Enzyme Supplements: Do You Need Them?

January 11, 2017   /

Digestive enzymes are proteins that are used in the digestion of carbohydrates, fats, proteins, and alcohol. Specific enzymes have different roles within the body. Pepsin and trypsin work on proteins, amylase on carbohydrates, and lipase on fats.

Metabolic enzymes are found in every cell of the body and are involved in a multitude of chemical reactions. Some enzymes are antioxidants. Food enzymes are found in uncooked nuts, vegetables, and fruit. Raw-food advocates believe that these food enzymes allow the body to preserve its digestive enzymes for other jobs, such as detoxification.

Enzymes are used as supplements with increasing frequency. They are advertised to aid in digestive problems, to improve immunity, and to decrease inflammation. These supplements might originate from animals or plants. The enzymes trypsin and chymotrypsin are extracted from animal pancreases while papain is obtained from papaya and bromelain originates in pineapple.

Phlogenzym (consists of bromelain, trypsin and the antioxidant rutosid) may have anti-inflammatory and analgesic properties and may benefit people with osteoarthritis. Bromelain reduces inflammation and swelling, and may help people suffering from sinusitis when used with other appropriate therapies, such as antibiotics.

Because enzymes are proteins, they are broken down and digested in the stomach or intestines, so some are enteric-coated. Still, no proof exists to show that these enzymes will survive long enough to get into the bloodstream. No high-quality, well-designed studies prove that these enzymes work in humans. Many medical experts have pointed out that if a person truly needs an enzyme supplement, they likely have a chronic medical condition and are under the care of a physician.  Overt digestive enzyme deficiencies are rare and most likely occur in malnourished, ill people.  

Other health practitioners note that although no hard evidence exists to confirm that these supplements are beneficial, they have seen improvement in their patients. However, they warn not to use supplements until after other potential causes for patient symptoms, such as celiac disease or small intestinal bacterial overgrowth, are ruled out.

Digestive enzyme therapy often is prescribed for pancreatic disease, chronic inflammatory bowel disease, or cystic fibrosis. Lactase is an enzyme used by people with lactose intolerance to help them digest foods that contain the sugar lactose. Beano® and similar products contain an enzyme, alpha-galactosidase, which breaks down some of complex sugars in food so that they do not ferment and cause gas and indigestion.

People with fungal allergies should use some of these enzyme supplements with caution, because the enzymes are made in fungi. It is believed that proteolytic enzymes are safe, and digestive enzymes rarely cause side effects. Occasionally, people using enzyme supplements have reported gastrointestinal distress and/or diarrhea.

Bromelain has possible cross-reactivity and may result in allergic symptoms among individuals who are sensitive to wheat, celery, papain, carrot, fennel, cypress pollen, grass pollen, ragweed, chrysanthemums, marigolds, daisies, and echinacea.  If you are on blood thinners, you should not take bromelain or papain before talking to your doctor, because they may enhance the effects of your medication. Some research has shown that bromelain might increase the absorption of some antibiotics, including amoxicillin and tetracycline.

Digestive enzymes might enhance absorption of sedatives. Pancreatin might interfere with folate absorption.


References and recommended readings
Boncompagni T. Enzymes try to grab the spotlight. The New York Times Web site. Published February 22, 2012. Accessed January 8, 2014.

Digestive enzymes. Cleveland Clinic Wellness Web site. Accessed January 14, 2014.

Freuman TD. Digestive enzymes: help or hype. U.S. News & World Report Web site. Published April 23, 2013. Accessed January 8, 2014.

Johannes L. Can enzymes make the meal? The Wall Street Journal Web site. Published April 1, 2013. Accessed January 8, 2014.

University of California Berkley, School of Public Health. Enzyme supplements: yea or nay? Berkley Wellness Web site. Accessed January 8, 2014.


Contributed by Elaine Koontz, RD, LD/N