Digestive Enzymes - Ask a Nutritionist

Transcript:

BRITNI: Welcome to Dishing Up Nutrition's “Ask a Nutritionist” podcast brought to you by Nutritional Weight and Wellness. My name is Britni Vincent and I am a Registered and Licensed Dietitian. We at Nutritional Weight and Wellness are thrilled to be celebrating 20 years on air, discussing the connection between what you eat, how you feel, while sharing practical, real life solutions for healthier living. And we want to thank you so much for your support and your listenership over the years. It is greatly appreciated.

Now let's get into today's topic. On today's show, I will be answering a nutrition question we've received from one of our Dishing Up Nutrition listeners. The question is, “What are signs you need a digestive enzyme supplement?”

What are digestive enzymes & what do they do?

Before I get into answering the question and providing you some signs and symptoms, I first just want to talk about digestive enzymes and what they are so you have a better understanding. And digestive enzymes play a really critical role in overall digestion.

And specifically what they do is break down food into smaller pieces, making it easier for your body to absorb and digest. And your body does naturally make digestive enzymes, but there are some factors that impact how well your body is actually making them, like age and just overall health of your gut.

And the process of breaking down and digesting your food actually starts in your mouth, because your saliva contains enzymes that begin to break down your food. Your stomach, pancreas, and small intestine also produce some digestive enzymes.

When you don't have enough digestive enzymes on board, you can't properly convert the foods you eat into the raw materials necessary for your brain and your body to function efficiently. And not only that, but lack of digestive enzymes can lead to a lot of uncomfortable digestive symptoms, as well as a lower immune response, too.

Types of enzymes & where we get them

Let's talk a little bit about types of enzymes. Each enzyme targets a different nutrient and I'm going to highlight just I'm going to list a few of these because there are many more that our body produces. Amylase breaks down carbohydrates, starches, and sugar. Proteases such as trypsin, pepsin, are going to break down proteins into amino acids. Lipase breaks down fats into fatty acids and glycerol. And lactase breaks down lactose, which is a sugar found in dairy products.

In addition to these endogenous digestive enzymes, which are the ones that our body makes on its own, we also get some from food. Fermented foods: we talk about those a lot. Not only are they going to give you naturally occurring probiotics, they also provide you with some of these enzymes.

So, reminder of the fermented foods: sauerkraut, kimchi, both of which should be purchased from the refrigerated section. Otherwise they're not going to have these naturally occurring enzymes and probiotics. Yogurt, kefir, and pickles without vinegar would also be some examples of fermented foods.

We do get some enzymes from pineapple. That enzyme is called bromelain and papain from papaya breaks down proteins into amino acids.

The importance of having adequate stomach acid

And in talking about the digestive enzymes, I also want to touch on stomach acid because those two work together synergistically in this process of absorption and digestion of our food. And stomach acid, or the lack thereof, contributes to a lot of these signs and symptoms I'm going to be talking about as well.

Having that adequate stomach acid is really, really critical to efficiently break down and absorb your food. Specifically, stomach acid is important for mineral and B12 absorption. Enzymes and stomach acid are going to unbind B12 from the protein that you're eating into its free form to be able to be absorbed into the body. So without enough stomach acid, you aren't able to utilize the B12 and the minerals from your food.

The other key point of stomach acid is, it's acid. So we really want our stomach to be an acidic environment because this is one of our first lines of defense against pathogens. And by pathogens, I mean bad bacteria, viruses, yeast like candida and even parasites. Having low stomach acid puts you at a higher risk of developing one of these overgrowths of bacteria, yeast, or even having parasites live in your body.

What can cause low stomach acid?

There are various different causes of low stomach acid. Medications are a big reason why people have low stomach acid. Any sort of acid reducing medication can contribute to low stomach acid.

And when these medications first came out, they were only prescribed for a short amount of time, about a month or two, because they knew the impact that these medications could have on digestion and absorption. And now, decades later, from when these medications first came out, I see some individuals that have been on these for 10, even 20 years. I do want to mention that it is possible through diet changes and some supplementation that you can get off of some of these.

