From the Guidelines
Low amylase levels should be addressed by consulting a healthcare provider for proper diagnosis and treatment, which may include pancreatic enzyme replacement therapy (PERT) and dietary modifications to improve nutrient absorption and digestion. When evaluating low amylase levels, it is essential to consider the underlying cause, which may be related to conditions such as pancreatic insufficiency, liver disease, or cystic fibrosis 1. The healthcare provider will likely order additional tests, such as lipase levels, comprehensive metabolic panel, or imaging studies, to determine the underlying cause of low amylase levels. Treatment depends on the specific diagnosis, but pancreatic enzyme replacement therapy (PERT) is a crucial component of managing exocrine pancreatic insufficiency (EPI), as it improves outcomes and quality of life 1. Some key points to consider when treating low amylase levels include:
- PERT should be taken during meals, with an initial treatment of at least 40,000 USP units of lipase during each meal in adults, and half of that with snacks 1
- The dosage can be adjusted based on meal size and fat content, and routine supplementation monitoring of fat-soluble vitamin levels is recommended 1
- Dietary modifications, such as consuming smaller, more frequent meals that are lower in fat, may also help improve nutrient absorption and digestion 1
- Over-the-counter commercially available pancreas enzyme replacements should not be used, as they are classified as dietary supplements only and their dosing and efficacy are neither standardized nor regulated 1. Regular follow-up with a healthcare provider is essential to monitor the condition and adjust treatment as needed.
From the Research
Low Amylase Level
- A low amylase level has been associated with various health conditions, including pancreatic cancer and chronic pancreatitis 2.
- Studies have shown that extreme low and extreme high plasma pancreatic amylase levels are associated with a 2-threefold higher risk of both pancreatic cancer and chronic pancreatitis 2.
- Low serum amylase has also been linked to obesity, diabetes, and metabolic syndrome, with some research suggesting that it may be a novel interpretation of these conditions 3.
- In a hospital population, hypoamylasaemia (low amylase level) was found to be associated with diabetes mellitus, cystic fibrosis, hypertriglyceridaemia, and the use of certain antibiotics such as gentamicin 4.
Causes and Associations
- Salivary amylase, which is produced by the salivary glands, has been found to play a role in digestion and metabolic syndrome, with some research suggesting that it may have an impact on oral perception, nutrient signaling, and blood sugar levels 5.
- In patients with acute pancreatitis, low elevation of serum amylase has been found to be associated with biliary etiology, low-density lipoprotein cholesterol, and triglyceride levels 6.
- The predictors of acute pancreatitis with low elevation of serum amylase include biliary etiology, low-density lipoprotein cholesterol, and triglyceride levels, which were found to be independently associated with the development of acute pancreatitis 6.