How Low Is Too Low For Lipase
Lipase tests that consistently show low lipase levels, or values below 10 units per liter, may indicate the presence of other health conditions that can affect your pancreas. In particular, decreased levels of lipase may indicate the presence of: Cystic fibrosis.
If you’ve ever had a blood test, then you know about enzymes – those little helpers in our bodies that keep everything running smoothly and efficiently. Enzymes break down food into its basic building blocks so we can use them to produce energy from carbohydrates, fats and proteins. They also help us digest food by breaking it down into amino acids. And they make many important chemicals, including hormones and vitamins, possible.
Enzyme activity is measured in units of measurement called “units.” One unit represents one milligram of enzyme (for example, amylase) produced over an hour. So if a person has two hundred units of amylase in their saliva after eating a bowl of sugary cereal, it indicates that he or she is producing approximately four grams of glucose in less than an hour. Amylase is typically used as a marker for pancreatic function because the pancreas produces large amounts of this type of enzyme. Pancreatitis often causes elevated levels of salivary amylase. Saliva testing with amylase is commonly performed on patients who have suspected pancreatitis. However, some people have low levels of salivary amylase even when there are no problems with the pancreas, which happens sometimes during surgery or trauma. The condition is known as congenital hypoamylasaemia and it affects both children and adults. Children under age six usually don’t need treatment but older ones do.
The pancreas makes another type of enzyme called lipase. This enzyme helps break down fat molecules into fatty acids and glycerol. It’s found all throughout the body, especially in the small intestine. When digestion begins in the mouth, stomach and small intestine, lipids are broken down into smaller particles. Then these digested products move through the intestinal wall. At the end of the small intestine, where watery fluids flow out of the intestine and into the bloodstream, lipoproteins form. These lipoproteins carry the lipids away from the digestive tract and back up toward the liver. Once in the liver, lipids are converted back into triglycerides and stored in fat cells. Lipases are important because they play such an essential role in how our bodies store fat. If lipase isn’t working properly, however, not only does that mean that fat doesn’t get absorbed effectively, but it could also be a sign of more serious problems.
This article will explore what happens when lipase levels are too low, and why this issue might be relevant to you.
Low Levels of Lipase Could Indicate Other Health Conditions
Decreased levels of lipase may indicate the presence of cystic fibrosis.
A decline in lipase levels may be due to pancreatic insufficiency.
An increase in lipase levels following meals may suggest celiac disease.
In order to understand why having low levels of lipase might be problematic, let’s first consider the process of digestion. Our mouths contain hundreds of tiny teeth that grind foods together until they’re ready to be swallowed. After that, the food travels through the esophagus and into the stomach. Here, gastric juices break down protein, carbohydrates and fats into smaller pieces. Some of the resulting substances dissolve into the fluid while others combine to form chyme. Chyme moves through the small intestines where the nutrients are absorbed into the bloodstream.
When lipase works correctly, it breaks down fat molecules into fatty acids and glycerol. Glycerol is a simple alcohol made of carbon, hydrogen, and oxygen atoms. Fatty acids consist of long chains of carbon, hydrogen, and oxygen with carboxyl groups at each end. A molecule of glycerol contains three hydroxyl radicals attached to each carbon atom. Inside the human body, lipase is most concentrated in the small bowel where it plays a key role in how fats work. It’s also present in high concentrations in the pancreas, a glandular organ that sits just behind the stomach. The pancreas releases insulin, a hormone that transports sugar across cell membranes, into the blood stream. Insulin increases the number of receptors on the surface of the cells that absorb glucose. Without sufficient insulin, the cells aren’t able to take up enough glucose.
When someone has low levels of lipase, his or her body may not be absorbing certain types of fats effectively. As we mentioned earlier, lipoproteins transport lipids away from the gut and deliver them to the liver. In the liver, lipoproteins either release the fat directly into the blood stream or shuttle it to fat storage sites. Sometimes, lipoproteins become damaged and lose their ability to transfer fat properly. That means that instead of moving the fat out of the system, the lipids remain trapped inside the body. This results in higher cholesterol levels and contributes to heart disease. People with low levels of lipase may experience similar symptoms. Let’s look at what else could cause low lipase levels.
