Digestive enzymes sound like one of the more logical supplements on the shelf. Your body uses enzymes to break food down, so adding more should help you digest better. The reality is more specific than that, and more useful to understand.
Here are the questions we hear most often, with what the research actually supports.
What do digestive enzymes do?
Enzymes are proteins that speed up chemical reactions. In digestion, each one has a narrow job. Amylase breaks down starch. Proteases break down protein. Lipase breaks down fat. Lactase splits lactose, the sugar in milk. Alpha-galactosidase breaks down certain carbohydrates in beans and some vegetables that people can't digest on their own.
Your mouth, stomach, pancreas and small intestine all make enzymes. The pancreas does much of the heavy lifting, releasing a mix of enzymes into the small intestine when you eat.
Does your body make fewer enzymes as you get older?
Somewhat. In a study of 180 people aged 16 to 83 without pancreatic disease, the output of the pancreatic enzymes lipase, phospholipase and chymotrypsin declined steadily with age, starting from about the third decade of life. The researchers noted that this didn't mean everyone needed replacement enzymes (Laugier et al., 1991).
A systematic review found that pancreas volume stays fairly stable between about 20 and 60 and declines after that. About 5% of people over 70 and 10% of people over 80 had pancreatic insufficiency based on a stool test (Löhr et al., 2018). For most women in their 40s and early 50s, a significant enzyme shortage from age alone is less likely to be the main issue.
What's actually in an enzyme supplement?
It varies a lot. A review of enzyme supplementation describes products that differ in enzyme type, source and dose. Animal-derived pancreatic enzymes are the established standard of care for medical conditions, while enzymes made by plants and microbes are a growing area of research (Ianiro et al., 2016).
Over-the-counter blends are sold as dietary supplements. Prescription pancreatic enzyme products are a separate category, used for diagnosed conditions under a doctor's care.
Do enzyme blends help with indigestion?
A few small trials suggest they might, for some people. In a double-blind trial, 40 people with functional dyspepsia took a multienzyme blend or a placebo three times a day for 60 days. The enzyme group improved more on all of the symptom measures used, and no side effects related to the product were reported (Majeed et al., 2018).
In a single-center trial, 120 adults aged 18 to 59 with functional dyspepsia took 2 capsules a day of an enzyme blend made through fungal fermentation, or a placebo, for 2 months. The enzyme group reported better quality of life scores, less pain and better sleep (Ullah et al., 2023).
That's encouraging, but it's two specific blends in two modest studies. The results don't automatically apply to other products, and larger independent trials are still needed.
Which enzymes are easiest to study?
The single-purpose ones. Lactase and alpha-galactosidase each target one carbohydrate whose digestion can be measured, for example with a breath test after a dairy or bean meal. Lactase is one of the enzyme supplements that reviews discuss in the most detail (Ianiro et al., 2016). Broad "digestive support" blends are harder to evaluate because they aim at vague symptoms.
How should you take them?
With the meal, not after. Enzymes need to meet the food to work, so take them with your first bites.
Match the enzyme to the food. If dairy is your issue, lactase matters. If beans are, alpha-galactosidase is the relevant one. A blend makes more sense if several food types bother you.
Look for activity units. Enzyme strength is measured by activity, such as FCC units for lactase or GalU for alpha-galactosidase. Milligrams alone don't tell you much.
Test it fairly. Try it with the same trigger meal a few times, and compare with that meal on days without it.
As one example of a blend, noonlife's Meal Enzymes combines protease, amylase, lipase, lactase and alpha-galactosidase.
When enzymes aren't the answer
Some symptoms call for a medical workup, not an over-the-counter product. Pancreatic insufficiency can cause fatty stools, diarrhea, abdominal pain and weight loss (Löhr et al., 2018). See a doctor if you have:
Pale, greasy or floating stools that keep coming back
Weight loss you can't explain
Diarrhea after most meals
Trouble swallowing, persistent vomiting, black or bloody stools, or anemia
A history of pancreatitis, pancreatic surgery, celiac disease or long-standing diabetes along with new digestive symptoms
Sources
Laugier R, Bernard JP, Berthezene P, Dupuy P. Changes in pancreatic exocrine secretion with age: pancreatic exocrine secretion does decrease in the elderly. Digestion. 1991;50(3-4):202-11. PMID 1812045
Löhr JM, Panic N, Vujasinovic M, Verbeke CS. The ageing pancreas: a systematic review of the evidence and analysis of the consequences. J Intern Med. 2018;283(5):446-460. PMID 29474746
Ianiro G, Pecere S, Giorgio V, Gasbarrini A, Cammarota G. Digestive enzyme supplementation in gastrointestinal diseases. Curr Drug Metab. 2016;17(2):187-93. PMID 26806042
Majeed M, Majeed S, Nagabhushanam K, et al. Evaluation of the safety and efficacy of a multienzyme complex in patients with functional dyspepsia: a randomized, double-blind, placebo-controlled study. J Med Food. 2018;21(11):1120-1128. PMID 30156436
Ullah H, Di Minno A, Piccinocchi R, et al. Efficacy of digestive enzyme supplementation in functional dyspepsia: a monocentric, randomized, double-blind, placebo-controlled, clinical trial. Biomed Pharmacother. 2023;169:115858. PMID 37976892
This article is for general information and isn't medical advice. Check with your healthcare provider before starting a supplement, especially if you have a digestive or pancreatic condition, are pregnant or take prescription medication.
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