The market for enzyme supplements is growing faster than ever. Experts project an increase from £700 million in 2021 to £1.6 billion by 2031. Yet many people don’t prioritise their gut health – about 57% turn to these supplements without seeking medical advice.
These supplements help people with specific conditions like cystic fibrosis and lactose intolerance. This piece gets into the safety aspects of enzyme supplements. You’ll learn about common myths and find evidence-based information to make better decisions about using these products.
What are digestive enzyme supplements?
Digestive enzymes are the hidden champions of our digestive system. These proteins break down food into nutrients our bodies can absorb. Many people take digestive enzyme supplements when their natural enzyme levels are low. These supplements want to copy or boost the natural digestive process. You should know what they are and how they work before adding them to your health routine.
Natural enzymes in your body
Your body makes thousands of enzymes that help with about 5,000 different biochemical functions [1]. The digestive system produces these specialised proteins in several places:
- Saliva: Contains amylase, which begins breaking down starches, and maltase that converts maltose into glucose [1]
- Stomach: Produces pepsin and peptidase to start protein digestion [2]
- Pancreas: Generates the majority of digestive enzymes, including amylase, lipase, and proteases [3]
- Small intestine: Houses enzymes such as lactase, sucrase, and trypsin on its brush border [2]
These natural enzymes work as a team. Amylase breaks down complex carbohydrates, protease targets proteins, and lipase handles fats [4]. Some enzymes have specific jobs – lactase breaks down lactose in milk, while sucrase tackles sucrose in fruits and vegetables [2].
Your pancreas is the powerhouse of enzyme production. It floods the small intestine with digestive enzymes once food arrives [3]. The cells on your intestine’s surface store enzymes that complete the digestive process [4].
Types of enzyme supplements
Supplements can help if your body doesn’t make enough digestive enzymes. They come in two main types:
Prescription enzyme supplements:
- We used these mainly for serious conditions like exocrine pancreatic insufficiency (EPI), chronic pancreatitis, cystic fibrosis, and after pancreatic surgery [5]
- They contain pancrelipase, which combines amylase, lipase, and protease [6]
- A special coating protects them from stomach acids until they reach the intestines [6]
- Doctors prescribe them as Pancreatic Enzyme Replacement Therapy (PERT) [6]
Over-the-counter (OTC) enzyme supplements:
- You can buy these without a prescription at health food stores and pharmacies
- They come from animal sources (like pig pancreas) or plant sources (moulds, yeasts, fungi, or fruits) [6]
- Popular OTC enzymes include lactase for lactose intolerance and alpha-galactosidase that helps digest beans [3]
- You can find them as capsules, tablets, and powders [6]
About 75 percent of people worldwide have hypolactasia (decreased lactase activity), especially as adults [5]. This makes lactase supplements one of the most popular digestive enzyme products.
How they work in your digestive system
Digestive enzyme supplements help your body by adding to or replacing natural enzymes you might lack. They do the same job as your natural enzymes by breaking large food molecules into smaller pieces your body can absorb.
Digestive enzymes break down:
- Proteins into small peptides and amino acids
- Fats into fatty acids and glycerol
- Carbohydrates like starch into simple sugars [4]
Your body needs this breakdown process. Without it, nutrients can’t pass through the small intestine into your bloodstream [6]. Low enzyme levels often lead to bloating, gas, and diarrhoea [4].
The timing of enzyme supplements matters. Take them right before eating so they’re ready when food enters your system [6]. For longer meals over 30 minutes, you might need more enzymes halfway through [6].
Most adults on prescription enzymes take two to four 25,000-unit tablets or capsules with meals and snacks [6]. Doctors usually start with the lowest dose that works and adjust from there.
Not everyone needs digestive enzyme supplements. A healthy diet provides enough enzymes for people without chronic health conditions [1]. These supplements can help improve nutrient absorption and reduce digestive discomfort if you have specific digestive issues.
The science behind digestive enzymes
Scientific research on digestive enzyme supplements shows mixed results. The evidence changes a lot based on specific enzymes, medical conditions, and study designs.
Research on effectiveness
Current scientific evidence shows a clear difference between prescription enzyme treatments and over-the-counter supplements. Prescription digestive enzymes have shown clear benefits for specific medical conditions. The effectiveness of supplements accessible to more people still needs more proof [7].
A randomised, placebo-controlled, double-blind clinical trial with 120 participants who had functional dyspepsia showed big improvements. Their quality of life scores, sleep quality, and pain levels got better after taking a multi-enzyme blend [8]. The treatment group improved without side effects, which suggests benefits for this condition [7].
