Digestive enzymes play a key role in breaking down the food you eat. These proteins speed up chemical reactions that turn nutrients into substances that your digestive tract can absorb.
Digestive enzymes take the place of natural enzymes, helping to break down carbohydrates, fats, and proteins. Once foods are broken down, nutrients are absorbed into your body through the wall of the small intestine and distributed through the bloodstream.
Because they’re meant to mimic your natural enzymes, they must be taken just before you eat. That way, they can do their work as food hits your stomach and small intestine. If you don’t take them with food, they won’t be of much use.
The main types of enzymes are:
Amylase: Breaks down carbohydrates, or starches, into sugar molecules. Insufficient amylase can lead to diarrhea.
Lipase: Works with liver bile to break down fats. If you don’t have enough lipase, you’ll be lacking in fat-soluble vitamins such as A, D, E, and K.
Protease: Breaks down proteins into amino acids. It also helps keep bacteria, yeast, and protozoa out of the intestines. A shortage of protease can lead to allergies or toxicity in the intestines.
Pancreatic enzyme replacement therapy (PERT) is available only by prescription. These medications are usually made from pig pancreases. They are subject to the Food and Drug Administration’s (FDA) approval and regulation.
Some prescription enzymes contain pancrelipase, which is made up of amylase, lipase, and protease. These medications are usually coated to prevent stomach acids from digesting the medication before it reaches the intestines.
Dosage varies from person to person based on weight and eating habits. Your doctor will want to start you at the lowest possible dose and make adjustments as needed.
OTC enzyme supplements can be found wherever dietary supplements are sold, including online. They may be made from animal pancreases or plants such as molds, yeasts, fungi, or fruit.