A Gut Check on Probiotics and Enzymes
Probiotics and enzymes are versatile, as they address gut health and general wellness.
Every person has bacteria in his or her body. Some bacteria are, of course, harmful, but others are helpful. To balance the gut, many people take probiotics, which are live bacteria that are particularly beneficial to the digestive system by improving one’s intestinal microbial balance. Probiotics can be particularly helpful for people with food sensitivities or following a course of antibiotics, though many people can benefit from a daily dose, as maintaining a healthy gut overall is essential for wellness.
The National Center for Complementary and Integrative Health, a division of the National Institutes of Health (NIH), reported that probiotics contain a variety of microorganisms, with the most common bacteria belonging to the lactobacillus and the bifidobacterium groups.
A 2012 survey found that the use of probiotics quadrupled between 2007 and 2012, with about four million people reporting having used them within the past 30 days of the survey.
“When you supplement the body with probiotics, you’re essentially repopulating the gut with the healthy bacteria it needs to maintain a balanced microbiome (the collection of microbes that lives in and on the human body). The microbiome can be thrown off balance by a lack of sleep, antibiotics, stress, travel or a poor diet, so probiotics can play a positive role for many people,” said Leah Linder, ND, science and education manager with Klaire Labs, a Nevada-based manufacturer.
And then there are enzymes, which also help the digestive process.
“Enzymes help break down macronutrients like carbohydrates, protein and fats. Taken in between meals, they can also serve as an anti-inflammatory,” said Serena Goldstein, ND, a practitioner based in New York.
“Enzymes are catalysts that help fuel the energy of life. Every chemical reaction that happens within the body is influenced by enzymes,” added Ryan Sensenbrenner, director of trade marketing with the Florida-based manufacturer, Enzyme Science.
Some people have problems with digestive enzyme production. “This can occur when there is a dysfunction in the ability of the pancreas and other organs to produce enzymes or the body’s demand for enzymes exceeds the supply. This can occur for a variety of reasons, including genetic predisposition, illness, injury or trauma, excessive exercise, aging, toxic exposure or a combination of these things,” said Claire Barnes, DipNT, mBANT, technical advisor at ADM Protexin/Bio-Kult, a manufacturer based in Florida.
Amanda Abbinanti, director of business development for the U.S. division of Nutritional Fundamentals for Health (NHF, Canada), also president and founder of the manufacturer Evolving Nutrition (Mukilteo, WA), said that three main types of digestive enzymes are:
• Proteases: They break down protein into small peptides and amino acids.
• Lipases: They break down fat into three fatty acids plus a glycerol molecule.
• Amylases: They break down carbs like starch into simple sugars.
In general, said Caitlin Higgins, MS, CNS, technical writer with Designs for Health, a Florida-based manufacturer, “A healthy digestive system is essential for total body wellness and helps bolster the immune system’s defense against invading bacterial and viral pathogens, as well as help combat inflammation caused by oxidative stress.”
Digestive Health
Both enzymes and probiotics play a significant role in digestive health, but digestion is so closely linked to general health and wellness that they cannot be separated. “Given this, anything that improves digestive health will invariably have a positive impact on general health and wellness,” said Adam Sutter, quality director with ChildLife Essentials, a manufacturer based in California.
Abbinanti agreed, adding, “Gut health is the first line of defense against most, if not all, health ailments. As time goes on, more and more research is being done to help us better understand the role of our gut in overall health.”
Consequences of impaired digestion can include many GI (gastrointestinal) tract symptoms, explained Linder. These can include “…diarrhea, gas or bloating; food sensitivity; intestinal dysbiosis; inflammatory bowel disease; and autoimmune diseases, such as rheumatoid arthritis, fibromyalgia and chronic fatigue syndrome.”
“The phrase ‘you are what you eat’ would actually be better expressed as ‘you are what you digest and absorb,’” noted Barnes. “If your food is not adequately broken down by the stomach acid and digestive enzymes, the nutrients from the food are not adequately absorbed; this can lead to malnourishment.”
However, neither probiotics nor enzymes are one-size-fits all. “The composition of everyone’s microbiome is different; therefore, which type of probiotic will be most beneficial will depend on the specific individual and the health concern at hand,” said Barnes.
“Practitioners need to look for enzymes that are therapeutically blended across wide pH ranges,” added Sensenbrenner.
Beyond Digestive Health
Though they are digestive superstars, probiotics and enzymes may have other uses.
“Enzymes play a role in every function of the body, and many supplements are recognized for their support of cardiovascular and circulatory health, the function of specific organ systems and for seasonal support of the sinuses,” said Sensenbrenner.
