Pancrelipase e.g Creon vs. OTC Enzymes

Peyt

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Hi,
My G.I. doctor wrote a prescription for Creon because I am not digesting fats properly. I wanted to ask if anyone has taken Creon before and how does it compare with OTC Enzymes sold in the market? The reason is I noticed it's pretty expensive, and I don't mind paying for it as long as it's much better than OTC enzymes....
I would love to hear your thoughts,
Peyt
 

PatJ

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@BeADocToGoTo1 has a lot of experience with enzymes and has written a useful book on pancreas function called Primal Pancreas.

I noticed this on an Amazon.com review for Enzymedica LypoGold:
"I was taking Creon but it was too expensive, so my gastrointerologist told me what to look for in a over the counter version. I found several that I would have to take a lot of each meal. LypoGold was the only one that offered close to my original dose of Creon. I've been taking it for a couple of weeks and it works just as well."
I tried LypoGold but it was too strong and caused mid-chest pain. Some other people have noticed the same thing.

To help digest fats I use powdered sunflower lecithin (which helps to emulsify the fats) plus Enzymedica Digest enzymes.

These sites provide more information about enzymes:
* https://www.lifeextension.com/magazine/2013/1/are-you-obtaining-the-proper-enzymes/page-01
* Animal vs. plant source, from: http://www.enzymestuff.com/basicsenzymeguide.htm
* Comparing products, from: http://www.enzymestuff.com/basicsenzymeguide.htm
* A different view that says the bile and pancreatic enzymes ducts are congested and can gradually be cleared: https://lifespa.com/digestive-enzymes-the-hidden-dangers/
 

ebethc

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@BeADocToGoTo1 has a lot of experience with enzymes and has written a useful book on pancreas function called Primal Pancreas.

I noticed this on an Amazon.com review for Enzymedica LypoGold:


I tried LypoGold but it was too strong and caused mid-chest pain. Some other people have noticed the same thing.

To help digest fats I use powdered sunflower lecithin (which helps to emulsify the fats) plus Enzymedica Digest enzymes.

These sites provide more information about enzymes:
* https://www.lifeextension.com/magazine/2013/1/are-you-obtaining-the-proper-enzymes/page-01
* Animal vs. plant source, from: http://www.enzymestuff.com/basicsenzymeguide.htm
* Comparing products, from: http://www.enzymestuff.com/basicsenzymeguide.htm
* A different view that says the bile and pancreatic enzymes ducts are congested and can gradually be cleared: https://lifespa.com/digestive-enzymes-the-hidden-dangers/

what causes pancreas damage?
 

BeADocToGoTo1

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Hi,
My G.I. doctor wrote a prescription for Creon because I am not digesting fats properly. I wanted to ask if anyone has taken Creon before and how does it compare with OTC Enzymes sold in the market? The reason is I noticed it's pretty expensive, and I don't mind paying for it as long as it's much better than OTC enzymes....
I would love to hear your thoughts,
Peyt
Hi @Peyt

I am glad to read that your doctor caught it!

Creon keeps me alive as it allows me to break down food into useful nutrients. For over the counter 'digestive enzyme' it can often mean a lot of things and does not necessarily mean pancrelipase (pancreatic enzymes such as amylase, lipase, protease). Many over the counter versions contain a whole host of other ingredients, if they even include those 3 pancreatic enzymes from a pig's pancreas (closest to a human pancreas). In addition, over the counter ones are in no way regulated tightly for specific enzyme quantities by type:
  • amylase - breaks down carbohydrate
  • protease - breaks down protein
  • lipase - breaks down fat
There is a good chance that your body is not breaking down protein and carbs well either. This subsequently means deficiencies in vitamins, minerals, fatty acids, amino acids, etc. Fat is the one doctors focus on as it is the 'easiest' to capture in tests. Do you remember what your stool elastase number was?

