What Is It?
Digestive enzymes are proteins specially tailored to break down foods into nutrients that your body can then readily digest. The human body produces some 22 different digestive enzymes. Many more are found in the fruits, vegetables, meats, grains, and other foods we eat. A number of digestive enzymes, from both plants and animals, are also sold as supplements.
When you eat a meal, digestive enzymes released from the salivary glands, stomach, and small bowel immediately get to work to speed up digestion. Each enzyme acts on a specific type of food. A variety of different proteases, for example, break down the components of protein. Amylases help digest carbohydrates. Lipases break down fats. And cellulases, found in plants, digest fiber.
Both conventional and nutritionally oriented doctors often turn to digestive enzyme products to promote good digestion and enhance nutrient absorption They contend that many people are lacking in enzymes because of inadequate diets, over-refined foods, environmental toxins, or poor health. Symptoms such as bloating, gas, heartburn, and indigestion are thought to be a common result.
Conventional physicians including gastroenterologists believe that when chronic indigestion is caused by decreased enzyme production, symptoms can often be relieved when these enzymes are replaced. Taking this one step further, some nutritionally oriented practitioners believe that even in the absence of symptoms most people can benefit from routinely taking extra enzymes to maintain peak digestion and enhance stores of vital nutrients.
Many physicians will rely on the fact that some enzymes can be absorbed into the bloodstream and can be used in a variety of clinical situations. These include the swelling and inflammation following sprains or soft tissue injury or even to help dissolve blood clots. .
Some alternative practitioners prefer plant-based digestive enzymes, such as bromelain (from pineapples), papain (from papayas), and enzymes grown on the fungus aspergillus. Animal-based products (often called pancreatic enzymes because they are derived from the pancreas, the tongue-shaped digestive organ that sits under the stomach) are also used, alone or together with plant-based enzymes.
Undeniably, conventional physicians use enzymes much less frequently than nutritionally oriented physicians and alternative practitioners. They believe that most of us get all the enzymes we need, except in the case of a true enzyme deficiency, which can be detected with an analysis of stool specimens. . Doctors sometimes prescribe Pancreatin, for example, a digestive enzyme that comes from the pancreas of pigs, as a part of the treatment for chronic pancreatitis, an fairly uncommon condition in which the enzyme production in the pancreas steadily declines. Far more commonly, conventional doctors recommend over-the-counter enzyme products such as Lactaid for lactose intolerance or Beano for chronic gas.
Nutritionally oriented doctors recommend digestive enzyme supplements for various ailments, from simple heartburn and bloating to more persistent problems, such as chronic indigestion and irritable bowel syndrome. . The supplements also are given as a digestive aid for patients battling cancer, and sometimes even for nondigestive complaints, such as the skin ailment rosacea. Some practitioners even advise patients to take enzymes daily in the belief that it will result in peak digestive performance.
Specifically, digestive enzyme supplements may help to:
• Reverse the digestive upset that can occur with normal aging. Many practitioners contend that digestive problems often develop in later decades because stores of digestive enzymes decline with advancing age. Taking supplemental enzymes helps to restore good digestion by replenishing these dwindling supplies. .
• Treat flatulence, heartburn, irritable bowel syndrome, and other digestive complaints. Nearly all types of digestive problems can benefit from enzyme therapy. In the case of heartburn, for example, the thinking is that any means of accelerating the stomach’s emptying of food may well reduce stomach acid and lessen irritation along the digestive tract. Upset due to irritable bowel syndrome or inflammatory bowel disease (Crohn’s disease, ulcerative colitis) may also respond well.
• Provide nutritional support for cancer patients. Although definitive studies are lacking, some practitioners prescribe high-dose enzyme therapy as adjunctive (supportive) treatment for cancers of the pancreas, colon, lung, and other organs. Enzymes are also given to ease side effects from harsh chemotherapy and radiation regimens. Among the different enzymes being tested is one called Wobe-Mugos, a highly concentrated blend of pancreatic enzymes, that has shown some early promise against the immune-system cancer, multiple myeloma. Some physicians who use alternative therapies to treat cancer will include high doses of enzymes because they believe the enzyme can have a direct effect on the cancer itself.
• Ease symptoms of candida overgrowth syndrome. This controversial illness, thought to be due to runaway growth of candida yeast in the intestines, can cause diarrhea, gas, bloating, joint aches, and many other discomforts. Plant-based digestive enzymes may help to restore good digestion.
• Control the ruddiness of rosacea. Taking a small amount of digestive enzyme supplements with meals may improve this chronic skin complaint. Patient testimonials and a handful of small studies indicate that it is an effective approach.
