Should You Be Taking Digestive Enzyme Supplements?

Let’s clear the air: Running to the bathroom after your meal is not normal. Feeling stuffed or bloated should not constitute a miserable, curl up in a fetal position and watch Game of Thrones feeling. (Unless you’ve eaten an obscene amount of food, that is; but that’s a different topic.)

Post-meal constipation and other bathroom problems could be a huge flag you’re not digesting food well. They could also suggest bigger problems like leaky gut and irritable bowel syndrome (IBS). Simply put, your body might not be making sufficient amounts of digestive enzymes to break down food.

To get nutrients from your food, you’ve got to break down that food efficiently. Most foods don’t retain their natural enzymes, and various conditions including age, chronic stress, and gut health can impact your body’s enzyme production.

We live in a digestive-deprived world triggered by bad diets, chronic stress, rushing through meals, antibiotics overuse, and many other conditions that deliver a serious whammy to our gut, and we’ve got the dismal stats to provide it.

In fact, digestive problems send a lot of people to the doctor: An estimated 60 – 70 million Americans visit every year for gastrointestinal problems. In 2004, GI problems created about 4.6 million hospitalizations, 72 million ambulatory care visits, and 236,000 deaths. These problems cost Americans an astounding $142 billion per year. (1)

Then you’ve got practical repercussions. You didn’t digest your lunch well and come mid-afternoon, you feel tired, nauseous, and frequently hitting the office restroom. Or that late-night snack didn’t sit well and you wake up at 3:15 a.m. with stomach miseries. Those and other minor catastrophes can have serious effects on your health and happiness.

Fortunately, many are entirely preventable.

Here’s Why Digestive Health is So Important

Imagine you’re a health fanatic. You almost always shop organic, avoid genetically modified (GMO) foods as well as food intolerances, you’re tight with the local farmers, and you only choose animal foods raised humanely in their natural environment.

You’re the walking picture of eating healthy.

But for whatever reasons, you’re not making enough digestive enzymes or they can’t do their job because of an infection or other problems. So even with the best intentions, you’re not breaking down those foods optimally. All those amazing vitamins, minerals, and antioxidants aren’t going where they need to go. That healthy protein is absorbing through your gut before it gets fully broken down, creating all sorts of other havoc including inflammation and an immune system gone haywire.

All that time, money, focus, and energy gone to waste. Your body has become nutrient-starved and inflamed, and the ramifications are more widespread than you might imagine.

“Headaches, migraines, allergies, autoimmunity, weight gain, acne, skin rashes, yeast infections, hormonal imbalances, fatigue, immune challenges, even the way you sense pain— they all relate to the condition and health of your gut,” says Dr. Vincent Pedre in Happy Gut.

In all fairness, digestive enzymes (or lack thereof) aren’t entirely to blame. Maybe you indulged your friend’s Southern nostalgia and ate fried chicken for dinner, and at midnight you’re struggling with heartburn. Perhaps you took your significant other to a popular pasta eatery, couldn’t pass up the hot garlic bread, and here you are on the drive home with gas and bloating.

Don’t blame the bad food you ate for poor digestion. Sugar, food intolerances like gluten and dairy, fried foods, and for some people spicy foods can create post-meal miseries that manifest as gas, bloating, constipation, and an overall why did I eat that thing!? feeling.

We’re human, which means we indulge in less-than-ideal foods sometimes. The bigger problem becomes when you do eat the right foods and still suffer a digestive-misery aftermath.

Those issues might be red flags you could benefit from a digestive enzyme supplement.

Many conventional doctors don’t connect the dots between digestive problems and nutrient malabsorption or bigger problems including intestinal permeability (leaky gut), pancreatic burnout, and non-alcoholic fatty liver disease (NAFLD).

If preventing inflammatory conditions and food allergies doesn’t get you excited, consider that digestive enzyme supplements can also help you lose weight. After all, when you absorb nutrients better, you optimize your metabolism.

