Because of CF’s multi-system impact on inflammation, lung, and digestive function, a number of supplements have been examined with regards to cystic fibrosis. Some of the longer-studied supplements (fat-soluble vitamins and pancreatic enzymes) are becoming part of routine care.[1] Though pancreatic enzyme replacement supplementation is frequently recommended to improve pancreatic and digestive function in cystic fibrosis patients, there doesn’t appear to be any consensus on the optimal dosage, formulation, duration, or timing of administration.[2] The same goes for several other supplements, including fat-soluble vitamins, omega-3 fatty acids, probiotics, antioxidants, and creatine.[3][4][5][6][7][8]
When it comes to specific fat-soluble supplements, for both vitamin E (to treat deficiency) and omega-3 fatty acids (for inflammation), minor benefits (such as increased serum vitamin E) have been observed, with few to no negative side effects. However, the quality of the evidence for both of these interventions was considered to be low/too weak for clinical recommendations, and further research is needed to determine whether other supplements (such as pancreatic enzymes) should be adjusted or specially formulated/delivered for effects to be seen.[3][4]
N-Acetylcysteine (as a precursor to glutathione) may improve forced expiratory volume when taken for 6 months. However, people with cystic fibrosis are often also on high doses of antibiotics, making it difficult to isolate the effects of antioxidant supplementation alone.[7] While probiotics (specifically, Lactobacillus reuteri) may not consistently improve respiratory difficulties, they have somewhat more consistently produced reductions in fecal markers of intestinal inflammation for both children and adults with cystic fibrosis.[5][6] In one pilot study, creatine supplementation demonstrated consistent improvements in isometric muscle strength; however, no changes in lung function or sweat electrolyte concentrations were seen.[8]