Digestive Enzymes

Everything You Ever Wanted to Know about Digestive Enzymes

Digestive enzymes. We’re betting you’ve heard of them, have a vague idea that they’re good, and wonder if you should be taking them. But this is one area where we also see a lot of confusion. Supplementation of any sort without knowing what or why you’re doing what you’re doing can be just as detrimental to your health as doing nothing at all. So before you stock up on papain and bromelaine, let’s get the complete low-down on all things digestive enzymes from today’s guest expert, Dr. Tim Gerstmar of Aspire Natural Health.

What are digestive enzymes, and why are they so important?

We eat food, but our digestive system doesn’t absorb food, it absorbs nutrients.  Food has to be broken down from things like steak and broccoli into its nutrient pieces: amino acids (from proteins), fatty acids and cholesterol (from fats), and simple sugars (from carbohydrates), as well as vitamins, minerals, and a variety of other plant and animal compounds. Digestive enzymes, primarily produced* in the pancreas and small intestine, break down our food into nutrients so that our bodies can absorb them.

*They’re also made in saliva glands and stomach, but we’re not going to focus on those here.

If we don’t have enough digestive enzymes, we can’t break down our food—which means even though we’re eating well, we aren’t absorbing all that good nutrition.

What would cause digestive enzymes to stop working correctly in the body?

First, diseases may prevent proper digestive enzyme production.

  • Pancreatic problems, including cystic fibrosis, pancreatic cancer, and acute or chronic pancreatitis.
  • Brush border dysfunction, the most severe is long standing Celiac disease, where the brush border is flattened or destroyed. Other diseases like Crohn’s can also cause severe problems.

But even in the absence of any obvious disease, things still may not be working properly.

  • Low-grade inflammation in the digestive tract (such as that caused by “food allergies,” intestinal permeability, dysbiosis, parasitic infection, etc.) can lead to deficiencies in digestive enzymes.
  • Aging has been associated with decreased digestive function, though I personally wonder if this is a result of aging, or aging badly.
  • Low stomach acid—we’ll talk about this more in a future article, but if you have low stomach acid, it’s likely that you won’t have adequate digestive enzymes either.
  • Chronic stress. This is the most common reason for digestive enzyme problems. Our body has two modes: sympathetic “fight or flight,” and parasympathetic “rest and digest.” When we’re in “fight or flight” mode, digestive is given a very low priority, which means digestive function (including digestive enzyme output) is dialed down.  Chronic stress= constant “fight of flight” mode = impaired digestive enzyme output.

How do we correct a digestive enzyme deficiency?

First, a Whole30 or a Paleo-style diet can help to restore normal digestive function, including digestive enzymes.  Dietary interventions work by reducing inflammation in the body and the digestive tract, improving nutrient deficiencies, removing enzyme inhibitors by taking out things like grains and legumes, and fixing gut bacteria.

However, just because you eat Good Food doesn’t automatically mean your digestion will be healthy. In my previous article, I talked about gut bacteria, which may not be in perfect balance with a Paleo diet alone. Improper digestion is another issue that diet alone may not solve.

Managing chronic stress is vitally important to restoring healthy digestive function. Most of us are cramming food in our faces at our desks or while we’re on the go, then we’re off to do the next thing on our list. We live most of our lives in sympathetic mode—and aren’t giving a high priority to properly digesting our food. When we sit down to eat food, we should switch into a parasympathetic mode, and ideally stay in parasympathetic mode for a while afterwards. Think long European meals, followed by a siesta. (Refer to pages 182-185 in It Starts With Food for more specifics.)

Finally, after implementing these healthy dietary and lifestyle practices, digestive enzyme supplementation may be necessary to help your body properly break down your food.

How do I know if I should be taking digestive enzyme supplements?

The best way to know is by stool testing, to measure how well you’re digesting and how well your pancreas is producing digestive enzymes. Many traditional medical doctors are unlikely to run these tests, and they may not be covered by insurance. If you’d like to run one of these tests, seek out a qualified alternative provider who you trust.

Other symptoms that suggest you might have problems with digestive enzymes are:

  • Gas and bloating after meals
  • The sensation that you have food sitting in your stomach (a rock in your gut)
  • Feeling full after eating a few bites of food
  • Undigested food in your stool*
  • Floating stools (an occasional floating piece is fine, but if all your poop consistently floats, that might be a sign something is wrong)
  • An “oil slick” in the toilet bowl (undigested fat)

The good news is that since digestive enzymes are very safe and reasonably cheap, you can always try them and see if you notice any difference in your digestion.

*If you’re serious about your health, I encourage you to periodically look at your poop—it’s one of the simplest ways you can gain insight into your health. Take a glance a few times a week. If there’s a significant change, have a talk with your doctor; it could be a sign of something going on.

What kinds of digestive enzyme should I take?

There are a variety of digestive enzymes on the market, including single enzyme and multiple enzyme. Without testing, I typically recommend a mixed enzyme to cover your bases.

