What are the effects of enzymes on vitamins?
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Food fuels your body. Digestive enzymes (proteins in the body) help break down your food into smaller parts so your body can use it more easily. Usually, digestive enzymes are produced in different parts of the body, like the mouth (where digestion begins), stomach, pancreas, and small intestine. These digestive enzymes are "endogenous" (made in the body). Sometimes the body doesn't make enough of these endogenous enzymes or can't use them properly. In this case, people would take digestive enzymes to replace them. The following are examples of digestive enzymes. Show
Digestive enzymes that break down carbohydrates (and where they're found):
A digestive enzyme that breaks down fat: Lipase (pancreas). Digestive enzymes that break down proteins:
A digestive enzyme that breaks down multiple nutrients: Elastase (pancreas) helps digest carbohydrates, fats, and proteins. Oral digestive enzyme supplements made from plants:
This is not an exhaustive list of endogenous digestive enzymes and/or available over-the-counter (OTC) products. Some people can't produce or use digestive enzymes effectively. A healthcare provider will likely prescribe prescription enzyme replacement therapy (ERT) for these conditions. However, this article will focus on major OTC digestive enzyme supplements, not prescription enzyme replacement therapy products (ex., pancreatic enzyme replacement therapy (PERT)). OTC enzymes have been studied in people with autism, arthritis pain, celiac disease, Crohn's disease, irritable bowel syndrome, muscle soreness, and more. It's important to discuss any digestive symptoms with your
healthcare provider. OTC digestive enzymes are not meant to treat life-threatening medical conditions. Dietary supplements are not regulated in the United States, meaning the FDA does not approve them for safety and effectiveness before products are marketed. Choose a supplement tested by a trusted third party, such as USP, ConsumerLabs, or NSF, when possible. However, even if supplements are third-party tested, that doesn't mean they are safe for all or effective in general. You must talk to your healthcare provider about any supplements you plan to take and check in about any potential interactions with other supplements or medications. Supplement Facts
Uses of Digestive EnzymesSupplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian nutritionist, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease. Digestive enzymes help break down the food you eat so your body can get the most nutrients. When this process is disrupted, you may experience discomfort (ex., bloating, gas). In more severe conditions where digestive enzymes aren’t produced or used efficiently, your body could become malnourished as it can’t use nutrients from your food as well. Over time, this can cause issues like osteoporosis. 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). Over-the-counter (OTC) supplements may be used in other conditions (lactose intolerance, trouble breaking down carbohydrates in beans). OTC digestive enzyme supplements have been studied for use in inflammatory bowel disease (Crohn’s, ulcerative colitis), irritable bowel syndrome (with FODMAP intolerance), lactose intolerance (due to aging, premature digestive systems in babies, injury, or disease like celiac), trouble digesting carbohydrates, and more. This article covers these conditions. Be sure to discuss your symptoms and use of digestive enzymes with your healthcare provider. Digestive Symptoms in AutismEating a balanced diet is a part of an overall approach to health. However, eating a wide variety of foods can be challenging for some people with autism spectrum disorder (ASD). People with ASD may have special dietary needs, including help slowly introducing foods that otherwise may cause them to experience sensory overwhelm (issues with integrating the mouth-feel, taste, or smell of a food) or even digestive upset, which may cause rejection of certain foods. If you or a loved one are having issues or concerns in the area of eating and ASD, or you find yourself needing support, consider speaking with your or your child's healthcare provider about working with a food therapy specialist (ex., an occupational therapist or a registered dietitian nutritionist with food therapy training). Note: digestive enzymes are not a cure for autism. Please discuss digestive enzymes with your child's healthcare provider before using them. Reports suggest anywhere from nine to 70% of people with autism spectrum disorders (ASD) experience gastrointestinal problems. Abdominal discomfort, gassiness, loose stools, or constipation (which may contribute to limiting food variety) have been reported. Some studies have suggested enzyme deficiencies - in lactase, maltase, sucrase, alatinase, and glucoamylase - may contribute to digestive discomfort, which may, in turn, contribute to big feelings and behaviors that seem challenging. These behaviors are trying to communicate something important. One study of 199 adults and children (ages 33 