Other medications would be antibiotics and even birth control can contribute to low stomach acid. Age is a big factor. Naturally as we age our stomach acid production does reduce and enzyme production also reduces as we age. So I think anybody over the age of 50 is going to be a lot more likely to have lower stomach acid and even enzyme production. And then this is no big surprise: chronic stress can cause low stomach acid as well.

Now it is time for me to take a quick break here. And when we get back, I'll talk about some signs and symptoms that a digestive enzyme might help you.

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Signs and symptoms a digestive enzyme might help

Welcome back. Now I want to dig into some signs and symptoms. that a digestive enzyme might help you: reflux or heartburn. And I want to explain this further because it's completely counterintuitive that reflux or heartburn could actually be caused from low stomach acid.

You know, for many individuals, low stomach acid is a big cause of heartburn and reflux. And what happens is the lower esophageal sphincter, which is really a ring of muscles between your stomach and your esophagus, that is supposed to stay closed except when we're swallowing and eating.

You can think of it as working like a gate, and it prevents acid from your stomach going back up into your esophagus. But when your stomach isn't acidic enough, the lower esophageal sphincter remains partially opened, and this allows the acid to come from your stomach into the esophagus, creating that heartburn, reflux.

And then also, when you don't have enough stomach acid to break down your food, you're going to get larger food particles that go into your intestinal tract. That's going to create some fermentation and growth of more bad bacteria, which can also contribute to the reflux, the heartburn.

And not all digestive enzyme supplements contain HCL, which is stomach acid. So look for one that contains betaine HCL. Other signs, symptoms would be food in your stool. And yes, I'm actually encouraging you to look at your bowel movements. It really tells us a lot about what's going on internally. And that is a question I ask my clients on a regular basis. What are your bowel movements like? What do they look like? And then I am better able to help them and get to the bottom of what's actually going on.

Bloating would be another sign or symptom and feeling really heavy after eating, especially eating meat. And I've experienced this myself, and it does feel different than just bloat. It feels like there's a brick in your stomach. This is really because meat, especially, red meat, needs more stomach acid to be broken down efficiently.

Gas, frequent burping, constipation or diarrhea, and nutrient deficiencies would all be some other signs or symptoms that a digestive enzyme supplement might benefit you. And with the nutrient deficiencies, a lot of this points more to the low stomach acid.

Low B12 would be a sign. And optimally B12 should be at the upper half of the range. So that would be above 500 picograms per milliliter. Low iron or low ferritin; ferritin is our iron storage marker. Ferritin optimally should be above 75.

And then mineral deficiencies can also point to low stomach acid. This is more difficult to test for because standard blood tests of minerals like calcium and magnesium really are not accurate measures of stored levels of our body. So I would look more at symptoms of these to determine deficiency. And we have lots of podcasts, lots of articles talking more about minerals, so you could identify if you might have some deficiencies of those.

If you've had your gallbladder removed, then you may benefit from a digestive enzyme supplement. Especially if you feel like your digestive system has just never been the same since having your gallbladder removed. And the reason for this is, your gallbladder stores bile, and then when you eat food, it releases bile. Bile emulsifies fat and breaks it down, and you can think of bile as dish soap.

So, if you are cleaning a greasy dish without dish soap, you're never going to get all that grease off; same thing with bile. Without enough bile, you're never going to be able to break down that fat well enough.

So when you have had your gallbladder removed, your liver should make enough bile to digest your food, but instead of the bile being stored in your gallbladder and released when we eat food, it will continuously drip into your digestive system. And for some people, that's just not enough. So after gallbladder removal, some individuals, their system bounces back really well.

And for others, you may experience diarrhea or greasy stools, and you may see a layer of fat in the toilet after having a bowel movement. That would mean that you are not breaking down your fat well. And if this is you, then you would likely benefit from a digestive enzyme that contains ox bile in it. So you would want to look specifically for that ingredient.

