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HEALTH CONCERN? BioHealth Health Concerns

Understanding Malabsorption

Contributing Author: Warnke, Cheryl L.Ac.

Cheryl WarnkeCheryl Warnke, LAc, is an acupuncturist and herbalist based in California, helping to resolve a broad variety of conditions including pain, gastrointestinal disorders, fatigue, and hormone imbalances. Because she believes in a holistic approach to health, she works to uncover the underlying cause of complex health issues instead of just masking symptoms. Cheryl has been using functional diagnostic testing for over a decade to complement her traditional Chinese approach, to help resolve even the most complex of patient cases.

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Malabsorption in the gut is defined as the body's inability to properly absorb vitamins, minerals, and other nutrients from food. Even though your diet may be balanced and adequate, and although you may be taking the best vitamin supplements on the market, if you are suffering from malabsorption, you may develop various nutritional deficiencies.

The most obvious sign of malabsorption is bowel/digestive dysfunction. This may entail a wide scope of complaints, from constipation, diarrhea, gas, abdominal discomfort and/or pain, mucus in the stool, or pale bulky stools. Less obvious signs of malabsorption may include fatigue, anemia, stunted growth, thinning hair, dry skin, depression, muscle cramps or weakness, edema, PMS, vision problems, and weight loss. Weight gain is common because if the body is not absorbing vital nutrients, the body may crave more food in an attempt to make up for the deficiency. Often, a person suffering from malabsorption will have a carbohydrate craving that seems insatiable.

Digestion basically begins in the mouth during the chewing process and the mixing of saliva. From there, the liver, gallbladder, and pancreas all play a part along with the intestines in breaking down food to allow vital nutrients to be absorbed. Theoretically, dysfunction along any part of the digestive tract, such as a blocked duct from the pancreas or gall bladder, can cause malabsorption. This results in a lack of bile or digestive enzymes that help digest fats.

Malabsorption may also be caused by excessive laxative use, excessive alcohol intake, over-the-counter medications such as antacids, radiation therapy, or overuse of prescription medications such as antibiotics or other drugs, and severe illness. Also, food intolerances or allergies may cause bowel dysfunction and damage to the intestinal walls. Other influences such as parasites or the presence of unfriendly bacteria can prevent proper absorption of vital nutrients by crowding out the good bacteria, or by damaging the walls of the intestines. Moreover, stress may be a major cause of malabsorption, as body chemistry is compromised when the system is under huge emotional/mental strain.

Malabsorption is a serious condition in itself, which can lead to other problems and diseases. If there is a deficiency in even one vital nutrient, the body is left with a deficit and cannot function properly. For example, minerals are large molecules and are not as easily absorbed as other nutrients. So, if there is poor absorption or supply of calcium, the body may suffer from bone loss, muscle cramps, and tremors. Malabsorption is also a condition that, if unchecked, can be self-perpetuating. For instance, many nutrients need the presence of others to be absorbed. It is vital that the B vitamins are present for the absorption of amino acids.

At the final and primary stage of digestion, nutrients are transported across the intestinal wall (or mucosa) and absorbed into the bloodstream. This process is microscopic and occurs at the sight of the villi, finger-like projections that comprise the lining of the intestines. At this, the cellular level, individual cells on the villi "collect" the proper nutrients after they have been prepared in the earlier stages of digestion. The inability of nutrients to be absorbed into the bloodstream at the cellular level of the villi is the most accurate description of malabsorption.

Given all of the factors that can cause malabsorption, uncovering the cause of this dysfunction entails a broad scope of investigation. After taking into consideration the history of the patient in regards to medication, stress levels, etc., other factors must be examined as well. Diet is a primary aspect to consider, as many people have allergies or intolerances to various foods, which can actually damage villi to such a degree that they cannot function. Another aspect is to rule out the presence of parasites or bacterial imbalances.

When someone comes to me for help with their digestive complaints, I may require them to supply medical records of any previous tests done, a list of present and past medications, and a detailed history of any problems they have had in the past... and what therapies or diets seemed to help alleviate their discomfort. Most likely, I will request a three-week food diary as well. I also ask them to track in their food diary their digestive function, mood, etc., for each day, time and description of bowel movements, and a description of any other digestive problems that may have occurred. After compiling the information that I gathered at the first session, I will determine if the diet needs to be altered, or if I need to do lab testing to investigate any number of things, such as allergic responses, immune response, the presence of parasites, the extent of gut damage, liver function, and toxicity levels, to name a few.

After gathering such valuable information, a complete and proper protocol can be determined. Malabsorption issues can then be addressed in a logical, holistic manner that considers the most primary causes and addresses the deepest level of compromise.