Digestive enzymes are proteins that help break down food into smaller parts so your body can easily use the nutrients. The enzymes are produced in different parts of the digestive system, including the mouth, stomach, pancreas, and small intestine.
Some people have problems making or using digestive enzymes. This can lead to nutrient deficiencies and other health conditions. In these cases, they may use prescription or over-the-counter (OTC) digestive enzyme products to supplement their levels. Condroitin
This article discusses digestive enzyme supplements and when they may be recommended. It also looks at digestive enzyme side effects and precautions for using these products.
The following are examples of digestive enzymes that occur naturally in the body. Some of these are also available as supplements or prescription products.
The following are enzymes that break down additional macronutrients in the body:
Both enzymes above are found in the pancreas.
Select foods, including the following, also contain digestive enzymes:
Both enzymes above digest proteins.
Digestive enzymes help break down your food so your body can get the most nutrients. When this process is disrupted, you may experience discomfort (ex., bloating, gas).
Your body could become malnourished in more severe conditions where digestive enzymes aren’t produced or used efficiently. Over time, this can cause issues like osteoporosis.
Over-the-counter (OTC) supplements may be used in cases such as the following:
People with more severe conditions (ex., exocrine pancreatic insufficiency (EPI), pancreatitis, surgical removal of the pancreas, cystic fibrosis) will likely need prescription enzyme replacement therapy (ERT).
Be sure to discuss your symptoms and use of digestive enzymes with your healthcare provider. OTC digestive enzyme supplements are not meant to treat life-threatening medical conditions.
Most digestive enzyme supplements are safe at doses recommended by the manufacturer. Side effects are generally mild. However, the risk of severe side effects does exist.
The risk of an allergic reaction is present with all digestive enzyme supplements. Do keep this in mind, especially if you have a known allergy to them or the products from which they are derived (for example, an allergy to papaya or pineapple).
Common side effects of digestive enzyme oral supplementation are primarily gastrointestinal upset, such as the following:
Side effects, when applied to the skin, include the following:
Severe side effects of digestive enzymes are rare and depend on the supplement used.
Examples of severe effects and enzymes they are associated with include, but are not limited to:
Some digestive enzyme products are derived from animals (ex., cattle, pigs). If you’re following a diet that avoids animal products, please check the origin of your enzymes.
Avoid using a product if you are allergic to its ingredients or derivatives (e.g., fruit latex, pineapple, papaya).
If you're unsure about whether a digestive enzyme supplement is safe for you after reading the complete list of ingredients, speak with your pharmacist.
Bromelain may increase your risk of bleeding if you take blood thinners or have low platelets. In either case, please talk to your healthcare provider before taking it, and be sure to be aware of side effects if you do.
Anyone who is pregnant or breastfeeding should also consult a healthcare provider before taking digestive enzymes or other supplements.
Dosing for digestive enzyme supplements differs for each enzyme and different conditions. The following has been suggested:
Digestive enzymes are usually taken before meals.
As a general rule, never take more than the recommended dose. Follow instructions on product labels and include your healthcare provider and pharmacist in your decisions.
Dietary supplements are not regulated like drugs in the United States. This means the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed.
When possible, choose a supplement tested by a trusted third party, such as the United States Pharmacopeia (USP), ConsumerLab.com, or NSF.org. However, even if supplements are third-party tested, that doesn't mean they are necessarily safe for all or effective in general.
Talk to your healthcare provider about any supplements you plan to take. Checking in about potential interactions with other supplements or medications is important.
While probiotics and prebiotics are used for digestion, they are not the same as digestive enzymes and work differently in the body.
Digestive enzyme supplements may interact with blood-thinning medicines such as the following:
Digestive enzymes, specifically bromelain, may interact with other supplements with blood-thinning effects. These include the following:
Bromelain may impact absorption and the body's use of medications such as the following:
Papain may impact how the body absorbs amiodarone, levothyroxine, diabetes medications, and warfarin.
Digestive enzymes have been studied for several health conditions, like IBS, IBD, digestive symptoms of autism, and more. The evidence is mixed regarding whether or not they’re useful for some of these conditions.
Digestive enzymes are readily available over-the-counter for issues like lactose intolerance and for help with digesting other carbohydrates. Some digestive enzymes may have mild side effects.
Since digestive symptoms can also be connected with more severe conditions, discuss your symptoms and concerns with your healthcare provider.
People with conditions like cystic fibrosis, pancreatitis, and pancreatic cancer are prescribed prescription enzyme replacement therapy, usually in the form of pancreatic enzyme replacement therapy (PERT). Prescription PERT products include Creon, Pancreaze, Ultresa, Viokace, and Zenpep. Prescription PERT is different from over-the-counter products.
While digestive enzymes are typically taken before meals, read the manufacturer’s suggestions. Ask a healthcare provider or registered dietitian nutritionist if you have any questions.
Lactaid is an over-the-counter product that contains the digestive enzyme lactase. Lactase breaks down lactose (a sugar) in dairy products. It helps people with lactose intolerance.
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By Regina C. Windsor, MPH, RDN Regina Windsor, MPH, RDN, is an editor for Verywell Health. Her expertise includes population health, data analysis and synthesis, nutrition and dietetics, publishing, and education. She is a systems-oriented thinker with a passion for exploration and authentic connection.
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