Study: Pancreatin inhibits Folic Acid

[dannybex]

Just thought this may be important if one is taking both folic acid and also a digestive enzyme product with pancreatin...


Dig Dis Sci. 1980 May;25(5):369-73.Links

Impairment of folic acid absorption by oral pancreatic extracts.
Russell RM, Dutta SK, Oaks EV, Rosenberg IH, Giovetti AC.

Higher serum folate levels were found among newly diagnosed, untreated patients with pancreatic insufficiency than among treated patients despite greater fat malabsorption in the former group.

In vivo folate absorption tests using Tritium-labeled pteroylmonoglutamatic acid showed folate absorption to be enhanced in pancreatic insufficiency patients as compared to control subjects (P less than 0.01). Moreover, pancreatic extract significantly inhibited folate absorption in both normal subjects (P less than 0.05) and pancreatic insufficient patients (P less than 0.001). In vitro testing showed pancreatic extract to form insoluble complexes with folate. Such complex formation may diminish absorption of dietary folate and lead to folate deficiency. Since both pancreatic extract and bicarbonate are used in the treatment of pancreatic insufficiency and both are known to impair folate absorption, folate status should be monitored in patients being treated for pancreatic insufficiency; supplementation may be indicated.


(and I would assume, 'supplementation' of either pancreatic enzymes and folic acid should be taken hours away from each other...or the folic acid could be held in the mouth per Freddd's protocol?)

 

[klutzo]

enzymes and folate

Dannybex,
Thank you so much for posting this. I take more than 600 prescription enzyme pills a month for pancreatic insufficiency and may be having that dose raised even higher after spending all day Monday in the Emer. Rm. and not being able to eat solid food since Sunday. I had no idea of this problem, since my GI doc knows zip about nutrition. I will use the supplement between meals.

klutzo

 

[Lisa]

The way this reads to me is that if you are already taking something that has folate in it, that counts as supplementation. They are more concerned with the natural folate found in foods, like leafy greens, that is being bound into an insoluble form.

So if you take a multiple vitamin, b-complex, or folate on its own then you should be getting enough that you won't have deficiencies. Keep in mind the huge difference in amount of folate in one capsule of a supplement compared to what you might find in an average meal.

As well, they are speaking in terms of taking both the enzymes and the sodium bicarbonate in the same meal, thus creating an environment for even less folate absorption. Hence the reasons to be concerned about monitoring folate levels. A double whammy you could say if you did both the enzymes and the bicarbonate at the same meal.

Lisa

 

[Cynthia]

Interesting. I had a son born with Spina Bifida with Mylomyningacele... the number one birth defect back in the 80's. L5 area. I was asked all sorts of questions..anything from..if I smoke or drank, which I didn't, if I lived near any type of industrial plants and if so what/which one, to if I owned a microwave. Through questions asked, to many I'm sure, they decided to do a 5 year study with women that would take folic acid 3 months before they even tried getting pregnant again, then continue taking them once they were pregnant. I was part of that study. I sent them blood monthly, they sent me pre natal supplements with plenty of folic acid in it. I was on the supplements for the three months, then it took me three months to get pregnant...so, six months of it before I even got pregnant.
This study was done in the state of Washington. I had a good result, healthy baby boy. They had asked me for an announcement of my baby, and how the child was when born. So, they had some pretty good news at the end of the 5 years. Foic Acid is very important "before" and during. Eat those leafy greens. Sad to say, I was not eating all that well throughout my younger years. Now, for the Pancreas...I was having a lot of pain inside of my belly area for years, still do at times, so back in the 90's, I had exploritory done. Of course they were looking for the number one scare, cancer, but first thing said to my husband when the surgeon came out was..I didn't see any cancer, but, for some reason she has a lot of scar tissue on her pancreas. No answers were ever given for that. They don't know why it's scarred.

 

[lucyhem]

I am wondering about the pancreatic enzymes and folate supplementation issue. I don't see any further discussion of it on the forum. It seems important for all of us who are taking methylfolate and folinic acid as well as enzymes. I imagine many of us do. Any further information about this. Will taking the enzymes away temporally, from the folates make a difference? I have poor digestion but I have never been sure the enzymes do anything at all for me. Shall I forgo them while on the SMP?

 

[dannybex]

I am wondering about the pancreatic enzymes and folate supplementation issue. I don't see any further discussion of it on the forum. It seems important for all of us who are taking methylfolate and folinic acid as well as enzymes. I imagine many of us do. Any further information about this. Will taking the enzymes away temporally, from the folates make a difference? I have poor digestion but I have never been sure the enzymes do anything at all for me. Shall I forgo them while on the SMP?

Good questions Lucy. Sorry I missed your post a few months ago.

I've recently been prescribed pancreatin and am working on methylation, so have the same questions.

Also, I wonder why folate would be increased in those with pancreatic insufficiency???

 

[dannybex]

August 2012 Update: This study measured FOLIC ACID, not actual "folate". Note this paragraph:

"In vivo folate absorption tests using Tritium-labeled pteroylmonoglutamatic acid..."

Pteroylmonoglutamatic acid is synthetic folic acid, not "folate" as they loosely use the word in the study.