The quantity per pill is important in figuring out what is the ideal quantity per meal for your body's needs. OTC versions are practically impossible to get a consistent and specific quantity determined per pill, which is crucial in getting your life back.

Another crucial element is that the pancrelipase enzyme pills should be (except for a few exceptions) enteric coated versions so that they pass through the stomach unscathed and are activated only in the duodenum, where they are needed. You do not want them activating in the stomach as it will either be pointless (stomach acid is powerful!) or an irritant to the stomach lining. Most OTC ones are not enteric coated ones.

And thirdly, timing and type of meal is important to consider. Taking it as a vitamin is also pointless and a potential irritant at that point. It needs to be taken with a meal. The first pill after the first bite or so, and the last pill before the last bite or so. And depending on how much you are taking somewhere in the middle of the meal. More fat in the meal means more quantity of enzymes. With Creon (or other prescription versions) you can over time dial in the amount of pills you personally need for a specific type of meal or snack. It takes a bit of time in the beginning but you will get the hang of it.

Any questions, please let me know.

Hope that helps.
 
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BeADocToGoTo1

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what causes pancreas damage?
The list of possible causes is quite long, but what you put in your body during your lifetime is the most common root cause for damage. It can slowly chip away until a breaking point. Anyone with diabetes, pre-diabetes, pancreatitis, exocrine pancreatic insufficiency has some form of damage to the pancreas.

Here are a few:

● Excess sugars of any kind
● Excess carbs (especially simple) in the diet
● Bacteria
● Viruses
● Parasites
● Cancer
● Excess chemical exposures including drugs, pesticides, herbicides
● Alcohol ( a form of chemical exposure but worth mentioning by itself)
● Smoking or other highly oxidative stress exposures
● Pancreatitis (Chronic, autoimmune or acute)
● Non-alcoholic fatty pancreas
● Atrophied pancreas
● Cystic fibrosis
● Duct obstructions
● Surgery of pancreatic or gastrointestinal functions
● Physical trauma
● Celiac or Crohn diseases
● Genetics, epigenetics
● Shwachman-Diamond or Johanson-Blizzard syndromes
● Zollinger-Ellison or Pearson-Marrow syndromes

In my case, it was damage accumulated over decades of exposure to the standard modern Western food supply, and that was with me thinking I ate healthily.
 
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Peyt

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Hi @Peyt

Do you remember what your stool elastase number was?
I looked at the test. It says normal range is suppose to be less than 20% and mine was 44%
This was just the regular stool test not the 72 hour one.
I also asked my Doctor to test me for CF because I have a lot of symptoms for the adult (less sever) version of CF or something similar...

My only worry is what if the only problem is fat digestion and I don't have any issue with Carbs or Proteins and the enzymes (being an all spectrum product) will make the rest of the pancreas get lazy and stop producing what it is doing now.
How long have you been taking enzymes with your food? Would love to know your thoughts about that.

Thanks so much
 

BeADocToGoTo1

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I looked at the test. It says normal range is suppose to be less than 20% and mine was 44%
This was just the regular stool test not the 72 hour one.
I also asked my Doctor to test me for CF because I have a lot of symptoms for the adult (less sever) version of CF or something similar...

My only worry is what if the only problem is fat digestion and I don't have any issue with Carbs or Proteins and the enzymes (being an all spectrum product) will make the rest of the pancreas get lazy and stop producing what it is doing now.
How long have you been taking enzymes with your food? Would love to know your thoughts about that.

Thanks so much
It is worth ruling out CF if not just for peace of mind. I did the same at the time, and then some. Pancreatic cancer was also a big one to rule out. The MRI with MRCP test of the abdomen, which also provides a 3D map of ducts, was a great one.