Reduce or eliminate processed foods to minimize digestive symptoms

Now, I think it's really important for me to mention that low stomach acid or lack of digestive enzymes are not the only cause of these symptoms. Gut health is really complicated, and there are lots of factors that affect it. So if you have some or a lot of these symptoms that I've mentioned, but you're still eating a lot of processed food, I would recommend first cleaning up your diet.

You know, significantly reduce or even eliminate processed foods. And by that I mean bread, pasta, sweets, candy, crackers, chips, cereal, etc. And then instead focus on real, whole foods; proteins like meat, fish, dairy, if tolerated, seafood, eggs; those would all be great sources of protein. Get some healthy fats in there like nuts, seeds, olive oil, butter, coconut oil, avocados, and then replace those processed carbohydrates with real carbohydrates, lots of vegetables, some fruits in there.

And making these changes, I recognize that it's a process and this, it takes time for people to make these changes, but doing so for a lot of people eliminates or at least significantly improves their digestive symptoms. So I would start there, if you haven't already, because taking a digestive enzyme without changing your diet, it may not help your symptoms at all, frankly. Because a digestive enzyme is really just a piece of the puzzle with gut health.

Eliminate food sensitivities to improve gut health

So, in addition to digestive enzymes, big picture, some things to think about for improving gut health would be eating that whole real food diet that I mentioned; eliminating foods that you're sensitive to. This is really difficult to figure out on your own sometimes, but the top two culprits are going to be gluten and dairy, and then eating probiotic rich foods. I talked about those earlier.

Consider a probiotic & gut healing supplement support

Or considering a probiotic supplement, or maybe both, doing both. And then if necessary, healing the lining of your gut as well with a supplement like glutamine, or there's other things that can help with that too.

More on who might benefit from taking a digestive enzyme supplement

So if you have already modified your diet, you are eating a real food diet, and you identify with a lot of these symptoms that I've mentioned today, then maybe taking a digestive enzyme would be helpful. And there are many different kinds out there. So just a reminder, if you identify with some of the signs or symptoms that I mentioned in relation to low stomach acid, you'll want to look for one with betaine HCL.

If you've had your gallbladder out or you feel like you're not breaking down your fat well, then you would look for an enzyme with ox bile. And then to take them, you want to take the digestive enzymes with your meals right before, but let's say you forget to take it, you're mid meal, and then you remember, I would still take the digestive enzyme because you will get some benefit from it.

And a side note, I have a lot of clients that do smoothies. You, I would say you don't need to do an enzyme before your smoothie. The comprehensive digestive enzyme that we have on our Nutrikey website is called Key Digestive Enzymes, and it contains the digestive enzymes, ox bile, and betaine HCL. And the product is cool in that it also has some herbs that tell your own body to make more stomach acid and enzymes. One to two capsules with meals is the dosage on that one.

And if you have a lot of digestive symptoms, I know it can be really overwhelming to know where to start, and especially when you're not feeling well. So that's where we come in. I or any of the other nutritionists at Nutritional Weight and Wellness would be happy to help you figure out an individualized plan to get you feeling better.

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Recap

Let's do a little recap today of our topic. Digestive enzymes and stomach acid are naturally produced in your body to break down your food so that the molecules are easier to be absorbed and digested. But for various reasons, your body may not be making enough digestive enzymes and stomach acid.

Some signs that you might benefit from a digestive enzyme supplement are reflux, food in your stool, bloat, gas, feeling really heavy after eating, especially after eating meat, frequent burping, constipation or diarrhea, nutrient deficiencies like B12, iron and mineral deficiencies, or you've had your gallbladder out. Those would all be possible signs or symptoms that you could benefit.

And then just a reminder, all of these symptoms could be due to other reasons, not just a lack of enzymes and stomach acid. Always focusing on food first, incorporate more real foods, and decrease the processed foods. But if you feel like you've already done that, and you're still having some or many of these symptoms, then a digestive enzyme might be worth trying to see if it gives you some relief.

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