Linder added that studies have shown that probiotics and enzymes can positively impact nutrient absorption; women’s health; immune health; brain health; cardiovascular health; and even the skin. “Probiotics and digestive enzymes can support total body wellness by influencing the full spectrum of physiological processes from immune to neuroendocrine function, and everything in between,” she said.
And probiotics have been studied for many other extra-intestinal conditions, said Barnes. These include allergies, asthma, eczema, cardiovascular disease and obesity. “Greater understanding of the gut-brain axis now indicates that our gut and gut microbiota plays a fundamental role in our brain health; such as our mood and even migraine attacks,” she added.
Benefits
Enzymes and probiotics generally are safe and tolerable for most people to take with very few contraindications. “The only exceptions where they may warrant additional consideration or caution is in patients with certain gastrointestinal conditions that are acute,” said Higgins. Also, added Linder, enzymes may be contraindicated for those who are diabetic or who have damage to the gastrointestinal mucosa; that is a good reason why they should be used under the guidance of a practitioner.
Barnes said that probiotics specifically can be beneficial for older people, as it is common to experience reduced stomach acids and reduction in many pancreatic secretions in conjunction with the aging process.
“The advantage of enzymes is clear: when a patient takes an enzyme product, they should feel an immediate difference the first time they take it. There is no ‘ramping up’ period for digestive enzymes,” said Sensenbrenner.
“Utilizing probiotics and enzymes can help with decreasing bloat, weight loss (even feeling “less heavy/lethargic”), gas, irregular bowel movements, and helping people get the nutrients they need. I don’t necessarily think there is a typical patient or demographic, but it’s understanding to what degree is digestion due to these factors, or if there are many other obstacles to cure that will then have a trickledown effect and help their gut, for example, much more effectively than solely taking probiotics or enzymes,” said Dr. Goldstein.
Along with the potential for having a positive impact on digestive systems, Higgins said, “Probiotic supplementation may help replace beneficial bacteria lost to antibiotic use, illness, poor diet, stress and other factors. Enzyme therapy may prove beneficial results for patients with intestinal permeability, food sensitivities, allergies, and/or intolerances, celiac disease, those who have had gastric bypass surgery, the elderly population, and for those whose GI tract has been damaged by poor dietary habits, chronic stress, alcohol misuse, and certain medications such as antacids and NSAIDs (nonsteroidal anti-inflammatory drugs).”
Still, supplements should be used with caution and under the guidance of a practitioner, particularly if a patient is immune-compromised or is septic, and to make sure that no prescription drugs or other nutraceuticals interfere with probiotics or enzymes. Moreover, probiotics and enzymes may only be needed for a short-term as a patient’s gut begins to heal.
Products on the Market
Probiotics can be found in such foods as yogurt and certain fermented foods, like milk and teas.
However, when food alone isn’t enough, and it often is not, many consumers turn to supplements, which can be individual or multi-strain formulations.
Enzyme Science, a division of Enzymedica, offers many products that combine the benefits of enzymes and probiotics, with the most popular called Critical Digestion, a comprehensive formula. “Our enzyme formulas are set apart by our Thera-blend process, where we combine multiple enzyme variants to cover a wide pH range,” said Sensenbrenner. Another product is Intolerance Complex, which covers all the major food intolerances in one product, reflecting a major growth area in awareness about the effects of food intolerances.
Though ChildLife Nutrition has been manufacturing products in the child wellness space for two decades, they have recently branched out into probiotics and enzymes. The company’s ChildLife Clinicals Line will offer three such products: ChildLife Clinicals Digestive Health, which includes a full spectrum of 11 digestive enzymes; ChildLife Clinicals Kidney/Urinary Health containing Lactobacillus reuteri 1E1; and ChildLife Clinicals Oral Care Probiotic containing BLIS K12 Steptococcus salivarius.
NHF manufactures five probiotics for gut health: Probio SAP, Recovery SAP, Bifido SAP, Children’s ProBio SAP, and S. Boulardii SAP. The company also offers two enzyme products: Digestive Enzymes SAP and Plant Enzymes SAP. NHF offers monographs on all of its products, all of which are available for practitioners, along with references that allow practitioners to research more information about the products.
