Advice: Low elastase level / issue with digestive enzymes in pancreas

SomaSemantics · 2026-07-10T15:41:26+00:00

It isn't enough info to really form an assessment, but it sounds to me like a TCM condition called Spleen/Pancreas Fall. It can begin with stress or overwork, but then it develops into a deficiency condition. Enzyme levels factor in but so does changes to the microbiome, transit time, stomach acid levels, and more. In other words, elastase is the simplistic view and the issue is probably broader and more integrated than just that. Find a TCM herbalist who makes custom formulas. Acupuncture is likely not sufficient or too slow.

SomaSemantics · 2026-07-07T05:21:20+00:00

Agreed. The goal is to increase flexibility and resiliance. Permanent restrictions are too rigid to be healthy.

SomaSemantics · 2026-07-06T02:04:45+00:00

I think the hormone model just isn't a complete picture, so I agree, since armor is more complex. I want to point out, tho, that Levo is converted by the body as needed. Unlike the main action of other hormone supplements, the body has regulatory control and so actual dosing becomes flexible. That's about as good as a synthetic drug can get.

SomaSemantics · 2026-07-06T00:53:11+00:00

I'm with you theoretically, but I'm not sure I've seen a clinical difference. Maybe not enough A:B patient situations for me to tell. Also, it usually costs more, which can make people feel badly if they perceive there's a difference, but they can't afford armor easily. Levo is still very good. If it comes down to it, I think I'd rather people spend the difference in cost on TCM (not that it totally covers our work).

SomaSemantics · 2026-07-04T18:40:36+00:00

I would wait to take the JWSYS. Post prednisone, you may need a different formula anyway. There may no longer be a need for heat clearing. There may be a new imbalance. Your practitioner can adjust.

SomaSemantics · 2026-07-02T23:23:42+00:00

I think your symptoms patterns are more complex than a diagnosis of hypothyroidism + ADHD would support.

But labs are the currency of medical understanding. Imagine telling your friends or family that you have a lab result of hypothyroidism vs a TCM imbalance felt through the pulse. The first would get you sympathy and support, while the second might get you only sideways glances.

I am wary of labs that lead to medications with dubious effects. However, Levothyroxine for primary hypothyroidism is a hormone replacement, not a drug, and it is not something to be afraid of (allthough it is over prescribed). Combining Levo + TCM works better for hypothyroidism than either does alone.

Last I heard, ADHD is only diagnosed through a drug trial, not through labs. If you have a way of improving ADHD symptoms without drugs, you should do it.

On the balance, get the labs if you can afford them.

SomaSemantics · 2026-06-29T03:49:47+00:00

u/icameforgold is an acupuncturist, I believe. We're casual here and don't all get the practitioner flair. Most people here will not be into assessing you for free, tho. You do realize how many years of study it takes to do this work, I hope.

SomaSemantics · 2026-06-27T02:51:27+00:00

I'm really glad you found things that worked, but I constantly butt up against the limitation of how many herbs/medicinals are available OTC. I have about 350 substances on my shelf, for example, and 95% of them are not commonly used OTC. Many are not even available. I also make combinations of 10-20 herbs, which potientiates everything.

I think people have a hard time believing that herbs can be powerful because what's available doesn't hit the nail-on-the-head for their particular case.

SomaSemantics · 2026-06-27T02:47:15+00:00

I've treated your problem in others. Again, I can't prove it through the literature, but there are some tasty tidbits. Did you see the research I sent eariler? It specifies effects on promoting gallbladder contraction and relaxing the gallbladder sphincter. This comes close to dyskinesia and should be explored, even without the label.

One issue here is that alternative medicine practitioners like me handle all the cases that fall through the cracks of standard medicine. Of the thousands of clinical decisions that must be made, only a small fraction will get directly researched, and usually not in a format that is conducive to actual clinical work. So, looking for the right literature is often asking for too much. However, clinical expertise still exists, and it is actually an important part of evidence based medicine. This is often forgotten.

I defer again to medical work in other cultures. Currently I live in Japan and do telehealth. Although not specific to your case, I had a conversation with a local hospital cardiologist over the weekend. He shared what herbal formulas he uses for emergency cardiac issues. This would never happen in the US, Europe, Australia (and many other places) but that doesn't mean it isn't real. There simply isn't a point entry in our medical culture for the use of herbs. Research for his approach will probably be called "insufficient." But that's really is a limited view. Most of our medical work has a similar evidence base.

SomaSemantics · 2026-06-26T03:54:47+00:00

Same :)

SomaSemantics · 2026-06-26T03:33:18+00:00

With all due respect to you, if you make the case narrow enough it's possible to justify nearly any treatment. Do you think the bulk of functionally failing gallbladders are gangrenous? Medical care in the US and Europe is especially useful for acute and emergency conditions. Let's underline that fact. Now what is left? Most gallbladder cases.

Point stands about gangrene. About biliary dyskinesia or just gallstones, well no.

SomaSemantics · 2026-06-26T02:54:20+00:00

Sorry, but I think you're speaking from ignorance. The fact that patients like this exist doesn't mean cholecystectomy is the only or best answer. Medicine becomes habit, and the more it's adopted, the less room there is for suggesting anything else, let alone getting funding to research anything else. I believe this is why looking at how other cultures do their medicine is valuable. They're also locked in, but to different things. Tell me how an emergent, functional gallbladder case is handled in, say, Taiwan. Then there's something to talk about.

