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Digestive Enzymes Prevent Nutrient Deficiencies & Support Gut Health

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Digestive enzymes - Dr. Axe

The phrase “you are what you eat” is a fallacy. The truth is you are what you digest — and digestive enzymes are key to both better digestion and nutrient absorption.

Surprising as it may seem, up until relatively recently, little was known about how your digestive system actually works. Today, there’s a growing incidence of illnesses that, when traced back to the source, appear to be linked to nutrient malabsorption due to a lack of digestive enzymes. (1)

The Chinese proverb, “He that takes medicine and neglects diet, wastes the skill of the physician,” may not quite be as true as we like to believe. Oftentimes, good nutrition on its own isn’t the only issue involved in maintaining good health.

Why are enzymes important in avoiding illness? The role of digestive enzymes is primarily to act as catalysts in speeding up specific, life-preserving chemical reactions in the body. Essentially, they help break down larger molecules into more easily absorbed particles that the body can actually use to survive and thrive.


What Are Digestive Enzymes? Role in the Body

All enzymes are catalysts that enable molecules to be changed from one form into another. The digestive enzymes defintion is “enzymes that are used in the digestive system.” (2) These enzymes help break down large macromolecules found in the foods we eat into smaller molecules that our guts are capable of absorbing. (3Digestive enzymes are split into three classes: proteolytic enzymes that are needed to digest protein, lipases needed to digest fat and amylases needed to digest carbohydrates. (4) There are various types of digestive enzymes found in humans, some of which include:

  • Amylase — Found in saliva and pancreatic juice and works to break large starch molecules into maltose. Needed to break down carbohydrates, starches and sugars, which are prevalent in basically all plant foods (potatoes, fruits, vegetables, grains, etc.).
  • Pepsin — Found in the gastric juice within your stomach and helps break down protein into smaller units called polypeptides.
  • Lipase —  Made by your pancreas and secreted into your small intestine. After mixing with bile, helps digest fats and triglycerides into fatty acids. Needed to digest fat-containing foods like dairy products, nuts, oils, eggs and meat.
  • Trypsin and chymotrypsin — These endopeptidases further break down polypeptides into even smaller pieces.
  • Cellulase — Helps digest high-fiber foods like broccoli, asparagus and beans, which can cause excessive gas.
  • Exopeptidases, carboxypeptidase and aminopeptidase — Help release individual amino acids.
  • Lactase — Breaks the sugar lactose into glucose and galactose.
  • Sucrase — Cleaves the sugar sucrose into glucose and fructose.
  • Maltase — Reduces the sugar maltose into smaller glucose molecules.
  • Other enzymes that break down sugar/carbs like invertase, glucoamylase and alpha-glactosidase.

How do digestive enzymes work? Digestion is a complex process that first begins when you chew food, which releases enzymes in your saliva. Most of the work happens thanks to gastrointestinal fluids that contain digestive enzymes, which act on certain nutrients (fats, carbs or proteins). We make specific digestive enzymes to help with absorption of different types of foods we eat. In other words, we make carbohydrate-specific, protein-specific and fat-specific enzymes.

Digestive enzymes aren’t just beneficial — they’re essential. They turn complex foods into smaller compounds, including amino acids, fatty acids, cholesterol, simple sugars and nucleic acids (which help make DNA). Enzymes are synthesized and secreted in different parts of your digestive tract, including your mouth, stomach and pancreas.

Below is an overview of the six-step digestive process, starting with chewing, that triggers digestive enzyme secretion:

  1. Salivary amylase released in the mouth is the first digestive enzyme to assist in breaking down food into its smaller molecules, and that process continues after food enters the stomach.
  2. The parietal cells of the stomach are then triggered into releasing acids, pepsin and other enzymes, including gastric amylase, and the process of degrading the partially digested food into chyme (a semifluid mass of partly digested food) begins. 
  3. Stomach acid also has the effect of neutralizing the salivary amylase, allowing gastric amylase to take over.
  4. After an hour or so, the chyme is propelled into the duodenum (upper small intestine), where the acidity acquired in the stomach triggers the release of the hormone secretin.
  5. That, in turn, notifies the pancreas to release hormones, bicarbonate, bile and numerous pancreatic enzymes, of which the most relevant are lipase, trypsin, amylase and nuclease.
  6. The bicarbonate changes the acidity of the chyme from acid to alkaline, which has the effect of not only allowing the enzymes to degrade food, but also killing bacteria that are not capable of surviving in the acid environment of the stomach.

