Meds & Biologics
If you have ulcerative colitis, you have almost certainly encountered recommendations for supplements and alternative treatments. Probiotics, turmeric, CBD, acupuncture, aloe vera, and fecal microbiota transplant all appear regularly in social media wellness content and patient forums. Some of these have real clinical trial data behind them. Others have almost none. The challenge is sorting the two categories apart, because the marketing rarely makes the distinction. This article applies a consistent framework to the most commonly discussed supplements for ulcerative colitis: what do controlled studies actually show, how strong is that evidence, and what do you need to discuss with your gastroenterologist before trying anything new?
Probiotics: The Strongest Supplement Evidence for UC
Among all supplements for ulcerative colitis, probiotics have the most robust clinical data, though the evidence is strain-specific. The high-concentration multi-strain formulation VSL#3 (now marketed as Visbiome in some regions) has been studied in multiple randomized controlled trials. A meta-analysis published in PLOS One found that VSL#3 achieved clinical remission in a significantly higher proportion of patients with active mild to moderate UC compared to placebo, with an odds ratio of 2.40 for remission and 3.09 for clinical response. In pediatric UC, the results were even more striking: remission was achieved in 92.8% of children receiving VSL#3 alongside standard therapy versus 36.4% on placebo. VSL#3 has shown no significant adverse events in these trials, and it is generally considered safe alongside standard UC medications like mesalamine. However, a generic probiotic from a supplement aisle does not contain the same strains, concentrations, or quality controls used in the clinical research. If you want to try probiotics for ulcerative colitis, discuss VSL#3 or Visbiome specifically with your GI team rather than selecting a product based on marketing.
Curcumin: Promising as an Add-On Therapy
Curcumin, the active compound in turmeric, has been studied as an adjunctive treatment for UC in several randomized, placebo-controlled trials. A 2024 systematic review and meta-analysis of eight randomized controlled trials involving 482 patients found that adjunctive curcumin therapy significantly improved clinical remission compared to placebo. In one multicenter double-blind trial, only 4.65% of patients taking curcumin as maintenance therapy relapsed over six months, compared to 20.51% on placebo. A 2025 meta-analysis of placebo-controlled trials confirmed these findings, reporting that curcumin combined with mesalamine produced superior clinical and endoscopic outcomes compared to mesalamine alone. The safety profile has been consistently favorable, with no increase in serious adverse events. However, turmeric from your spice rack is not equivalent to a standardized curcumin supplement; the doses studied in clinical trials typically range from 1 to 3 grams of curcumin daily, which requires dedicated supplementation. This is one of the more evidence-supported options for patients with mild to moderate ulcerative colitis who are already on standard therapy.
Cannabis and CBD: Popular but Unproven
Cannabis and CBD oil rank among the most discussed alternative treatments in UC patient communities, but the clinical evidence has not kept pace with the enthusiasm. A Cochrane review concluded that the effects of cannabis and cannabidiol on UC are uncertain, and no firm conclusions regarding efficacy and safety can be drawn. In the most rigorous CBD-specific trial, clinical remission at 10 weeks was nearly identical between the CBD group (24%) and the placebo group (26%). THC-rich cannabis did reduce patient-reported symptom scores in one small randomized trial, but changes in objective inflammatory markers like C-reactive protein were not significant. What this means is that cannabis may improve how patients feel (particularly pain and anxiety) without reducing the underlying intestinal inflammation. That distinction matters, because feeling better while inflammation continues unchecked can lead to progressive bowel damage. If you are using or considering cannabis for UC symptom management, your gastroenterologist needs to know, both to monitor for drug interactions and to avoid misinterpreting symptom changes.
Omega-3 Fatty Acids: Safe but Underwhelming
Omega-3 fatty acids from fish oil have well-documented anti-inflammatory mechanisms, which makes them a logical candidate for UC treatment. The clinical results, however, have been disappointing. A Cochrane review found no evidence supporting the use of omega-3 fatty acids for maintenance of remission in ulcerative colitis. A systematic review in the British Journal of Nutrition reached the same conclusion, noting that negative results were particularly consistent in UC remission maintenance trials. Fish oil supplements are generally safe, though high doses can cause gastrointestinal side effects that may be hard to distinguish from UC symptoms. Omega-3s are not harmful as part of a balanced diet, but the evidence does not support taking them specifically to manage ulcerative colitis.
Emerging and Less-Studied Options
Several other alternative treatments appear in UC conversations but have limited or very early-stage evidence.
Fecal microbiota transplant (FMT) has the most promising data in this group. A 2025 meta-analysis of randomized controlled trials found that FMT significantly outperformed placebo for inducing combined clinical and endoscopic remission, with an odds ratio of 2.25 across 14 trials. About 41% of patients achieved clinical remission. FMT is not yet a standard UC treatment and is primarily available through clinical trials or specialized centers, but it represents a genuine area of active research with measurable results.
Boswellia serrata (Indian frankincense) showed early promise in small trials. In one study, 350 mg three times daily for six weeks produced remission in 82% of UC patients, comparable to sulfasalazine. However, these trials were small, methodologically limited, and have not been replicated in large, rigorous studies.
Aloe vera gel was tested in a single randomized, double-blind, placebo-controlled trial, where 100 mL taken twice daily for four weeks produced clinical response in 47% of patients versus 14% on placebo. While encouraging, one small trial is not enough to recommend routine use.
Acupuncture has been evaluated in a systematic review of 13 randomized trials involving over 1,000 participants. The results suggested potential benefit, but the review authors noted high risk of bias across the included studies and concluded that no firm recommendations could be made.
How to Evaluate Any Supplement for UC
Before starting any supplement or alternative treatment for ulcerative colitis, a few principles apply across the board. First, tell your gastroenterologist. Some supplements can interact with UC medications, and any symptom changes need to be interpreted in the context of your full treatment regimen. Second, recognize that "natural" does not mean "evidence-based." A product being plant-derived or available without a prescription tells you nothing about whether it has been tested in controlled trials for your specific condition. Third, be skeptical of any product claiming to replace conventional UC therapy. The treatments with the best evidence in this article, such as VSL#3 probiotics and curcumin, were all studied as additions to standard medication, not replacements for it.
Trying a supplement? Track it alongside your symptoms in Aidy to see if it is actually making a difference for you, not just the placebo effect. When you log what you started, when you started it, and how your symptoms and biomarkers responded over weeks, you turn a personal experiment into useful data for your next GI appointment.