Digestion 101

Digestion begins in your mouth, which secretes an enzyme called salivary amylase (many digestive enzymes end in -ase) that begins breaking down carbohydrates. Among its roles, salivary amylase helps prevent plaque buildup and dental caries. (2)

From your mouth, food passes from your esophagus to your stomach, which initiates protein breakdown. Proteases break down protein into amino acids or small peptides that that your small intestine eventually absorb and transport into the blood.

Your stomach is incredibly acidic, and hydrochloric acid – also called gastric acid – initiates protein digestion and helps your body absorb nutrients.

Gastric acid also keeps your gut sterile. Along with pepsin and lipase, gastric acid prevents bacterial overgrowth and other potential problems that can create harm as food passes down your gut.

“The low pH (high acid) environment in the stomach activates peptidases (enzymes) that begin to break down any protein,” says Pedre. “The acid environment is also a first line of defense against bacteria, parasites, and yeast that you may inadvertently ingest.”

As the breaking-down process continues, food moves into your small intestine and your pH becomes more alkaline as your liver and gallbladder secrete bile to break down dietary fat.

The final stop on your digestive pathway is your colon, which absorbs water and creates a well-formed stool you eventually excrete. Your colon also ferments fiber and prebiotic-rich foods into short-chain fatty acids (SCFAs), which provide your colon cells energy.

Overall, three organs play roles in producing and secreting digestive enzymes. Your liver produces bile, which your gallbladder stores and secretes. Your pancreas secretes lipases and proteases to break down fat and protein, plus it secretes alkaline-pH pancreatic juice to neutralize your stomach’s acidity.

If any of these organs don’t function optimally, that could spell trouble for breaking down food.

When Digestion Goes Haywire

Above is how your digestive system should work. Among the reasons you might not be making sufficient digestive enzymes include chronic stress, inflammatory conditions, poor diet and lifestyle, malnutrition, malabsorption, illness, and age. (3)

And that could spell big trouble. Without sufficient digestive enzymes, you don’t break down nutrients sufficiently. Larger proteins slip through your gut wall, triggering an immune reaction and inflammation.

So now your immune system is in overdrive and chronic inflammation eventually triggers a cascade of various health disorders including malnutrition, food allergies, leaky gut, autoimmune, cystic fibrosis, and inflammatory conditions like irritable bowel syndrome (IBS).

Your gut isn’t the only area that suffers. Chronic inflammation plays a role in nearly every disease on the planet and holds your weight hostage.

Overall, it spells bad news, and much of the blames lies with a faulty digestive process.

Where a Digestive Enzyme Supplement Can Help

Whenever your body isn’t making enough digestive enzymes – whether that occurs from age, chronic stress, gut problems, or other issues – supplementing can help. Essentially, a digestive enzyme supplement provides the enzymes your body should be but isn’t making.

Studies show digestive enzymes can help reduce digestive disorder symptoms like bloating, gas, and abdominal pain. (4)

“By ‘activating’ digestion through digestive enzyme supplementation, we improve the breakdown of proteins, fats, and carbohydrates, and if you can break down your food into its component parts, you stop reacting (because our bodies don’t react to broken-down molecules, such as amino acids),” says Pedre.

Let’s be clear: You want to do everything possible to ensure your body makes enough digestive enzymes, yet even if you’re doing everything correct, you might not be making enough. That’s when you want to consider a digestive enzyme supplement.

At their simplest, digestive enzyme supplements provide all three macronutrient enzymes: amylases (for carbohydrates), proteases (for protein), and lipases (for fat). Let’s briefly look at each of these.

Carbohydrates

Depending on the product, you might find a general “amylase” to cover all your carbohydrate digestive-enzyme bases or you might find a more specific breakdown such as the following:

• Amylase and glucoamylase help break down starch and glycogen.
• Lactase helps break down dairy sugar (lactose).
• Invertase helps break down sucrose (table sugar).
• Enzymes like cellulase, hemicellulase, beta-glucanase, and phytase help break down fiber-containing foods.
• Alpha-galactosidase helps relieve gas and bloating grains legumes, and some vegetables can create.