At this point, for people without digestive enzyme insufficiency (lack of digestive enzymes), most of the work is done. For others, supplementation is needed and helps this process along.


Digestive Enzymes Benefits

What are the benefits of digestive enzymes? The answer is simple: Without them, we couldn’t process food! With that said, there are three main reasons why many people should take digestive enzymes:

  • Help treat leaky gut by taking stress off the gastrointestinal tract.
  • Assists the body in breaking down difficult-to-digest protein and sugars like gluten, casein and lactose.
  • Greatly improve symptoms of acid reflux and irritable bowel syndrome.
  • Enhance nutrition absorption and prevent nutritional deficiency.
  • Counteract enzyme inhibitors naturally in foods like peanuts, wheat germ, egg whites, nuts, seeds, beans and potatoes.

You might be wondering, do digestive enzymes help you lose weight or burn fat, and will digestive enzymes help with constipation? If you’re not making enough digestive enzymes to help the digestive process unfold smoothly, it’s possible you’ll experience constipation that may improve when you supplement. However, enzymes are generally not linked to weight loss and are not intended for this purpose — although eating a healthy diet that supports natural enzyme production may lower inflammation and help you reach a healthier weight.

It’s also possible that digestive enzyme supplements may help curb your cravings and allow you to feel satisfied with less food, helping you to consume an appropriate amount of calories.

 

Digestive enzymes - Dr. Axe

 


Digestive Enzymes Sources

Many raw plants, such as raw fruits and vegetables, contain enzymes that aid in their digestion. For example, pineapple, papaya, apples and many other plants contain beneficial enzymes, but when these foods are grown in depleted soils or are highly processed, enzymes will likely be lacking or destroyed.

Digestive enzyme supplements are derived mostly from three sources:

  • Fruit-sourced — usually pineapple– or papaya-based. Bromelain is an enzyme derived from pineapple that breaks down a broad spectrum of proteins, has anti-inflammatory properties and can withstand a broad pH (acidic/alkaline) range. Papain is another enzyme that’s derived from raw papaya and works well to support the breakdown of small and large proteins.
  • Animal-sourced — including pancreatin sourced from ox or hog. 
  • Plant-sourced — derived from probiotics, yeast and fungi.

What are natural digestive enzymes? Many digestive enzymes available on the market are “natural” because they are sourced from plants or animals. Products in the digestive enzyme range can present a dizzying array of ingredients, which can make it hard to know what the best digestive enzyme supplements are. The bottom line is that the “best digestive enzymes” differ from person to person, since enzymes are nutrient-specific and help with absorption of different foods.

Some products contain only plant-based enzymes, which are aimed at vegetarians and vegans. These usually at least contain bromelain derived from the pineapple, and many include papain enzyme from the papayaProducts designed specifically for vegans will usually contain pancreatin derived from Aspergillus niger. This is a fungus-based, fermented product rather than an enzyme sourced from ox or hog bile, which is the usual source.

In addition, some have complementary herbs and spices. Amla (gooseberry) extract — which isn’t an enzyme, but an herbal remedy from Ayurveda medicine taken for general well-being — is often included. It’s believed to work in synergy with the other compounds.


Pancreatic Enzymes vs. Digestive Enzymes

“Digestive enzymes” is a broad term that includes pancreatic enzymes, plant-derived enzymes and fungal-derived enzymes. Pancreatic enzymes are found in the whopping eight cups of pancreatic juices that most humans produce daily. These juices contain pancreatic enzymes that aid in digestion and bicarbonate that neutralizes stomach acid as it enters the small intestine. (5) Pancreatic enzyme names usually end in -in (like trypsin or pepsin), while other digestive enzymes usually end in -ase or -ose (like lactose, sucrose, fructose).

Dealing primarily with fats and amino acids, pancreatic enzymes include: (6)

  • Lipase converts triglycerides into both fatty acids and glycerol.
  • Amylase converts carbohydrates into simple sugars.
  • Elastases degrades the protein elastin.
  • Trypsin converts proteins to amino acids.
  • Chymotrypsin converts proteins to amino acids.
  • Nucleases convert nucleic acids to nucleotides and nucleosides.
  • Phospholipase converts phospholipids into fatty acids.

