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:
- 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.
- 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 for the endocrine side of the pancreas).
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.