As with all supplements, you’re looking for brands that meet the following criteria:

  • Quality/Price: Buying cheap supplements is almost always a waste of money—you’re almost never going to get the benefit you’re looking for.  When buying enzymes, don’t look for the cheapest brand on the shelf, and steer clear of conventional grocery stores and drug stores, as they carry poor quality product.
  • Reputation: There are about a zillion companies selling supplements right now, and I don’t pretend to know all of them. Two over-the-shelf companies are Jarrow and NOW Foods. A couple of ‘doctor’ grade companies that you can get over the Internet are Thorne and Klaire labs.  These companies have good reputations, and I’ve seen patients have good luck with their products.
  • Source: There are three major sourcing for digestive enzymes. Fruit sourced (isolated from papaya or pineapple) work well for some people, but tend to be the weakest digestive enzyme supplement, and aren’t sufficient for people who need more support. Animal sourced (typically listed as pancreatin) are  not for vegetarians or vegans, and can have issues with stability. They work really well for some people, but typically are not the forms I’m using. “Plant” sourced (from fungus) are the most stable of all the enzymes, survive digestion well, and have a broad spectrum of action. These are the ones I most commonly use.
  • Multiple enzymes: Most people are going to benefit from a multi-enzyme product, so you’ll want to see a number of enzymes listed, including proteases (which break down proteins), lipases (which break down fats), and carbohydrases (such as amylase, which break down carbohydrates). Look at the labels of the products linked above for specifics—there are a ton of enzymes, but your product should include at least some from these labels.
  • Strength/potency listed: Enzymes are rated on various scales (which are too complicated to go into here), but you want to see numbers beside each enzyme showing their strength. If it’s just a proprietary formula without strengths listed, be cautious—it usually means a weak product.
  • Ingredients: As with all supplements, you want to see all the ingredients listed. And you especially want to see what ingredients are not in the product like gluten, dairy, etc. If it doesn’t say “contains no:  sugar, salt, wheat, gluten, soy, milk, egg, shellfish or preservatives,” you need to assume that it does. (The above-referenced NOW Foods enzyme is a good example.)

When should I take digestive enzyme supplements, and how much should I take?

Take your digestive enzymes with food. Some people make a big deal of timing, but my bottom line is just to get them in around the time you’re eating. Most people find it easiest to pop them just before they sit down to eat, but anytime within about 30 minutes of your meal is going to be beneficial.

If you have a high quality product, most people need 1-2 capsules with their major meals. (Most people don’t need to take any with light meals or snacks unless their digestion is very messed up.) The most I’ve ever had to use with a person was 4 capsules with each meal.

When you’ve found a dose that works well for you, your symptoms should go away—that gas or bloating after meals, the feeling of a stone in the guts, or your messed up poop should get better. If not, try increasing your dose slowly, by one pill per meal, giving it at least a 3 days (and up to a week) to evaluate how things are working.


tim gerstmarDr. Tim Gerstmar is a Seattle-based Naturopath who specializes in treating complex chronic diseases – those issues that leave most other doctors stumped. His area of expertise is in digestive health. He uses clinical nutrition (primarily Paleo, Weston A. Price and GAPS) and lifestyle counseling, botanical medicine (herbs), functional medicine, homeopathy in his practice. You can learn more about Dr. Gerstmar and Aspire Natural Health at http://aspirenaturalhealth.com, or contact him via Facebook (http://facebook.com/AspireNaturalHealth) or Twitter, @DrTimGerstmarND.

Comments

  1. Amy says

    Hi Dr. Tim,
    My 17 year old daughter has been living a nightmare for about a year now. She went off of gluten , corn and diary 3 years ago (gluten was giving her migraines) but still had stomach issues. We had her scoped (endo and colon) and everything looked good. One doc thought she had candida and did the IgG food blood test. She took anti fungal and ate no sugar or the food that showed up as triggers on the IgG test for 3.5 months. No change. This was Dec-Feb and at that time she rated her bloating as a 5 on a scale of 10 (with 10 the worst). As the months went on her bloating got worse and her weight slowly creeped up. We tried the FOD diet – no change. in May we did the MRT testing and she went off of the foods that showed up as trigger foods (rice, potato & fructose). She seemed to have withdrawal symptoms to the removal of rice. The bloating is now between a 5-8. She has gained 20 plus pounds through all of this and that is killing her along with the limited foods!! She is an athlete so she gets a lot of exercise. She has had her thyroid testing and it falls in the normal range (1.250). They did a baseline blood test for endocrinology and only her Triglycerides were high 193. As you can imagine this is extremely stressful for her. She started taking digestives on a regular basis a week ago. She does take a probiotic (Culturelle Probiotic) and just started a few weeks ago. In addition to the above she was treated for SIBO with Rifaximin (strong dose) in July. No change to the bloating but her stomach stopped burning. It used to burn after increased exercise and that would put her in bed for hrs, a day and sometimes longer.

    I am wondering if it will take time to heal the intestines from the food intolerance but what fears her the most is how much weight she will gain and when will it stop. Her weight and food intake have not made sense to me for years but this is really off the charts.

    Any feedback you have is GREATLY appreciated! She is angry, feels trapped in her own body and is tired of feeling like a freak (her description)!!

    Amy

    • Isabelle says

      Hi, i’m brazilian and I have the SAME history of your dagther!!!!! My name is Isabelle, I discovered digestive enzymes recentlly and this is my last hope, i’m very sad, angutied.. I’m not lime that, I just want stop all this things… On my food intolerance test detect banana, egg, sugar, all cheese and milk, gluten, whole, meat, some fish, suin, mango, papaya, beans… Your daughter can eat this things now? She is better?? What is the name of the best digestive enzime that can I buy on the USA? Sorry for the bad English..
      Isabelle

  2. shay says

    Amy,
    You should try naet therapy.many people have had great life-changing results with this therapy which desensitizes the body against allergens. I just started this and it has helped me already after only two treatments.best of luck to you,hope you feel better soon. Look up .n.a.e.t therapy allergy elimination technique

  3. Pamela says

    Hi Dr. Tim,

    What is the maximum time someone can use DGL as suggested in your previous comments? I’ve read some mixed reviews about it. Some say DGL has no side effects, while others say that it can cause many adverse side effects and interactions even after it’s been deglycyrrhizinated. I’ve also read that it has estrogen like effects in the body, and that it should not be used with diuretics or other medications.

