Preventing Digestive Enzymes Side Effects

If you’re someone who struggles with digestive issues, such as acid reflux, irritable bowel syndrome, inflammatory bowel disease or nutrient malabsorption (a common problem among elderly adults), then digestive enzymes may be one of many dietary supplements that can help offer you relief. Many raw fruits and vegetables, such as pineapple and papaya, plus some types of fungus and animals contain enzymes that aid in their digestion. When we take these enzymes in supplement form we can benefit by more easily absorbing nutrients from our diets. That’s one of the beneficial side effects of digestive enzymes, but there are also other digestive enzymes side effects that can negatively impact health.

An increasing number of people take digestive enzymes today, especially those with certain health conditions. This includes gastrointestinal diseases, such as ulcerative colitis or Crohn’s, hypochlorhydria (having too little stomach acid), or pancreatic insufficiency (too little pancreatic enzymes). While they’re normally safe and beneficial supplements to take, it’s still possible for digestive enzymes side effects to affect certain people, including those taking medications that can potentially interact with digestive enzymes.

Digestive enzymes side effects - Dr. Axe

Why You Need to Digest Enzymes

“Digestive enzymes” is a broad term that includes pancreatic enzymes, plant-derived enzymes and fungal-derived enzymes. Digestive enzymes may be able to help alleviate gastrointestinal (GI) issues by helping properly break down the foods you eat.

What exactly do digestive enzymes do? They help turn larger molecules founds in foods (carbs, protein and fats) into more easily absorbed particles (such as amino acids, fatty acids, cholesterol, simple sugars and nucleic acids) that the body can actually use to function and for energy. In the human body, specific digestive enzymes are made to help facilitate absorption of different types of foods. Digestive enzymes are split into three classes: lipases that are needed to digest fat, proteolytic enzymes that are needed to digest protein and amylases needed to digest carbohydrates.

Digestive enzymes benefits include:

  • Helping lower risk for nutrient malabsorption. This can occur due to low stomach acid or a lack of digestive enzymes/enzyme insufficiency and is more likely to affect the elderly.
  • Reducing symptoms of acid reflux and irritable bowel syndrome (IBS).
  • Managing digestive symptoms like bloating, gas, abdominal pain, diarrhea and fatigue.
  • Helping treat leaky gut by taking stress off the gastrointestinal tract.
  • Preventing symptoms of food intolerances, such as by breaking down difficult-to-digest protein and sugars like gluten, casein and lactose.
  • Counteracting enzyme inhibitors that block nutrients from being absorbed. These are naturally found in foods like peanuts, wheat germ, egg whites, nuts, seeds, beans and potatoes.
  • Potentially helping manage symptoms tied to liver disease, pancreatic cancer, pancreatic insufficiency and cystic fibrosis.

Digestive Enzymes Side Effects

Is it safe to take digestive enzymes? In most cases, yes, however digestive enzymes side effects can affect some people. It’s generally believed that unless someone has digestion concerns and is experiencing unwanted symptoms, taking enzymes is simply not needed since the body should produce adequate amounts on its own.

That said, most people tolerate digestive enzymes well — however you’re more likely to deal with digestive enzyme side effects if you take a high dose and ignore dosage recommendations.

Side effects of taking digestive enzymes can include:

  • Upset stomach, stomach pains and cramping
  • Diarrhea
  • Nausea
  • Gas and bloating
  • Headache
  • Swelling
  • Dizziness
  • Changes in blood sugar
  • Allergic reactions
  • Changes in bowel movements/abnormal feces

Signs that you might be experiencing an allergic reaction to ingredients in a digestive enzyme supplement include:

  • Difficulty breathing or talking or wheezing
  • Swelling of the mouth, face, lips, tongue or throat
  • Chest tightness
  • Skin rash and itching
  • Red, swollen, blistered or peeling skin

Digestive Enzymes Drug Interactions

If you currently take medications or have a chronic health problem, be sure to visit a health practitioner for help with customized enzyme therapy before supplementing on your own. Depending on the drugs you take, your symptoms and medical history, your doctor can determine which are the safest and best digestive enzymes for you to take. You can also ask your pharmacist about any possible interactions that might occur.

If you have a history of liver or gallbladder disease, or stomach ulcers, then you definitely want to consult a physician before taking digestive enzyme supplements.