months to 28 years) with ASD looked at digestive enzyme activity, specifically lactase, maltase, and sucrase. The researchers suggested that boys under five years with ASD were more likely to have lactase deficiency than girls with ASD. Other digestive enzyme deficiencies they noted were sucrase and maltase. Only 6% of the participants had small intestine (duodenum) inflammation. An investigation of different ways to support digestive health in children with ASD has been suggested. However, research on using digestive enzymes (or any supplements) for gut issues in children with ASD is mixed. In one placebo-controlled study with 92 children (three to nine years) with ASD, 47 were given digestive enzymes (Neo-Digestin; papain 0.08 grams and pepsin 0.04 grams per 5 milliliters solution) three times daily (for a total of papain 0.24 grams and pepsin 0.12 grams per 15 milliliters solution per day) before meals for three months.The children who took enzymes had improvements in emotional response and general behavior. They also had improvements in the following:
In a study of 29 children with ASD, a combination supplement with caso-glutenase 10,000 AU; bromelain 230 BTU; acid-fast protease 100 SAPU; lactase 330 LacU; phytase 125 U; and galactose 100 milligrams was taken with each meal for twelve weeks.Guardians, parents, teachers, or therapists evaluated thirteen health and behavior parameters. Socialization and hyperactivity improved by 90% and 80%, respectively. Stimming and speech improved the least. However, several other studies using a different enzyme combination have not found similar effects. More research is needed. Talk to your child's healthcare provider (ex., pediatrician) before giving them digestive enzymes. Cancer Treatment ComplicationsA review showed mixed results for using digestive enzymes to treat complications from cancer or cancer treatment. While some studies suggested OTC enzymes improved the quality of life for people with colorectal cancer or increased survival in people with multiple myeloma also receiving standard treatment, other studies reported conflicting results. More research is needed. Talk to your healthcare provider before taking any supplements or over-the-counter medications due to possible interactions, especially during cancer treatment. Celiac DiseaseEnzymes have been studied for celiac disease (an autoimmune disease). A review highlighted studies using gluten-degrading enzymes like cysteine proteases, prolyl endopeptidases, and subtilisin. Some of these enzymes are being studied for drug development.However, the review suggests that gluten-degrading enzymes could potentially increase or decrease the body’s immune response to gluten, potentially worsening symptoms. Other studies using other enzymes for celiac were inconclusive. Enzymes alone should not be used to manage or treat celiac disease. Follow the guidance of your healthcare provider (ex., registered dietitian nutritionist, gastroenterologist) and your body. Fermentable Carbohydrate Digestion Some people have trouble digesting specific carbohydrates in beans. Studies have suggested an alpha-galactosidase
supplement (ex., Beano) reduced gastrointestinal symptoms (ex., abdominal discomfort, bloating). Functional DyspepsiaResearchers conducted a randomized, double-blind, placebo-controlled study of 40 individuals (32 people assigned female at birth, eight assigned male at birth) with symptoms of functional dyspepsia (including indigestion). Fifty milligrams of a combination enzyme product (α-amylase, protease, cellulase, lactase, and lipase) were used twice daily for 60 days. The researchers reported that the treatment reduced indigestion symptoms compared to the placebo. Of note, the study's authors were founders or employees of the company that manufactured and marketed the enzyme product used in this study. This could introduce bias in study results and needs to be considered when interpreting the findings. Further study is required to confirm any of these results. Inflammatory Bowel DiseaseInflammatory bowel disease (IBD) includes ulcerative colitis (bowel disease) and Crohn’s disease (inflammation anywhere in the digestive tract, even the mouth). The use of digestive enzymes has been suggested as a potential treatment option for IBD, although conflicting evidence exists. It’s also been suggested that people with IBD may not make enough lactase or use it effectively, leading to dairy intolerance. A few case studies in humans suggested bromelain may help symptoms in people with colitis. Digestive enzymes have also been studied for IBD-IBS syndrome. IBD-IBS syndrome is an inflammatory bowel disease (IBD) with irritable bowel syndrome (IBS) symptoms, such as abdominal pain and diarrhea. In a study, people with IBD-IBS (including those with Crohn’s disease or ulcerative colitis) were given Asacol (an anti-inflammatory drug) with Biointol (a combination product with digestive enzymes, inositol, and beta-glucan) for four weeks. The control group received Asacol only. After four weeks, those who received Asacol and Biointol said they had less abdominal pain. They