    I used it like you suggested, however, I found myself having to keep taking it to help with the irritation in my stomach. For a period of may be two weeks I came down on the dose as I wasn’t having any issues anymore, but now the irritation started again. I was taking 1 enzyme pill and one ginger capsule for digestion and that seems to really help me digest my food, but now, I’m feeling a mild warm feeling in my stomach shortly after, and while its more soothing than anything else, soon after that warm feeling goes away, the irritation begins. I decided to cut down on the ginger to see if it helps, but I am gassy again and it feels like my food just sits there.

    In addition, I am currently taking Nature’s Answer, Pueraria Mirifica, Estro Balance to hopefully help with my acne, regulate my periods, moods, etc. but I’m concerned with the possible interaction in could have with DGL as I am having an aching pain now in my back, specially the lower right, right by my waist. I’m also feeling a little more bloated and like I’m retaining more water or gained weight. Could the estrogen affects of DGL and the Estro Balance be causing this?

    If I should not be taking DGL longer than 6 weeks, well I’ve definitely outdone it, but I don’t know what else to do to cope with the irritation in my stomach and now I’m concerned as to why I keep having this aching pain in my back.

    I appreciate your time and very helpful advice.

  4. says

    Hi Summer,
    Thank you for the comment, I’m sorry it’s taken me so long to get to it. I can’t of course say what’s wrong with your digestion, but it certainly seems from your diligence that the digestive enzyme is helpful (especially because it seems that when you ate without taking it your symptoms returned). The Life Extension brand is just fine, so if it’s working for you, I would continue it.

    With the chronic pain I would consider looking into inflammation in the digestive tract (especially since more “serious” things have pretty much been ruled out by your doctors). You might consider doing an “elimination” diet like the Whole30 or others or have a comprehensive digestive stool analysis done.

    I hope that helps.

    Best,
    Tim Gerstmar, ND

  5. says

    Hi Summer,
    I’m sorry to hear things are still challenging for you. While I can’t diagnose you over the internet, here are a few things I would consider if you came to see me as a patient

    1. If you press on your abdomen does it actually hurt? If so, where?
    2. I would probably run an antibody panel (blood test) for Inflammatory Bowel Disease (Crohn’s and Ulcerative colitis) to make sure that is not an issue for you. Yes the colonoscopy was normal, but damage has to progress to a certain level to be seen on colonoscopy and I have caught early cases of IBD before with antibodies
    3. Food diary – do certain foods lead to pain?
    4. Comprehensive stool analysis – done to evaluate the digestive system. How are your bacteria? Any issues with parasites or yeast? How well are you digesting? Inflammation? Etc.
    5. Has an endoscopy been done to examine the stomach? Is the stomach tender to touch?
    6. I would consider trying some herbal anti-inflammatories such as curumin. Does it help?

    Those are some of the things I would start with. I hope that’s helpful. And if you can’t find help locally I do do phone/Skype calls and would be happy to help if you’re interested.

    Best,
    Tim Gerstmar, ND

  6. says

    Hi Amy,
    I’m sorry to hear about all the trouble you and your daughter have been through. I wish I could offer more concrete advice, but this is a complicated situation and I can’t do it justice over an Internet comment. It sounds like you’ve pursued a lot of sensible treatments and given things a try.

    Just a few comments:
    -Her trigylcerides are high at 193 suggesting she is eating a lot of carbohydrates
    -Weight gain is going to be the result of a combination of lifestyle (diet, exercise, sleep, stress) and hormones. To understand why she is gaining weight you have to look at both factors. Hormones will probably need to be tested
    -Healing the intestines does take time. But the underlying issues need to be identified and removed. If the inflammatory factors remain then it is difficult at best for the intestines to heal

    I’m sorry I can’t offer more help here. Someone really needs to review what you’ve done in detail, what she’s eating + lifestyle, and what tests have been done to get a better idea of what’s going on for her. If you can’t find anyone local to you to do this, I do do phone/Skype calls if that’s something that might interest you.

    Please don’t give up. There is an answer, it’s just not always easy to find.

    My best,
    Dr Tim Gerstmar

  7. says

    Hi Shay,
    Thank you for the comment. I have seen NAET be very helpful for some people and also a complete waste of time and money for others. There is no “scientific” rationale for this therapy that I am aware of, so it’s hard for me to know who to recommend it to and who not to.

    I usually recommend if someone is interested, that they look into the therapy. If it sounds worthwhile to them and there is a “good” practitioner nearby to give it a try. I also recommend people talk with their practitioner and set a limit on the number of sessions to see some improvement. While things are highly variable, most people should see some changes with 5 (?) sessions or so. If they don’t, it may not be worth continuing the treatment.

    Best,
    Dr Tim Gerstmar

  8. moet says

    Can I take digestive enzymes with a probiotic ? Im trying to heal my gut & notsure if I can do both or just one until my gut is healed. Also what do you recommended for healing the gut? I’m currently on day 27 of my whole 30 but still experiencing stomach issues so maybe I need something else besides just a diet change. Thanks

  9. says

    Hi Pamela,
    Licorice is a complex herbal medicine and does seem to have some estrogenic potential, may modify other hormones like cortisol and testosterone and does not seem to affect the metabolism of other drugs. The lowest observed level that has caused problems is 100mg/day of glycyrrhizin which requires someone take quite a bit of the root. Of course properly prepared DGL has had this compound removed, so it is not a problem.

