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Evidence Based

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Digestive Enzymes vs. Probiotics: Which Supplement Is Best?

Written by Dr. Michael Ruscio, DC on November 3, 2020

Written by Dr. Michael Ruscio, DC on November 3, 2020 — Reviewed by Aimee Gallo

Two Great Options for Better Digestive Health

• What Are Digestive Enzymes?|
• What Are Probiotics?|
• How To Choose|
• How To Take Digestive Enzymes|
• How To Take Probiotics|
• Food Sources|
• Two Great Options|

Probiotics and digestive enzymes are two of the most common supplements for digestive health.

Bloating, indigestion, and other gastrointestinal symptoms suggest that your gut health may benefit from extra support. While a healthy, whole foods diet is the foundation of a healthy gut, supplements can play an important role in restoring specific aspects of digestive function.

Digestive enzymes vs. probiotics: how do you choose the most appropriate supplement for your digestive issues? In this article, we’ll explore how probiotics and digestive enzymes work and help you choose the best product for you.

What Are Digestive Enzymes?

Digestive enzymes are naturally produced by your body to help digest food. A variety of digestive enzymes break down different types of food in your digestive tract. This process ensures that your small intestine can extract nutrients from the food you eat.

Digestive enzymes are produced throughout the upper digestive tract and can be found in saliva, the stomach, and small intestine. The majority of digestive enzymes are produced by your pancreas.

Specific digestive enzymes play specific roles in digestion. Most digestive enzymes fall into one of three categories:

• Amylase breaks down carbohydrates.
• Protease breaks proteins down into amino acids.
• Lipase breaks dietary fats down into fatty acids.

A lack of specific enzymes makes certain types of food hard to digest. This can lead to food intolerances and nutrient deficiencies.

For example, if your body doesn’t produce enough lactase enzymes, you may become lactose intolerant. Diarrhea, gas, bloating, or cramping after consuming dairy products is a sign of lactose intolerance.

Over the long term, lactose intolerance can contribute to calcium deficiency and result in serious health consequences such as osteoporosis (low bone density) and hip fracture. Research suggests that the health consequences of lactose intolerance may mostly be the result of dairy avoidance (without adequate replacement of minerals found in dairy products) and that supplementation with a lactase enzyme can help to avoid these complications [1, 2].

What Are Probiotics?

Probiotics are live microorganisms that live in your digestive tract. They confer health benefits when consumed.

Your microbiome is the complex ecosystem of microorganisms that live in your digestive system. The live organisms in your microbiome perform critical functions for your digestion, hormonal health, nervous system, and immune function [3].

In a healthy gut, high levels of good bacteria keep bad bacteria in check, just as healthy plants keep weeds in check in a well-tended garden. However, if your gut health becomes unbalanced, unhealthy microbes can take over. Poor diet, antibiotics, overuse of antibacterial products, and many other factors can contribute to gut imbalances. Even lack of exercise and sleep can take a toll on your gut bacteria [4, 5].

An imbalance of microorganisms in your digestive system has far-reaching consequences for your health. Gut dysbiosis can lead to digestive symptoms and can also affect your energy levels, mood, hormonal health, immune health, metabolism, sleep, and much more.

The good bacteria in probiotics work by rebalancing the microorganisms in your gut [6, 7, 8], reducing overzealous immune system activity [9, 10], and reducing inflammation in your gut and throughout your body [11, 12].

Digestive Enzymes vs. Probiotics: How to Choose

Clearly, digestive enzymes and probiotics have different functions and health benefits. The supplement you choose depends on your current health symptoms and conditions.

When To Choose Digestive Enzymes

If you have specific food intolerances, digestive enzymes may be very helpful. For example, you can try:

• Lactase for dairy intolerance
• Alpha galactosidase if beans and legumes make you gassy
• DPP-IV for gluten intolerance (but not celiac disease)

Exocrine pancreatic insufficiency (EPI) is a condition that occurs when the pancreas stops producing normal enzyme levels. EPI can range from mild to severe enzyme deficiency. Milder cases of EPI often go undiagnosed while severe cases can cause life-threatening complications [13].

EPI is more common as you age and affects between 5% and 30% of people over the age of 70. Risk factors for EPI include [14]:

• Pancreatic disorders such as chronic pancreatitis, autoimmune pancreatitis, and pancreatic tumors
• Type 1 and 2 diabetes
• Cystic fibrosis
• Inflammatory bowel disease
• Celiac disease
• Sjorgen’s syndrome
• Tobacco and alcohol use

EPI symptoms are similar to IBS and include diarrhea, abdominal pain, bloating, and gas. One study of IBS-D patients in the UK found that 6.1% of them had EPI [15]. If your digestive symptoms include stools that float and are foul-smelling or greasy, it’s important to get checked for EPI. Steatorrhea, or fatty stool, occurs when you don’t have sufficient enzymes for digesting dietary fats.

When To Choose Probiotics

In general, probiotic supplements treat a broader range of symptoms and conditions than digestive enzymes. That’s because imbalances in your gut microbiome cause chronic immune reactions and lead to inflammation in the gut and elsewhere in the body.

