Should I Take Digestive Enzymes?

Have you been hearing a lot about digestive enzymes and how they can help with tummy troubles? What are the merits behind these products and are they worth taking? Also included is a tip on how to save over $300 this year!

I admit that sometimes I’m behind the trends.

I joined Instagram for the first time in 2020 and I still listen to 90’s hip-hop (though someone told me that’s cool again?). And though it’s my job to know about nutrition trends, there are so many whizzing by me these days that I sometimes end up relying on friends, family, or professional resources to clue me in.

So when Ann asked me what I thought about digestive enzymes, I thought she was referring to the natural processes of digesting food. But alas, she was in fact referring to the over-the-counter (OTC) digestive enzyme supplements that have become popular.

It certainly is a hot topic – the global digestive enzyme market is valued at nearly $770 million dollars and is expected to grow to $1.6 billion by 2025.

So why are people racing to pick up digestive enzyme supplements? What do they do that our own digestive enzymes can’t?

First, a quick review on digestive enzymes found in the body
Our bodies are remarkable – at the first smell or sight of food the digestive process starts working. Little by little food moves through the GI tract. The body absorbs the nutrients it needs and ultimately excretes what it doesn’t.

The production and release of digestive enzymes are required throughout the entire digestive process to break down food into their smallest components. This enables nutrient absorption, most of which occurs in the small intestines.

Here are some examples of digestive enzymes:

• Amylases are produced in the mouth and the pancreas and break down complex carbohydrates to simple sugars.
• Lactsase is produced in the small intestines. It is responsible for breaking down lactose into simple sugars.
• Proteases are produced in the stomach, pancreas, and small intestines. This is how proteins are broken down to amino acids.
• Lipases are produced in the mouth, pancreas, and stomach and break down fats into free fatty acids and monoglycerides.

What happens if you your body doesn’t produce enough enzymes?
If we don’t have these enzymes, the food won’t break down properly. This means the nutrients within the undigested matter won’t be absorbed before moving into the colon. Oftentimes this will lead to uncomfortable symptoms like gas, bloating, and/or diarrhea.

For example, those who are lactose intolerant may not produce enough lactase to break down lactose resulting in abdominal discomfort. This is why some people with lactose intolerance will take lactase pills when eating dairy foods.

There are a few other medical conditions in which a physician typically prescribes digestive enzymes. In these cases, certain enzymes may be required to prevent malnutrition, vitamin deficiencies, and weight loss in the setting of malabsorption.

This would include cystic fibrosis, pancreatitis, pancreatic cancer, or any pancreatic surgery – it’s referred to as Pancreatic Enzyme Replacement Therapy (PERT). As the name suggests, this is meant to replace the enzymes typically made by the pancreas and is provided in a specific dosage dependent on the patient’s unique needs. These are not available OTC.

*Note: enzymes are made from pork products. Vegetarian versions have been found to be much less effective.

Should I try digestive enzymes if I’m having tummy troubles?
The short answer is no. The longer answer is:

• Occasional gas, bloating, diarrhea, flatulence, abdominal discomfort is normal and does not require any intervention.
• Persistent or new onset severe gas, bloating, diarrhea, flatulence, abdominal discomfort should be checked out by a physician. Depending on the diagnosis, your physician may recommend an intervention.
• Food allergies cannot be cured with digestive enzymes. The food allergen needs to be avoided completely (unless monitored during exposure therapy).
• Currently, there is little research to confirm the efficacy of ANY digestive enzymes on ANY health condition beyond the specific ones noted above. Even alpha-galactosidase (aka Beano) has had spotty results.

Should I just try and see what happens? Are there downsides to this?
The short answer is no, don’t just try them. And yes there are downsides.

The longer answer is:

• Persistent or new onset GI discomfort should not be ignored or self-diagnosed. See a physician to get to the root of the problem.
• Labels on supplements can have misleading claims – do not believe everything that’s listed on the outside of these packages (especially weight loss claims). They are not as tightly regulated as labels on food packages.
• Some enzymes are contraindicated in certain medical conditions or with other medications such as blood thinners.
• Depending on the type of enzyme and brand, the cost to buy the products is around $40/month or $360/year.
• Theoretically to be effective, enzymes are to be taken at every meal with food. This is cumbersome.

I heard there are foods with high amounts of digestive enzymes – should I try those?

In a lab, digestive enzymes have been found in some foods such as kiwi, pineapple, and fermented foods. But this does not translate into health benefits or curative properties for any digestive disorder or upset stomach.

Are digestive enzymes probiotics?
Digestive enzyme supplements are completely different than probiotics. Sometimes people confuse the two, and sometimes they are intentionally but inappropriately linked. If interested, click here to read more about probiotics.

Bottom Line
OTC digestive enzymes are a popular nutrition trend advertised to treat a variety of ailments, mostly GI related.

There is no conclusive research to indicate OTC digestive enzymes are effective in minimizing uncomfortable symptoms such as bloating, gas, or diarrhea. Ask a physician about new onset GI symptoms, especially if accompanied by weight loss.

Though they aren’t particularly dangerous compared to some other dietary supplements on the market, there are risks to taking digestive enzymes.

My recommendation is to save your money for something more impactful or enjoyable this year. And, as always I welcome your comments and questions!