    I think, for the most part, the the estrogenic potential of plants is of minor consequence to people unless they are in a very hormonally precarious place or they care consuming large amounts of phytoestrogens. I personally am much more concerned about xenoestrogens from environmental toxicity but that’s a topic for another day.

    DGL can, in my opinion be taken for a long time without concern. After all the heartburn drugs all were only tested for 6 weeks periods, but are routinely used for years, and I have much more concern of their negative effects. Having said that it’s important to realize that in most cases DGL is not fixing the underlying problem only helping to alleviate symptoms. So while I am comfortable using DGL for long periods of time, my goal is also to discover what the underlying problem is and if at all possible to treat that.

    I hope that helps.

    Best,
    Dr Tim Gerstmar

  10. says

    Hi Moet,
    Yes you can take both at the same time, and i often recommend people do.

    What you need to do to heal the gut, of course, depends on what is going on, but here are a few general recommendations:

    1. Digestive enzymes, Hydochloric acid and/or ox bile – to assist digestion
    2. Anti-inflammatories & immune modulating compounds (herbs, nutrients, drugs)
    3. Anti-microbials – anti-fungals, anti-yeast, anti-parasites
    4. Gut healing nutrients
    5. Gut healing herbal compounds
    6. Probiotics

    I hope that helps.

    Best,
    Dr Tim Gerstmar

  11. moet says

    Thanks for your quick reply. Are you familiar with gastrazyme? Is that considered to be a digestive enzyme? If not should I start with that & then switch to a digestive enzyme?
    Also can you send me your fee schedule for your phone/Skype consultations. My email address is moet131@gmail.com

  12. Maria says

    Hi, I have issues with bloating and stomach distention that gets worse over the course of the day (I’m otherwise healthy and very active). A Low-fodmap diet helps, but does not solve the problem completely. I recently introduced digestive enzymes, hoping that improved digestion would help with the bloating. I’m taking enzymedica digest –started with one a day with dinner and progressed to one with every meal, perhaps too quickly. I haven’t seen any change with the bloating, but my stomach feels slightly uncomfortable when I take the enzymes. I have the impression that they are causing excess acidity, particularly at night. I thought that the worst that could happen with enzymes is that they wouldn’t have any effect. What could be causing my reaction? Thanks!

  13. Rash says

    I had a stomach infection 2 months back. Was prescribed anti-amoeba medication (without testing, just based on a physical examination). Symptoms went away, but returned after a few days.

    Symptoms

    Now I have constant bloating, distension and gas for the last 1.5 months.

    Undigested food seems to be lying in my stomach (A stool test revealed that undigested food is present in my stool too).

    My bowel movements are irregular.

    I have a bad taste in my mouth a lot of times

    I have observed that it gets worse after heavy meals (Also, reduced significantly in the one week that I was eating less).

    I suspected that the medication may have messed up my gut flora, and have been taking probiotic supplements and having fermented foods. However, symptoms persist. I have also been prescribed proton pump inhibitors, but they do not seem to be helping.

    I have eliminated H pylori and low stomach acid as possible causes (stool test and repeated baking soda test).

    Possible other causes (after research)

    Lack of digestive enzymes
    SIBO
    Development of a food intolerance
    leaky gut

    How should I deal with this? Should I get tested? If so for what first? Should I start digestive enzymes

    Please give me some advice because this is messing with my quality of life very significantly and doctors are being generally unhelpful.

    (I am an 18 year old college going male)

    Thank you for your time.

  14. Cindy says

    My daughter has cystic fibrosis. She is 19 years old and has only been diagnosed for a year now. She now has EPI and her enzyme level is less than 50%.

    We are both struggling with the issue of natural vs. drug (creon) She currently is taking a natural enzyme (Source Naturals Pancreatin 8X) and her CF Clinic Doctor wants her to take the creon. We would much rather her continue with an excellent natural enzyme, but afraid that she is truly not getting the enzymes released properly. My daughter and I as well as her doctor are worried that her pancreas will shut down.

    We know that it is the mucus destroying its function and the enzymes essentially do not help increase the function of the pancreas, yet, she needs to get proper nutrition.

    She is average weight 120 lbs. at 5 feet 3 inches. Only has stomach bloat or distention and currently no other major digestive issues.

    I think it is a no brainer to always use natural supplements, but, when it comes to a serious disease like CF I am confused.

    Could you suggest an enzyme supplement that is possibly really good for CF?
    She is taking serrapeptase which I feel good about.

    Also, living in Springboro, Ohio we could not possibly be seen by you. Would you have any connection with another naturopath treating chronic diseases closer to us?

    Please advise.

    Thank you,
    Cindy

  15. says

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  16. says

    Hi Moet,
    Sorry for the long delay in getting back to you.

    Gastrazyme is NOT a digestive enzyme product, it’s more of a GI anti-inflammatory product.

    I know the office sent your an email to try and get in touch. If that didn’t happen, and you’re still interested in getting in touch, please let me know.

    Best,
    Dr Tim Gerstmar

  17. says

    Hi Maria,
    I rarely see issues with digestive enzymes but symptoms like you describe do sometimes happen. Most often it is either: a. a reaction to something in the product causing inflammation or b. the protease in the product causing irritating to the stomach.