A significant body of research shows that probiotics are helpful for treating gut disorders, including:

• IBS [16, 17, 18, 19, 20, 21]
• SIBO (small intestinal bacterial overgrowth) [22, 23, 24, 25]
• Leaky gut syndrome [26, 27, 28, 29, 30]
• Bacterial, fungal, and parasitic gut infections [31, 32, 33, 34]
• Crohn’s disease [35] and ulcerative colitis [36, 37, 38]
• Constipation [39, 40, 41]
• Antibiotic-associated diarrhea [42, 43, 44]

Supplementation with probiotics can also be helpful for symptoms that may be rooted in gut imbalances, including:

• Depression [45, 46, 47] and anxiety [48, 49, 50, 51, 52, 53]. However, data is less conclusive that probiotics can help anxiety.
• Symptoms of stress [54, 55, 56, 57]
• Poor sleep quality [58, 59, 60, 61, 62]

Probiotics can also be helpful for bacterial infections outside the gut, including urinary tract infections [63], vaginal infections [64, 65], respiratory tract infections [66], gingivitis, and periodontal disease [67].

Finally, probiotics may be helpful for a number of other conditions, including skin conditions such as acne [68, 69] and dermatitis [70, 71], and seasonal allergies [72, 73, 74].

If You Are Not Sure Which To Take

If you have digestive symptoms such as indigestion, bloating, or acid reflux, you may not be sure how to decide between digestive enzymes vs. probiotics.

In this case, it’s worth doing a separate trial of each supplement, starting with probiotics. For each type of supplement, take a full dose for 2-3 weeks and monitor your symptoms. If your symptoms improve, continue to take the supplement. If your symptoms don’t improve, there is no need to continue taking that supplement.

When To Take Both

If you have food intolerances, you may benefit from taking both probiotics and digestive enzymes. Research suggests that probiotics can help with lactose intolerance [75, 76, 77] and gluten intolerance [78, 79]. This is one reason why we recommend starting with probiotics and adding digestive enzymes, if you want to test both supplements.

One clinical trial involving post-infectious IBS patients noted changes in the small intestinal microbiome that resulted in lactase enzyme deficiency. After 14 days of probiotic supplementation, 70.8% of patients had resolved their gut dysbiosis and received normal scores on the lactase test [80].

It’s also worth noting that stomach acid helps stimulate your pancreas to release enzymes. If you have low stomach acid, Betaine HCl supplements can provide further help with digestion.

How To Take Digestive Enzyme Supplements

If you react to specific foods, look for specific types of enzymes in your supplement product. For example, if you are lactose intolerant, a lactase enzyme will be most helpful. If beans and legumes cause you excessive gas and abdominal pain, try using a product with alpha-galactosidase.

If you can’t connect your digestive symptoms with any specific food, it’s best to try a product that combines the most important enzymes that help you digest proteins, fats, and carbs.

Take digestive enzyme supplements before each meal, following the dosage guidelines on the product label. Allow 2-3 weeks of daily supplementation before deciding if digestive enzymes are helping to resolve your symptoms.

Digestive enzymes don’t usually cause side effects. However, protease enzyme supplements can be irritating for some. If you experience a burning sensation or increased bloating and gas right after taking digestive enzyme supplements, try a different formula.

How To Take Probiotic Supplements

One difference between digestive enzymes vs. probiotics: Probiotics don’t work like digestive enzymes, and there is no need to find the right strain for your health condition.

What you need to know is that almost all probiotic strains can be organized into one of these three categories:

The most effective approach for taking probiotics is to use one quality formula from each category and take them all together. Follow the full dosing schedule for 2-3 weeks, and then reevaluate your symptoms. If you are experiencing even a small improvement, keep going. If not, you can stop taking probiotic supplements and don’t need to try a different formula.

Research supports this approach to taking probiotics, finding multi-strain probiotics to be more effective than single-strain probiotics [82, 83, 84]. In my clinical experience, taking all three categories of probiotics together has made the difference between people experiencing minimal results or impressive results.

Digestive Enzymes and Probiotics From Food Sources

It’s possible to get both digestive enzymes and probiotics from food sources.

Many raw foods contain natural sources of enzymes which may be destroyed when heated. For example:

• Papaya and papaya contain different proteases (papain and bromelain) which help in digesting protein [85, 86].
• Raw honey contains several types of digestive enzymes

Probiotic lactic acid bacteria are found in fermented foods such as sauerkraut, kimchi, kefir, and kombucha) [87].

Including raw and fermented foods in your diet is a great idea. However, some people with digestive issues may have sensitivities to them. For example, fermented foods are not recommended for those with histamine intolerance.

Dietary supplements offer higher doses of probiotics and digestive enzymes than food sources. While food sources are great for a general maintenance diet, choose supplements if you are treating specific symptoms and conditions.

Digestive Enzymes vs. Probiotics: Two Great Options for Better Digestive Health

Probiotic supplements and digestive enzymes can effectively support your digestive health and overall wellness.

Choose digestive enzymes if you have specific food intolerances or one of the conditions associated with exocrine pancreatic insufficiency.

Choose probiotics if you have IBS, SIBO, or other types of gut imbalance. Probiotics can also be helpful for improving immune health, reducing inflammation, and resolving a wide variety of symptoms that result from gut dysbiosis.

If you have general digestive symptoms, a separate trial of each supplement can help you to determine which supplement will work best for you.