Digestive Enzyme Basics
Digestive enzymes are a staple in the integrative practitioner’s dispensary, because we know proper digestion and nutrient absorption is essential to good health. While many of us are fortunate enough to be born with a robust digestive system, many others are not.
There may be inherent or genetic functional deficits to begin with or allergy / immune dysfunction that leads to changes within the GI system, ultimately resulting in the insufficient breakdown of nutrients and thus, malabsorption. The digestive system can be affected by illness or injury (either acute or chronic) and, most important to remember, easily derailed by stress. Digestive system stress comes in many forms, but here are a few reminders:
- Irritating / inflaming foods or drinks like coffee, alcohol, sugar, highly processed foods, etc.
- Individual food sensitivities like gluten, dairy, corn, soy, etc.
- Excessive physical stress (hard exercise, physical labor)
- Emotional / mental stress
- Chronic GI infection or inflammation
- Repeated antibiotic exposures
While there are many ways to support digestion, enzymes as digestive aids compensate for endogenous enzyme deficiency or insufficiency and combat indigestion. We are all familiar with lactase deficiency, which is specific and identifiable. But even the hardiest digestive systems occasionally succumb to stress, which can lead to the uncomfortable symptoms of bloating, gas and reflux. It may be for a day or a week—or become a chronic insufficiency of enzyme activity. I remember throughout much of my young life watching television ads for “antacids”. If only those advertisements were for enzymes, we would be a healthier, happier society.
In addition, and very important to keep in mind, is that with aging, digestive functions begin to deteriorate, so even someone who has never had digestive issues in the past may find they require digestive enzymes from time to time. The appropriate use of enzymes in the aging population, especially with the elderly, can help prevent nutritional deficiencies and even inflammatory conditions. Improper diagnosing of enzyme insufficiency as an “acid excess” state, as well as the huge medical trend toward the use of acid-reducing pharmaceuticals, has led to an epidemic of poor digestion. These drugs alter the natural acid production needed to activate our own endogenous enzymes, properly digest food and release nutrients (especially calcium, magnesium, iron, Vitamin C and folate) and, let’s not forget, protect against pathogens.
Supplemental digestive enzymes can originate from three different sources: animals, plants and microbes. Pharmaceutical companies have been producing enzyme supplements from animal sources for well over 65 years as treatment for malabsorption syndromes and pancreatic insufficiency. Animal-sourced enzymes include pancreatin, pepsin, trypsin and chymotrypsin. Pancreatin is still often preferred by many practitioners and usually includes most of the enzymes necessary for digestion of proteins, fats and carbohydrates in the small intestine (i.e., proteases to break down proteins into amino acids; amylase to cleave complex carbohydrate molecules into manageable sugars; and lipase to facilitate the breakdown of lipids).
Plant-sourced enzymes like bromelain (from pineapple), papain (from papaya), ficin (from fig tree latex) and actinidin (from kiwi fruit) are proteolytic enzymes which break down proteins, and are included in many digestive formulas. These can be very useful even as the occasional “after-meal” enzyme to encourage the completion of the digestive process. They have additional use as systemic enzymes in promoting healthy inflammation resolution.
Microbial-sourced enzymes from fungi (including yeasts) and bacterial sources can be used by vegetarians and vegans and have good gastric survivability. Microbial enzymes can include amylase, glucoamylase, proteases, lipase and multiple types of saccharidases. These very important saccharidases include lactase (to digest lactose), alpha-galactosidase (for digesting beans, legumes and cruciferous vegetables) and my favorite, cellulase (to digest cellulose), along with hemicellulase, xylanase and pectinase, which are all very important enzymes for digesting plant components. The healthy choice to move toward a plant-based diet can trigger digestive problems for anyone, but especially older adults. The addition of these saccharidase enzymes are of tremendous value in any digestive formula, because they target the foods which are, in general, most difficult to digest. I like formulas that contain high cellulase activity (2,000-4,000 CU) for older adults and for anyone who knows they have difficulty with legumes and high-fiber plant foods. Many of my patients have been relieved to find that their annoying digestive problems have been completely solved using a good food enzyme with their meals!
Enjoy this chart on measurements of enzyme activity or download it from our Practice Management/Practice Tools located in our Practitioner Resource Center at: bit.ly/PRC_Enzymes
By Lisa Murray, RDN, LD