Use of enzyme supplements is a dimension of holistic medicine that has great potential to change the course of many diseases, and may effectively improve outcomes from other nutrition-based preventive and therapeutic approaches.
Enzyme supplements are clearly growing in popularity. According to Nutrition Business Journal, a publication that tracks business trends in the nutrition industry, sales of enzyme supplements are experiencing double digit growth, and it is no wonder, when we look at the state of American digestive health.
The American Gastroenterological Association estimates that one million people in the US suffer from chronic digestive problems every year. Common complaints include abdominal pain, constipation, diarrhea, nausea, and gastroesophageal reflux disease (GERD). The most common way Americans deal with the majority of these complaints is to reach for antacids, which are now available in just about any flavor or delivery form one could imagine: from liquid to tablets, from effervescent powders to bubble gum. But how good can antacids be for us, and do they really address the problem? Moreover, what do the myriad digestive problems say about overall health in this country?
Everything Starts in the Gut
One of the core principles of holistic medicine is that everything starts in the gut. Digestive health is a cornerstone of many traditional medicine systems, such as Ayurveda and traditional Chinese medicine, because the healers who founded these systems recognized that impairment in assimilating nutrients and eliminating toxins is bound to lead to imbalances and illness. Diet is inseparable from health, and many acute and chronic conditions may be helped, if not reversed or prevented, by proper nutrition. This may sound like common sense, but if it is something we all know, why are Americans popping antacids like after-dinner mints?
Antacids are not a cure for digestive problems—they are merely a way of temporarily easing discomfort and allowing people to go on eating in a way that is extremely unhealthy. Interestingly, the perceived relief many people experience when they take an antacid has been found to be due only to the placebo effect (Richter JE. J Clin Gastroenterol. 1986; 8 Suppl 1: 72–80). In fact, unless a person has an ulcer, where the antacids may help to reduce stomach acid irritation, there is little evidence that an antacid is doing anything beneficial (Berstad A, Weberg R. Scand J Gastroenterol Suppl. 1986; 125: 32–41).
The evidence is beginning to show that antacids may actually be worsening digestive health. Antacids may cause a rebound effect wherein the stomach is stimulated to produce more acid. They also alter the environment of the GI tract, resulting in adverse changes of gastrointestinal flora. Healthy GI flora are important for systemic health, with known effects on immune system, not to mention digestive system health. Gut flora have a significant influence on prevalence and outcomes of many diseases (Vaughan EE, et al. The Intestinal LABs. 2002 Aug; 82(1–4): 341–352).
The plain fact is that most upset stomachs are not caused by disorders in stomach acid production, but in the over-consumption of food, not eating the right foods, or in a lack of digestive enzymes. Many digestive problems can be reversed or prevented through changes in eating habits and/or supplementation with digestive enzymes. As everything starts in the gut, by reversing or alleviating digestive distress, we can influence the course of other health conditions.
Enzymes and Digestion
Digestive enzymes should be one of the first therapeutic options we consider in our efforts to resolve gastrointestinal problems and improve digestive health. Enzymes not only play an essential role in the process of digestion, they are also important for the proper functioning of the immune system, as well as in clearing inflammation.
The basic digestive enzymes, protease (for protein), lipase (for fat), and amylase (for sugar) are present in our digestive system but may be in higher or lower quantities depending on age, genetics, and lifestyle factors. For many people, endogenous enzyme production decreases as we age
Deficiency in any one enzyme can lead to digestive distress. A common clinical example of this is lactose intolerance. This is a significant problem for many people, especially those of African or Asian ethnic descent. With the exception of people of European descent, most peoples of the world do not produce significant amounts of lactase, the enzyme responsible for digesting milk sugars in dairy products, beyond adolescence. Some populations lack lactase all together in adulthood. If a lactase-deficient individual drinks milk or eats dairy, the result may be gas, bloating, cramping and diarrhea. In light of this, one can certainly question the wisdom of promoting dairy as a healthy basic food group for many ethnic subpopulations.
That said, by supplementing with a lactase enzyme at mealtimes, patients who are lactose intolerant can prevent these symptoms of poor lactose digestion.
Many important enzymes are available in raw fruits and vegetables. It is an interesting fact of nature that edible plant foods come packed with enzymes that help us to digest them. But how many of us have a diet high enough in raw foods? Even with a relatively healthy diet, the quantity of enzymes in raw food cannot compensate for deficiencies, particularly if a patient has age-related declines in enzyme production.
Enzymes for Inflammation & Wound Healing
Beyond digestive complaints, researchers are discovering applications for enzymes in managing other health problems. One of the most well-researched areas in enzyme therapy is in the effect of enzymes in modulating inflammation, promoting tissue healing, and speeding recovery from sports injuries. Protease supplementation has been shown in a number of clinical trials to attenuate soft tissue injury after intense exercise performance. Some of the initial work in this field was published as early as the mid-1960’s (Deitrick RE. Pa Med. 1965 Oct; 68(10): 35–37; Trickett PC. J Am Coll Health Assoc. 1964 Dec; 13: 270–274). The growth of the sports and fitness movement in this country has fostered a renewed interest in this line of investigation in recent years (Brown SA, et al. Plast Reconstr Surg. 2004 Jul; 114(1): 237–244; Miller PC, et al. J Sports Sci. 2004 Apr; 22(4): 365–372).
A recent clinical study aimed to evaluate if protease supplementation was able to affect muscle soreness and contractile performance. Two groups of runners were tested by running at a –10% grade for 30 minutes at 80% of their predicted maximal heart rate. The runners took either a high-protease supplement or a placebo four times daily, for 4 days. The treatment group showed superior recovery of contractile function and greatly reduced incidence of delayed-onset muscle soreness when compared to the placebo group. The authors commented that beyond helping with immediate soreness, the protease supplements may have promoted faster muscle healing and faster restoration of contractile function post-exercise (Miller et al., 2004).
Choosing Enzyme Products
An important consideration with enzyme therapy is to make sure you are recommending high quality supplemental digestive enzymes. According to Tom Bohager, founder of Enzymedica/Theramedix, a company that produces enzyme product lines for both consumers (Enzymedica) and healthcare professionals (Theramedix), there are major differences between the various enzyme products available on the market.
For example, papaya-derived enzymes are very popular in digestive health products, but they may not provide optimal therapeutic effects in managing digestive problems. Papaya enzyme does not work optimally at the pH and conditions found in the digestive tract. Rather, papain is better suited for reducing inflammation and speeding recovery from sports injuries. Supplemental enzymes should match a person’s digestive needs, and it is best to use a product that also contains broad-spectrum amylase, protease and lipase.
The field of enzyme therapy is clearly ripe for further research, not only in assessing the clinical benefits of enzymes in general, but also in discerning the best forms of enzyme supplementation for various clinical conditions. For more on enzymes, join www.holisticprimarycare.net and read “Good Digestion Requires Right pH at the Right Place at the Right Time,” April 2003.