    Have you been tested for SIBO?

    Best,
    Dr Tim Gerstmar

  18. says

    Hi Rash,
    If your symptoms have continued I would definitely get a thorough work-up. A stool test from the likes of Genova/Metametrix or Doctors Data (there are other companies, these are the two I primarily use) would tell you a lot about the health/function of the digestive tract. If you suspect SIBO, I would test that at the same time as well.

    If you have someone near you (Google search: Naturopathic doctor, Functional Medicine doctor, integrated doctor, etc) I would go with them. If not, I do distance consults and would be happy to help.

    I hope this helps!

    Best,
    Dr Tim Gerstmar

  19. says

    Hi Cindy,
    Let me just say that my expertise is not with cystic fibrosis. Re: enzymes. The Creon at the higher potencies will be more powerful than anything I”m aware of that’s over the counter or “natural”. So, from my perspective it depends on what “tool” is needed to do the job (of ensuring adequate digestion). If you want to use, and natural enzymes are sufficient then go ahead. If the dose of a natural product becomes too high/unwieldy than I would go with the Creon.

    I do do distance consultations and would be happy to help if I can. Also, I’d be willing to look and see if there might be someone local for you to see. I would start by doing a Google search for Naturopathic doctor or Functional Medicine doctor or alternative doctor or similar wording and see what comes up in your area. You can also search naturoapthic.org or acam.org for other options.

    If I can help further please contact me directly from my website.

    I hope that helps.

    Best,
    Dr Tim Gerstmar

    My daughter has cystic fibrosis. She is 19 years old and has only been diagnosed for a year now. She now has EPI and her enzyme level is less than 50%.

    We are both struggling with the issue of natural vs. drug (creon) She currently is taking a natural enzyme (Source Naturals Pancreatin 8X) and her CF Clinic Doctor wants her to take the creon. We would much rather her continue with an excellent natural enzyme, but afraid that she is truly not getting the enzymes released properly. My daughter and I as well as her doctor are worried that her pancreas will shut down.

    We know that it is the mucus destroying its function and the enzymes essentially do not help increase the function of the pancreas, yet, she needs to get proper nutrition.

    She is average weight 120 lbs. at 5 feet 3 inches. Only has stomach bloat or distention and currently no other major digestive issues.

    I think it is a no brainer to always use natural supplements, but, when it comes to a serious disease like CF I am confused.

    Could you suggest an enzyme supplement that is possibly really good for CF?
    She is taking serrapeptase which I feel good about.

    Also, living in Springboro, Ohio we could not possibly be seen by you. Would you have any connection with another naturopath treating chronic diseases closer to us?

    Please advise.

    Thank you,
    Cindy

  20. Frank Conard says

    Having a terrible time. Came down sick about 8 weeks ago. Doctor’s say organs look structurally good but I keep hurting in the middle back and sometimes higher. More importantly I keep losing weight. My doctor hinted it could be my pancreas. Lots of stool collection constipation in colon and I have been prone to Trichinella and Toxoplasmosis and bacterial overgrowth when my thyroid was failing. The only thing I do not know is someone cannot fully see into the colon on a catscan. Hard to fight parasites when hard to keep colon open. Castor Oil seems to work good but do not want to slow down the colon. When I eat anything Digestive Gas and can be loud.

  21. Mary Murphy says

    I had a strange headache for about 3 months in nov 2012. I had an MRI and CT scan done, and both were clear. Then I had my wisdom teeth out after which, i had 4 courses of anti biotics in the space of about 3 months at the beginning of the year. About a month after I started pooping a lot of mucus and having runny poop. I started taking probiobtics (udo’s choice super 8) and having yogurt with live probiotics in it. I also started taking Grapefruitseed oil extract. I cut out sugar, yeast, wheat, gluten, started using lactose free milk/cheese. After about 6-8 weeks everything had cleared up. I then got pregnant in july, but had a miscarriage in Sept (i was 11 weeks when i found out). A couple of weeks after the symptoms started to return – mucus, runny poop etc. I started taking the probiotics and yogurt and cut out yeast, wheat etc again. I am scheduled for a colonoscopy in a few weeks. I just wanted to see if you had any advice or opinions on what it could be. I was wondering if you thought digestive enzymes would help? Also do you think that the problems with my gut could have caused the miscarriage? ( i already have a 4 yr old daughter and had no problems at all with that pregnancy). I am 34 years old. I would really appreciate any advice/help you can offer. Kind Regards, Mary

  22. Ann Wiber says

    Can you take enzymes with Olive Leaf and Oil of Oregano and probiotics. I have had a yeast problem and now I have a problem with my stomach. I get heart burn very bad and bloating and I am hoping the enzymes will help. I also cannot lose weight. I work out for a hour and a half a day and have not lost a pound. Maybe you can shed some light on the matter. Thank you.

  23. says

    Hello sir i am troubleing with indigetion, appetite loss. also i have found undigested food in my faces. My LFT, KFT ULTRASOUND TEST came negative. one doctor prescribed me a lupizyme enzyme syrup. i found relief too much. but when i gave up taking enzymes my symtoms. came back . now i want to know that will i take enzymes rest of my life. what to do . it could be risky

  24. Khil says

    I’ve been using digestive enzymes off and on for a while now.
    I try to avoid them when I can though for fear that they will not be good for me in the long run. Hence I use only when i fear my meal is going to be rough on me.

    My question to you is for how long can one use them and are there any long term implications. I’m using a mixed enzyme digestive by the way.

