High Fecal Elastase Results

[Sparkle44]

Hi just wondering if anyone knows the relevance of a ‘high’ fecal elastase test?

The normal reference range is between 100-500ug/g. Although, in the hospital lab that tested me the reference range was up to 200 ug/g.

My test result came back as 800 ug/g

Does anyone know what can cause such an elevation? Are there any risks of having a high fecal elastase? My result came back with a flag next to it.

I can’t seem to find anything online that is helpful.

Any help or advice would be greatly appreciated!

Many thanks.

[Linda_MC Partner]

Hi Sparkle44- A high fecal elastase test is a strong indicator of exocrine pancreatic insufficiency (EPI) meaning your pancreas isn’t producing enough enzymes to digest and absorb food properly. This condition is treated by taking medical grade pancreatic enzymes (PERT) which is a prescription you take with food. Your doctor may start you on enzymes or repeat the test for accuracy depending on your symptoms.

[Sparkle44 in reply to Linda_MC]

Hi Linda thanks so much for your response. That might explain why my Folic Acid; Ferritin; Phosphate are all below the normal range. Plus, my Homocysteine is 3 times higher than it should be and my TSH is now under-active and I am on Thyroid tablets.

I don’t suppose you can signpost me to an article where it supports that there is a strong indicator for EPI so I can discuss it with my consultant, as they wrote in a letter that I had an MRI and Elastase test and there are no concerns, but there is a clear flag next to my result and the hospital reference range goes up to 200.

Maybe this is an oversight on the part of the consultant?

Many thanks x

[Linda_MC Partner in reply to Sparkle44]

Sparkle44- here are some good resources from Mission: Cure that you'll probably find helpful. One is a blog post and the other is the most frequently watched webinar- both on EPI. mission-cure.org/for-patien.... Also, here is an article from NHS - bsuh.nhs.uk/documents/pancr.... If you want a medical article to share with your consultant, here is one from PubMed that has good info-ncbi.nlm.nih.gov/pmc/articl... I hope these are helpful- good luck!

[nanagizer in reply to Linda_MC]

I have always read that anything above 200 is normal??

[nanagizer in reply to Linda_MC]

Hi there, I had mine done as well and it was 800+. My gastro specialist said that was great. He said range is above >200. He is a specialist at Cedars Sinai in LA and does extensive research/treatment of the pancreas. Hope this helps. 🥰

[Sparkle44 in reply to nanagizer]

Hiya this is beautifully reassuring thanks so much for sharing x

[nanagizer in reply to Linda_MC]

Hi Linda. I just had an elastase test done that came back as >800. My GI specialist said that was good. He said anything below 200 is indicative of EPI. I am confused by your comment here???

[Sparkle44]

Hiya Linda thanks so much you are a gem! I had a look at the links but can’t seem to see anything about Elastase levels being too high. They refer to insufficiency as being 100-200 ug/g.

*Normal exocrine pancreatic sufficiency: 200 to >500 ug E1/g stool

*Moderate to mild exocrine pancreatic insufficiency: 100 – 200 ug E1/g stool

*Severe exocrine pancreatic insufficiency: below 100 ug.

My result is 800+ ug/g

This is above the normal range.

But the result had a flag against it.

I just want to be able to challenge the consultant who appears to think this is okay.

Sorry to be a pain, but anything on high levels of elastase and the impact would be great.

Huge thanks x

[HealthSleuths in reply to Sparkle44]

Hi Sparkle. Did you ever turn up anything on high elastase? Mine is also above the lab ref range, >750.

[Sparkle44 in reply to HealthSleuths]

I think I also recall them saying that above 200ug was normal and that they were more concerned with the lower numbers as the lower the numbers there was a chance of pancreatic insufficiency!

[Sparkle44]

Hiya HealthSleuths, I didn’t find anything & just totally lost sight of this in amongst all the other health issues at the time. I am so glad you got in touch though as this is very timely on Wednesday I have been asked to have a 24 test to monitor reflux which involves having a tube inserted into my nose and into my gut 😳 I might chicken out!! I think this could all be linked!!

They have also diagnosed me with a mild bile malabsorption issue.

I wish I could be of more help!!

I think you should follow up with your GP for further advice and maybe a repeat test. Do you have IBS??

[nanagizer]

Hi there. Did you ever find out anything more about the high elastase reading of 800+? I just had it done again and mine is the same at 800+. I am confused why some here are saying that is indicative of EPI. I cannot locate anything on the web about it being too high.

[Sparkle44]

Hi Nanagizer the consultant just wasn’t concerned about the high elastase… If I recall they were only concerned about low numbers (anything below 200) as that could affect the Pancreas causing insufficiency..

[Jackie1947]

I have severe EPI but as I'm allergic to pork I cannot take it supplements so I'm left with no alternatives. I have severe pancreatitis and what with both to deal with life's a blast! Good news my rheumatoid arthritis is in remission.

[Sparkle44]

Oh wow that’s a lot to be dealing with! Glad to hear your arthritis is in remission at leat that is one thing! My sister has severe pancreatitis too! Very distended stomach bless her. Take it easy and sending lots of blessings your way x