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. So taking digestive enzymes because they are all the rage these days or because someone on the internet told you to do it, is not a good idea.
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 probably won’t cover them. However, digestive enzymes are generally safe and inexpensive so they are easy to take for a bit and see if you notice a difference in your digestion or reduction in other other symptoms you may be experiencing.
What Are Digestive Enzymes?
You need to eat food to fuel your body, but your body can’t absorb or use food on its own. It has to break down what you eat into smaller components which can then be absorbed by your digestive tract and used for fuel. 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, a majority of which are produced in the pancreas (but they are also present in the saliva and small intestines) help break down food into these smaller components so that your body can actually use it.
If you don't have enough digestive enzymes, your body won’t be able to break down the food you eat. This means that even if you are eating lots of whole, nutrient-dense foods, you may not be getting all the nutrients from those foods. This can cause deficiencies of important nutrients even though it appears that you may be getting enough of them through your diet.
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 the food continues on from your stomach into your small intestines the acidity of this mixture of food and HCL (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 all directly affect digestive enzyme production. Celiac disease and Crohn's disease affect the brush border of the small intestines which contain enzymes that aid in the digestion of starches, lactose, proteins, and some fats.
Even in the absence of an obvious disease, there are several 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 your digestive system is not considered a priority and does not get adequate blood flow or function optimally which will leave you with improperly digested food.
After you've addressed these important lifestyle factors if you have not achieved the desired level of improvement 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 that they will help break down all of the components of your food.
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 main meals should be adequate. You may need to play around with dosing, but I have rarely anyone need more than 4 capsules at each meal. Once you've found a dose that works for you, your symptoms should go away or at least improve drastically. You should have less bloating after meals and you shouldn't feel like food is just 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.
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 go along with 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, no matter how harmless they may seem.