The main enzyme-producing structures of the human digestive system are the salivary glandsstomach, pancreas, liver and small intestine.  The pancreas produces bile salts or acids — which comprise water, electrolytes, amino acids, cholesterol, fats and bilirubin — and these are all sourced from the liver via the gallbladder. (7) It’s the cholic and chenodeoxycholic acids that, when combined with the amino acids glycine or taurine, produce the bile salts themselves. The bile salts break down fats in food to enable the lipase enzyme to reduce further. (8)

The duodenum (the first and shortest segment of the small intestine) is also a busy place when it comes to digestion. Amino acids are extracted from proteins, fatty acids and cholesterol from fats, along with simple sugars from carbohydrates. Nuclease cleaves (or splits) the nucleic acids essential for DNA into nucleotides. All the macronutrients are broken down into molecules small enough to be carried in the bloodstream and boost metabolism to ensure it runs effectively. Micronutrients, if they haven’t already been cleaved in the stomach acid, are released and transported into the bloodstream, too.

In regard to mostly sugar metabolism, intestinal enzymes include the following key (but complicated!) processes:

  • Aminopeptidases degrade peptides into amino acids.
  • Lactase, a dairy sugar, converts lactose to glucose.
  • Cholecystokinin aids digestion of proteins and fats.
  • Secretin, as a hormone, controls the secretion of the duodenum.
  • Sucrase converts sucrose to disaccharides and monosaccharides.
  • Maltase converts maltose to glucose.
  • Isomaltase converts isomaltose.

Who Needs Digestive Enzymes?

The answer to the increasingly asked question — “Who should take digestive enzymes?” — may ultimately turn out to be many more people than you might expect.

How do you know if you should take digestive enzymes? If you’re lacking specific enzymes that are needed to break down certain nutrients (such as some types of sugars), you might experience symptoms like bloating, gas, abdominal pain and fatigue. Other signs that you might benefit from taking digestive enzyme supplements? Symptoms like: (9)

  • Acid reflux
  • Cravings for certain foods
  • Thyroid problems
  • Heartburn, indigestion or burping 
  • Hair that is thinning or falling out
  • Dry or lackluster skin
  • Trouble concentrating or brain fog
  • Morning fatigue
  • Trouble sleeping well
  • Arthritis or joint pain
  • Muscle weakness or feeling too tired to exercise
  • Mood swings, depression or irritability
  • Headaches or migraines
  • Worsened PMS

Depending on how you view nutrition today, you can either take a proactive or reactive approach to digestive enzyme supplements. On one side of the coin, “If it ain’t broke, don’t fix it, right?” This perspective holds that, unless someone has digestion concerns, taking enzymes is simply not needed. On the other side, with the depleting nutrient supply in our diets and influx of chronic disease, a little extra help couldn’t hurt.

Either way you look at it, an increasing number of people take digestive enzymes today, and certain health conditions like the ones below are good reasons to supplement:

1. Digestive Diseases

If you have any type of digestive disease — such as acid reflux, gas, bloating, leaky gut, irritable bowel syndrome (IBS), Crohn’s disease, ulcerative colitis, diverticulitis, malabsorption, diarrhea or constipation — then digestive enzymes may be able to help. Digestive enzymes can take stress off of the digestive organs, including the stomach, pancreas, liver, gallbladder and small intestine, by helping break down difficult-to-digest proteins, starches and fats. This can help decrease symptoms like bloating and pain that are associated with gastrointestinal disease. (10)

2. Age-Related Enzyme Insufficiency

As we age, the acidity of our stomach acid becomes more alkaline. In respect to enzyme production, this means there’s an increasing likelihood the the much-needed acidic “trigger” produced when chyme enters the intestine may fail. If the acidity trigger fails, then the “signal” isn’t given to the hormone called secretin, which in turn prevents pancreatic secretions from releasing.

Concurrent illnesses aside, as we age there’s increasing suspicion that digestive problems may result from either low stomach acid or enzyme insufficiency in the elderly, which could be what causes acid reflux. (11) Therefore older people may benefit from taking digestive enzyme supplements, especially if they suffer from unpleasant symptoms.

3. Hypochlorhydria

It’s not only the elderly who suffer from hypochlorhydria (or having too little stomach acid). (12) Aside from a decrease in stomach acid that fails to trigger reactions, the acid itself cannot break down foods to release minerals, vitamins and nutrients. Many micronutrients are “cleaved” or released from food while it’s in the stomach — if this action fails, then there’s an automatic nutritional or enzymatic insufficiency.

