Digestive enzymes are popular supplements — some are over the counter, while others are prescription-only. A great deal of their popularity comes from the fact that digestive enzymes' side effects are minimal or even nonexistent. However, research is limited on whether or not they're effective.
Enzyme Supplements and Digestive Enzymes
There are a wide variety of enzyme supplements currently on the market. These supplements are meant to have a wide range of benefits. According to the chapter "Transforming the Healthcare System Through Therapeutic Enzymes" in the book Enzymes in Food Biotechnology, published in August 2018, certain enzymes may be able to:
- Combat cyanide poisoning.
- Help combat cancer.
- Help combat infectious diseases.
- Help treat genetic disorders.
- Help treat damaged tissues.
- Help treat cardiovascular issues.
- Support blood clotting and coagulation.
- Support the treatment of gastrointestinal diseases.
- Support the treatment of diabetes.
Digestive enzymes are typically used to support the treatment of gastrointestinal conditions and associated health issues. These include conditions like lactose intolerance, pancreatic insufficiency and Celiac disease. People are able to take these enzymes when their bodies cannot produce enough of their own.
For instance, consumption of the lactase digestive enzyme can help support the consumption of lactose-containing foods, like dairy products. Similarly, the consumption of the glutenase enzyme can help support the digestion of foods with gluten, like pasta, bread and other grain-based foods.
Digestive enzymes may also play roles in other conditions. For instance, they can help enhance digestion and nutrient absorption in people with malabsorption disorders or diabetes. They may also be able to have secondary benefits, like improving circulation, reducing kidney issues, supporting immune system function and decreasing inflammation.
Natural Digestive Enzymes vs. Medicines
There are a variety of enzymes in your body that support digestion. Three main enzymes can help support the digestion of the main macronutrients that you consume. These enzymes are amylase, lipase and protease, and they help your body digest carbohydrates, fats and proteins, respectively. These enzymes are primarily made by your pancreas.
Sometimes, your body doesn't make enough of certain specific enzymes. Over-the-counter products tend to focus on a lack of one of these enzymes. Insufficient lactase for lactose digestion is particularly common; Lactaid and Lactase are both lactose enzyme supplements that are widely consumed. Similarly, products like Beano or Bean Relief are alpha-galactosidase supplements that can help you digest sugars.
Your doctor may recommend prescription-strength digestive enzymes if you have certain health issues. Harvard Health states that prescription-strength digestive enzymes are typically prescribed for people who have chronic pancreatitis or cystic fibrosis.
Prescription-strength digestive enzymes like Creon, Nutrizym, Pancrex and Pancreaze are very different from over-the-counter products like Beano or Lactaid — they contain the major enzymes involved in digestion (amylase, lipase and protease).
Enzyme Supplements vs. Medical Products
In addition to the digestive enzyme products you can obtain from your doctor or a pharmacy, there are also digestive enzyme supplements. These are typically sold as pills and powders and come from different plant and animal sources.
A few common digestive enzymes include bromelain, which can be found in pineapples, and papain, which comes from papayas. There are also various types of trypsin, which typically come from porcine (pig) and bovine (cow) sources.
These enzymes are meant to have a wide variety of benefits. They may advertise themselves as being able to help treat cancer, reduce muscle soreness after workouts, reduce inflammation and swelling, promote digestion and support weight loss. However, a September 2014 study in the journal Mayo Clinic Proceedings states that there's insufficient evidence to support the majority of those claims.
Unfortunately, there is very little regulation involved in these products compared to prescription-based or medically recommended digestive enzymes. Unlike well-studied enzymes like lactase and alpha-galactosidase, digestive enzyme supplements may or may not work as they say they will.
Digestive Enzymes' Side Effects
Digestive enzymes are considered to be fairly safe and have minimal side effects. Nonprescription and prescription digestive enzymes can produce gastrointestinal side effects, like nausea, diarrhea, constipation and other stomach issues.
An August 2014 article from the Mayo Clinic News Network featured an interview with Brent Bauer, MD, director of the Mayo Clinic Complementary and Integrative Medicine Program, who stated, "Fortunately, for most over-the-counter enzymes, unless you're taking super-high doses, the risks are pretty minimal. Some people get gastrointestinal upset or some irritation."
Dr. Bauer was one of the authors from the Mayo Clinic Proceedings study discussing nonprescription digestive enzyme supplements. This study also reported other potential digestive enzymes' side effects, including:
- Allergic reactions (anaphylactic shock) from the enzyme chymotrypsin.
- Pain and burning sensations from the enzyme trypsin.
- Gastritis, esophageal issues and allergic reactions from the enzyme papain.
issues, like cramping and diarrhea, as well as allergic reactions from the
Reportedly, these side effects are fairly rare. However, digestive enzymes' side effects may increase if you're taking a certain medication. Bromelain, for instance, has the potential to interact with antibiotics like amoxicillin, and anticoagulant and antiplatelet drugs. This interaction could be dangerous because it may affect your body's ability to coagulate blood, and thereby increase your risk of bleeding.
Digestive enzymes' side effects can also be severe if you consume excessive amounts. For instance, consumption of too much papain can cause esophageal tears, while raw papain is an irritant and can cause blisters.
Digestive enzyme supplements are not for everyone. Even medically prescribed enzyme supplements have the potential to cause side effects.
In general, if your digestive enzymes' side effects are severe or don't go away within a few days, you may want to stop taking them. You can try products from other manufacturers; not all digestive enzyme supplements are made in the same way, but it's best to consult your doctor or nutritionist about the best next steps to take. As Dr. Bauer says, "If it's not working, don't just keep taking more and hoping for something magical to happen."
- Mayo Clinic Proceedings: "Over-the-Counter Enzyme Supplements: What a Clinician Needs to Know"
- Mayo Clinic: "Should You Add Enzyme Supplements to Your Shopping List? Mayo Expert Explains Pros & Cons"
- Harvard Health Publishing: "Digestive Enzyme Supplements for Heartburn?"
- Enzymes in Food Biotechnology Production, Applications, and Future Prospects: "Chapter 35 - Transforming the Healthcare System Through Therapeutic Enzymes"
- Harvard Health Publishing: "Gut Reaction: A Limited Role for Digestive Enzyme Supplements"