Do You Really Need A Digestive Enzyme Supplement?Published on Friday, July 29, 2022 by
Your body needs digestive enzymes to function properly.
But does it really need a digestive enzyme supplement?
That’s a very different story, and after reading today’s article you will understand why.
Digestive Enzymes 101
Digestive enzymes are naturally occurring biological compounds that exist throughout the GI tract and, as the name suggests, help to break down various macronutrients into much smaller components that can be more easily absorbed by the human body.
There are digestive enzyme classes for each of the major macronutrient types, which include:
Lipases – Which breakdown fats.
Proteases – Which breakdown proteins.
Amylases – Which break down carbohydrates.
These enzymes exist throughout the human digestive tract, including the mouth, and many of them are actually produced by the pancreas which is an enzyme powerhouse.
In some instances, individuals with rare pancreatic or other conditions like cystic fibrosis may not make enough digestive enzymes and require prescription enzyme replacement therapy which differs from widely available over the counter products.
Let’s talk about those next.
Over The Counter Enzymes
I have to be honest in admitting the overall body of scientific evidence surrounding OTC enzyme supplements was very limited.
After taking a thorough look at the enzyme supplement landscape, my impression is that these products fall into two broad categories.
Specific enzymes for specific digestive issues:
Lactose intolerance is the most common digestive enzyme concern globally and is heavily related to the digestive enzyme lactase which breaks down lactose into simpler sugars to be absorbed by the human digestive tract.
There are studies that suggest that lactase enzyme supplements may help individuals with lactose intolerance better tolerate certain lactose-rich food products.
The utility of such supplements must also be balanced against the fact that there are a growing number of lactose-free alternatives on the market.
Alpha Galactosidase is another enzyme supplement with some evidence to support its use in those who have issues with foods high in the sometimes poorly tolerated food component GOS.
GOS is most notably found in large supply in various types of legumes (kidney beans, chickpeas, etc) and a recently published study out of the American Journal Of Gastroenterology demonstrated some utility for a Alpha Galactosidase enzyme supplement in those with known issues related to these foods.
Beyond these specific uses there is no real indication for digestive enzyme supplements to be used as a treatment for general digestive issues, which are challenges which are better met using dietary optimization and other supplemental strategies – talk to a dietitian!
Multi-enzyme blends for general/digestive health:
This is where it gets a bit more interesting.
I took a look at the top selling product under the“enzyme supplements”category on Amazon.com to get a sense of what was grabbing consumer attention and found it was a multi-enzyme blend that was sold packaged with much better studied components such as probiotics & prebiotic fiber.
The product contained multiple enzymes including some of the traditional human digestive enzymes mentioned such as amylase and lipase, as well as enzymes extracted from certain plants including Papain (from papaya) and Bromelain (from pineapple).
There is no abundantly clear utility for supplementing enzymes like amylase and lipase in an otherwise healthy person and the most impactful components of this particular supplement are overwhelmingly likely to be the probiotic/prebiotic ingredients.
As for the additional plant-based enzymes, they have been suggested to potentially have an anti-inflammatory effect on the body – as discussed in this 2014 Mayo Clinic review paper – but the quality and totality of the evidence is not particularly compelling.
Ironically, there is some evidence to suggest that the use of these types of enzymes might actually cause rather than improve digestive symptoms in some people.
There may be a limited role for specific digestive enzyme supplements in otherwise healthy people, but generally speaking my impression is that the growth in popularity of enzyme-blend type supplements has not yet been matched by an appropriate body of scientific evidence to support their use.
Many of the benefits these products make around digestive health improvements or anti-inflammatory capacity may be better accessed through dietary changes and other more well-studied supplements.
Andy De SantisMPH, RD