 

Protein

To break down protein, you’ll usually find several proteases in a digestive enzyme supplement. Protein digestion begins in your acidic stomach and continues in your alkaline small intestine. Because no single protease works optimally in both environments, you want several proteases in a supplement and one should be acid-stable. (5)

Fat

Dietary fat might be the simplest digestive enzyme. Lipase breaks down fat, and supplemental lipase is usually acid-stable to pass through your stomach. Some formulas also contain bile salts (as ox bile) to aid bile secretion. (6)

Some formulas break down these enzymes into specific measurements with strange-looking acronyms. Proteases like be measured in HUT (Hemoglobin Unit Tyrosine base), whereas amylase might be in DU (Alpha-amylase Dextrinizing units). Others contain a “proprietary blend” of enzymes, meaning they don’t disclose specific amounts.

Along with these enzymes, some formulas also contain betaine hydrochloric acid (betaine HCl). You secrete less gastric acid in your stomach as you get older, and frequently popping antacids only compounds the problem, hindering protein digestion in the bargain.

As I’ve noted, faulty protein digestion means you absorb bigger proteins because you aren’t breaking them down well enough. Nutrient deficiencies can result, but your body also sees these abnormal proteins as foreign invaders and create antibodies.

According to Pedre, low stomach acid also leads to other conditions including small intestinal bacterial overgrowth (SIBO), yeast overgrowth, calcium malabsorption (increasing your risk for osteoporosis), and bacterial infections.

Do Digestive Enzymes Give You Permission to Indulge?

Some digestive enzymes contain lactase, an enzyme that breaks down lactose in dairy. Considering about 75 percent of the world is lactose intolerant (they can’t sufficiently break down the milk sugar lactose), (7) adding it to an enzyme formula makes sense. Lactase might help if you eat a little dairy, but that doesn’t give you permission to indulge in a pint of Ben & Jerrys.

That said, dairy along with gluten and other problem ingredients can slip into the best-intended dishes. If you eat out or attend a friend’s dinner party, you can’t always be sure you’re entirely eliminating these ingredients. A digestive enzyme might cover your bases here.

A few formulations have stepped in to minimize the havoc these foods can create. “Starch blockers,” which have been around forever (or at least since the 1970s), are one such supposed solution. Devotees swear you can pop a few and enjoy a plate of fettucine Alfredo while minimizing its carbohydrate impact.

Maybe, but I’m doubtful. These non-genetically modified (GMO) white bean (Phaseolus vulgaris) extract supposedly work as an amylase inhibitor, meaning they block carbohydrate absorption.

One review of clinical studies about weight loss and glycemic (blood sugar) control found Phase 2® Carb Controller, a specific and proprietary product, has “the potential to induce weight loss and reduce spikes in blood sugar caused by carbohydrates through its alpha-amylase inhibiting activity.” (8)

Caveat emptor: Some of these studies were funded by Phase 2®. (Follow the money trail.) Taking a few capsules before meals might block a little bit of carbohydrate, but you’re still going to suffer the consequences if you gorge on a big plate of pasta (or whatever your starch-heavy food might be). Consider too if you’re gluten intolerant, you’ll probably be getting gluten (unless the pasta is gluten-free) as well as some other no-no ingredients like dairy, corn, and even sugar in that dish.

Manufacturers know you want to occasionally indulge without the guilt. Enter a few new digestive enzyme formulas to “rescue” you from gluten, dairy, or other potential food sensitivities.

One formulation I found contains proteolytic enzymes that supposedly inhibit gluten absorption along with specific digestive enzymes like alpha-amylase, alpha-glucosidase, and pancreatic lipase that prevent starch and sugar breakdown.

Another supposedly reduces the impact from foods like soy, egg, whey, and other sensitive proteins.