Regarding your pancreas becoming lazy, that is not something you have to worry about at all. It will produce the enzymes in the quantities it can. The pills will arrive in the duodenum with your partially broken down food (chewing, stomach acid, some amylase produced in the saliva), and whatever the pancreas can produce will arrive through the duct into the duodenum as well. What is not used is passed through. It is not like an antibiotic where you blast all the good and bad bacteria in a big spectrum. If you take too much, you may get a little irritation in the stomach or nausea. If you take too little, you may notice symptoms such as your stool soften (more wiping) or become yellower, intestinal discomfort, bloating, nutrient deficiencies.

The ratio of the various enzymes is also not something to worry about as it is different per person and practically impossible to easily test. Creon notes the lipase quantity in 12,000, 24,000, 36,000 unit pills (in the US) and it also contains a ratio of the other enzymes. Other prescriptions might have slightly different ratios. I have a prescription for all 3 sizes so that I can dose the way I want, and then I have a buffer on hand if there is an issue with the supply chain.

I take about 84K-108K per meal, depending on how large the meal is and how much fat is in it. A snack can be around 12K-24K. But when I started out, I did 12K per meal and quickly built up to 36K and more as I initially did not know how it worked. I think many doctors will start you with 36K per meal. This will be different per person and something you will dial in over time.

No need to worry about making your pancreas lazy! You are in fact helping your pancreas directly and indirectly, since nutrient deficiencies will cause havoc with all kinds of metabolic processes, which includes the working of your pancreas. But also a wild ranging list of symptoms, many which doctors never put together with EPI.

I think that pancrelipase should be standard in even life extension treatments, since our pancreas will produce fewer enzymes the older we get as part of the aging process, which in turn accelerates aging through nutrient deficiency impacts.

When there is an issue with the exocrine side of the pancreas, it is a no brainer to take it. And the peace of mind of having the correct quantity of enzymes (for you) dialed in without having to worry if that OTC pill, or that batch, or that brand had enough enzymes causing fluctuations that impact quality of life is huge.

When you have been having issues for a while, and it can be sneaky and unknowingly have dragged on for many years, it can take a bit of time to turn the ship around. All the nutrient deficiencies need to be fixed and healing needs to happen in potentially many areas of the body.

Let me know if you have any questions.
 

BeADocToGoTo1

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I looked at the test. It says normal range is suppose to be less than 20% and mine was 44%
This was just the regular stool test not the 72 hour one.
I also asked my Doctor to test me for CF because I have a lot of symptoms for the adult (less sever) version of CF or something similar...

My only worry is what if the only problem is fat digestion and I don't have any issue with Carbs or Proteins and the enzymes (being an all spectrum product) will make the rest of the pancreas get lazy and stop producing what it is doing now.
How long have you been taking enzymes with your food? Would love to know your thoughts about that.

Thanks so much
Forgot to add. I have been taking Creon for over 5 years and turned my life around from bedridden with no hope to fully functioning.

Regarding stool fecal lipids, it might be worth doing a 24hr (what I did) or 72hr one. It will show in grams per 24 hours.

The results of stool elastase should of be shown in micro gram/mL. But it still is not a completely accurate test and can be a bit finicky.

This one might be intesting as well, that is often used by veterinarians (they seem to be far more advanced on anything EPI than human docs):
  • Blood test fasting trypsin (to see if you produce enough enzyme for protein breakdown)
These tests were also very helpful but not covered by my insurance:
  • Genova Diagnostics - Comprehensive Digestive Stool Analysis 2.0 with Parasitology, Fecal Fat Distribution, Elastase and Chymotrypsin.
  • Genova Diagnostics - FMV
Blood glucose tests (the other side of the pancreas). Also worth doing and should be covered by insurance.

1. A1c. "Low" carb means something slightly different for everyone, but if your A1c is too high (5.3% or higher) you should try to lower carb intake as it can indicate excess sugar or carb intake.

2. Triglycerides. If your triglycerides are high (<100 mg/dL is optimal) you should try to lower your carb intake as your liver is transforming excess into energy storage.

3. Ketones. I also try to keep my ketone level around 0.5 or higher, but I never go to extremes and never add exogenous ketone salts either. Great indication of diet quality.

