Digestive Enzyme Supplementation

written by Dr. Jo Ford

Digestive enzymes (DEs) break down macronutrients to be digested and absorbed by the body. The digestive system produces them. In some cases of gastrointestinal illness or malfunction, practitioners recommend DEs to improve digestive function. But do they actually benefit digestion? If so, do they benefit digestion in the long term?

DEs may come in enteric-coated or non-coated forms.  Enteric-coated supplements are found to be more effective because the coating protects the enzymes from the low pH of the stomach and parts of the small intestine.  They are typically derived from beef or pork substances.  In some instances, the supplements are derived from microorganisms. Microbe-derived enzymes are found to be most effective as they are less sensitive to the pH changes associated with travel through the GI tract. Despite this efficacy, microbe-derived enzymes are banned in some countries. 

DEs have been found to help people with digestive orders to digest foods and nutrients that they ordinarily wouldn’t be able to. They are used in clinical care by clients with digestive diseases affecting the organs that produce enzymes (i.e., pancreas, intestinal brush border, etc.). They also help people who have an insufficient amount of certain enzymes, causing an inability to digest specific foods. Lactase, for example, is a digestive enzyme that helps people digest lactose.  However, after the first months of life, humans’ ability to produce lactase declines. In some ethnic groups, the decline is more drastic (i.e., Africans) than in others (i.e., Europeans).

A few enzyme therapies and corresponding disorders include:

EnzymeDisorder
Chymotrypsinogen 
exocrine pancreatic insufficiency (EPI), chronic pancreatitis, pancreatic cancer, cystic fibrosis (CF), and diabetes

Lactase

hypolactasia, lactose intolerance,

Lipase 

steatorrhea, cystic fibrosis
Pancreatin
exocrine pancreatic insufficiency (EPI), chronic pancreatitis, pancreatic cancer, cystic fibrosis (CF), and diabetes

Prolyl endopeptidase 

Celiac disease

Trypsinogen (active form trypsin)

exocrine pancreatic insufficiency (EPI), chronic pancreatitis, pancreatic cancer, cystic fibrosis (CF), diabetes

Combining multiple DEs is a promising treatment for some digestive disorders.  For example, when provided an enzyme cocktail while consuming 1 gram of gluten per day, patients diagnosed with celiac disease experienced no changes in TTG lab markers pre & post gluten exposure and treatment.

A combination of probiotics and DEs may also be beneficial, as evidenced by a study that showed improved digestion of lactose upon consuming yogurt.  In this case, the yogurt (which contains natural probiotics) actually improved lactase activity.  The combination was also shown to help treat pancreatic insufficiency.

In practice, I found that combining digestive enzymes with probiotics has shown the most improvements in digestion. My favorite digestive enzyme/probiotic combo is Complete Digestion by Enzyme Science, but several good ones are out there. You can check them out in our natural supplement dispensary by clicking here (you’ll be prompted to create an account – don’t worry, it’s totally free to look). As always, be sure to consult with a licensed healthcare provider before beginning any new supplements.

References

Deng, Y., Misselwitz, B., Dai, N., & Fox, M. (2015). Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients7(9), 8020–8035. doi:10.3390/nu7095380

Ianiro, G., Pecere, S., Giorgio, V., Gasbarrini, A., & Cammarota, G. (2016). Digestive Enzyme Supplementation in Gastrointestinal Diseases. Current drug metabolism17(2), 187–193. doi:10.2174/138920021702160114150137

Stoven S., Murray J.A., Marietta E. (2012). Celiac disease: advances in treatment via gluten modification. Clinical Gastroenterology and Hepatology, 10(8), 859–862.

Leave a Reply