Do You Need to Take Digestive Enzymes?
Over-the-counter digestive enzymes supplements have grown increasingly popular and are marketed to help with digestive symptoms like indigestion, bloating, and gas. But can these supplements really help you digest your food better or relieve these symptoms?
Monica Reinagel, MS, LD/N, CNS
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Do You Need to Take Digestive Enzymes?
Melissa writes: “I’ve heard that as you age the amount of digestive enzymes your body produces decreases making it more difficult to digest your food. So you end up with symptoms like excessive belching, bloating, gas. Some people recommend taking digestive enzyme supplements with each meal. Is this information correct? How and when should you use digestive enzyme supplements if at all?”
Over-the-counter digestive enzymes supplements have grown increasingly popular and are marketed to help with digestive symptoms like indigestion, bloating, and gas. But can these supplements really help you digest your food better or relieve these symptoms?
What Are Digestive Enzymes?
First, a little background: Enzymes are proteins that enable chemical reactions, and most of the enzymes in our body are ones that we build ourselves. Our DNA contains the instructions for building the many thousands of enzymes that our bodies require to function. Most of these enzymes are involved in cellular metabolism. The rest help us digest our food by breaking down proteins, fats, and carbohydrates into smaller pieces so that they can be absorbed.
Digestive enzymes are found in various places throughout your digestive tract: the saliva, stomach, and small intestine. But most of our digestive enzymes are produced by the pancreas and excreted into the small intestine, which is where most digestion and absorption of food occurs.
If your pancreas is not producing enough digestive enzymes, you may not digest your food as thoroughly. A mild enzyme insufficiency might cause symptoms like gas or bloating. A severe enzyme deficiency can lead to weight loss and malnutrition. In cases where there is medically diagnosed pancreatic insufficiency, prescription digestive enzyme preparation can be absolutely essential.
But what about everyone else?
Does Enzyme Production Decrease with Age?
The idea that digestive enzyme production always decreases with age is just speculation. In fact, production of certain digestive enzymes actually increases with age. So you don’t need to start taking digestive enzymes just because you are a certain age.
If you have symptoms like indigestion, gas, or bloating, it’s possible that digestive enzymes might help. One study that is frequently cited by people who sell OTC digestive products found that taking a digestive enzyme supplement with a heavy meal notably reduced gas and bloating. However, the product tested in this study is a pharmaceutical-grade product that is not available without a prescription. It’s hard to say whether an OTC supplement would produce the same effect.
How Effective Are Over-the-Counter Enzyme Supplements?
For one thing, OTC digestive supplements is a large (and largely unregulated) category of products containing all kinds of different things, including various types of enzymes but also herbs and other nutrietns that are thought to aid digestion. Because they are classified as dietary supplements and not drugs, the manufacturers are not required to prove that these products work or even to test them. As long as they don’t claim to “cure, treat, or prevent” a disease, it’s pretty much the Wild West.
Some of these supplements, for example, claim to break down gluten, allowing people with gluten intolerance to eat wheat without problems. Independent testing on such supplements finds that they are NOT effective in breaking down wheat proteins, so this is certainly not a safe approach for those with celiac disease. Nonetheless, people without celiac disease who believe themselves to be gluten intolerant often report that these supplements help them—but it’s a little hard to explain why.
See also: Is Non Celiac Gluten Senstivity for Real?
Symptoms like gas and bloating can be caused by all kinds of different things, and enzyme supplements may or may not be the solution. Even if it is, you’d need to pick the right enzyme for the problem. If, for example, your symptoms are being caused by the complex carbohydrates in legumes or cruciferous vegetables, you’d want a supplement containing alpha-galactosidase. This is the enzyme found in Beano, and it can be very effective in reducing gas from these foods.
See also: Got Gas?
If, on the other hand, your symptoms are due to the lack of lactose-digesting enyzmes, then all the alpha-galactosidase in the world isn’t going to help. You’re going to need a supplement containing lactase. Or, you could simply avoid dairy products, which are the only foods that contain lactose. And if your symptoms are due to incomplete digestion or protein or fats, then you’d want to try a product containing protease or lipase. Because all of this can be hard to guess, most digestive enzyme products just throw the entire kitchen sink in and hope for the best.
The good news is that over-the-counter digestive enzymes appear to be pretty safe when used as directed. If you suspect that your digestive symptoms are due to a lack of enzymes, you could always try one of these supplements and see if it helps. If you decide to try one, look for one that is enterically coated, which increases the likelihood that the enzymes will actually survive their passage through your stomach and arrive intact in the small intestine.
The other good news is that you should know pretty much right away if a supplement is helping. If it doesn’t seem to reduce your symptoms, then there is no point in continuing to take it.
Digestive Enzymes for Arthritis Pain
Ironically, one of the most promising uses for digestive enzyme supplementation has nothing to do with digestion. A pair of double blind studies found that a supplement containing protein-digesting enzymes bromelain, trypsin, and rutin (sold in the US as Wobenzym), was as effective in reducing arthritis pain as non-steroidal anti-inflammatory drugs use to treat arthritis pain.
The Bottom Line
Before you try a supplement, though, it might be worth trying another approach first. Simply slowing down and chewing your food more thoroughly can increase the activity of the enzymes produced in your body, reduce gas and bloating, improve digestion and increase nutrient absorption. But be careful what you wish for! Digestive enzymes are often marketed as a way to increase nutrient absorption—which sounds like a good thing. But we’re not talking about increasing your absorption of vitamin C or calcium. More complete digestion of carbohydrates, fats, and proteins will allow you to absorb more energy (or calories) from these foods!
See also: How does chewing affect nutrition
About the Author
Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes’ most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation’s leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show.