    Thanks in advance,
    KK

  25. Jeff says

    Amy
    -I am in the same boat as your daughter(male 26). I have found best results with removing the sensitive foods. Im having problems with everything except paleo foods it seems. Going on a paleo diet(hard!), but important for all man kind. Build up digestive enzymes & bacteria. Sounds like she was still taking in carbs and not on a paleo diet for at least 6months to a year to weed out candida as an issue. Most people cant fathom or understand it and never properly treat it or are able to rule out. (dont take antibiotic yeast stuff! itll come back later in life worse & immune). Candida is one of the biggest issues related to gut problems which leads into many other illness or diseases. She probably has taken many antibiotics in her life as I have, as this was the norm growing up and still is. Parents trust doctors too much and in the end only harm their children unknowingly as did mine. Americans are brain washed to run to the doctors to get a pill every time they get a symptom, which might be a quick fix(or cover up!), but will put you in a worse position in the long run. Avoid drugs & antibiotics. Chances are that is what got her in this mess in the first place as they did me. If she has had any yeast infections this is a sign of candida or yeast overgrowth in the body and can take years to put the body back to stable. Paleo diet + enzymes + probiotics(refrigerated and in 30 Billion+). Yogurts are the biggest scam and are full of sugar which only feeds the candida fungus/yeast. You have to starve the fungus/yeast/bad bacteria out of the body over long time & replace the good. There are formulas to figure out how long you have to do it per how long you have had issues/symptoms. Im suppose to do it for 3yrs, or so, but once you get it down and fail, you will see all the bad come back and its hard because you cant fail in order to accomplish your goal. I think naet specialist can speed up the process but I cant afford much of anything so I am in the long hall of paleo & other stuff mentioned. Once you learn to eat properly, you realize that you’ve been slowly killing yourself eating all this fake crap. Humans are vegetable eaters! I love meat, but its true. This is why we have long intestines & flat teeth! Avoid liquor(high in carbs/sugars) and eat protein & vegetables. Red meat is toxic to the body when broken down. Knowledge! Take your health into your own hands before issues occur and you fall into the abyss running to a doctor who is out for quick buck & insurance slush fund grab!
    Good luck!

  26. Jasmin von Stetten says

    Hi,
    I had acute pancreatitis about a year ago. The dr had tested and found very high number of digestive enzymes in my blood. It was unexplainable why because I’m a personal trainer, eat a balanced diet, no alcohol or medication, and after testing no gal bladder stones. After a day of fasting I was back to normal and never had problems again until recently I’ve been feeling a little bit off again which I will get tested this week.
    My husband has been not feeling good lately and got tested today and was told it’s a pancreatitis (same thing high digestive enzyme count in blood). With him it is more understandable because he does drink alcohol on a regular basis and does take medications and has high stress levels.
    I am a little bit thrown by the fact that I had it last year and he has it now and I am feeling like something is going on in my pancreas again. I guess my question is what could cause the digestive enzyme levels to climb so high and therefore creating pancreatitis? Is it likely just coincidence that both of us have been hit by it within a year or could there be a commen nominator? I can’t find anything about this other than the descriptions of pancreatitis and it sounds like you might have some ideas. Thanks for you input. A wonderful article by the way,
    Jasmin

  27. Audri Parker says

    I am 18 years old and have never had a problem excess flatulence. However as soon as I went off to college I noticed a problem. I typically eat pretty healthy and am still a healthy eater in college, but the problem seems to be getting worse. It seems as if everything I eat gives me some sort of gas and it can sometimes be loud, last a long time, or have a foul odor. Do you think digestive enzymes could fix this problem? Also can you give me some reason of why you think this is happening?

  28. Alex says

    Amy- I am going through the exact same thing with the same procedures and Riafaxfan and would like to ask you how you fixed it. I really need your help. Please contact me at Alexjag85@yahoo.com

  29. William perez says

    Hello,there’s so many formulations out there how can I know if I’m choosing a high quality product and where can I get nothing but the best on digestive enzymes, can you please send me addresses! Thank You/William

  30. says

    Hi Dr.Tim
    I have been living with ulcerative colitis for many years now and haven’t been able to get my condition under control.
    I use prescriptive medication from my doctor and have cut out gluten from my diet. I am also fructose intolerant and have cut that out of my diet too.
    I was wondering what you would suggest I try. I have been told that probiotics, zinc and digestive enzymes are a good idea. What are your thoughts?
    I have also heard ph levels of the bowel is highly correlated to reoccurrences of flare ups!
    Also I am wondering where your clinic is based, if you have one, as I am looking for a new doctor to help manage my condition. I would love some answers as I am in desperate need of gaining back some control of my health/life!
    Thanks
    Stefanie

  31. William perez says

    Hello, I would reccomend first that you read a book that I purchase from Amazon. Com first titled (“The Healing Power Of Enzymes “)by DicQie Fuller!

  32. Sheila says

    I am looking seriously into the digestive enzymes for my sensitive stomach. I am 63 years old and have had this problem for probably 30 years. After some meals, especially if it is a restaurant meal I almost immediately have diarrhea. I will have maybe two to three episodes and then I am perfectly fine. I have been struggling with this for so long and now that we are older and want to travel more, eating out is inevitable and I want to find out how to fix it. I have been taking probiotics for quite a few years also. Does anyone else have this kind of a problem? Any help would be greatly appreciated.

  33. says

    This blog is informative. I appreciate its helpful advice. I have a confirmed dx of microscopic colitis and eating raw veggies and fruits, steamed or cooked, causes complete havoc in my system. That’s why doctor prescribed me to take digestive enzyme supplements once in a week.

