Malabsorption, Nutrient Deficiencies, Pancreas Damage, Exocrine Pancreatic Insufficiency (EPI)

Malabsorption, Nutrient Deficiencies, Pancreas Damage, Exocrine Pancreatic Insufficiency (EPI)

Often Overlooked and With Recovery Actions to Consider

For those struggling with Chronic Fatigue Syndrome (ME/CFS) and ailments that are wide ranging and difficult to diagnose, pancreas dysfunction and malabsorption are hardly ever considered as a possible link to many symptoms, both by doctors and sufferers.

Everyone is aware of the diabetes crisis, but the pancreas has another crucial but far lesser known function, the exocrine side, which produces the enzymes we need to digest and absorb our food. Any level of pancreatic enzyme dysfunction can cause nutrient deficiencies and subsequent health issues affecting the functioning of, for example, heart, lungs, intestines, brain, nerves, bones, muscles, neurotransmitters, hormones, immune system, mitochondria and microbiome, as it did with me.

Pancreas damage, specifically exocrine pancreatic insufficiency (EPI), causes malabsorption, nutritional deficiencies, and often related issues such as small intestinal bacterial overgrowth (SIBO), Candida yeast overgrowth, acid or silent reflux which exacerbate the situation. Over time your metabolism struggles, and metabolic pathways no longer function properly. The body’s mitochondria have a tougher time generating energy (ATP). This can subsequently have an impact anywhere in the body, cause vicious cycles, and hence be an underlying source of a wide variety of seemingly unrelated symptoms.

The long lasting impact of EPI and malabsorption on metabolism and mitochondrial functioning from chronic nutrient deficiencies is often overlooked.

Root causes and bodily insults that cause oxidative stress, mitochondrial dysfunction, microbiome imbalances and pancreatic damage are frequently not addressed comprehensively, to the detriment of the sufferer.

Pancreas Damage and Exocrine Pancreatic Insufficiency (EPI)

There are 2 major areas that this little and sensitive organ, that I did not even know existed before my life had ground to a halt, is crucial for:

1. Endocrine. The side which handles the management of blood sugar levels in the body. It is very much in the news due to the massive (pre-) diabetes rates.

2. Exocrine: The rarely mentioned, but just as important side which produces the enzymes necessary to break down proteins, fats and carbs into usable nutrients. Without these we would starve to death.

Exocrine pancreatic insufficiency (EPI) is a condition which occurs when the acinar cells in the pancreas are damaged or the organ is unable to deliver pancreatic juice in sufficient quantities, and at the right time, into the small intestine. The main enzymes the pancreas produces are:

Lipase: enzymes that break down fats

Protease: enzymes that break down proteins

Amylase: enzymes that break down carbohydrates

EPI causes maldigestion and malabsorption of food. This causes microbiome dysbiosis, malnutrition and nutrient deficiencies, which in turn impact mitochondria, metabolism and metabolic pathways in the body. Subsequently, this can cause a great many downstream health effects, including ME/CFS symptoms.

An official EPI diagnosis is often done when around 90% of the exocrine functionality has been impacted, in part due to the difficulty in determining gradations of damage. However, your health can still be impacted through nutrient deficiencies even if a much smaller portion of the functionality is not optimal. Anything between 1 to 90% pancreatic enzyme insufficiency is something I have called pre-EPI (like pre-diabetes).

Most doctors, especially family practice or primary care physicians, who are often the 'gatekeepers' to the specialists, are not experienced in recognizing the huge range of symptoms, and have no idea how to properly test for it. Even if you are eventually diagnosed by a specialist, potentially many years of suffering and further damage later, there is little practical comprehensive help.

Pancreas, the Canary in the Modern Food Supply

The pancreas is the proverbial canary in the coal mine of today’s modern food supply and eating habits. It sometimes takes decades before the damage starts to really show, as it is often a slow and stealthy decline. Some of the damage can initially be masked through the intake of multi-vitamins and other supplements, fortification of foods, and even eating larger and more frequent quantities of food.

