Digestive Enzyme Supplements: Who Needs Them and Who Doesn't

Digestive enzyme capsules promise to ease bloating, gas, heartburn and that heavy feeling after meals. Blends often combine several enzymes in one pill. Here is what a Johns Hopkins dietitian says about who benefits and who’s better off skipping them.

What the enzymes do

Your body makes its own digestive enzymes. Amylase breaks down starches, lipase breaks down fats and protease breaks down proteins. Lactase, made in the small intestine, breaks down the milk sugar lactose.¹

Most healthy people don’t need a blend

Johns Hopkins notes that over-the-counter enzyme supplements aren’t regulated by the FDA, so the dose, ingredients and enzyme concentration aren’t guaranteed, and side effects aren’t known. Some make unsupported claims such as weight loss or a flatter stomach. In the dietitian’s words, a healthy person generally doesn’t need them.¹ Cleveland Clinic² adds that the purity and strength of supplement enzymes can vary.²

There’s also no definitive evidence that enzymes help irritable bowel syndrome, and no good evidence that enzyme-rich foods like pineapple or avocado aid digestion.¹

Two enzymes with a specific job

• Lactase helps if you’re lactose intolerant and eat dairy.¹ Our article on dairy, bloating and gas explains how to tell.
• Alpha-galactosidase is an enzyme your body doesn’t make. It helps break down a fiber found mostly in beans and some root vegetables that can cause gas and bloating in some people.¹

If one of these matches your problem, a single-enzyme product makes more sense than a blend.

When enzymes are a medical need

Some people don’t make enough enzymes, such as those with exocrine pancreatic insufficiency, where the pancreas doesn’t produce enough to digest food.¹ That condition needs diagnosis and prescription enzyme treatment, not a store-bought blend. Our article on prescription pancreatic enzymes covers how they’re taken.

Johns Hopkins lists symptoms of enzyme shortfalls: belly pain or cramps, bloating, diarrhea, gas, oily stools and unexplained weight loss. If these persist, talk to your doctor.¹

Before you buy

1. Name your symptom and match it to a specific enzyme, if any.
2. Read the label for each enzyme and its amount.
3. Try it for a short, set period and track symptoms.
4. See a clinician for oily stools, weight loss or symptoms that don’t improve.

Try: “I’ve been taking an enzyme supplement for bloating after meals, but it hasn’t helped. Could this be lactose intolerance, a pancreas problem or something else we should test?”

Bloated by Dinner includes a Belly Clock log and a Test-It list with a visit script. Use them to record meals, symptoms and what you tried, so your clinician can see the pattern. See the book.