Q: Are digestive enzymes helpful? Are there any disadvantages to taking them?
A: Digestive enzymes work by breaking down the food you eat. Lipases digest fats, proteases or proteolytic enzymes digest proteins, and amylase digests carbohydrates. Typically, you take one or two (follow dosage instructions by your practitioner) with each main meal.
Digestive enzymes are indicated if you’re having digestion issues such as gas, bloating, constipation, diarrhea, or acid reflux. They also help to counteract any trypsin inhibitors in the foods you eat that are slowing digestion and aggravating symptoms. Low stomach acid or hypochlorhydria diminishes the digestion and absorption of important nutrients—another example where digestive enzyme formulations including HCl are beneficial. This is important given the chronic use of PPIs like Prilosec and Nexium which reduce beneficial stomach acid.
Additional uses for enzymes are for IBS and as an adjunct to treating leaky gut syndrome. This allows for the healing of the GI tract. Many with inflammatory bowel disease such as Crohn’s or ulcerative colitis benefit from the use of digestive enzymes.
Food intolerances such as lactose intolerance are aided by the addition of lactase, for example, in digestive enzyme supplements. If you’re low in pancreatic enzymes, normally described as pancreatic insufficiency, the addition of pancreatic enzymes is indicated.
Another setting where digestive enzymes come in handy on a temporary basis is when you’re making a diet change, like going from vegan/vegetarian to eating more animal protein. As your digestive system normalizes its secretion of proteases and lipases, you can start to taper their use.
Other than the conditions listed above, there really isn’t a need for digestive enzymes since the body produces adequate amounts on its own.
While digestive enzymes are well tolerated by most, taking too high a dose can cause side effects like upset stomach or stomach pain, cramping, nausea, diarrhea, gas and bloating, and possibly headache. If you have stomach ulcers or a gallbladder condition, be sure to follow your health practitioner’s advice to determine if they’re appropriate.
Because enzymes are made using a variety of ingredients including porcine, botanical, and fungal sources, allergic reactions are possible. Check ingredients before use.
To your health!
Leyla Muedin, MS, RD, CDN
