Should You Take Digestive Enzymes?
You've probably heard about digestive enzymes and maybe you even take them, but how do you know if you need them? There should always be a what and why behind any supplement that you take (and you should know what those are) because taking supplements that you don't actually need can be detrimental to your health.
Should You Take Digestive Enzymes?
If you are experiencing any of the following symptoms, you may benefit from taking digestive enzymes:
Gas, bloating, or indigestion after eating
A sensation of being full for a long time after meals
Feeling full after a few bites of food
Undigested food in your stool
There is testing that can be done to determine whether you might need digestive enzymes, but many healthcare providers won't order them and insurance is unlikely to cover them. The good news is that digestive enzymes are generally safe and inexpensive so they are easy to try and see if you notice a difference in your digestion.
What Are Digestive Enzymes?
You eat food, but your body doesn't absorb food, it has to break down what you eat into nutrients which are then absorbed and used by your body. Food gets broken down into amino acids (from proteins), fatty acids and cholesterol (form fats), sugars (from carbohydrates), and vitamins, minerals, and various other compounds. Digestive enzymes, which are primarily produced in the pancreas (but also in the saliva and small intestines) help to break down food into these smaller components that can be used by your body.
If you don't have enough digestive enzymes, you won't be able to break down the food you eat, which means that even if you are eating lots of whole, nutrient-dense foods, you may not be getting all the nutrients from them which means you can still be deficient in important nutrients.
The digestive process begins in your mouth where chewing and saliva beings the process of breaking down your food. Your food then passes into your stomach where your stomach acid (hydrochloric acid or HCL) starts to breaking down any proteins. As your food passes from your stomach into the small intestines the acidity of the mixture (called chyme) triggers your pancreas to release digestive enzymes.
Note: This is also a place where this process can break down. If you do not have sufficient stomach acid the signal never gets sent to your pancreas to release the enzymes. Sometimes it's difficult to determine where in the process the problem is occurring.
The enzymes produced by your pancreas have very specific purposes:
Amylase: breaks down starches and complex carbohydrates
Lipase: breaks down fats
Protease and peptidase: breaks down proteins
What causes digestive enzyme dysfunction?
There are several disease processes that can affect adequate digestive enzyme production:
Cystic fibrosis, pancreatic cancer, pancreatitis, or removal of the pancreas can directly affect digestive enzyme production
Celiac disease, Crohn's disease, or other diseases that affect the brush border of the small intestines.
Even in the absence of obvious disease, there are many things that can prevent adequate digestive enzyme production:
Inflammation from food sensitivities, gut dysbiosis, or hidden infections such as SIBO
Low stomach acid (see note above)
Chronic stress, which causes your digestive system to be given low priority and decreases digestive function
How do you treat digestive enzyme deficiency?
The very first thing you can do to improve your digestive function is to eat a nutrient-dense diet of mostly whole foods. A Whole30 is a great place to start if you are unsure how to manage the transition to a Paleo-style diet. Eating a diet that focuses on whole foods and is full of nutrients will help decrease inflammation and improve your gut bacteria which can improve overall nutrient status.
Addressing your stress is another important aspect of improving your digestive function. You do not want to be in "fight or flight" mode while you are eating because in that state your digestive system is not considered a priority and does not function optimally, leaving you with improperly digested food and likely missing out on lots of important nutrients and energy.
After you've addressed these important lifestyle factors if you have not achieved the desired level of imporvement in your symptoms, you should consider supplementing with digestive enzymes.
What kind of digestive enzymes should you take?
As with most supplements, there are tons of options and figuring out which is right for you can be overwhelming and confusing.
When searching for a digestive enzyme, look for a brand that meets the following criteria:
Quality/Price: While more expensive supplements are not always higher quality, cheap supplements are almost always going to be a waste of money. I usually suggest something that is middle of the road as far as price goes (in most cases).
Reputation: There's no way that you can keep track of all the supplement companies - there are just too many of them. I tend to stick with a few brands that I've researched and trust. Two brands that are found on the shelves of most natural foods stores that I trust are Jarrow and NOW Foods. I also like Throne, Integrative Therapeutics, and Klaire Labs brands which are available online but tend to be more expensive.
Enzyme sources: There are three sources for digestive enzymes, I prefer a mixture of at least two different sources (typically fruit and fungi)
Fruit sourced (from papaya and/or pineapple) which work well for some people but are generally on the weaker end of the supplement spectrum and might not be great for everyone.
Animal sourced (listed as pancreatin), which can have issues with stability and work well for some people
Fungi sourced are generally the most stable and have a broad spectrum of action
Multiple actions: Since digestive enzymes have specific actions (i.e. they break down specific substances) you'll get the most benefit from a mixture of different enzymes. I like to use products that list at least once source of protease, lipase, and amylase to ensure a broad spectrum of activity.
Strength: Make sure that the brand that you choose has the strength of each enzyme on the label (listed as a number next to the name).
Ingredients: In any supplement, you want to see the ingredients listed as well as some labeling listing what is not in the product (such as gluten, soy, or dairy). If it doesn't say "contains no: sugar, wheat, gluten, soy..." etc. then assume that it does contain those things.
How much and how often should you take digestive enzymes?
Since the job of digestive enzymes is to break down food, you should always take them with a meal. There's no need to stress about exactly when you take them relative to your meal, generally within 30 minutes (before or after) is fine.
As long as you have a good quality product, 1-2 capsules with your big meals of the day is a sufficient dose. You may need to play around with dosing, but I have never seen anyone need more than 4 capsules with each meal. Once you've found a dose that works for you, your symptoms should go away. You should have less bloating after meals and you shouldn't feel like there are rocks sitting in your gut after you eat. If you do not see improvement in your symptoms, you can increase your dose by one pill per meal every three days to see if that makes a difference.
The bottom line
Restoring optimal digestive function is critical to your overall health and digestive enzymes are just a piece of a bigger puzzle. You need to be sure to address the diet and lifestyle issues that surround digestive issues as well, even though digestive enzymes are relatively safe to use. You always want to make sure that you are looking for the root of your problem, not covering up symptoms with medications or supplements.