Scientists studied how digestive enzyme supplements affect post-meal symptoms in healthy people. The results were promising. Participants had 58% less abdominal distension after 30 minutes compared to placebo. This difference grew to 68% less distension after 90 minutes [7]. The test product reduced distension in 80% of participants [7].
Research has confirmed that lactase supplements work well for lactose intolerance. Scientists tested three different lactase formulations against placebo: 
- Higher doses (6000 IU) reduced total hydrogen production by a lot compared to lower doses (3000 IU)
- Symptoms improved by a lot with all tested products [2]
Common myths about enzyme supplements
The popularity of digestive enzyme supplements keeps growing, and so do the myths about how they work and whether they’re safe. Companies make big promises in their marketing, and you need to know what’s true and what isn’t about these digestive aids. Let’s get into three common myths about enzyme supplements.
Myth 1: Everyone needs enzyme supplements
Your body makes enzymes right in your digestive tract and organs like the pancreas. These break down foods without any extra help. You might benefit from enzyme supplements especially when you have specific medical conditions:
- People with exocrine pancreatic insufficiency (EPI)
- Those with chronic pancreatitis
- Individuals with cystic fibrosis (affecting 90% of CF patients) [3]
- Some people with celiac disease
- Individuals with diagnosed lactose intolerance
These groups need enzyme supplements to treat their conditions.
Myth 2: Enzymes decrease natural production
Many people worry that taking digestive enzyme supplements will make their body lazy and stop making its own enzymes. This sounds like it could make sense, but science doesn’t back it up.
Several things trigger your digestive enzyme production: hunger, food’s smell and appearance, its taste, and food entering your digestive system [6]. The supplements you take don’t mess with these natural triggers.
Medical experts agree on this point: “It is unlikely that digestive enzyme supplements have an effect on endogenous (your body’s) production of digestive enzymes” [6]. They also note: “I could not find documentation to support the claim that taking digestive enzymes will down-regulate your body’s production of digestive enzymes” [6].
The truth is simple – if your enzyme levels are normal, supplements won’t help or hurt your natural production.
Potential benefits of digestive enzyme supplements
Scientific evidence helps us understand where digestive enzyme supplements offer real benefits. Let’s break down which conditions respond best to enzyme supplementation. This knowledge helps people make better choices about their digestive health.
For specific medical conditions
Several specific medical conditions show clear benefits from digestive enzyme supplements, especially when the body can’t produce enough enzymes naturally. The best evidence points to their use in exocrine pancreatic insufficiency (EPI), a condition where your pancreas doesn’t make enough digestive enzymes [3].
Doctors commonly prescribe enzyme supplements to patients with:
- Chronic pancreatitis: Between 30% to 90% of patients develop EPI and need enzyme supplementation [3]
- Cystic fibrosis: Up to 90% of patients have EPI and see benefits from enzyme therapy [3][8]
- Post-pancreatic surgery: Patients often need enzyme replacement after pancreatic procedures [3]
- Pancreatic cancer: Enzyme supplements help digestion when cancer affects the pancreas’s function [3]
Doctors prescribe pancreatic enzyme replacement therapy (PERT) in these cases. PERT has a combination of amylase, lipase, and protease [8]. These prescription- strength supplements help your body break down carbohydrates, fats, and proteins. This allows proper nutrient absorption despite pancreatic problems.
Enzyme supplements also work well for other digestive challenges:
Lactose intolerance: Lactase supplements like Lacto help people digest dairy products. Up to 75% of the world’s population has some degree of lactose intolerance, creating a huge need for these supplements [16].
Bean-related digestive discomfort: Alpha-galactosidase supplements cut down gas and bloating from beans and certain vegetables [5][16]. These supplements break down complex carbohydrates that humans find hard to digest. About 20% of people get abdominal pain from intestinal gas related to these foods [16].
Research suggests enzyme supplements might help people with celiac disease, though they’re not part of standard treatment yet [17]. Yes, it is exciting that new celiac treatments might tap into the potential of enzyme supplementation to break down troublesome gluten proteins [17].
Evidence for general digestive support
The benefits of digestive enzymes become less clear outside specific medical conditions. Many people take over-the-counter enzyme supplements for bloating, gas, and acid reflux, but scientific support varies.
