A friend recently messaged me about a supplement that she’s taking. It’s advertised as making your stomach flatter and improving your digestion – both great things! It consists of enzymes that break down protein, fat, carbohydrate, fiber, and lactose. The supplement would cost you $300 a year if you took it every day, so it’s essential to discern whether or not it makes sense to purchase it. It has been estimated that the enzyme supplements market will hit $1.6 billion by 2025.
Your body supplies several enzymes to break down your food. These enzymes include lipase to break down fats, amylase to digest carbohydrates, and proteases and peptidases to dismantle proteins. There are some instances when the body doesn’t make enough of a specific enzyme. The most common condition caused by insufficient enzymes is lactose intolerance, which is a problem caused by a deficiency of lactase, the enzyme that breaks down the primary protein in milk – lactose. Instead of being broken down and absorbed through the walls of the intestine, the undigested lactose continues through the small intestine and into the colon, where it wreaks havoc. Other health conditions that cause low levels of digestive enzymes include cystic fibrosis and pancreatic disease. In these cases, prescription enzymes are ordered to help overcome the deficiency. These prescription medications, such as Creon or Pancreaze, have been well-studied and are regulated by the Food and Drug Administration. Some over-the-counter enzyme supplements manufacturers have marketed their product by citing studies involving prescription enzymes, which are not comparable products.
Lactaid pills and beano supplements can be bought relatively cheaply over-the-counter and can be helpful to individuals who have these very treatable digestive woes. These two over-the-counter supplements are also safe and evidence-based.
Outside of Lactaid and beano, there is little to no evidence that a digestive enzyme will improve consumers’ health in any way. There is no oversight of the supplement industry in the United States. No one knows how much of the enzymes listed on the package your over-the-counter supplements really contain. Importantly, most buyers don’t know whether their supplements are made with the special coating that is necessary to prevent denaturation of the enzymes by stomach acid. If this coating isn’t present, the supplement will be rendered completely useless. In the case of a true food allergy, eating the allergen and then trying to fix the problem with enzyme supplements could be extremely dangerous.
Manufacturers of over-the-counter supplements claim that natural enzyme production decreases with age, which is not valid. In reality, we increase the production of some digestive enzymes as we age.
Some of the enzymes commonly included in over-the-counter supplements are blood thinners and could be risky for some individuals. Other enzymes might interact with antacids and certain diabetes medications. Bromelain from pineapple can cause cramping, diarrhea, and allergic reactions, while papain from papaya has been associated with esophageal perforation, gastritis, and allergic reactions.
If you feel that you suffer from digestive problems, it makes sense to see a doctor and be tested for conditions such as celiac disease or pancreatic insufficiency.