Do you really need more digestive enzymes?

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By The Gut Health Doctor Team

Dr Megan Rossi in a lab looking through a microscope

With everyone now latching onto the power of the gut, including supplement manufacturers, there are more pills than ever out there claiming to optimise your digestive health. Vitamin and mineral supplements are putting nutraceutical companies on the map (think nutrition and pharmaceutical combined). These companies are offering multivitamins, special combinations for particular purposes (e.g. ‘supporting’ your digestive system), probiotics and new generation categories such as adaptogens (which claim to protect you from stress). 

With all these new products flooding the market, do you find it hard to navigate the maze of different products and claims to know which preparations are best for you? If so, you’re not alone! From our experience at The Gut Health Clinic, people with gut health issues are generally confused about the products on offer, and looking for straight answers and effective solutions. Cue Dr Google…

One of the most common misdiagnoses and points of mismanagement we see in clinic is self-diagnosed ‘digestive enzyme deficiency’. Due to misinformation being spread, people have often tried this increasingly popular over-the-counter broad spectrum digestive enzymes which claim to include various — usually plant-derived forms — of amylase (to break down carbs), proteases (break down proteins) and lipases (break down fats) in the hope of relief. The convincing marketing for these supplements typically targets those suffering from symptoms of bloating, heartburn or irritable bowel syndrome (IBS). To help safeguard you against the inevitable marketing claims, let’s start by busting a couple of popular misconceptions:

Two people holding hands, one pair of hands looks older than the other with more wrinklesMyth 1: We produce fewer enzymes as we age

The internet is awash with this one — the story that enzymes diminish as we enter our thirties. This is simply not true. Indeed, one study comparing pepsin outputs (a type of enzyme released in the stomach) found that they were very similar in those aged 18-34 and those aged 35-6. But the marketing is everywhere, the false claims are compelling, and this myth preys on people’s anxieties. The fact is, if you keep yourself healthy, your body will continue to produce the required enzymes just fine. To add to the problem, most of these multi-enzyme over-the-counter products are only available in very low doses and are from plant sources (such as bromelain, types of proteases, from pineapple), which are not scientifically proven to have any measurable benefit. So even if you did have a digestive enzyme deficiency, these pills would be unlikely to work.

Myth 2: Drinking water with meals dilutes digestive enzymesA woman drinking water

Have you been led to believe that drinking water with meals compromises your digestive enzymes?

The truth is that whether you drink water with meals or not, your body can adjust to accommodate different meal compositions and dilutions — the digestive system is more than capable of adapting to these sorts of fluctuations. So have no fear, drinking water with meals is perfectly fine. In fact, unless you have something called “early satiety” where you get full quickly, I often recommend drinking water with meals. This is because it can help slow you down, be more mindful with your portions, and give your body time to prepare for the digestive process.


How do digestive enzymes work?

Enzymes are a type of protein our bodies produce that helps to break down food. They play a critical role in digestion. In fact, without them, we’d malabsorp our food, leading to malnutrition and typically loose and smelly stools.

Now, when we eat, the first enzymes food encounters are in the mouth. When we chew, we produce saliva, which contains amylase, an enzyme that breaks down complex carbohydrates into glucose, the simplest form of sugar. As food progresses through your stomach and small intestine it encounters lipases (enzymes that break down fat), proteases (that break down protein), and lactase (that breaks down lactose in dairy products).

These enzymes enable food to be digested into smaller molecules so your body can absorb nutrition from it. The whole process is remarkable and, in the vast majority of people, there are more than enough digestive enzymes to do the job.

What is digestive enzyme deficiency?

True multi-digestive enzyme deficiency is rare — it accounts for only 0.0001% of situations. In exocrine pancreatic insufficiency, as it’s called, food isn’t absorbed properly and its nutritional value is effectively lost. Symptoms include stomach upset, bloating, diarrhoea and other types of gut discomfort. If you had this condition, you would know about it – you would be losing weight, suffering from malnourishment and failing to thrive in any meaningful way. True multi-digestive enzyme deficiency is serious.

It rarely occurs in isolation but is more often secondary to another condition, such as pancreatitis (an inflamed pancreas) or cystic fibrosis. In these circumstances, doctors prescribe a high-dose combination of multi-enzymes to take with every meal and ensure the body can break down food in the gut while eating.

A more common type of genuine digestive enzyme deficiency is lactose intolerance. This is where levels of the enzyme, lactase, which is produced in the gut lining, is in short supply. This is one situation in which over-the-counter digestive enzymes might actually be justified as lactase enzymes are generally effective in relieving symptoms of lactose intolerance. That being said, in clinic, we typically recommend people continue to have small amounts of lactose-containing foods spread across the day without lactase enzymes. This is because research shows that this can help build lactose tolerance. This can be helpful in cases where you might accidentally have lactose (say at a friend’s house), as it will mean that your symptoms should be more manageable.

There are some other cases where we would recommend taking enzyme supplements, but again, these should be specific, single digestive enzymes such as for fructose intolerance and for those who struggle with legumes such as beans and pulses.

So the fact of the matter is that, unless you have been diagnosed with a specific food intolerance or pancreatic insufficiency, you should have no need for digestive enzyme supplements. However, if you are experiencing gut symptoms, there are some basic ways to support good digestion.

Some simple steps to support your digestion

A photo of fruit and vegetables

1. Feed your microbial friends

Optimal digestion doesn’t have to be more complicated for many than eating 30+ plant points a week and aiming to eat across the Super Six every day — this is the best way to look after those gut microbes so they can look after you (including equipping themselves with the right digestive enzymes to digest different types of plants for you).

A photo of a woman eating a bowl of food while smiling

2. Try mindful eating 

Outside of diet, there are many positive lifestyle factors that support and enhance your gut health. So rather than fixating on optimising digestion, check out ways beyond the plate that help to shape your microbiome — from exercise, to fresh air and de-stressing.

A photo of a patient speaking to a dietitian

3. Seek out specialist support

For those struggling with specific digestive conditions or symptoms, our team of gut specialist dietitians use the latest proven strategies to provide you with personalised support, bring relief and help you achieve your health goals. 


Illustration of a woman picking out a grain out of a tapestry of different types of plants to show plant diversity

It’s common to worry that your diet or digestion isn’t adequate and that you could be one supplement away from optimum health. But the reality is that you don’t need most, if any, of the pills that beckon on the supermarket shelves, in High Street shops and online.

Unless you are one of the few people with a diagnosed digestive enzyme deficiency, digestive enzymes are not warranted. They are generally ineffective, rather than dangerous, but if you’re on some medications (e.g. blood thinners or diabetes drugs), there is always the risk of drug interaction.

As a general principle, it’s best to stay away from unnecessary pills — and to spend the money you save on pepping up your 30+ plant points a week!


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