If you have EPI, your body can have a hard time extracting nutrients from foods, which can cause deficiencies. While supplements are sometimes helpful, they won’t fix the underlying problem.

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EPI is a condition that means your pancreas doesn’t produce enough digestive enzymes.

When you eat, food passes through your digestive system to the small intestine, where enzymes break down food molecules and draw out important nutrients. But if you have EPI, this doesn’t happen properly — potentially leading to malnutrition.

Taking supplements for the nutrients you’re lacking might seem like a logical solution, but they might not fix the problem. Most doctors recommend enzyme replacement therapy, and they might suggest you take some supplements alongside it.

Read on to learn more about common nutrient deficiencies and EPI and how supplements could help.

The way your body digests food is a surprisingly long and complex process. It starts in your mouth when an enzyme in your saliva, called amylase, breaks down carbohydrates.

After passing through your esophagus and stomach, food particles enter your small intestine. Your pancreas produces enzymes that break them down and draw out important nutrients like vitamins and minerals.

But in EPI, your pancreas doesn’t secrete enough enzymes, which means your intestines can’t extract the nutrients you need. This can lead to nutrient deficiencies, particularly in fat-soluble vitamins like A, D, E, and K.

Deficiencies are one of the hallmarks of EPI, and your doctor will likely run blood tests to check for them when diagnosing you with the condition.

According to research, about 30% of people with EPI have malnutrition. Vitamins A and D were the most common nutrient deficiencies.

Fat-soluble vitamins

The most common nutrient deficiency with EPI is fat-soluble vitamins. Having difficulty digesting fat is one of the main impacts of the condition, so your doctor might recommend supplementing for these.

Some fat-soluble vitamins you might be deficient in include:

  • Vitamin A: This is important for your eyes, skin, and immune system.
  • Vitamin D: As well as being essential for your immune system, vitamin D also keeps your bones healthy.
  • Vitamin E: This is an antioxidant and supports your immune system.
  • Vitamin K: In addition to contributing to bone health, vitamin K helps your blood clot.

Water-soluble vitamins

You might also have deficiencies in water-soluble vitamins. These include:

  • B vitamins: There are eight B vitamins, and they play a role in helping your body use food for energy.
  • Vitamin C: This helps with cell repair, wound healing, and healthy teeth and skin.

Minerals

In addition to vitamins, EPI can cause mineral deficiencies. Some of these you might have include:

  • Calcium: As well as supporting healthy bones, calcium helps your muscles and nerves function properly.
  • Magnesium: This mineral helps to maintain healthy brain and heart function.
  • Zinc: Importantly, zinc supports a healthy immune system.

Supplements aren’t the first course of treatment for EPI — but if you have a number of nutrient deficiencies, they might be useful.

It’s good to think of supplements as a temporary solution. They won’t fix the underlying problems that are causing your deficiencies, but they might help you manage the side effects of deficiencies in the short term.

Something you should also bear in mind: They might not work. When you take supplements, they pass through your digestive system just like food, eventually ending up in your small intestine. If you’re not producing enough enzymes to extract the nutrients, they’ll end up passing through you with the rest of your food.

Despite this, your doctor might recommend fat-soluble vitamin supplements alongside your treatment program. They’ll likely give you some options to try, and you should always check with them before taking anything new.

The first line of treatment for deficiencies with EPI is pancreatic enzyme replacement therapy (PERT), a form of prescription medication that contains a combination of digestive enzymes. Adding supplements to this protocol can help manage your EPI and treat your deficiencies in tandem.

Learn more about PERT.

If you have EPI, you might want to make some modifications to what and how you eat.

While there’s limited research on the “ideal” EPI diet, most experts recommend swapping your three meals a day for smaller, more frequent meals and snacks. Eating less at once is easier on your digestive system and might mean you absorb more nutrients each time you eat.

You should also be sure to get enough fat in your diet. Avoid high-fiber foods, like beans and cruciferous vegetables, because these put more strain on your digestive system.

For most people with EPI, it’s a good idea to work with a registered dietitian who can help you find an eating plan that works for you.

Learn more about dietary changes for EPI.

If you have EPI, your doctor will likely run blood tests to screen you for deficiencies. You should be sure to attend all your follow-up appointments so they can check your levels throughout your treatment plan.

Additionally, if you’re having symptoms of nutrient deficiencies like fatigue, dry skin, vision problems, hair loss, or mouth ulcers, you should contact your doctor.

Because EPI makes it hard for your intestines to extract nutrients from your food, deficiencies are common. In particular, about 30% of people with EPI are malnourished.

You can take supplements to increase your levels of important vitamins and minerals, but your doctor will likely recommend this alongside enzyme replacement treatment. This both helps treat the effects of EPI and makes your supplements more effective.