Roughly a third of the population in the United States now has pre-diabetes or diabetes. There are studies that mention between twenty-five and fifty percent of those with diabetes also suffer from exocrine pancreatic damage.

This could potentially mean millions of, mostly undiagnosed, people that are nutrient deficient, and suffering a wide range of chronic symptoms without knowing the underlying cause.

Metabolism, Metabolomics, Metabolic Pathways, Mitochondria

Due to chronic nutrient deficiencies, at some point my body’s standard metabolic pathways and enzymes were hindered from functioning properly, and my mitochondria had a tougher time generating energy, with all the subsequent health effects and years of ME/CFS symptoms. From deterioration, total breakdown, and back to turning my health around, my case was a good example of biochemistry in practice. Some important terms related to ME/CFS that are happily discussed more and more these days are:

Metabolism: the chemical processes occurring within a living organism in order to maintain life

Metabolic pathway: a series of interconnected chemical reactions that occur within a cell

Metabolomics: the scientific study of metabolites present within an organism, cell, or tissue

Mitochondria: Essential organelles in cells which are, simply put, the energy power plants of our cells. ATP (adenosine triphosphate) is the energy storage that they produce.

Our body is bombarded from all sides by the exposure to many toxins, unhealthy water, and the daily intake of excessive sugar, processed carbs, herbicides, pesticides, preservatives, chemicals, industrialized oils, antibiotics, and often highly processed and nutrient poor food. Add to this any issues with breaking down food into the nutrients we need and absorbing them properly, for example, through EPI or microbiome dysbiosis, and it is a recipe for metabolic and mitochondrial dysfunction. The body works hard to stay in homeostasis, filtering toxins and utilizing our amazing anti-oxidant system, and it can take a while to get to a diseased state. However, over time and with continued hits to the body, this damage spiral increases and vicious cycles ensue. Further nutritional deficiencies, microbiome imbalances, oxidative stress, mitochondrial and metabolic dysfunctions, and a subsequent myriad of illness symptoms can result.

Primal Pancreas: Pancreas Damage Survival Guide

There are many paths to ME/CFS, but whether the trigger for it is, for example, viral, bacterial, toxic overload, auto-immune, unknown, or pancreas damage as in my case, the results can be debilitating and life-altering.

Pancreas damage, especially EPI, malabsorption and its chronic nutritional deficiencies, is just one possible path to at least look into.

The steps I took to go from death's door to a functioning human being again are transferable to anyone suffering from chronic ailments and ME/CFS, and not just those with pancreas damage, as they help the body in the overall re-balancing and healing process.

It has been a journey of six years of unhealth, five years without knowing a pain-free day, four years of non-stop malaise, over three years of being homebound, and perplexing dozens of doctors. Like many others, my situation had stumped a few dozen doctors with varying specialties after countless ECGs, ultrasounds, X-rays, MRIs, CT scans, blood, urine and stool tests spread over the years prior to the diagnosis. For those of you suffering from ME/CFS, chronic pain or illness, or any pancreatic damage you have likely suffered far worse.

But, I was too stubborn to accept that the remainder of my life would have devolved into being a prisoner of my bed or couch, dependent on my wife for everything to just survive in pain and malaise. Determined not to take doctors' feedback and non-answers as gospel any longer, I was able to ask for the right medical tests to perform to finally uncover my pancreas damage, nutrient deficiencies, and microbiome dysbiosis. Four doctors had actually told me my pancreas was fine, even though it was so atrophied that I had less than 10% functionality left and I was pre-diabetic. This just shows you how pancreas damage is flying under the radar of most doctors until it is often far too late.

Since I wanted to find out what caused my health breakdown and how I could get better, I kept track of how I felt most days, including any symptoms, medical test trials, food and supplementation experimentation, bodily insult lowering actions, as well as any interesting bits of information I gathered during my research. Most available hours of energy I had in the last 4 years were spent in reading and researching my symptoms and possible ways to heal. The notes I kept throughout the years helped me to write this Primal Pancreas book. It is written it in a way that I wish had been available to me when my health first started to deteriorate, or after dozens of doctors still had no answers, or even after my official medical diagnosis.