While these sometimes come from professional brands, there isn’t a ton of science to support these formulas, and the verdict is still out whether taking a few pre-meal could prevent weight gain and other symptoms gluten and other problem ingredients often create.

If you’ve got the cash and want to take every precaution, these formulas might be worth a try. They might reduce the impact of a piece of birthday cake or a small plate of pasta, but they aren’t magical dietary fix-alls and they certainly don’t allow you to indulge in massive amounts of pasta, ice cream, and other indulgences guilt-free.

Finding the Right Digestive Enzyme Supplements

Practitioners argue many people can benefit taking digestive enzymes. Celebrity and Fitness Expert JJ Virgin says everyone over 35 or with chronic stress (that encompasses about all of us) could benefit from taking one. (9)

Maybe a favorite health expert or a good friend raves about how digestive enzymes can benefit you, so you head out to buy one at your local Whole Foods or health food store. You quickly discover buying one can be confusing. Most shelves contain a variety of brands, with different ingredients, at fluctuating price points.

Let me try to simplify the process with these five questions.

1. Are you vegetarian?

Unless they are specifically marked vegetarian, many contain pancreatin, from a porcine (pork) source, that contains the enzymes amylase, lipase, and protease.

Why porcine? Well, the pancreas of a pig resembles a human pancreas more than any other animal species. Enzymatic activity levels from pork sources are approximately 30 – 50 percent higher than beef sources.

If you avoid animal products or if glandulars – a fancy word for freeze-dried, defatted bovine or porcine tissues; in this case, pancreas – gross you out, you’ll also find vegetarian-based enzyme formulas that I’ve found to be just as effective. These are clearly marked “vegetarian” to ensure they don’t contain porcine or other animal sources.

Some formulas are combined with other enzymes like bromelain, derived from pineapple, and papain from papaya. Studies show synergistic effects of animal-based enzymes and bromelain. (10)

2. How do you make sense of ingredients?

If you want a basic all-around supplement, look for one with amylase, protease, and lipase. Again, these will be listed in various ways in the ingredients. Here are measurements from two professional-quality brands.

The first one is pretty simple:

Pancreatin 500 mg. (from porcine) (lactose free) provides:

• Lipase 17,500 USP units
• Protease 110,000 USP units
• Amylase 120,000 USP unit

Pretty straightforward, right?

Here’s another one that uses a proprietary blend (in other words, they don’t have to provide specific amounts of each enzyme):

Betaine HCl 200 mg

Proprietary Blend 180 mg: Ox Bile Extract, Peptidase (DPPIV), Amylases, Pepsin, Proteases, Glucoamylase, Lactase, Lipase, Invertase

Worth noting: Ingredients like porcine and ox bile signify these are not vegetarian-friendly. If that’s the case, you’ll look for a plant-based enzyme. Here’s a popular one:

Two vegetarian capsules contain:

Proprietary enzyme blend 391 mg providing:

• Amylase 24,000 DU
• Protease 60,000 HUT
• Protease 6.020,000 HUT
• Glucoamylase 30 AGU
• Lactase 1,600 ALU
• Lipase 3,000 FIP
• Beta-glucanase 20 BGU
• Invertase 900 SU
• Cellulase 800 CU
• Alpha-galactosidase 120 GalU
• protease 3.020 SAPU
• Phytase 10 FTU
• Hemicellulase 200 HCU

You don’t see any animal products here, the bottle will usually specify “vegetarian” somewhere, and these will be in a plant-based rather gelatin capsule.

3. Do you need hydrochloric acid in your digestive enzyme?

You’ll notice this one has Betaine Hydrochloride or Betaine HCl. The first one’s ingredients didn’t. That begs the question: How do you know if you have low stomach acid and could benefit from Betaine HCl?

A few tests exist, but here’s the easiest. Buy a digestive enzyme with Betaine HCl. (You can also buy Betaine HCl as a standalone supplement, sometimes combined with pepsin to optimize protein breakdown.)

