Essential vitamins and minerals in pancreatic disorders

Essential vitamins and minerals in pancreatic disorders

The nutrients you need in cystic fibrosis and exocrine pancreatic insufficiency


Everyone, not just those with CF (Cystic Fibrosis) and EPI (exocrine pancreatic insufficiency), needs essential vitamins and minerals for health. In addition, everyone needs protein, carbohydrates, water and fiber. In CF and EPI, minerals, like iron , and calcium, even the others, including zinc, and magnesium are important.  

People with CF and EPI need extra vitamins, especially the fat-soluble vitamins A, D, E and K because of their difficulty absorbing fat.   

The chart below shows the essential vitamins everyone needs, their functions and where to get them. They are separated into fat soluble vitamins (require fat for absorption), water soluble vitamins (easily absorbed and excess is excreted in urine) and conditional vitamins that are only needed in certain situations. 

Water Soluble/RequiredImportanceGood Sources
Thiamine (B1)Carbohydrate and amino acid metabolism, nerve and muscle membranesGrains, nuts, potatoes
Riboflavin (B2)Energy use, cell respiration and repairDairy, meats, green vegetables, eggs, yeast
Pyridoxine (B6)Enzyme activation and cofactorMeats, vegetables, fruits, nuts, grains, legumes
Cyanocobalamin (B12)Formation of genetic code, amino and fatty acid metabolism, blood cell and nerve developmentMeats, eggs, milk products
Folate Formation of genetic code, utilization of proteinGreen vegetables, nuts, liver
Ascorbic acid (vitamin C)Collagen formation/wound healing, immunityFruits, vegetables

Water Soluble/Conditional

Niacin (B3)                        need when prolonged diarrheaProtein and energy utilizationGrains, poultry, fish
Choline  Usually can be manufacturedCell transport signaling and integratingMilk, eggs, liver, peanuts
Biotin  (B7)   needed when tube feedings, excess egg whitesEnergy metabolism activation of folateIntestinal bacteria, organ meats, yeast, soy, nuts, cereals
Pantothenic acidUsually can be manufacturedFat metabolismMeats, whole grains, legumes, vegetables

Fat-Soluble Vitamins

Vitamin AVision, skin integrity, gene expressionFruits, vegetables, fortified milk, fish oils
Vitamin D Calcium and phosphorus absorption, role in immune regulationSun, Fish, eggs, fortified milk products
Vitamin ECell membrane stability, antioxidantFruits, vegetables, meats, oils
Vitamin KClottingIntestinal bacteria, meats, green vegetables


Most people are aware they need iron to avoid anemia. The condition where the red blood cells aren't able to get oxygen to the body's cells. They also know they need calcium for their bones. These minerals are especially important in CF and EPI because anemia and low bone density are common.

Also important are magnesium and zinc when they have diarrhea. Fortunately, a short course of 2-4 weeks of supplementation will raise the levels back to normal, if the diarrhea can also be stopped. 

Listed below is a table of essential minerals, functions and sources:

CalciumBone formation, nerve signaling, hormone secretionDairy, broccoli, kale
CopperCreation of bone structure, energy metabolismSeafood
ChromiumSugar metabolismMeats, fish, grains, Brewer's yeast
FluorideStrengthening of teeth, bone formationFluoridated water, toothpaste, mouth rinses
IronTransportation of oxygen and energyMeats, green vegetables, iron-fortified cereals
MagnesiumBone metabolism, metabolic processesGrains, nuts, leafy vegetables
ManganeseProtein and fat metabolism, bone formationVegetables, grains, organ meats
PotassiumRegulation of fluids in cells, nerve signaling, heart contractionsFruits (bananas, oranges), vegetables
SeleniumAntioxidant (similar to vitamin E), part of enzyme systemVegetables, meats, fruits, milk products
SodiumRegulation of hydration and fluid in blood vesselsSalt in food preparation, processed foods
ZincProtein and fat formation, processing of genetic codesFish, meats

The amount of these vitamins and minerals in the foods you eat are listed in our table on nutritional content. Some of the vitamins and minerals are listed on nutrition labels using a 2000 calorie diet as the standard. But if you need more or less than 2000 calories, your needs will be different. This USDA Tool , can calculate the amount in each food based on your individual needs.  

If you don't get enough vitamins or minerals in the food that you eat, it may be helpful to take a once daily multivitamin mineral for nutritional insurance.  

Of course, you always have to remember that when you eat, you have to be sure to take your PERT (pancreatic enzyme replacement therapy).

vitamins and minerals in pancreatic disorders