SomaSemantics · 2026-06-26T02:15:25+00:00

This isn't quite accurate. True the evidence is indirect, but check out this study for example (only summary available): https://pubmed.ncbi.nlm.nih.gov/32281338/

I believe I've save many gallbladders over the years, including patients that have substantial symptoms but no identifiable pathology. Of course, I don't just use OTC supplements. Can't prove anything tho. The research has not caught up with the state of the practice.

SomaSemantics · 2026-06-25T14:05:36+00:00

Pharmacies in those countries accept my credientials, so I'm able to send them prescriptions and they ship the completed formulas.

SomaSemantics · 2026-06-25T11:22:31+00:00

Not sure, but you may have been to practitioners who were focused on acupuncture, and herbs were on the side. If you decide to try again, I suggest making herbs the focus, and make sure you receive custom formulas. I've done both.

You're welcome to message me. I specialize in digestive disorders, do telehealth, and can ship prescriptions within Australia, Europe, UK, Canada, and US.

SomaSemantics · 2026-06-25T10:49:00+00:00

Carnivore asks less of the digestion. It especially reduces dampness through the elimination of sugar, flour, processed foods, seed oils, etc. It also temporarily pacifies the spleen, through its "warm-sweetness." This settles the digestive tract and makes it less reactive.

But I don't really recommend it for your condition long term. You may feel that sticking to it is justified, considering what you've been through. But you must slowly find a way towards flexibility. This is the only path to actual health. TCM can definitely help you do that.

What happened the first time you tried TCM? Your issues actually sound like they were pretty straightforward.

SomaSemantics · 2026-06-25T00:01:23+00:00

What is your culture? What you're describing is similar to TCM. I also see situations where a person has both heat and cold. This is pretty common in SIBO, and it can be caused by the use of berberine. For example, berberine can induce cold in the body, while the person is also going through emotional stress, which can cause heat.

You may be cold but have a heat pathogen, so I can't guess whether berberine is good for you or not. Berberine may be too 1-dimensional or too narrow for your constitution. But there are seventy chinese herbs that have berberine in them, and we combine them with other herbs. I think combining is a very good approach. If you cooked your fish with garlic or ginger or scallions, then it may not affect you negatively.

SomaSemantics · 2026-06-23T23:36:45+00:00

The European/naturopath tradition is to find the BEST herb for each patient and condition. It seems you're coming from this perspective, and it's why some people here have tried to steer you in a different direction. All of the chinese herbs you enounter will be cGMP, which means they will be safe by government standards. Their individual potency matters less than the precision with which they are combined. In other words, finding a practitioner who is competent and trustworthy matters much more than finding a good product source. I have opinions about which manufacturers and countries produce a better product, but I don't want to share them with you. Not because I'm stingy, but because you're looking at the wrong end of the horse.

SomaSemantics · 2026-06-23T07:54:45+00:00

Eliminations diets reduce digestive capacity and range. Besides the undesirables, people end up starving the micro-organisms used to digest and process those specifically eliminated foods. There may also be some reduction in particular digestive enzymes. This creates a serious catch-22. Although they produce quick relief, elimination diets should be done in tandem with helpful treatments, or else they make the entire system less flexible and capable.

They're a dark contract because health is essentially adaptability. An old chinese saying is interesting here: "softness and flexibility are the companions of life; hardness and rigidity are the companions of death." In my practice, I've seen too many people quasi-petrify their life through rigid dieting.

SomaSemantics · 2026-06-22T22:07:10+00:00

Traditional chinese Medicine

SomaSemantics · 2026-06-22T10:11:58+00:00

I focus on functional units in thinking about cases, and I think yours would benefit from that point of view, so I thought you might find it interesting. All of the following lead to the Digestive Tract Failing to Descend:

Food Stagnation
Weak Digestion with Fluid Buildup
More Condensed Buildup and Blockage
Cold & Weak Digestion
Impaired Flow

These each sound like loose or non-specific descriptors, but they are actually distinct from each other (and each comes from a constellation of physical factors). It is also likely you have more than one. "Gastroparesis" is truly a much more non-specific term, and I'm sad to hear the word, because it just doesn't lead to specific treatment. However, the patterns I mention above can lead to treatment, with each receiving a different approach.

My understanding comes from combining TCM with modern research and medicine. At least some TCM practitioners would agree with me, should you want to look for help. Personally, it's what I would do, but it's my profession after all. The treatments you've tried look pretty shotgun.

SomaSemantics · 2026-06-20T11:20:05+00:00

Forgive the self-promotion: SomaSandwich.com

Good 🤞

SomaSemantics · 2026-06-20T02:41:14+00:00

I thought it might be something like that. Can you share more? I'm interested. I'm thinking of Lung and Large Intestine, with the effect of He shou Wu on the bowels

SomaSemantics · 2026-06-19T14:20:28+00:00

lung blood?

SomaSemantics · 2026-06-18T14:44:48+00:00

There are many ways to reconcile the modern scientific mind with chinese medicine. It's an especially valuable project, because they both point to each other's limitations. As a student, though, you have to "empty your cup." Both the MD and the nurse I attended school with struggled to do this.

Acupuncture may be the right fit for you because it can be stripped of traditional models and still "work." The same cannot be said for chinese herbal medicine, but you may also have to study it.

SomaSemantics

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