4. Liver Disease and Other Enzyme-Related Illnesses

Anyone with liver disease should be suspected as having a concurrent enzyme insufficiency. One of the more common conditions is known as alpha-1 antitrypsin deficiency, a genetic disorder that affects roughly one in 1,500 people worldwide. (13) This condition typically first emerges in adults between the ages of 20–50 by causing breathing and other respiratory complaints. Roughly 15 percent of adults with this condition will develop liver disease, and about 10 percent of infants who are affected will as well. Other signs and symptoms that may be experienced include unintentional weight loss, recurring respiratory infections, fatigue and rapid heartbeats.

There are other illnesses too that may at first diagnosis appear unrelated to enzymatic deficiency but also deserve attention:

Diagnosed illnesses aside, there are many symptomatic indicators of enzymatic insufficiency. Although some could be attributed to other conditions, several relate primarily to the failure of pancreatic enzymes to be released.

  • Stool changes — If the stool is pale and floats in the toilet bowl, because fat floats, this is indicative of pancreatic enzymes not functioning correctly. Another indication can be greasy or fatty deposits left in the toilet water after you poop.
  • Gastrointestinal complaints — Another indicator, together with stomach distention, around an hour after eating is diarrhea. Flatulence and indigestion are also indicative that the patient may have an enzyme insufficiency.
  • Fluoridated water — Further, recent research suggests that fluoride in water may be responsible for the decreased activity of both pancreatic lipase and protease. (14) The study, although carried out on pigs, has broad-ranging implications relative to increased free radical damage and loss of mitochondria production. 

5. Pancreatic Insufficiency

Pancreatic insufficiency is the inability of the pancreas to secrete the enzymes needed for digestion, which is a common problem among people with pancreatic cancer. Prescription pancreatic enzyme products (also called replacement therapy) are also used in patients with pancreatic cancer, chronic pancreatitis, cystic fibrosis, and after surgery on the pancreas or gut. (15)


Best Digestive Enzyme Supplements: Full-Spectrum Digestive Enzymes

Because proteins, sugars, starches and fats all require specific types of enzymes, it’s best to get a supplement that covers all the bases. I recommend looking for a full-spectrum enzyme blend for general digestive improvement. Look for a supplement that includes a variety of enzymes, including some of the following:

  • Alpha-galactosidase (this is the enzyme found in beano®, derived from Aspergillus niger, which is said to help with carbohydrate digestion)
  • Amylase
  • Cellulase
  • Glucoamylase
  • Invertase
  • Lactase
  • Lipase
  • Malt diastase
  • Protease (or acid proteases)
  • Peptidase
  • Beta-glucanase
  • Pectinase
  • Phytase

Here are other tips for purchasing a digestive enzyme supplements, based on your symptoms and current health:

  • If you have gallbladder issues and are looking for a gallbladder diet natural treatment, purchase one with more lipase and bile salts.
  • Where you see betaine HCL listed as a product ingredient, make sure pepsin is also included.
  • Others contain lactase, which until recently was only available as an individual product. This enzyme is designed to assist those with specific issues relating to sugar absorption from dairy products.
  • Consider a supplement that contains protease, which helps with protein digestion, if you have an autoimmune or inflammatory condition.
  • Choose a blend with herbs, such as peppermint and ginger, that also support digestion.
  • Also, because some people need more pancreatic enzymes than others, you need to bear in mind the level of each dependent on your needs. (16) Most products contain some level of pancreatin, which is a combination of all three pancreatic enzymes.

For the best results, take digestive enzymes about 10 minutes before each meal or with your first bite. Protease supplement can be taken in between meals in addition to digestive enzymes with meals. Start by taking enzymes with about two meals per day and adjusting your dosage as needed.


Foods to Eat to Support Digestion + Foods with Natural Digestive Enzymes

While there’s no doubt that many people can benefit from taking enzyme supplements, something we should all focus on is obtaining enzymes naturally from a healthy diet. Which foods contain natural digestive enzymes? 

Raw fruits and vegetables grown in nutrient-rich soils are the best natural sources of digestive enzymes. These foods can help to provide you with digestive enzymes naturally: (17, 18)

  • Pineapple
  • Papaya
  • Kiwi
  • Kefir and yogurt
  • Bananas
  • Mango
  • Miso, soy sauce and tempeh (fermented soy products)
  • Sauerkraut and kimchi
  • Avocado
  • Bee pollen
  • Apple cider vinegar
  • Raw honey

Can you take probiotics and digestive enzymes at the same time? Yes. Take enzymes before a meal and probiotics after or between. It’s also beneficial to get probiotics from fermented foods like yogurt, kefir, kimchi or sauerkraut. Probiotics can help restore balance to the gut microbiome and further aid in digestion, while also curbing symptoms like gas and bloating.

