Apple cider vinegar

[Luac]

Hi all, I was diagnosed with PA before christmas but had been deficient and on b12 inhections for a couple of years already. I SI once a week atm.

I also have to take enzyme replacement therapy due to bad bowel movements and low faecal elastase. I have been on ert for 14 months.

A month ago I started taking ACV tablets (I took the max allowance of 6 tablets a day with food according to the brand) and noticed a huge difference within a short time. I suspected that the ERT wasnt doing much to improve my bowel movements but when i stopped for a week things got worse - they were working but not fully. The

ACV changed my stool in consistency and colour and it no longer floats. I am delighted as i think it is allowing me to absorb more nutrients.

I realise that many of you may not have a crossover issue between PA and ERT but we know PA causes low stomach acid and other vit/min deficiencies besides b12.

It is worth trying it and I would suggest to use VCA to improve acidity.

I have no idea about longterm use, I want to access a nutritionalist to discuss a better diet to improve acidity naturally and to improve absorption.

Do you have any experience with that?

[Hidden]

I have both PA and EPI the same as you. What I have noticed is that when I increase my acidity my ‘waste’ is much healthier. I also used to have to take folic acid tablets as I couldn’t absorb it easily from food. I know this as I have my bloods checked every quarter and I ate huge amounts of folic rich foods and my folate still did not increase. I take Betaine HCL, sometimes 3 with a meal if it’s high in protein. When I retested for my folate it was back in range, without supplementation. I have my fat soluble vits tested too, due to the EPI and they are all good. Like you I think it’s the acidity that’s helping. In terms of diet I generally follow a Mediterranean diet do lots of fish and vegetables, fruits and yoghurt and that works well for me. I worked with a registered dietitian and we tried previous diets which did not work such as low carb etc - they just made me lose weight and were pretty uninspiring. As you have EPI you should get an appointment with a registered dietitian through the NHS if you’re in the U.K.

[Luac in reply to Hidden]

Who authorised the testing if fat soluble vits? I was told by my gastroenterologist that they dont test for anything apart from vit d, b12 and folate/iron etc. I really want to know how i am deficient. Both PA and EPI (which i suspect i have, it is undiagnosed) cause vit and mineral deficiencies.

[Hidden in reply to Luac]

My GP. I get it done once a year on NHS. It’s a known side effect of pancreatic insufficiency. If needed the FS vits will be supplied on the NHS

[Hidden in reply to Luac]

How low is your fecal elastase? If your gastroenterologist is any way decent he will know that 100 to 200 is mild EPI and under 100 is severe EPI. You only get PERT if you have pancreatic insufficiency. You should also have had an MRCP to check the structure if your pancreas and biliary tree. Again this is standard. They check for solid mass tumours and blockages as well as pancreatic cysts. They did not find any of that with mine, thank goodness, but they can find atrophy which is often unexplained.

[wedgewood in reply to Hidden]

Yes , fish and veg are easier to digest than meat when you have low/no stomach acid ( Hypochlorhydria / Achlorhydria

[clivealive Forum Support]

I have had P.A. for over 49 years and I too have moderate exocrine pancreatic insufficiency and it was an NHS dietitian that arranged for the test to be carried out in the U.K. a couple of years back

Once the result was known the dietitian "dictated to my doctor" that I be prescribed "Creon" capsules containing lipase, amylase and protease (25,000) with every meal and suggested that I had had the "insufficiency" since the gastric surgery I had carried out at the age of 17 sixty-two years ago, The dietitian also recommended sprinkling flax seeds onto my breakfast cereals each morning to "ease things along".

Personally I add lime juice to my water not only to increase stomach acidity but also to make the water taste nicer.

I am not a medically trained person but I'm still "clivealive" coming up to 80.

I wish you well.

[Damn-it]

I take betaine HCL with each meal, and also digestive enzymes if I’m having anything slightly away from my regular diet. ACV is a winner fir me too. And I’ve found chewing gum before meals has helped a little. I also eat pickles with my main meals too. I’m pretty much carnivore, but have been for some time and can manage the protein well with these approaches. Plants - far less so. Especially any plant-based foods that are moderate to high in oxalates.

[lynxis]

I'm mildly allergic to apples so I try to avoid ACV, but sometimes my gastritis gets really painful and I take Betaine HCL with Pepsin with meals; it works wonders for me. I also try to drink kombucha every day. I was on proton pump inhibitors for years and I think it really messed my stomach up (on top of B12 deficiency with positive intrinsic factor antibodies).

[Dolansan]

Wow thank you for sharing! I was just debating on whether to give ACV a shot since I suspect low stomach acid. Please let us know if you suggest a brand or discover anything else that may be of long term benefit.

[Luac in reply to Dolansan]

I take tablets of 300mg when eating - a maximum of 6 a day.