4. Insulin. Higher than 5 uIU/mL is an indicator of too high carb/sugar intake and/or start of insulin resistance

5. Blood glucose. <100 mg/dL is the expected norm, but <85 is better for longevity and health.

6. C-peptide. Indication of insulin production
 
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kangaSue

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There are a few other prescription type of enzymes available other than Creon - Pancreaze, Pertzye, Ultresa, Zenpep, Viokace (non-enteric coated, should be taken with a PPI) - don't know about pricing but maybe something cheaper among them.

If it's a fats only issue, many of the otc enzymes don't have a high enough lipase content to deal with that. A high lipase only supplement is Integrative Therapeutics Lipase Concentrate HP
 

PatJ

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You do not want them activating in the stomach as it will either be pointless (stomach acid is powerful!)
Stomach is powerful but so are acid stable enzymes. This article explains why:
Plant-based enzymes and fungal-derived enzymes, which comprise the bulk of enzyme supplements, are derived from organisms that secrete acid-stable enzymes. These enzymes have been purified and characterized so their pH optimum (acidity/alkalinity at which they work best) is well known and easily determined.

The majority of these fungal-derived and plant-derived enzymes can work in a pH range of 2 to 9 with no loss of activity.

This is not an opinion. The enzymes can be assayed, or analyzed, under lab conditions at different pH. This is easily verified by enzyme manufacturers.

The ability of enzymes to work in the stomach provides the means by which particular enzymes degrade gluten, casein, soy and other food proteins. The peptides that many find intolerable are degraded or not produced.

The stomach actually becomes a "safe house" when someone who does not tolerate dairy ingests these foods. No peptide or protein absorption occurs in the stomach, so you have a couple of hours to use the enzymes to break down the proteins before they move into the small intestine where the bulk of protein/peptide absorption will occur.
And here's another comment:
From: http://www.enzymestuff.com/basicsenzymeguide.htm

[Animal source] Pancreatic enzymes are available by prescription (Creon, Viokase) or over the counter. However, pancreatic enzymes are not stable to the acid conditions found in the stomach, so a good portion of them may be destroyed unless the preparation is treated in such a way, like being enterically coated, so that the enzymes will not be released until they arrive in the small intestine.

[Plant source] Plant and microbial enzymes, however, are stable in acidic conditions. They help digest the cooked and raw foods in the higher pH of the upper part of the stomach, the acidic lower part of the stomach as well as in the alkaline intestines. Digestion in the upper stomach actually mimics the natural process of eating raw foods, which contain some amount of the enzymes needed to break down the food itself. The additional ‘pre-digestion’ provided by plant and microbial enzymes leaves the pancreas to provide the ‘finishing touches’ to the digestive process in a less stressful manner. The intestinal tract will be better able to absorb and assimilate the nutrients and vitamins in the meal.
or an irritant to the stomach lining.
I've taken fairly high doses of Enzymedica Digest and Digest Gold and only experienced benefits, no irritation. Enzymedia LypoGold did cause irritation but it didn't feel like it was in my stomach, more like it was over to the left where my pancreas is located.

My only worry is what if the only problem is fat digestion and I don't have any issue with Carbs or Proteins and the enzymes (being an all spectrum product) will make the rest of the pancreas get lazy and stop producing what it is doing now.
According to this quote, taking supplemental enzymes isn't a problem for pancreas function:
From: http://www.enzymestuff.com/digestion.htm

So if supplementing enzymes has never been reported to have caused the pancreas to permanently stop producing enzymes, where did this idea even come from? Some people may be assuming pancreas function is similar to thyroid function and 'if you don't use it you will lose it.' Supplementing the thyroid may result in it stopping to make thyroid hormone. Normal thyroid function may not revive when the supplement stops. This may be true of that endocrine issue, but pancreatic enzymes are different. They are EXOcrine and operate differently.
 

ebethc

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Great list of tests! thanks.