This book includes actions to help heal the body, lower oxidative stress and inflammation, and lists of medical tests (some not commonly used like urine metabolites or comprehensive stool tests), food and supplements to consider.

If it can help even one person by shedding some light in order to help the healing process, or help a doctor with any of their patients, it was worth writing.

Resolved Issues


Some examples of major symptoms that were resolved in my case, including many classic ME/CFS symptoms are:

• Debilitating chronic weakness and fatigue

• Post-exertional exhaustion, malaise, fatigue (PEM)

• Many layers and types of chronic pain

• Cardiovascular dysfunctions: heart arrhythmia and premature ventricular contractions

• Breathing dysfunctions: asthma-like breathing issues, oxygen starved feeling

• Neurological issues: delayed reactions, memory loss, abnormal sleep patterns, headaches, temporary dyslexia, temporary stuttering, brain fog, confusion, difficulty processing information, difficulty understanding conversations, paresthesia

• Motor impairments, poor coordination, sudden clumsiness, spasms

• Immune symptoms, non-stop flu-like malaise, difficulty healing, swollen glands

• Gastrointestinal dysfunctions: malabsorption, nutrient deficiencies, microbiome dysbiosis, silent reflux, small intestinal bacterial and Candida yeast overgrowth

• Pre-diabetes, hypoglycemia, triglycerides, HDL, homocysteine, and HbA1c levels

• Low testosterone, sleep disorders, neurotransmitter issues

• Slow wound and soft tissue healing, easy bruising

• Sensitivities to light, noise, heat, cold, smell, taste, food

• Blurry eyesight, night blindness

Road to Recovery Actions

I had to figure the recovery steps out myself through lots of reading, trial and error, by being proactive with doctors, and researching desired medical tests. Healing required root cause analysis and a comprehensive approach that looked at the overall metabolic and mitochondrial functioning. Almost all the steps I had to take would be helpful for anyone trying to heal, or even as preventative maintenance.

This included the following major areas:

1. Removing any bodily insults I had control over in order to lower oxidative stress, inflammation, and the toxic load strain to the body. Help the body rebalance and heal is the goal.

2. Analyzing and correcting nutrient deficiencies.

3. Medical testing for pancreatic damage and any related downstream health effects.

4. Pancreatic Enzyme Replacement Therapy (PERT) to be able break down food into useable nutrients.

5. Strict food and water intake quality analysis and adherence. Immensely important step! Many elements were completely surprising to me during my research and recovery, as I always thought I ate and lived healthily.

6. Supplementation to resolve deficiencies in vitamins, minerals, phytonutrients, amino acids and fatty acids.

7. Tackling microbiome dysbiosis through medical testing, food, water, medicine and supplements.

8. Testing and re-balancing Small Intestinal Bacterial Overgrowth (SIBO) and Candida yeast overgrowth. Both of these also hinder nutrient absorption and production, impact auto immune reactions, increase food sensitivities, and increase the toxic load on the body.

9. Silent or acid reflux resolution, as this is a big signal from your body on food and water quality intake, as well as microbiome dysbiosis. The potential for further damage impact and malabsorption is not trivial. This signal should not be ignored nor constantly suppressed by the common antacids and PPIs.

10. Rebalancing neurotransmitters through nutrient support, food and water quality. Much of it can be caused by nutrient deficiencies and microbiome dysbiosis, but there is also a mental element of being chronically ill that needs addressing, both of which can get you into a vicious cycle.

11. Other primal healing elements to help support the body in its healing process, for example, meditation, sauna, mineral baths, sleep hygiene, etc.

My goal with the Primal Pancreas practical guide book is to share all my findings with you in the hope that it provides one more avenue to at least consider.

https://www.primalpancreas.com/
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