Studies show promise in specific cases: Research found that multi-enzyme supplements improved symptoms in people with functional dyspepsia (indigestion) [9]. Patients reported less pain and better quality of life. The study’s authors worked for the supplement manufacturer, which is worth noting [9].
IBS patients saw symptom improvements with digestive enzymes in another study [9]. Medical experts say we need more research before making solid recommendations [8].
A small study of inflammatory bowel disease (IBD) patients found benefits from supplements containing beta-glucan, inositol and digestive enzymes [9]. These early results need confirmation through bigger trials.
Researchers have looked at enzyme supplements for muscle soreness and osteoarthritis too. Some enzymes (especially bromelain, trypsin, and rutin) reduced osteoarthritis pain, but we need more evidence [9].
About 20% of people struggle to digest complex carbohydrates in beans and certain vegetables [16]. This shows why it’s crucial to identify specific digestive issues rather than using enzymes as a catch-all supplement.
Possible side effects and risks
Digestive enzyme supplements might seem harmless, but they can cause effects ranging from mild discomfort to serious health problems. You should know these potential risks before adding these supplements to your health routine.
Common side effects
The gastrointestinal system takes the biggest hit from most digestive enzyme supplements. Here are the common reactions people experience:
- Abdominal pain and cramps
- Gas and bloating
Most people experience mild symptoms that go away as their body adjusts to the supplement. In spite of that, you should get medical help if these effects don’t improve or get worse [18].
Some users report more serious symptoms like severe abdominal discomfort, frequent or painful urination, and joint pain [18]. In rare cases, allergic reactions can be demonstrated as rash, itching, swelling (especially when you have it in the face, tongue, or throat), severe dizziness, or breathing difficulties [18].
Clinical trials show 85% of participants reported some gastrointestinal side effects while taking enzyme supplements. The control groups showed similar rates [19]. This suggests many reported side effects might not come directly from the enzymes.
Long-term safety concerns
Certain enzymes come with their own risks during long-term use. Children with cystic fibrosis who take high-dose pancreatic enzymes might develop fibrosing colonopathy, a rare but serious complication [7]. High doses of papain can cause esophageal perforation in extreme cases [7].
Pregnant and nursing women should be extra careful with enzyme supplements because of lack of safety data for these groups [7]. People with specific allergies need to watch out too—especially those allergic to pineapple, papaya, or animal products that provide certain enzymes [9].
Interactions with medications
These supplements can mix with various medications and affect how well they work or how safe they are. Here are the important interactions:
Blood thinners need special attention when combined with certain enzymes, especially bromelain. This mix might increase bleeding risk with medications like aspirin, heparin, and warfarin [9]. Bromelain can also interact with supplements that thin blood, like garlic, ginger, and fish oil [9].
The supplements can affect diabetes medications, antibiotics, and some blood pressure drugs. Bromelain might change how your body absorbs antibiotics like amoxycillin and tetracycline. Papain could impact how your body handles diabetes and heart medications [9].
Watch out for these medications too:
- Acarbose and miglitol (diabetes medications) [18]
- Chemotherapy drugs like 5-fluorouracil [9]
- Amiodarone and levothyroxine [9]
Your healthcare providers need to know about all supplements you take. One source puts it well: “Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist” [18].
Scientists often discover drug interactions after the fact rather than during clinical trials. That’s why you should be careful when combining any new supplement with medications [4].
Who should consider taking enzyme supplements?
Digestive enzyme supplements aren’t necessary for everyone, but they can help certain people a lot. Healthcare providers prescribe these supplements mainly to treat specific medical conditions rather than boost general wellness. You should know if you need these supplements based on your health situation.
Medical conditions that benefit from supplementation
Doctors commonly prescribe enzyme supplements to treat conditions that affect natural enzyme production or function. These prominent conditions include:
Exocrine Pancreatic Insufficiency (EPI): Your pancreas can’t make enough digestive enzymes with this condition. It affects about 80% of people with cystic fibrosis and up to 90% of those with advanced chronic pancreatitis [5].
Chronic Pancreatitis: This inflammatory condition damages pancreatic tissue and reduces enzyme production over time. About 30% to 90% of patients need enzyme supplements [1].
Cystic Fibrosis: Almost 90% of CF patients develop pancreatic problems in their first year [2]. These patients need enzyme supplements to absorb nutrients properly.
Pancreatic Cancer: About 90-100% of patients with advanced pancreatic cancer need enzyme supplements because both the cancer and its treatments can harm pancreatic function [1].