  • Blood test fasting trypsin (to see if you produce enough enzyme for protein breakdown)
what's the diff between trypsin and chymostrypsin?

what's the diff in breaking down protein between betaine w hcl and trypsin?

1. A1c. "Low" carb means something slightly different for everyone, but if your A1c is too high (5.3% or higher) you should try to lower carb intake as it can indicate excess sugar or carb intake.
how do you define low carb? <100 g carbs per day? < 30g carbs per day? something else?

3. Ketones. I also try to keep my ketone level around 0.5 or higher, but I never go to extremes and never add exogenous ketone salts either. Great indication of diet quality.
how do you test? do you find the urine strips to be a decent measure?
 
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ebethc

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@BeADocToGoTo1

when you were sick, did you have low immune function, too? ie, get every cold, flu that goes around and have a hard time recovering?

Did you have low NK cells, and if you did, have they increased since you started on creon and recovered your health?
 

BeADocToGoTo1

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what's the diff between trypsin and chymostrypsin?
Both are enzymes produced by the pancreas and fall under the protease enzyme group which helps break down protein. They each focus on different amino acids.

what's the diff in breaking down protein between betaine w hcl and trypsin?
Two different processes and areas of the body where they function.

Betaine hydrochloride (HCl) is to help lower the pH (increase acidity) of the stomach so that the initial break down of large food particles in the stomach is supported and to help kill pathogens.

The pancreatic enzymes are released by the pancreas into the duodenum via the pancreatic duct. Or if you take pancrelipase pills, the enteric coating will get them through the stomach acid bath and into the duodenum, where they are activated. The pancreatic enzymes help further digest the partially broken down food particles (bolus), that come into the duodenum from the stomach, into usable nutrients such as vitamins, minerals, amino acids, fatty acids.

how do you define low carb? <100 g carbs per day? < 30g carbs per day? something else?
'Low carb' is different per person. Some people can handle a much higher load through e.g. genetics, pancreatic function, basal metabolic rate (calories needed to keep the lights on), exercise level, brain usage and other energy requirements. When you are at a healthy body composition, 100-150 grams per day is fine unless you have (pre-)diabetes issues. If you are an athlete or perform a lot of sports and heavy energy use activity you could go a bit higher. The type of carbs is important for your health. No need to worry about non-starchy vegetable carbs. All the simple carbs, added sugar in all the various forms and simple carbs in processed foods are the problem that no one needs.

When you are eating Primal or Paleo it is easy to go lower as you are not eating processed food and very limited starchy veggies. I have to go quite a bit lower since my pancreas does not produce enough insulin anymore. Anyone with (pre-)diabetes should also go lower than a healthy person. (Which sadly is a third of the US now)

I may have 1 potato, a tablespoon of rice, or a table spoon of pasta total in a week or two, but see them more as a treat. Many weeks I will have none. The only wheat products I do is a slice or two of old school organic sourdough (no yeast, just water, whole grain flour, salt, seeds and natural leaven), a small cookie once in a while as a treat, or if the rare small bit of pasta contains wheat.

how do you test? do you find the urine strips to be a decent measure?
Urine strips are inaccurate except for maybe an indicator of being in ketosis in the very beginning. I use a glucose meter and a ketone meter that requires a strip and a drop of blood from the finger. I used to check how my body reacted to everything I ate ( I do not drink calories) to study my own pattern, and to know which foods I had to cut out, or how much exercise I needed to do before bed to lower my blood sugar level to a healthy level. The KetoMojo meter will do both using different strips.

In the morning, pre-breakfast, I would test both ketone level and glucose levels to check if I am still maintaining. Now I only do so sporadically to keep myself honest and check whether there has been any more deterioration.

It truly is an eye-opener to see how your body reacts to what you eat or drink. This is why 'low carb' will mean different things for different people.

You do not want to get fasted measurements over 100 mg/dL in the morning, and you want to see ketones.

HbA1c of 5.2% is a 6-8 week average that equates to around 100 mg/dL.