 

Digestive enzymes - Dr. Axe

 


Digestive Enzymes in Traditional Medicine, Ayurveda and TCM

Throughout history, traditional medicine systems emphasized treating poor digestion holistically by making dietary and lifestyle changes, rather than supplementing. Digestive enzymes only became available in supplement form in the past 50 years or so, but long before this people were encouraged to consume raw and probiotic foods that naturally contain enzymes. Fresh/raw enzymes are emphasized most because heat is said to destroy plants’ delicate enzymes.

According to the ancient medicinal system Ayurveda, digestion depends on sufficient agni, “or digestive fire.” Agni is said to be improved by removing causes of indigestion (such as eating while stressed or close to bed time), improving your diet, and using herbs and home remedies to strengthen the digestive organs. Spices play an important role in supporting digestion in Ayurveda, especially ginger, turmeric, cumin, coriander, fennel, cardamom, fenugreek, cinnamon, rosemary, sage and oregano.

One remedy to improve digestive fire is to drink herbal tea that can help with enzyme functions, such as tea made with one-third teaspoons each of cumin, coriander and fennel that is boiled and strained. (19) Eating papaya is also encouraged, since it naturally provides papain which is said to reduce bloating, act as a diuretic and help decrease inflammation.

In Traditional Chinese Medicine (TCM), digestion is improved by supporting the stomach/spleen and improve “Qi,” or vital energy. Acupuncture, herbs, movement and stress management complement the use of plant-based enzymes that are obtained from eating whole foods. Raw fruits and lightly cooked veggies are recommended most for digestive support. Other ways to encourage digestive health include eating local/seasonal foods; choosing organic, unprocessed, non-GMO foods; limiting intake of added sugar, liquids during meals and cold foods; chewing foods thoroughly; not eating within two to three hours of bed time; and practicing tai chi, yoga, exercise and stretching to increase appetite. (20)


Precautions and Digestive Enzyme Side Effects

If you’re dealing with a chronic health problem, it’s a good idea to visit a health practitioner for help with customized enzyme therapy. Depending on your health condition, your doctor can determine which are the safest and best digestive enzymes for you to take. If you have a history of liver or gallbladder disease, or ulcers, then consult a physician before taking digestive enzyme supplements.

What are the potential side effects of digestive enzymes? While they are generally well-tolerated and helpful, digestive enzymes side effects can sometimes include nausea, diarrhea, abdominal cramping, gas, headache, swelling, dizziness, changes in blood sugar, allergic reactions and abnormal feces. (21) You’re most likely to deal with side effects if you take a very high dose and ignore dosage recommendations, so always read product labels carefully. Consult your doctor or pharmacist if you take medications daily and want to begin taking digestive enzymes.

Be sure to understand the pros and cons of taking prescription pancreatic enzymes before beginning supplementation, and always carefully follow directions.


Final Thoughts on Digestive Enzymes

  • Digestive enzymes help break down large macromolecules found in the foods we eat (carbs, protein and fat) into smaller molecules that our guts are capable of absorbing.
  • Digestive enzymes are split into three classes: proteolytic enzymes that are needed to digest protein, lipases needed to digest fat and amylases needed to digest carbohydrates.
  • People who can benefit from taking digestive enzyme supplements include those with inflammatory bowel disease, IBS, low stomach acid (hypochlorhydria), enzyme insufficiency, pancreatic insufficiency, autoimmune diseases, constipation, diarrhea and bloating.
  • Digestive enzyme supplement sources include fruits (especially pineapple and papaya), animals like ox or hog, and plant sources like probiotics, yeast and fungi. Proteins, sugars, starches and fats all require specific types of enzymes, so it’s best to get a supplement that covers all the bases (a full-spectrum enzyme blend).
  •  Foods that can help to provide you with natural digestive enzymes include pineapple, papaya, kiwi, fermented dairy, mango, miso, sauerkraut, kimchi, avocado, bee pollen, apple cider vinegar and raw honey.

Read Next: Pancreatic Enzymes Benefits for Gut & Immune Health


From the sound of it, you might think leaky gut only affects the digestive system, but in reality it can affect more. Because Leaky Gut is so common, and such an enigma, I’m offering a free webinar on all things leaky gut. Click here to learn more about the webinar.

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