also said they had less bloating and flatulence. Those who took only Asacol slightly improved fecal urgency (sudden need to have a bowel movement). While these effects may seem promising, more studies are needed to confirm the results. Irritable Bowel Syndrome (IBS)Digestive enzymes have been studied in people with irritable bowel syndrome (IBS). One study discussed in a review used Essential Enzymes 500 (Source Naturals, Scotts Valley, CA, USA), a combination product containing protease (4375 USP units), lipase (375 USP units), a-amylase (2614 USP units), as well as amyloglucosidase, cellulase, hemicellulase, and lactase in people with diarrhea associated with IBS. Of the 86 people in follow-up (the people that finished the study), 71 (82.5%) experienced improved or eliminated IBS-D symptoms. It’s important to note that this study used a combination product. It would be challenging to understand which ingredients were most effective over time. Further studies are needed to confirm these results. Lactose Malabsorption and IntolerancePeople who have trouble digesting dairy (ex., lactose malabsorption, lactose intolerance) may take OTC digestive enzymes like lactase. Lactase digests lactose. Lactose is the primary sugar in milk and other dairy products (ex., buttermilk, condensed and evaporated milk, yogurt, ice cream, and cheese). Lactase supplements can help prevent indigestion in people who have trouble digesting lactose. Secondary lactose intolerance can arise in people with IBD (Crohn’s, ulcerative colitis) and other diseases like celiac. This is due to potential intestinal damage and, thus, decreased lactase production in the body. Lactase malabsorption and intolerance must be addressed to prevent diseases like osteoporosis. Speak with your healthcare provider if you have any questions or concerns. Muscle SorenessStudies have also looked into OTC enzymes as a treatment for sore muscles. In a placebo-controlled study, 20 men were given protease (breaks down proteins) supplements containing 325 milligrams of pancreatic enzymes, 75 milligrams of trypsin, 50 milligrams of papain, 50 milligrams of bromelain, 10 milligrams of amylase, 10 milligrams of lipase, 10 milligrams of lysozyme, and two milligrams of chymotrypsin. The supplement reduced pain in men after intense downhill running. A study using a different product (300 milligrams of bromelain, twice daily) on another area of the body showed no difference in elbow pain soreness after exercise between the bromelain group, 400 milligrams of Advil (ibuprofen) twice daily, placebo, and control groups. These studies are small and not enough to make a firm recommendation for digestive enzymes for muscle soreness. Further study is
needed. OsteoarthritisResearchers have studied the effects of bromelain on osteoarthritis (OA) pain. It's been suggested that bromelain works by reducing inflammation. A review of studies on supplements in OA found evidence that bromelain may ease OA pain. The authors noted, however, that many of the studies had a suboptimal design, meaning the study designs weren't great, so they may not necessarily capture useful information. Another study of 150 people with moderate-to-severe knee OA compared Voltaren (diclofenac) with Wobenzym. Voltaren is a prescription non-steroidal anti-inflammatory (NSAID) pain reliever. In the suggested daily dose, Wobenzym contains milligrams of trypsin (an enzyme derived from pig or cow pancreas that breaks down proteins), 540 milligrams of bromelain (from pineapple), and 600 milligrams of rutoside trihydrate (rutin, an antioxidant derived from the Japanese pagoda tree, Sophora japonica). After 12 weeks, people taking Wobenzym had less joint pain and improved knee function (walking ability and knee flexibility) compared to the NSAID group. The effects of the individual enzymes on arthritis are unclear. A study with a similar supplement suggested only minor improvements in pain. Based on the current research, it's challenging to know how effectively individual enzymes may improve OA symptoms, especially when using combination products that contain more than just enzymes. Larger, high-quality studies are needed before these results can be confirmed. Digestive Enzyme DeficiencyIn the body, most digestive enzymes are made by the pancreas, small intestine, and mouth (saliva). These are called endogenous digestive enzymes. These enzymes help your body break down fats, proteins, and carbohydrates from food. When your body doesn't make enough enzymes, it can't break down food as easily. That means it cannot absorb the nutrients from those foods easily. This can cause malabsorption. Malabsorption can lead to nutritional deficiencies and uncomfortable symptoms, like:
What Causes a Digestive Enzyme Deficiency?Diseases that cause digestive enzyme insufficiency include but are not limited to:
These conditions may require prescription enzyme replacement therapy (ERT). Prescription products are different from over-the-counter products. Other conditions that may cause inefficient
production or use of digestive enzymes include:
