In late 2021/early 2022, I realized I have moderate exocrine pancreatic insufficiency (EPI). There’s not a lot of information written and targeted at patients, and there’s also gaps in the medical literature and research studies regarding optimal titration of enzymes (known as Pancreatic Enzyme Replacement Therapy, or PERT). I spent some time figuring out how to optimally dose and titrate PERT and other enzyme sources, essentially developing a method for creating a lipase:fat and protease:protein ratio for better dosing enzymes (and building an iOS app called “PERT Pilot” to help other people do the same).
These are some of the posts that I’ve written about EPI (also known as PEI) that might be of use to anyone else with EPI.
- What You Should Know About EPI
- What you should know about starting on Pancreatic Enzyme Replacement Therapy (PERT) for EPI
- Cost calculations of Pancreatic Enzyme Replacement Therapy (PERT) for Exocrine Pancreatic Insufficiency (EPI) and alternative over the counter enzyme products
- A Do-It-Yourself Protocol for Over-The-Counter Enzymes for Suspected Exocrine Pancreatic Insufficiency (EPI) Before Gaining Access to Pancreatic Enzyme Replacement Therapy (PERT)
- An example of the challenges of (constantly) titrating pancreatic enzyme replacement therapy (PERT)
- How I calculate fat and protein for pancreatic enzyme replacement therapy (PERT) dosing in homecooked meals
- What it’s like to feel hungry for the first time in two years after discovering Exocrine Pancreatic Insufficiency (EPI or PEI)
- Why it feels harder to dose pancreatic enzyme replacement therapy (PERT) than insulin
- Reflecting on 4 months with Exocrine Pancreatic Insufficiency (EPI) and Experiences with Pancreatic Enzyme Replacement Therapy (PERT)
- New Research on Glycemic Variability Assessment In Exocrine Pancreatic Insufficiency (EPI) and Type 1 Diabetes
- Modifying Thanksgiving and Other Holiday Meals with EPI
- Cost, Price, and Calculations for Living With EPI (and diabetes and other chronic conditions)
- How to dose pancreatic enzyme replacement therapy (PERT) based on what you are eating, and a free web calculator to help you calculate enzyme dosing
- How to talk to your doctor about adjusting your enzyme dose
- A systematic review looking at prevalence of EPI in Type 1 diabetes and Type 2 diabetes
- You’d Be Surprised: Common Causes of EPI
- Why I have taken 5,000+ pills in 534 days
- New research on people’s real-world experiences with PERT (n=111 study)
- New research opportunity – take this survey to share your experiences with EPI-related symptoms!
- A systematic review on the PERT research studies and PERT guidelines
- Understanding elastase tests for EPI: what sensitivity and specificity tell us about mild/moderate and severe EPI
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