What are Digestive Enzymes and Who Needs ‘Em?

There is a time and place for digestive enzymes and those circumstances may actually surprise you. Digestive enzyme supplements are various formulations of lipase, amylase and protease — enzymes (proteins) that help you break down fats, carbohydrates, and proteins. In your body, these enzymes are made in saliva, the stomach, small intestine, and pancreas. 

A very common reason to need digestive enzymes is gut inflammation. Whether you have Celiac disease, Irritable Bowel Syndrome, Crohn’s, Ulcerative Colitis or mere leaky gut syndrome, the inflammation in the intestines will naturally begin to create an upper GI insufficiency, or hinder the production of digestive enzymes. 

Having episodes of diarrhea and constipation also means you need digestive enzymes. Insufficient amylase will inhibit the breakdown of carbs, starches, and sugar molecules, adding to diarrhea. Are you deficient in Vitamin D, A, E or K – the fat-soluble vitamins? This can be caused by inadequate lipase. Do you have chronic bacterial overgrowth in the bowel, or,  SIBO? Signs of this are usually bloating, indigestion, belching, and foul-smelling gas. You are likely not secreting enough protease to break down proteins into amino acids to feed a healthy microbiome in the bowel. Lack of protease also contributes to the gut inflammation underlying IBS, Celiac, Crohn’s, and allergic responses in the digestive system. All of these circumstances mean you need digestive enzymes. 

In addition to gut inflammation, stress is another big reason for upper GI insufficiency. The sympathetic nervous system (or “fight or flight” response) decreases stomach acid production, weakens bile, and inhibits pancreatic output. Why would your body do this to you? The fight-or-flight response is designed to allocate resources to primal survival, and in those moments, blood supply is actually shunted from the digestive system to the skeletal muscles, so that you can run from danger. 

We actually have to access the parasympathetic nervous system (“rest and digest” system) to secrete stomach acid, bile, and digestive enzymes. So, eating over the sink in a rush during your 15 minute lunch break is not ideal for your digestion. 

Stomach acid, bile, and pancreatic output are actually cued up together. When you experience heartburn, acid reflux, or indigestion, this means you have problems with stomach acid production. Inadequate bile and pancreatic output are certain. This is called upper GI insufficiency, and is a strong call for digestive enzyme support. In addition, if you have gallbladder insufficiency or gallstones, you need digestive enzyme support as well. 

Last reason to take a digestive enzyme – Age. One of my pet peeves is using age as an excuse for pathology. Your body does not know how old you are, and merely aging is not a pathology. Telling someone “you are getting old” is dismissive, and a failure to understand the true cause of the pathology and subsequently, not going to get you very far towards healing it. 

But, as we age, many of us do start to make less stomach acid, bile, and pancreatic enzymes. This is likely a reflection of how long we have been inflamed and stressed. When does this magic shift take place? It’s different for everyone, which is why I don’t utilize age as an excuse for pathology. I ask questions to determine how long you have been stressed and inflamed. 

A Note on Nutrient Absorption 

When someone has signs of malabsorption, vitamin and mineral deficiencies, or has unintended weight loss, fatigue, poor cognition, hypothyroidism, and osteoporosis or osteopenia, this means the nutrients consumed in the diet are actually not being absorbed. Even taking a multivitamin may not be beneficial without adequate upper GI support. Taking digestive enzymes helps prevent malabsorption. 

Ok, I’m In. Now When Should I Take Them?

The best time to take your digestive enzymes is shortly before, during or directly after the meal. Exact times are not really known, but generally the span of 15-30 minutes before a meal, anytime during the meal, and 15-30 minutes after the meal can be effective. Taking digestive enzymes on an empty stomach outside of these timeframes is largely useless. 

Which Formulas Should I Take? 

If you are experiencing chronic stress and basic indigestion, a basic formula will suffice – Digest Gold, Complete Digestion, and Digest Enzymes Ultra are great formulas. If you have more stomach acid insufficiency (heartburn) and poor bile output (gallbladder insufficiency), you likely need a basic formula with betaine HCL and ox bile. My two favorites for this situation are Digestzymes by Designs for Health or Panplex 2 Phase by ITI

Do you have more substantial gut inflammation? Using digestive enzymes with stronger proteolytic agents are best. This would be formulas like Intolerance Complex and GlutenEase Extra Strength. 

As you can see, there are many circumstances that call for digestive enzymes, many people who could benefit from adding them to their daily wellness protocol. The fact of the matter is that if you are stressed or inflamed, as so many of us are, you likely need digestive enzymes. The friendly folks at Peoples Rx would love to help you decide which combination is best for you.

If you have comments and/or questions about this blog, email us at blog@peoplesrx.com.

Amy Nelson, ND* received her Naturopathic Doctorate from the National College of Natural Medicine in Portland, OR where she studied nutrition, homeopathy, herbal and functional medicine. In addition, Dr. Nelson was the Associate at The IBS Treatment Center in Santa Monica where she treated irritable bowel syndrome and complex food allergies. Dr. Nelson utilizes her experience in natural medicine to address female and male hormonal imbalances, mental health, and digestive disorders. Amy is available for consultation at Peoples Lakeline.

*Although licensed in other states, Naturopathic Doctors are not currently licensed in Texas. To support licensure efforts, please visit www.txand.org.