Lactose Intolerance: This affects about 75% of people worldwide due to low lactase enzyme production [17]. Lactase supplements can help digest dairy without discomfort.
Patients who undergo pancreatic surgery usually need supplements because removing pancreatic tissue reduces their enzyme production. Most of these conditions require prescription-strength pancreatic enzyme replacement therapy (PERT) instead of over-the-counter options.
Signs of enzyme deficiency
Your body shows several distinct symptoms when it lacks digestive enzymes. Food doesn’t break down properly, which leads to:
- Digestive discomfort: Your stomach might bloat, produce excess gas, and cramp after meals [2]
- Stool changes: You might notice pale, oily, foul-smelling stools that float, look greasy, or don’t flush easily [21]
- Malabsorption signs: You might lose weight unexpectedly despite eating enough [14]
- Nutritional impacts: You could experience fatigue, dry skin, brittle nails, and hair loss that points to malnutrition [2]
Steatorrhoea (fatty stools) serves as a key sign of pancreatic insufficiency. This condition means having more than 7 grammes of fat per 100 grammes of stool, and severe cases can show more than 14 grammes [1]. These obvious symptoms usually appear only after your pancreatic enzyme production drops by about 90% [1].
You should see a healthcare provider if you have ongoing digestive problems. They can run specific tests, like checking faecal elastase levels, to see if enzyme supplements might help. Readings below 200 μg/g suggest pancreatic insufficiency, while levels under 100 μg/g point to severe deficiency [1].
Remember that digestive discomfort doesn’t always mean you need enzyme supplements. Sometimes changing your diet or treating other health issues works better than taking supplements.
Prescription vs. over-the-counter options
The difference between prescription and over-the-counter digestive enzyme supplements is nowhere near just about availability. These differences help buyers choose what works best for them. Quality, regulation, and cost vary substantially between these options.
Potency and quality considerations
Prescription enzymes pack more active ingredients than OTC versions [22]. They also maintain the same quality between batches, while OTC supplements can vary quite a bit [6].
Quality products should show their strength through standardised activity units rather than just weight in milligrammes. The best supplements use specific codes like “HUT,” “USP,” or “FCC” with numbers [15]. These numbers show “a standardised rate of change that each enzyme is able to achieve under controlled environmental conditions” [15].
Enteric coating is a vital quality feature that “protects the enzymes, which are proteins, from being digested by the acid contained in, and secreted by, the stomach” [22]. Enzymes need this protection to reach the small intestine where they work their magic.
Third-party testing provides extra confidence in OTC options. NSF, USP, or ConsumerLab.com certifications prove that supplements match their label claims [22].
How to choose a quality enzyme supplement
Choosing a quality enzyme supplement needs more than just believing marketing claims. The market offers thousands of options with minimal oversight, so you need to know what makes a supplement safe and effective.
Important label information
The label should show these key elements to ensure maximum digestive benefits:
- Enzyme activity units – Look for enzyme supplements that suggest standardised measurements like HUT (for protease), FIP (for lipase), or DU (for amylase) instead of just milligramme content [24]. These units show the actual enzyme potency.
- Ingredient transparency – Quality supplements list all ingredients clearly, including the enzyme’s source (animal, plant, or microbial) [10]. Check for fillers, artificial sweeteners, or common allergens.
- Serving size – Compare enzyme activity per serving, not just per capsule [24].
Red flags to watch for
Stay away from supplements that promise weight loss, flatter stomachs, or miracle cures [8]. These claims usually lack scientific backing. You should also avoid products that don’t show enzyme potency in standardised units [25].
Conclusion
Digestive enzyme supplements play a vital role if you have specific medical conditions, though their benefits for general digestive health are nowhere near as clear. Prescription enzymes work well for conditions like pancreatic insufficiency and cystic fibrosis. However, you should think over using over-the-counter supplements carefully.
Research backs enzyme supplements mainly for diagnosed enzyme deficiencies rather than general digestive problems. You should talk to your healthcare provider before starting any enzyme supplements if you have ongoing digestive issues. These symptoms might point to why it happens that they need proper medical care.
The quality of enzyme supplements matters a lot. Products that have third-party testing certifications, standardised enzyme measurements, and clear ingredient listings are more reliable than others without these features. Digestive enzyme supplements help specific conditions but shouldn’t replace proper medical evaluation or a balanced diet. You need to weigh the benefits against possible risks, interactions, and costs before taking these supplements. A healthy person’s body usually maintains adequate enzyme levels through good nutrition. People with real deficiencies get the most benefit when healthcare professionals guide their supplement choices.
