Functional Medicine/Lipase?


Here is the background:
I used to suffer from irritable bowel, mostly bloating and nausea. I traced the cause to my 'low carb' diet. I wasnt losing weight (I am about 30 pounds overweight) but wasnt gaining.
After cutting out ALL fats,including red meats, I am starting to feel much better and am down a couple belt notches. I am taking fish oil capsules as I realise some healthy fat is important.
Question: Although I cant find much on this, I am beginning to suspect I may be deficient in lipase, which is why I had so much trouble with fats. This may be a genetic thing as my Dad and uncles all had the same problems. I always took digestive enzymes which helped, they had a little lipase, but I found some actual lipase only capsules. I just started on them and while not eating fat it will be hard to tell if they are effective.
There is a rare condition called lipoprotein lipase deficiency, which seems to mirror my symptoms. However I cant find much on lipase digestive enzyme deficiency. Are they the same? Do you think I am taking the right steps going low fat and taking extra lipase? Thanks so much!

Hey Bud!

This is a more complex issue so I'd like to take it in pieces.

Yes, lapase is an enzyme that helps to break down fats. Lipase can come from the stomach, pancreas and liver and bile. And although it's possible to have a genetic predisposition, it's more rare than people think. It's far more common that people have a lifestyle that exacerbates any genetic problems they might have. For example, do you (or have you) eaten many of the same foods your dad liked? How about alcohol or sugar intake, activity, and favorite foods/snacks? Are they (were they) similar?

I see you exploring some dietary approaches which is a good start (red meat is higher in saturated fats and pro-inflamatory), and you've had some initial results. The thing I'm concerned about is that you might be seeing the problem too narrowly.  

For example, excess fat in the abdominal region is metabolically active, and it disrupts hormones and sends out inflammatory chemicals which spread all over! That alone can harm the pancreas, liver, intestines and their ability to function. If those organs become inflamed, they can be compromised. That could easily contribute to digestive problems with fats. And all of that could have contributed to the IBS and the bloating and nausea you've had. Inflammation in the intestines can claso cause IBS, as can the wrong bacteria if they overgrow. Food allergies also contribute.

I'd want to see a range of blood screenings, such as a basic metabolic panel (sometimes called a chem 22, including fasting glucose, liver and kidney function, plus basic cholesterol and thyroid), a hsCRP test (which measures systemic inflammation), plus age, heath history, height/weight/body fat percent and activity levels. BTW, You can also get a blood test for lipase.

I'd also want to know your vitamin D levels because D is a hormonal regulator for inflamation (that test is called a 25-hydroxy vitamin D test). I'd also want to see more detailed cholesterol and triglyceride levels, especially those from a VAP or NMR test (those give specific particle sizes). Did you know? A high-carb diet (including grains like wheat) can trigger large numbers of small, dense LDL particles. Those are very inflammatory and atherosclerotic.

I'm in the US where most people can get their own screenings at reduced cost. I'm not sure if Canada has a similar system but these types of tests will give a bigger picture.

You are right about needing healthy fats in your diet(usually 20-30% of calories). I'd consider cold water fish several times a week (salmon, mackerel and sardines are good sources of omega-3s) or the fish oil. Olive oil is also great and helps lower inflammation. Dropping red meat is okay (high in saturated fats) if you get other lean proteins, such as chicken, fish or seafood. Veggies/beans/legumes can also provide some good protein when combined properly.

As for the lipoprotein lipase deficiency (also called chylomicronemia or hyperlipoproteinemia), did you have these problems in childhood? That's probably when you would have noticed if it was from a significant genetic defect.  

As a health/wellness coach, I look at the big one! Your body is a universe of organs and tissues all working together, either in or out of balance. And most modern health problems are tied to systemic inflammation, especially those that show up later in life. Most are driven by lifestyle issues and are fixable!

Do you exercise? That can help to balance glucose and lower inflammation. It's also important in lifestyle-driven health conditions. I recommend that people look at basic issues first, which is something you started to do. Even if you have some genetic problem, it's not fixable so looking deeper at your lieestyle for solutins is the easiest place to start and fastest way to improve your health!

I hope that helps!

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Steven Carney


I can answer questions that involve nutrition, fitness and weight loss issues. I'm also able to answer questions for chronic, lifestyle-driven conditions, such as high cholesterol/triglycerides, high BP/hypertension, atherosclerosis/heart disease, systemic inflammation, arthritis, high blood sugar, obesity, etc.


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