FAQ Category: General

Yes. The gut is adaptive to real food and formula can be used for numerous diagnoses. Start slow and titrate, but the gut will likely adapt similar to any standard or specialty formula.

Transition from your current formula to Functional Formularies products in a step wise method. Substitute half to one pouch for half to one can/carton of your current formula as appropriate. Clinicians must use their clinical judgement, but research has indicated that “specialty/elemental” formulations are often tolerated/digested similar to standard formulations.

Yes. Since our products are nutrient dense and high in calories and fiber, caregivers may need to deliver formula at room temperature, or they may need to “thin” the formula. If products are stored below room temperature, have patients bring formulas up to room temperature to allow for easier infusion. If there is a need to add water to the formula, use this rule of thumb as a starting point: add 10ml of water for every 60ml formula. Again, if adding water to the formula, you must re-blend before administering.

An independent third party microbial assessment shows that there is no microbial growth on a 12 hour hang time at ambient room temperatures. A 2 year shelf life indicates that there is no microbial spoilage and no significant loss in nutritional value in unopened pouches stored at ambient room temperatures.

Yes. Our products have been tested down to 8 French NG tubes.

Liquid Hope has been used for other tubes that are 8 French or larger and Nourish works with tubes that are 6 French or larger.

No. Our products are pre-blended/mixed in a sterile environment, no need for food preparation, handling, or mixing. No more concerns of guessing at nutritional amounts caregivers are providing patients. Additionally, ingredients are certified organic and of the highest quality and nutritional content. Deliver via syringe, gravity drip bag, or pump — the same as you would with any high kcal/high fiber enteral formula.

Fully formed and biologically active vitamin A is known as retinol or retinyl ester.  It is measured in both micrograms and International Units (IUs). The RDA for adults ranges from 700 to 900 micrograms (1mcg =3.33IUs) or approximately 3000 IUs and the tolerable upper level (TUL) of the safe range is 10,000IUs for pregnant women and all adults.  The body converts different carotenoids to vitamin A (retinol/retinyl esters) at varying rates.  This conversion is a function of the type of carotenoid consumed (beta carotene, alpha carotene, lycopene, lutein, etc), the individual’s nutritional status, and the individual’s genetics. There is wide variability based upon the fruit or vegetable source and an individual’s genetic expression for conversion.  In general, it takes approximately 18,000 to 36,000 IUs of mixed carotenoids to generate 3000 IUs of vitamin A in the form of retinol.

Carotenoid consumption has never been shown to generate vitamin A toxicity.  This is a function of a biological feedback loop where less is converted with higher levels of circulating vitamin A.  Additionally, and equally important, carotenoids are converted to vitamin A at low rates and at a much slower speed. Some carotenoids that are not converted may end up being stored in fat cells and can, at very high levels of consumption, generate a slight change in an individual’s skin color.  This increase in stored carotenoids is known as hypercarotenoidosis and is associated with a reduced risk of several forms of cancer.

The amount of carotenoids in Liquid Hope and all Functional Formularies meal replacements are not capable of generating any type of vitamin A toxicity. They are present at moderate levels and are from its sweet potato, carrot, and green vegetable content.