Start with one capsule per meal and gradually increase to two or more with subsequent meal. You’ll know you’ve hit your “Betaine HCl limit” when you feel a slight warmth or heaviness after the meal.

If you take one capsule and feel that way, you probably have sufficient gastric acid and would be fine with a digestive enzyme without Betaine HCl. If you have ulcers, gastritis, or overproduce stomach acid, you should not take a supplement with Betaine HCl.

4. What other considerations should you take with digestive enzymes?

You might also look for a digestive enzyme that fits your specific condition. If you’re doing a ketogenic diet, for instance, a higher-lipase enzyme can help your body optimally break down fat.

Considering experimenting with a few formulas and find which works best for you. There are a number of ways to know whether a digestive enzyme works, and foremost is how you feel after a meal. That’s a pretty good indication you’re sufficiently breaking down nutrients your body can use.

Alternately, I suggest conferring with a healthcare professional if you’re unsure which digestive enzyme to choose, if you’re on a special diet, if you have food sensitivities or allergies, or if you’re concerned certain ingredients in a formula could be problematic.

If you buy from your healthcare professional, they can help you choose. If you buy from a professional brand online, most companies have customer service reps and even an in-house health expert to answer your question.

That raises an important issue: Regardless whether you go animal- or plant-based, quality becomes absolutely critical. Many commercial brands come diluted with fillers including lactose. While I recommend buying all your supplements from a professionals-based company, that goes triple for digestive enzymes.

5. How should you take digestive enzymes supplements?

Ideally, you’ll take digestive enzymes before meals to signal your body enzymes are present. If you forget, you can also take them during your meals, but before is usually best.

I’ve heard people say they break open capsules and sprinkle them on food. Heat can potentially destroy these enzymes, plus you’ve got a nasty powdery taste to your food if you sprinkle. I recommend swallowing capsules whole whenever possible.

Most formulas will specify how many capsules to take, though typically they require one or two before every meal. Some people do better with fewer capsules. You might find (especially with bigger meals) that you need three capsules.

Remember: Optimizing Digestion Goes Beyond Digestive Enzymes

Even when you’re doing everything correctly, don’t totally depend on digestive enzyme supplements as a cure-all for all your digestive woes.

Gut conditions like leaky gut and SIBO often depend on more comprehensive nutrient protocols including dietary fiber, prebiotics, probiotics, caprylic acid, and gut-healing nutrients like L-glutamine.

Finally, more practical concerns about gas, bloating, and other post-meal problems require you become more aware about what you’re eating. A food journal can track any potential glitches, and as an added “bonus,” one study found people who tracked what they ate lost twice the weight of those who didn’t track. (11)

Just as importantly, be aware how you eat. Minimize liquids during meals, which can dilute gastric acid and encumber nutrient breakdown. Slow down and be mindful when you chew food. You’re not in an eating contest, and besides, engulfing your food becomes a surefire way to trigger indigestion and all its woes. Chewing adequately activates vital enzymes so you optimally break down food. (12)

While they provide a great way to relieve post-meal misery, enzymes won’t magically solve your digestive woes, and they might mask underlying problems like leaky gut or IBS. In other words, they provide a temporary fix to what could be a deep-rooted gut problem.

I believe that everyone’s body is individually unique. We’re not all designed to eat the same way. I love the science of nutrition, but I also believe in listening to one’s own body. In this case, listening to your body might tell you that you’re better off not eating that lactose-filled dairy, than eating it after all but with a supplement. Ideally, you’d take no supplements at all — and just eat real, whole foods.

That said, many of us aren’t making enough digestive enzymes due to age, chronic stress, and a host of other reasons. If you’ve addressed underlying gut issues and do everything correctly – you’re getting great sleep, you’re dialing down stress, you eat well, and supplement smartly – digestive enzymes might be that boost to manage gas, bloating, and other post-meal problems.