  34. Mary says

    I have no gallbladder, or spleen, or Appendix! Hysterectomy at 23, I’m 58!
    I had severe Pancreatitis, Esophagitis, Peritonitis, when the gallbladder was removed! Now that was done in 1990… We are going Wheat Free/Gluten Free/Dairy Free/Sugar-free…but I had a CT Scan and they said I have Fatty Infiltration of the Liver, Non-Alcoholic, as I’ve never been a drinker ever! But I also have a Calcified Pancreatic Head? They want me to follow up again, with a specialist, but I’m so sick of Dr’s…My spine is held together with rods and 48 screws…Cancer OD the Cervix at 17 and ectopic Pregnancy in my left Ovary at 20… 2 full Term babies, before hysterectomy! Thank goodness! I am a DES Baby…so how much of my problems are from that? Who knows! I’m also pretty sure my Lymphatic system isn’t draining right! Sever inflammatory issues! So I’m interested in the Digestive Enzymes, also, Lymphatic Cleansing? Any suggestions! 16 surgeries…I’m tired and I’m a grandma, and so want to enjoy my Grandkids, my pain is so bad! They want to replace my hips, knees…I’m saying NO! I’m beyond desperate! Thanks so much for listening! Bless you! Mary

  35. Jaimie says

    Hello
    I have been diagnosed with delayed gastric emptying. I have had every test done, I think, to try and find out why I am always nauseated. I get the full feeling after I eat, but not until lunch and dinner. I am currently on day 3 of no gluten or dairy-I am trying this on my own as a last resort to all of this. Drs tried giving me a rx for reglan for the gastric emptying but never mentioned the digestive enzymes. The rx makes me nervous due to all the side effects. I am always gassy and bloated as well as the nausea that never subsides at night. Would you suggest trying the digestive enzymes for relieving all of this discomfort?

  36. kw says

    Dr. Tim, I underwent hiatal Hernia repair in 2010 during which my spleen was nicked and vagus nerve damaged. Since, I have suffered with gastroparesis. I am plagued by weight loss, rock hard stomach, severe stomach pain at times, chronic constipation, nausea, and sometimes vomiting.

    I cannot eat foods with high fat or fiber content. I am wondering if I might benefit from taking enzymes.

  37. Ginni says

    Hi there, I am a 25 year old female suffering from acid reflux and indigestion/stomach aches. About 8 weeks ago I came down with a stomach “flu” virus. I had bad diarrhea, severe nausea and stomach aches that lasted all day. It was really bad and I had no energy because I couldn’t eat, taking two bites of rice or toast made me feel like I had just eaten 2 meals, I lost 10 lbs, and was in pain all day. As the virus symptoms went away I started to feel acid reflux, something I had never felt before. I had chest pain, a feeling that there was a lump in my throat, burning in my stomach, a cramping feeling around my ribs (almost like hunger pangs but more severe). I went to the doctor, and put me on omeprazole. I just want to mention that before any of this happened, I never had any problem with food, I’ve always eaten whatever I wanted. Anyways, I did a 4 week course of the omeprazole and I ate lightly, slowly getting back into regular foods. I finished the course 2 weeks ago and after 6 days of being off of it, I felt the acid reflux return. I’m back on omeprazole now and I plan on seeing my doctor again, I believe he is going to refer me to a gastroenterologist. I’m eating almost totally normal again, but I feel indigestion often, especially if I eat something heavy, a feeling of trapped gas, like I need to burp all the time, and I noticed that I get stomach upset if I eat fatty foods or meat too often. I’m just at a complete loss at what happened. I’ve done blood tests, stool samples, everything is normal. I just don’t feel normal ever since this virus. I’ve never had acid reflux before this, and have never had any other medical problems. I’ve been looking into taking enzymes and I wonder if I would benefit from them, I want to get off the omeprazole and I want to be my normal self again.

  38. Kylie says

    Hi,
    After reading your article, I have decided to begin taking a digestive enzyme supplement. What brand that I can buy in stores (GNC, CVS..etc) do you recommend?

    Thanks so much,

    Kylie

  39. Ash says

    Hi Dr. Tim,

    Great site! Like many of the people on this site, I have struggled with digestive issues for quite some time. I recently had blood work done showing intolerance to a few foods but unfortunately, not foods that I eat much of. So once again, I was left wondering why I felt so awful. My doctor recommended a few supplements as well as the stool test for digestive enzymes. I was not able to get the test for another 1-2 weeks and I was beyond miserable. I decided to take matters into my own hands and buy a recommended digestive enzyme supplement from “The Vitamin Shop”. It has been 4 days and I have already seen more improvement than 4 years of doctor’s appointments and “guesses” as to what is wrong. My question is, would you still recommend the stool test or can I explain the situation to my doctor and simply continue on with the pills? I am wondering if the test can distinguish between which enzymes I might need more. If so, should I discontinue the pills during the test? Thank you so much!!

    Ashley

  40. Ash says

    And I am wondering the same as Kylie…what brand do you recommend that is broad spectrum, gluten/dairy free and vegetable based?

