Types and Effectiveness of Over-the-Counter Supplements

By Barbara Bolen, PhD 

 Medically reviewed by Melissa Nieves, LND

Digestive enzyme supplements are products designed to mimic the effects of naturally occurring digestive enzymes found within our bodies that aid in breaking down and absorbing food. These products are sold over-the-counter with manufacturer claims that they ease stomach problems and are helpful for many different types of health conditions. This overview will educate you as to the most common types of digestive enzymes sold as supplements and help you to decide if such a supplement might be right for you.

londoneye / Vetta / Getty Images 

Say Hello to Your Pancreas

You cannot have a full understanding of the benefits of digestive enzyme supplements without understanding what naturally-occurring digestive enzymes do within the body. Take a moment to reacquaint yourself with your pancreas. Among other things, your pancreas secretes a variety of enzymes that help to break down the fats, proteins, and carbohydrates that you have ingested.1

When the pancreas is not functioning as it should, due to disease or injury, malabsorption of important nutrients occurs. In these cases, the use of supplemental pancreatic enzymes will be indicated. Medical researchers have also considered the use of digestive enzymes for a variety of other health conditions.

Types of Digestive Enzyme Supplements

Digestive enzyme supplements may be derived from plants, animals, or fungi. Here are some of the more common types sold over-the-counter.

Bromelain

Bromelain contains a variety of enzymes derived from the stem and pulp of pineapples. Useful in the digestion of protein, bromelain is thought to be helpful in reducing symptoms of indigestion as well as inflammation stemming from injury or infection.2 The helpfulness of bromelain in relieving pain caused by arthritis is also being evaluated, with some mixed findings.

There is much anecdotal evidence, but scant formal research support, for the use of bromelain as a digestive aid. Dosage estimates vary, but generally, it is recommended that bromelain is taken several times a day with meals. Bromelain should not be taken by pregnant women or children. Bromelain may affect the action of prescription drugs, so be sure to get clearance from your healthcare providerbefore taking bromelain.

Lipase

Lipase is important for the digestion and absorption of fat.3 Lipase supplements are derived from pigs, cows, plants, and fungi. Lipase formulations may include other enzymes, such as amylase, lactase, and protease.

Lipase supplements are purported to reduce symptoms of gas and bloating, although little research has been done. Certain health conditions may involve a lipase deficiency and therefore supplemental lipase would appear to be helpful. In addition to those involving pancreas disease or injury, the following are some other illnesses in which lipase supplementation might be indicated:4

• Celiac disease

• Crohn's disease

• Cystic fibrosis

If taking as a digestive aid, it is recommended that lipase is taken 30 minutes prior to eating. Be sure to get clearance from your healthcare provider before taking lipase. Other digestive enzymes may reduce the effects of lipase supplementation.

Papain

Papain is derived from the papaya fruit. Papain is thought to be useful in the digestion of proteins, and to a lesser extent, fats.5 Although recommended as a digestive aid, there is little to no research to support papain's effectiveness in this regard. Other conditions papain has been considered for, yet with minimal research support, include arthritis, food allergies, injury recovery, shingles, and some autoimmune diseases.

Papain taken as recommended is generally considered safe. High doses of papain may result in throat injury. Do not take papain without the consent of your healthcare provider or if you are pregnant or breastfeeding. You are likely to have an allergic reaction to papain if you are allergic to figs or kiwi.

Lactase

Lactase differs from the above described digestive enzymes as it is produced by the small intestine, not the pancreas. Lactase is needed for the digestion of lactose, the sugar found in dairy products.6 Individuals who have low levels of the enzyme lactase are deemed to be lactose intolerant.

If you have been diagnosed with lactose intolerance, there are certain dairy products that are lower in lactose. You may find that you are able to enjoy these products in small doses without a problem. Taking a lactase supplement just prior to eating dairy products may also be a way for you to obtain the nutritional benefits of dairy products. Lactase enzymes may also be added directly to milk prior to drinking.

Should You Try Digestive Enzyme Supplements?

Digestive enzyme supplements appear to be a fairly safe intervention in terms of dealing with digestive distress. However, whether you'll see a significant difference in your symptoms may be less clear. As with any over-the-counter product, always get clearance from your healthcare provider before taking such a supplement.

Sources

Zhou Q, Melton DA. Pancreas regeneration. Nature. 2018;557(7705):351–358. doi:10.1038/s41586-018-0088-0

Rathnavelu V, Alitheen NB, Sohila S, Kanagesan S, Ramesh R. Potential role of bromelain in clinical and therapeutic applications. Biomed Rep. 2016;5(3):283–288. doi:10.3892/br.2016.720

de la Iglesia-García D, Huang W, Szatmary P, et al. Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis. Gut. 2017;66(8):1354–1355. doi:10.1136/gutjnl-2016-312529

Penn State Hershey Medical Center. Lipase. Review June 2015.

Papaya. MedlinePlus. Reviewed March 2019.

Lactose Intolerance. National Institute of Diabetes and Digestive and Kidney Diseases.

Additional Reading

Bromelain. University of Maryland Medical Center. http://www.umm.edu/health/medical/altmed/supplement/bromelain.

Lipase. University of Maryland Medical Center. http://www.umm.edu/health/medical/altmed/supplement/lipase.

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.