowdsource those answers from real people living with Crohn’s, and our upcoming wellness store will make it easy to find quality, third-party-tested products.
- Log your symptoms, supplements and doses in a private daily tracker
- See what’s working for people with the same disease location and medications
- Contribute to the largest real-world dataset on natural Crohn’s support
- Shop curated, third-party-tested protocols from our upcoming store
Be one of the first to join
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