  41. Rylee says

    Hello,
    I will be turning 17 in a few days, and for almost a week now I have been noticing that I am constantly hungry. If I eat a big meal I will be fine for a couple of days but then it gets right back to being hungry. I don’t know why this is happening. I do have some ideas, I’m not getting enough protein, I have been bench pressing, my metabolism has sped up, and I do know one thing I am NOT pregnant. And also I am not feeling well and I am a little tired throughout the day. I didn’t know if taking an enzyme pill will help or not. Please help me with this issue and what you suggest I should do. I have band camp starting on Monday and it’s not going to be good if I’m feeling this way.
    Thank-You for your time

  42. Justin says

    Hi Dr. Tim,

    A quick question for you. My Dr. suscribed Zenpep digestive enzymes to me. How do these compare to other brands you’ve came across? Thanks!

  43. Kaylee says

    I need your thoughts. I have a 5 week old and he’s having horrible reflux and acidic stools he had a horrible rash for 3 weeks and is just barely getting over it. He got tested for acid and digestive enzymes they came back as stressed. Is there anything I can do to help his problem?

  44. says

    Hey folks,
    Back from a very long hiatus, but would love to get all of your questions answered. As you can see there’s quite a backlog so I doubt I’ll be able to get them all done. Also heading to AHS14 tomorrow, but will make an effort to get caught up ASAP.

    Frank, Mary, Ann, Rajeev, Khil, Jeff & Jasmin,
    I’m sorry I never responded. It’s been months and months since you posted. If you’re still interested in a reply, please let me know.

    Best,
    Dr Tim Gerstmar

  45. says

    Hi Audri,
    If you haven’t tried them I certainly think digestive enzymes could be very helpful for you. Flatulence has to do with gut bacteria, so it may be the new bacteria you were exposed to at college, or changes in what you’re eating. I would pair it with a probiotic and see if that helps. If not you may be looking at something like SIBO which would require a work-up.
    I hope that helps!

    Best,
    Dr Tim Gerstmar

    Hi Stefanie,
    I hope you’ve found some help since you posted your message. Yes zinc, digestive enzymes and probiotics can all be helpful, plus there is a lot more that can be done. I’ve had good success with UC – sometimes it’s pretty straight forward, and sometimes it is difficult to get things under control but we usually get there. Sometimes it’s primarily with diet and a little bit of supplementation, sometimes we need drugs + supplements + diet to get where we want to go.
    If you still need help, please feel welcome to contact me at: info@aspirenaturalhealth.com and we can talk more.

    Best,
    Dr Tim Gerstmar

    Kera,
    Thanks for sharing that!

    Best,
    Dr Tim Gerstmar

    Mary,
    Wow. I’m sorry for your situation, that’s really tough. I would definitely try some digestive enzymes and possibly some ox bile as well, if you haven’t already. And, even though I know you’re sick of doctors, I recommend finding a good integrative/holistic practitioner to really help you.

    Best,
    Dr Tim Gerstmar

  46. says

    Hi Jamie,
    If you haven’t already tried it I would definitely try a digestive enzyme to see if it helps. Cost & risk are minimal. You may also consider trying some HCL and see if it helps.

    I hope this helps!

    Best,
    Dr Tim Gerstmar

    Hi kw,
    Wow that’s a terrible side effect. I would definitely try some digestive enzymes. The vagus is important for stimulating the pancreas to release digestive enzymes. I would also strongly consider some HCL (stomach + vagus nerve = HCL) as well.

    I hope that helps!

    Best,
    Dr Tim Gerstmar

    Hi Ginni,
    Sounds like that “stomach flu” really hit you hard. If you haven’t already I would consider probiotics and digestive enzymes to see if they help. It sounds like you may need to be worked up for SIBO. I would also run an expanded stool test on you to see how the digestive system looks.

    I hope that helps!

    Best,
    Dr Tim Gerstmar

    Hi Kylie,
    A couple of brands are mentioned in the article. I would start there.

    I hope that helps!

    Best,
    Dr Tim Gerstmar

    Hi Ashley,
    Good on you for finding some relief for yourself. I’m not sure what type of stool test you’re being recommended, but an expanded one (such as the Genova GI effects panel or similar from another company) would provide a lot of useful information. I don’t think you need a test to tell you that the digestive enzymes seem helpful. I do not know of a test that looks at enzymes specifically, but the tests can suggest you are having trouble with proteins, or fats, etc. If your doctor isn’t open/helpful/supportive I would find another doctor.

    I hope that helps!

    Best,
    Dr Tim Gerstmar

  47. says

    Hi Rylee,
    Are you having other symptoms? Insomnia? Heat intolerance? Sweating? Rapid heart beat? Or anything else? Are you gaining or losing weight?

    It’s tough to say. I would get a good check-up with a knowledgeable practitioner, it could be nothing or it might be significant.

    I hope that helps!

    Best,
    Dr Tim Gerstmar

    Hi Justin,
    Zenpep is a prescription enzyme. It’s from pigs and is quite strong. I haven’t found most people need this potency enzyme and most do fine with a good quality OTC vegetable/fungal source. Still if it’s working for you and isn’t too expensive I’d say use it.

    I hope that helps!

    Best,
    Dr Tim Gerstmar

    Hi Kaylee,
    That’s a very tough situation and very stressful as a new mom. Hopefully you have a good practitioner on your side to help you through this.

    You may need to temporarily put him on an acid blocker to get things stabilized. Not sure if you’re breastfeeding but if you are you’ll want to check and see if something you’re eating is causing him issues. If he’s on formula you may want to switch formulas.

    You might also consider DGL for soothing the digestive system and some digestive enzymes (Klaire labs makes a chewable one that can be crushed and mixed to give it to him – no affiliation with the company). I would also strongly recommend some probiotics for him.

    I hope that helps!

    Best,
    Dr Tim Gerstmar