Digestive enzymes generally don’t pose the risk for severe interactions with other drugs. However, some interactions of digestive enzymes may be possible, including with the drugs Warfarin, miglitol and acarbose. Warfarin is an anticoagulant drug that inhibits the clotting of blood/the formation of blood clots. Acarbose (Precose) and miglitol (Glyset) are alpha-glucosidase inhibitors (oral anti-diabetes medications). It’s possible that taking these drugs with digestive enzymes may reduce the activity of the medications or enzymes.

In most cases, digestive enzymes do not interact with antibiotics, so both can be taken if necessary.

Pregnant women can usually take digestive enzymes safely, but there hasn’t been much research showing how digestive enzyme supplements affect breastfeeding.

How to Avoid Digestive Enzymes Side Effects

What are the best digestive enzymes to take?

Digestive enzymes are not one-size-fits-all. The best digestive enzymes to take depends on the person, since enzymes are nutrient-specific and help with absorption of different foods. For general digestive health, it’s a good idea to take a full-spectrum enzyme blend that includes a variety of different enzymes.

Based on your reason for taking digestive enzymes, here are some helpful tips:

  • Most products contain some level of pancreatin, which is a combination of all three pancreatic enzymes.
  • If you have gallbladder issues, purchase digestive enzymes with more lipase and bile salts.
  • Where you see betaine HCL listed as a product ingredient, make sure pepsin is also included.
  • Purchase a supplement with lactase if you have issues relating to sugar absorption from dairy products.
  • Consider a supplement that contains protease, which helps with protein digestion, if you have an autoimmune or inflammatory condition.
  • Look for delayed release capsules that are enteric coated to help prevent the enzymes from breaking down in the stomach.

Remember that proteins, sugars, starches and fats all require specific types of enzymes, so taking a supplement that covers all bases may be most helpful, unless only a specific enzyme is needed.

You may also want to choose a blend with herbs, such as peppermint and ginger, that also support digestion. To avoid consuming potentially harmful impurities and additives that are found in some supplements, be sure to purchase from a reputable brand and/or check with your pharmacist or doctor for recommendations.

What dose of digestive enzymes should you take?

Dosage depends on the specific product being taken. For example, prescription digestive enzymes are normally taken in different amounts than over-the-counter enzymes. Always read product labels carefully, since taking a high dose of enzymes can cause side effects. Some people need more pancreatic enzymes than others, so bear in mind the level of each enzyme may need to be altered depending on your needs.

Keep in mind that certain foods (especially those that are raw/fermented) can help provide you with natural digestive enzymes. Try including these foods that supply enzymes in your diet, ideally in raw/uncooked form: pineapple, papaya, kiwi, kefir, yogurt, bananas, mango, miso, soy sauce and tempeh (fermented soy products), sauerkraut, kimchi, avocado, bee pollen, apple cider vinegar, and raw honey.

When should you take digestive enzymes?

For the best results and least risk for experiencing side effects, take digestive enzymes about 10 minutes before each meal or with your first bite of food. Protease supplements can be taken in between meals in addition to digestive enzymes with meals. Start by taking a low dose of enzymes, such as having them with one or two meals per day, and increasing/adjusting your dosage as needed depending on your reaction.

Take digestive enzymes separately from calcium- or magnesium-containing antacids, since taking these together might reduce their effectiveness.

Can you take probiotics and digestive enzymes at the same time?

You can certainly include both probiotics and digestive enzyme supplements in your diet to boost digestive health. Some products contain both probiotics and digestive enzymes. If taking them separately, take enzymes before a meal and probiotics after or between. It’s also beneficial to get probiotics from fermented foods like yogurt, kefir, kimchi or sauerkraut. Probiotics can help restore balance to the gut microbiome and further aid in digestion, while also curbing symptoms like gas and bloating.

Final Thoughts on Digestive Enzymes Side Effects

If you’re concerned about digestive enzymes side effects or interactions, the best thing to do is to talk to your health care provider. Make sure any medications you take do not pose the risk for interacting with digestive enzymes. Talk to your doctor about any other potential reasons why you shouldn’t take digestive enzymes, plus ways that you can monitor your progress and determine if the enzymes you take are benefiting you (for example, you can track whether certain symptoms are improving).

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