— When buying a digestive enzyme product, look for one that mixes several enzymes (enzymes all end in the letters “ase”). The highest quality products contain amylase (for starches), lipase (for fats), protease (for protein), and lactase (for dairy). Bromelain (from pineapples) and papain (from papayas) are two plant-based digestive enzymes frequently found in enzyme mixtures as well. Clearly, if you know you have a particular problem with a certain food (say, dairy), look for that specific enzyme (lactase helps digest dairy products).
–Enzymes are taken orally and no other route of administration should be attempted unless under the supervision of a physician familiar with enzyme therapies.–For most ailments, the dosage of plant-based digestive enzymes recommended is 2 to 4 capsules with each meal. The higher amount is usually needed for a larger meal. Specific needs vary from person to person, however, so experiment until you find the right dose to relieve your symptoms.
–Check the label carefully for “activity units.” Examples include GDUs (gelatin digesting units) and MCUs (milk clotting units). Ounce for ounce, products with the highest activity levels are the most potent–and the best buy.
*For poor digestion due to normal aging: Take 2 to 4 pills with meals.
*For common digestive complaints such as flatulence, heartburn, or irritable bowel syndrome: Take 1 to 2 capsules with smaller meals; 2 to 4 with large meals.
*To enhance digestion during cancer treatment: Take 2 to 4 pills with meals.
*For candida overgrowth syndrome: Take 1 to 2 capsules with meals.
*For rosacea: Take 2 to 4 pills on an empty stomach to enhance absorption .
Guidelines for Use
• For digestion-related complaints, take an enzyme product at the start of a meal.
• For non-digestive complaints, such as skin inflammation, doctors typically recommend taking digestive enzyme supplements on an empty stomach.
• If you don’t like swallowing pills, buy a powder, or sprinkle the contents of a capsule over your food.
• Some sources recommend that people with digestive problems take another supplement called betaine chloride in conjunction with digestive enzymes. The purpose of this strategy is to add more stomach acid to the digestive process, a remedy that many people with heartburn, and older people, appear to benefit from. However, you should contact your doctor before taking this supplement; it’s not safe if you have had a peptic ulcer at any point or any condition associated with excess acidity.
• Wait a couple hours after taking digestive enzymes before taking an antacid, since the acid neutralizers may interfere with the activity of certain enzyme supplements. However, the various ‘acid-blockers,’ like Tagamet or Prilosec, will not interfere with enzyme function
• Discontinue taking the enzymes and check with your doctor if you don’t notice any improvement in your condition after using them for a month or so. Enzymes may not be right for you.
•Most digestive enzymes have no known drug or nutrient interactions associated with their use.
•Pancreatin, a pancreatic enzyme from pigs that is prescribed as a drug, may interfere with diabetes medicines such as miglitol (Glyset).
•If you’re on anticoagulants or other medications to thin the blood, let your doctor know. Some enzymes, such as bromelain, can thin the blood further and possibly cause complications.
Possible Side Effects
Digestive enzyme products have a good safety record, and serious side effects are rare. Even if you take a lot of pills, the body rapidly eliminates the enzymes. Side effects tend to be minimal. Cramping, diarrhea, or digestive upset may arise during the first few days or so of treatment, but typically subside rather quickly. If any reaction is severe or persistent, however, see your doctor.
•Some people are highly sensitive to enzyme supplements. See your doctor if you develop severe stomach or intestinal distress or develop other worrisome symptoms.
•Stop taking the supplements if a rash, sore throat, or red eyes develop. It could be an allergic reaction. Don’t use a particular enzyme if you know you’re allergic to its source, such as bromelain (from pineapples), papain (from papayas), ficin (from figs), or pancreatic enzymes (from pigs, cows, or oxen).
*Until benefits are proven, do not take enzyme supplements as a substitute for conventional, and potentially lifesaving, treatments for cancer and other serious maladies. Enzyme products are best suited as a nutritional complement to standard therapies.
*People with diabetes should consult their doctors before taking digestive enzyme supplements, since they can alter levels of nutrients and sugars obtained from foods.
*Like many supplements, enzymes have not been tested extensively in pregnant or breast-feeding women. Let your doctor know if you’re pregnant or are planning to have a child.
Aging / 2 to 4 pills with each meal
Cancer / 2-4 capsules with each meal
Candida Overgrowth Syndrome / 1-2 capsules 3 times a day with meals
Flatulence / 1-2 capsules with a small meal, 2-4 capsules with a larger one. Consider sprinkling contents of capsules over food.
Heartburn / 2 pills 3 times a day
Irritable Bowel Syndrome / 1-2 pills with a small meal, 2-4 pills with a larger one. Consider sprinkling contents of capsules over food.
Rosacea / 2-4 pills with each meal
David Edelberg, MD