Cystic fibrosis is a genetic disorder affecting roughly 30,000 newborns every year in North America alone. The disease primarily occurs among Caucasians but it can occur in anyone. There are more than 70 different mutations associated with cystic fibrosis, and researchers say that around 80 percent of cases result from inheriting one defective copy of a gene from each parent. The mutated gene codes for a protein called CFTR that helps create mucus-producing glands within organs like the lungs, pancreas and intestine. Normally, mucus acts as a lubricant between tissues and keeps bacteria and other irritants from entering deeper layers of tissue. With cystic fibrosis, excessive amounts of thick mucus build up in the lungs and other affected areas causing blockages that prevent air from getting into places normally occupied by healthy lung tissue.
People with cystic fibrosis don’t secrete nearly as much mucus as normal, which explains why they tend to develop chronic infections. Because the pancreas is part of the digestive system, pancreatic exocrine dysfunction is common in individuals with cystic fibrosis. Pancreatic exocrine failure refers to the inability of the pancreas to secrete adequate amounts of enzymes required to digest food. When the pancreas fails to secrete enough enzymes, undigested food becomes acidic. Acidic waste builds up in the gastrointestinal tract, creating inflammation and further irritation. Patients with cystic fibrosis may suffer from abdominal pain, bloating, diarrhea, malnutrition, and constipation. Those who live near the equator may notice that their skin darkens. This is referred to as megaloblastic anaemia. The reason is that without vitamin B12, red blood cells cannot transform folic acid into tetrahydrofolate needed to synthesize DNA. Folate deficiency leads to lower production of red blood cells.
Since cystic fibrosis disrupts the secretory processes of various organs, lipase secretion may also be impacted. When lipase is unable to break down fats properly, it can actually damage the small intestine. Undigested fat molecules collect in the lumen of the small intestine, forming bulky masses that interfere with nutrient absorption. This creates malabsorption syndrome that can lead to severe nutritional deficiencies. Additionally, without enough lipase, fat molecules accumulate in the stool, leading to diarrhoea and constipation. Diarrhea and constipation can also contribute to dehydration.
Decreased levels of lipase may also be caused by pancreatic insufficiency. We’ll discuss this next.
Without enough lipase, the small intestine isn’t able to absorb the necessary amount of fat molecules. Since the pancreas uses lipase to digest fats, pancreatic insufficiency prevents the body from using pancreatic juice effectively. Pancreatic insufficiency is a condition in which the pancreas is unable to manufacture enough digestive enzymes to break down complex carbohydrates, proteins and fats. Pancreatic insufficiency can be divided into partial and complete forms. Partial pancreatic insufficiency involves a reduction in the volume of pancreatic fluid released into the duodenum. Complete pancreatic insufficiency refers to the absence of any pancreatic secretions.
Normally, pancreatic enzymes are released into the duodenum once you start chewing. When you swallow food, it passes into the stomach where the pyloric valve opens to allow pancreatic juice to enter. Within minutes, the enzymes begin to breakdown the food. About 20 percent of pancreatic enzymes are active immediately upon contact with the food; 60 percent require activation by bile salts and cholesterol. Another 20 percent stay inactive until activated by the hydrochloric acid and proteolytic enzymes secreted by the stomach. By combining pancreatic enzymes with digestive enzymes from the mouth, the small intestine is able to continue the digestive process.
With pancreatic insufficiency, the small intestine is left without lipase and therefore unable to absorb the nutrients contained in dietary fats. This leads to malnutrition. Malnutrition puts added stress on your immune system, making you more susceptible to illness. Additionally, since lipase is vital for fat digestion, a lack of it can result in weight gain. Weight gain can also increase the risk of diabetes.
You should see your doctor if you suspect
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