My ketone blood level was between 0.4 and 1.7 (mmol/L) before breakfast, just by following my regular Primal diet, and eating within a 10-12 hour window. If I skip breakfast ketones climb.
 

BeADocToGoTo1

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when you were sick, did you have low immune function, too? ie, get every cold, flu that goes around and have a hard time recovering?

Did you have low NK cells, and if you did, have they increased since you started on creon and recovered your health?
Absolutely. I do not remember the NK cells. My vitamin B, C, D levels, Zinc levels, CoQ10 levels, many amino acid levels, to name a few, were all low. This impacts the immune system and antioxidant processes. Any little cold or virus would get me. Recovery of everything took forever. A little cut in the finger would cause a staph infection. Sprains would not heal. Etc.
 
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ebethc

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Absolutely. I do not remember the NK cells. My vitamin B, C, D levels, Zinc levels, CoQ10 levels, many amino acid levels, to name a few, were all low. This impacts the immune system and antioxidant processes. Any little cold or virus would get me. Recovery of everything took forever. A little cut in the finger would cause a staph infection. Sprains would not heal. Etc.
wow.. that's how I am... it's one thing after another.. thanks for sharing your story.
 

ebethc

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The pancreatic enzymes are released by the pancreas into the duodenum via the pancreatic duct. Or if you take pancrelipase pills, the enteric coating will get them through the stomach acid bath and into the duodenum, where they are activated. The pancreatic enzymes help further digest the partially broken down food particles (bolus), that come into the duodenum from the stomach, into usable nutrients such as vitamins, minerals, amino acids, fatty acids

'Low carb' is different per person.
thanks for the explanation!

what do you think of ribose? I started it again, and some days I actually feel normal! I haven't been on it that long, though... I took it one other time w okay results, but didn't think it was ultimately worth it... we'll see this time around

what do you think of carb cycling? I feel better when I do it (<30g carbs, w 1-2 days a week at <75g carbs) but I've read mixed things about the long-term benefits/risks...

How do you know if you have enough stomach acid? betaine w hcl has been super helpful sometimes, but it's inconsistent b/c sometimes it gives me a little stomach ache... so much guess work

do you eat saturated fats? I find that I like coffee w half / half for breakfast, w maybe an apple or grapefruit. the cream in the coffee fills me up. I don't see any undigested fat in my stool or greasy stool, but saturated fat can be too heavy for me, so cream in my coffee is both a treat and a way to fill me up until lunch.. monounsaturated fat, on the other hand, is really good for me... olive oil, etc.

I do 18/6 intermittent fasting, unless I'm sick, which, as I mentioned, happens way too often and throws off my program...
 

BeADocToGoTo1

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thanks for the explanation!

what do you think of ribose? I started it again, and some days I actually feel normal! I haven't been on it that long, though... I took it one other time w okay results, but didn't think it was ultimately worth it... we'll see this time around

what do you think of carb cycling? I feel better when I do it (<30g carbs, w 1-2 days a week at <75g carbs) but I've read mixed things about the long-term benefits/risks...

How do you know if you have enough stomach acid? betaine w hcl has been super helpful sometimes, but it's inconsistent b/c sometimes it gives me a little stomach ache... so much guess work

do you eat saturated fats? I find that I like coffee w half / half for breakfast, w maybe an apple or grapefruit. the cream in the coffee fills me up. I don't see any undigested fat in my stool or greasy stool, but saturated fat can be too heavy for me, so cream in my coffee is both a treat and a way to fill me up until lunch.. monounsaturated fat, on the other hand, is really good for me... olive oil, etc.

I do 18/6 intermittent fasting, unless I'm sick, which, as I mentioned, happens way too often and throws off my program...
Hi ebethc.

When I was really low on energy and before I had turned deficiencies around and improved my blood sugar balance I did take D-Ribose for a little while. I do know some people that became a bit nauseous or light headed from it. I have read that it can stimulate insulin production, but am not sure what the long term effects of it are. I would rather have a handful of blueberries than take d-ribose, for example.