How Do I Know If I Have a Digestive Enzyme Deficiency?Your healthcare provider will diagnose a digestive enzyme deficiency and can determine whether you need a prescription product or if an over-the-counter product will suffice. Symptoms of enzyme deficiency may include:
Keep track of when you
experience these symptoms and the foods you consume before experiencing symptoms. Consult your healthcare provider if you experience any of these symptoms. What Are the Side Effects of Digestive Enzymes?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 for all digestive enzyme supplements, particularly 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 EffectsCommon side effects of digestive enzyme oral supplementation are primarily gastrointestinal upset, such as:
Side effects, when applied to the skin, include:
Severe Side EffectsSevere side effects of digestive enzymes are rare. Each supplement can have different effects. Severe side effects include but aren't limited to:
PrecautionsSome digestive enzyme products are derived from animals (ex., cattle, pigs). If you’re following a specific diet that avoids animal products, please be aware of the origin of your enzymes. Avoid use if allergic to any ingredient in your supplement (ex., ingredients in fruit latex). Ask your pharmacist or review the product label for a complete list of ingredients. Use caution when using bromelain if you take blood thinners. If you take blood thinners or have low platelets, using bromelain may increase your risk of bleeding. If pregnant or breastfeeding, consult a healthcare provider before taking digestive
enzymes.  Dosage: How Much Digestive Enzymes Should I Take?Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs. 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. Look for supplements certified by a third party if purchasing in a store. What Happens If I Take Too Much Digestive Enzymes?A standard dose for over-the-counter digestive enzyme supplements is lacking. Follow the instructions on your supplement package. Consult with your healthcare provider for further guidance. In rare cases, an excess amount of digestive enzyme supplement has resulted in esophageal perforation (torn esophagus). InteractionsDigestive enzyme supplements may interact with blood-thinning medicines like:
Digestive enzymes, specifically bromelain, may interact with other supplements with blood-thinning effects. These include:
Bromelain may impact absorption and the body's use of medications such as:
Papain may impact how the body absorbs amiodarone, levothyroxine, antidiabetes medications, and warfarin. It is essential to carefully read a supplement's ingredient list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications. How to Store Digestive Enzymes Store digestive enzymes in a cool, dry place. Keep digestive enzymes away from direct sunlight. Follow the manufacturer’s guidance on your digestive enzyme packaging. Similar SupplementsSelect foods contain digestive enzymes, like pineapple and papaya. Pineapple contains bromelain, and papaya contains papain. Papain is a proteolytic enzyme found in papaya and is believed to aid digestive issues. However, eating papaya has the same benefits as taking papain as an oral supplement. While
probiotics and prebiotics are used for digestion, they have different mechanisms of action (they work differently) than
digestive enzymes. Frequently Asked Questions
Sources of Digestive Enzymes & What To Look For Digestive enzymes are typically found
naturally in the body. They are also sold as supplements and are found in foods like pineapple and papaya. Food SourcesThe digestive enzyme bromelain can be found in the core and stem of the pineapple. Papain can be found in papaya. While digestive enzymes exist in these plants, it’s unclear whether you’ll get extra digestive enzymes by eating the fruit of these plants. Some food products also contain enzymes, like Lactaid milk which contains lactase. Supplements Digestive enzymes are widely available online and in stores. They
typically come in capsule form. They may have different amounts of enzymes and sometimes may contain other ingredients like prebiotics or probiotics. Speak with your healthcare provider before using digestive enzymes, particularly if you’re having trouble with digestion. Summary Digestive enzymes have been studied for several health conditions, like IBS, IBD, 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 serious conditions, be sure to discuss your symptoms and concerns with your healthcare provider. What is the relationship between vitamins and enzymes?Vitamins (organic molecule to maintain the function of the body) made organic cofactor to help the functioning of enzymes (their activation). As coenzymes are organic molecules, they are made up of vitamins and inorganic substances are made from minerals. Enzyme cofactor is important for the activity of the enzymes.
What enzyme absorbs vitamins?Vitamins are used in their original form by the cells. They do not require digestion. They are either water soluble or fat soluble, hence no enzyme is required to digest vitamins.
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