FAQs
Are digestive enzyme supplements necessary for everyone?
No, digestive enzyme supplements are not necessary for everyone. Most healthy individuals produce sufficient enzymes naturally through their digestive system. These supplements are primarily beneficial for people with specific medical conditions like pancreatic insufficiency, chronic pancreatitis, or cystic fibrosis.
Can taking digestive enzyme supplements cause any side effects?
Yes, digestive enzyme supplements can cause side effects, although they are generally mild. Common side effects may include diarrhoea, abdominal pain, nausea, and gas. In rare cases, more severe reactions like allergic responses can occur. It’s important to consult a healthcare provider before starting any new supplement regimen.
How should digestive enzyme supplements be taken for maximum effectiveness?
For maximum effectiveness, digestive enzyme supplements should be taken just before meals. It’s important not to crush or chew the supplements, as this can reduce their efficacy. If you have difficulty swallowing pills, some capsules can be opened and mixed with food, but the food should be eaten immediately afterwards.
Do digestive enzymes help with weight loss?
There is no scientific evidence to support the use of digestive enzyme supplements for weight loss. While these supplements can aid nutrient absorption in people with certain medical conditions, they do not directly contribute to fat loss or weight reduction in healthy individuals.
How can I choose a high-quality digestive enzyme supplement?
When choosing a digestive enzyme supplement, look for products that have undergone third-party testing by organisations like NSF International or USP. Check the label for standardised enzyme activity units rather than just milligramme content. Be wary of products making extravagant claims or those that don’t disclose their full ingredient list.
References
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6858980/
- https://my.clevelandclinic.org/health/diseases/21577-exocrine-pancreatic-insufficiency-epi
- https://www.health.com/condition/digestive-health/digestive-enzymes
- https://badgut.org/information-centre/a-z-digestive-topics/drug-interactions-a-matter-for-enzymes/
- https://www.health.harvard.edu/staying-healthy/can-taking-enzyme-supplements-help-soothe-my-bloating
- https://pancan.org/facing-pancreatic-cancer/living-with-pancreatic-cancer/diet-and-nutrition/pancreatic-enzymes/
- https://www.mayoclinicproceedings.org/article/S0025-6196(14)00520-5/fulltext
- https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements
- https://www.verywellhealth.com/the-benefits-of-digestive-enzymes-89446
- https://www.humnutrition.com/blog/best-digestive-enzymes/?srsltid=AfmBOopK143CIrzb7Kambvb9C5-ieZ3k1R0Q2KwNnEwBfaHbs0YaBo19
- https://food.ec.europa.eu/food-safety/food-improvement-agents/enzymes/eu-rules_en
- https://www.healthline.com/nutrition/how-to-read-supplement-labels
- https://www.todaysdietitian.com/newarchives/0224p20.shtml
- https://www.healthline.com/health/exocrine-pancreatic-insufficiency/the-role-of-digestive-enzymes-in-gi-disorders
- https://enzymedica.com/blogs/digest-this/enzyme-potency?srsltid=AfmBOor08cVi7EBVNfmHnqgPZNdWbwLdnhwCFo5XBb2IbJU0D-mKZSrt
- https://www.health.harvard.edu/staying-healthy/digestive-enzymes-how-supplements-like-lactaid-and-beano-can-help-with-digestion
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4923703/
- https://www.webmd.com/drugs/2/drug-673/digestive-enzymes-oral/details
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3462488/
- https://cymbiotika.com/blogs/health-hub/is-it-safe-to-take-digestive-enzymes-long-term-understanding-the-risks-and-benefits? srsltid=AfmBOoqOHyXS0vMhwXJn_Cn9WtNty5LPG9XmbHh-ALSXL_KExeZRXP_-
- https://www.cuh.nhs.uk/patient-information/information-for-people-taking-pancreatic-enzymes-for-pancreatic-insufficiency/
- https://edition.cnn.com/2024/02/15/health/digestive-enzyme-supplements-pros-cons-wellness/index.html
- https://letswinpc.org/disease-management/diet/pancreatic-enzyme-alternatives/
- https://enzymedica.com/blogs/digest-this/how-to-read-an-enzyme-label?srsltid=AfmBOorZfb1nb4LRPdMxcEjV2Uz3YQduYFQoRmvw0KVfG8RYiprduwNl
- https://www.consumerlab.com/reviews/digestive-enzyme-supplements/digestive-enzymes/