Carb cycling and intermittent fasting can all do wonders in helping blood glucose balance, help in becoming a more efficient 'fat burner', produce more ketones, and give your system time to heal and clean up. <30 grams is very low, so you do have to be careful not to overdo it. Listen to your body as you also do not want to feel poorly, tired, achy, foggy, etc. when doing so. I usually do a 13 hour fast every day but could easily skip breakfast without feeling poorly. My wife usually skips breakfast completely, or will have a handful of walnuts until lunch if struggling for energy a bit, which ends up being about a 16-17 hour fast. Everyone will be a little different, but keep in mind that you do it to feel better in the long run, not to prove to yourself that you can struggle through it. :) Of course when you start out after following the classic Western/American diet it will be tough going initially, as your body adapts from sugar/simple carb addiction, but after a while it should come naturally.

Absolutely I eat saturated fat. It is good for you. I eat avocados, olives, seafood, bacon (occasionaly as a treat) and whole eggs, nuts and seeds, and use avocado and olive oil or sometimes a little grass butter in cooking, once in a while a little bit of coconut, dark chocolate as an occasional treat, full fat organic plain dairy, etc. But, the avoid processed food as much as possible mantra counts here too.

If cream or milk gives you issues, it could also be the lactose instead of the fat. You could play around with full fat cream instead of half/half, or ghee, or a lactose free version of half/half or cream. Even the smallest drop can have an effect. Have you tried it with a lactase pill? Some people also put grass fed butter in their coffee for that low insulin spike energy. I prefer my coffee black, but totally get the idea of doing so. If it really is due to trouble breaking down fat, can you try a really small quantity of pancrelipase with your breakfast?

If betaine HCL gives you a stomach ache, as with any supplement giving a negative reaction, I would stop it. Ideally you want your stomach to regulate the acid timing and strength. Often (barring specific malfunctions of course) when you have really cleaned up your food and beverage quality, your stomach can also rebalance this. Perhaps try without for a few weeks and see how you feel.

Saturated fats have sadly gotten a bad reputation (Ancel Keys' faulty and discredited study did not help here)

A great (Primal) site with explanations on saturated fat:

https://www.marksdailyapple.com/saturated-fat-healthy/

https://www.marksdailyapple.com/tag/saturated-fats/

https://www.marksdailyapple.com/how-should-you-balance-your-fat-intake/

Stomach acid:

A simple unscientific test to approximate acid level is by drinking a quarter teaspoon of baking soda (sodium bicarbonate) mixed in a glass of water on an empty stomach in the morning. This creates bubbles within two to three minutes when mixed with the hydrochloric acid in your stomach. If after five minutes nothing happens, there is a very good chance the pH of your stomach acid is too high (i.e., low stomach acid).

Gastroenterologists can do a measurement when performing an endoscopy, but it is not done as standard.
 

ebethc

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did you have histamine problems before? I can get overwhelmed by histamine, likely due to a mast cell problem.

just to clarify for anyone reading this thread: Betaine HCL w pepsin has been tremendously helpful. I just have a hard time finding the right dose b/c the amount I need seems to vary so much.. I have less stomach infections since I discovered it, and I had covid this spring, which REALLY screwed up my digestion even more than it's usual pitiful, default state.
 

BeADocToGoTo1

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did you have histamine problems before? I can get overwhelmed by histamine, likely due to a mast cell problem...
No histamine issues that I remember. But I was sensitive to most everything I ate for a long while. Nauseous for months and years of pain. Since I was not digesting properly with mucus and stomach lining issues, my body was sensing these partially digested particles as invaders and reacting. Everything felt inflamed and I lived on chicken and vegetable soup for a long time. It took a while to calm down once I took the insults away, started using pancreatic enzymes, and rebalanced the nutrient deficiencies.