- WHAT DOES THE
- The pancreas is below
& behind the stomach sitting in a bend of the duodenum, which is the
first part of the small intestines. There are 2 functional components.
- The first is part of
the gastrointestinal tract & participates in digesting & processing
food. The second is glandular & produces four hormones which modulate
the absorption & storage of glucose (sugar).
- The digestive part of
the pancreas works hard by secreting 50-133 ounces of “pancreatic
juices” daily. This juice has 2 major components: 1) water &
electrolytes, primarily bicarbonate to maintain an alkaline pH of 7.5-8.5.
2) and 6-12 grams of pancreatic enzymes needed to digest protein, fats &
carbohydrates. Zinc deficiency (which is not all that uncommon) compromises
the ability of the pancreatic enzymes to function. Vitamin B6 is needed to
enhance Zinc absorption.
- It’s quite
fascinating how it all works. When your stomach stretches with food intake
it release a hormone called Gastrin. This in turn signals the pancreas to
get to work releasing its’ juices. Just to make sure the pancreas gets the
message, when the acid contents of the stomach move into the duodenum , the
duodenum also releases a hormone called Secretin. This hormone signals the
specific release of the bicarbonate to create the correct pH environment for
the pancreatic enzymes. . Then as the food moves on, the small bowel
produces a hormone called Pancreazymin which says now is the time to release
- The fat digesting
enzymes are lipase, phospholipase A & B , & cholesterol esterase.
The protein digesting enzymes are trypsin, chymotrypsin, & proteases.
The carbohydrate digesting enzymes are amylase, lactase, sucrase , maltase,
- Poor digestive enzyme
production is a not uncommon cause of symptoms. Such enzyme depletion can
result from a poor diet since enzyme formation depends upon nutrient
precursors, especially amino acids. The resulting low level of enzymes
impairs food absorption further decreasing the enzyme formation &
maintaining a vicious malabsorptive cycle.
The obvious solution is to improve the diet & to provide pancreatic
support with supplemental pancreatic enzymes, or Pancreatin ( from the
pancreas of a lamb, pig, or cow) which contains the pancreatic enzymes.
Plant based enzymes are also available, although I have not found them to be
- Temporary support may
be all that is needed, unless a person has a constitutionally weak pancreas,
or other lasting disorders.
- WHAT HORMONES DOES
THE PANCREAS PRODUCE?
- We are most familiar
with Insulin. The other hormones are Glucagon, Somatostatin, &
- WHAT ARE THE
FUNCTIONS OF INSULIN?
- Insulin is essential
for life. It reduces blood sugar by stimulating sugar uptake by the cells.
It also stimulates amino acid entrance into the cells. It stimulates the
formation of gycogen which is the chief storage form of carbohydrates,
stored mainly in the liver , muscles, & fat cells. Insulin promotes the
synthesis of proteins & promotes growth. It regulates fat metabolism,
increases fat formation, maintains fat stores, & inhibits the
mobilization of fat from peripheral stores.
- Insufficient insulin
results in insulin dependent diabetes. Excess insulin can cause the cells to
become less sensitive to the insulin & result in adult onset insulin
resistant diabetes which is controlled with diet & medications other
than insulin. Excess insulin with insulin administration or with insulin
resistance can contribute to obesity, high blood pressure, high blood fats
& atherosclerotic heart disease.
- Insulin release is
stimulated by foods, other GI tract hormones, stress hormones, &
acetylcholine. Calcium is an important mediator of insulin activity &
activates the glucose transport system in the cells. A calcium deficiency
will compromise some of the actions of insulin.
- WHAT ARE THE
FUNCTIONS OF GLUCAGON?
- Glucagon is not
essential to life. It works antagonistically to insulin, by increasing
rather than decreasing blood sugar.. It acts as a fuel mobilizer by
stimulating glycogen (stored carbohydrate) release from the liver &
muscles. It also promotes the formation of glucose from amino acids
(protein) when that is needed. Its’ release is stimulated by hypoglycemia
& fasting. It stimulates fat metabolism helping to break down fat &
promotes the repair of injured tissues. It increases blood potassium,
increases oxygen consumption & promotes sodium excretion.
Proteins & amino acids, gastrointestinal hormones, prolonged exercise,
stress hormones, & acetylcholine also stimulate its’ release.
- Sugar, fatty acids,
& hormones suppress its’ release.
- Hypoglycemia is a
stress state stimulating the output of Glucagon & other hormones to
mobilize fuel from the liver & muscles. But this regulatory response to
hypoglycemia is impaired in many older people who have impaired ability to
maintain glucose balance. Influences are diet, exercise, nutritional status,
body fat per cent, hormone levels, medications, & disease.
- What I find most
commonly is inadequate dietary protein intake & too many refined
carbohydrates. Many people have no idea how much protein to eat, nor how
much is in what foods. You can determine your daily protein needs by going
& calculating based upon your weight & activity level. To find the
protein content in foods try http://www.nal.usda.gov/fnic/foodcomp/Data/SR15/sr15.html
- WHAT ABOUT THE OTHER
HORMONES FROM THE PANCREAS?
- The Somatostatin acts
to reduce both the insulin & glucagon secretion as needed. The
Pancreatic Polypepetides are less understood, but are felt to affect
- HOW ELSE TO
- Decreased pancreatic
enzyme production can be found on the Comprehensive Stool & Digestive
Analysis which several labs do. I like Great Smokies Lab http://www.gsdl.com/.
It is not unusual for to see find chymotrypsin deficiencies & fat
malabsorption. Blood sugar is best measured by a 6 hour glucose tolerance
test, though that can be grueling. Severe pancreatic disease can be hard to
diagnose & is done by symptoms, CAT scans, serum lipase & amylase
& other tests as indicated.