ADM Protexin has been developing probiotics for more than 27 years; the company acquired Bio-Kult in 2009. Some products include Bio-Kult Infantis for babies, toddler and young children, and includes seven trains of probiotic bacteria as well as omega-3 fatty acids and vitamin D3. Other products include Bio-Kult Advanced Multi-Strain Formulation, the company’s go-to product for digestive and immune support in older children and adults; it contains 14 strains. Other products include Bio-Kult Candea; Bio-Kult Pro-Cyan; and Bio-Kult Migrea. Bio-Kult Mind, already available in the U.K., will launch in the U.S. in March.
Designs for Health offers six distinct enzyme formulations, including Digestzymes, which are pancreatic enzymes with betaine HCl for comprehensive digestive support, and Plant Enzyme Digestive Formula, a digestive enzyme blend which is ideal for vegetarians. Other products are AllerGzyme, Hydrolyzyme, PaleoZym and ProtectZyme.
The company also manufactures several advanced probiotic formulas, such as ProbioMed range (ProbioMed 50, 100, 250), which consists of 10 probiotic strains. The latest is ProbioSpore, a broad-spectrum spore-based probiotic for optimization of gastrointestinal health. Designs for Health also offer technical sheets to educate practitioners about their products and corresponding scientific references.
Klaire Labs offers 29 probiotic products; the company’s top performing formulation is Ther-Biotic Complete, while the newest addition is Ther-Biotic Synbiotic, which combines strain-specific, targeted probiotics with a prebiotic called Sunfiber, a partially hydrolyzed guar gum. Klaire Labs’ products are all hypoallergenic. The company provides support to practitioners in the nature of educational and patient materials.
State of the Practitioner Market/Trends
Probiotics and enzymes remain sought-after supplements, though most agree that before undergoing any probiotic or enzymatic regiment, practitioners should discuss a potential protocol with their patients.
When it comes to enzymes specifically, Sensenbrenner said that practitioners are actively turning to them as “…the next generation solutions for natural digestive health,” in part because of the recognition of heartburn medication side effects.
“Overall, the practitioner-directed dietary supplement market is poised for another year of significant year-over-year sales growth. Products designed to support healthy gastrointestinal function have and continue to represent the largest category in the market. And probiotics and enzyme formulations are a key contributor,” noted Higgins.
The probiotic manufacturing explosion reflects “…the recognition of the importance of gut health to overall health. Gut microbial diversity and quantity are keys to health and wellness,” said Sutter.
It also reflects the inadequacies of a typical daily diet because of over-processed food or foods contaminated with an overabundance of antibiotics and pesticides, explained Abbinanti.
“Food is medicine and fuel for the human body, but the food we eat now is not the same quality that our grandparents consumed, leaving the number of natural benefits of food on a rapid decline and therefore the need for supplementation to once again create balance in a person’s diet,” she said.
Linder added that condition-specific probiotics are becoming more popular.
“Greater scientific understanding and therefore a greater understanding by the public at large of the critical importance of digestive health to overall health and well-being will be the driver and future of this market. More probiotics will continue to be discovered, each with great benefit,” said Sutter.
Abbinanti believes that there will always be a need for probiotics and digestive enzymes if people continue to make poor food choices. She said that because people tend to self-diagnose through the internet and don’t make time as much to see their doctors as they should. “It has become increasingly easy for the everyday consumer to find pharmaceutical grade supplements on internet sites rather than purchasing them directly from their health care provider. This creates a breakdown between the patient and doctor, and a struggle arises between the two parties. This breakdown of communication needs to be addressed between a health care provider and the patient directly for there to be any kind of change in the market place,” she said.
Higgins said that practitioners should run diagnostic testing to assess the status of their patients’ gut ecology, which will enable practitioners to determine if a patient needs to add enzymes and/or probiotics to their daily regimen.
Most agree that education is the key. Linder said that many patients know that they could benefit from taking probiotics and/or enzymes but don’t know the specifics. “This is where the connection with the practitioner is so important,” said Linder.
Dr. Goldstein said that anyone taking probiotics or enzymes should do so as part of an overall wellness routine, as consistency is important. She advised that patients take these supplements under the guidance of a practitioner, as he or she can guide a patient as to quality of specific supplements and dosage.
Healthy Take Aways
• Dietary supplements such as probiotics and enzymes should be used as needed to support a dietary and lifestyle protocol designed by a practitioner in conjunction with his or her patient.
• As health begins in the gut, practitioners should evaluate their patients’ gut health before integrating enzymes and probiotics.
• The market for probiotics and enzymes will continue to grow, as there is greater awareness that most patients can benefit from these supplements.
For More Information:
Bio-Kult, www.bio-kult.com
Childlife Essentials, https://childlifenutrition.com
Designs for Health, www.designsforhealth.com
Enzyme Science, https://enzyscience.com
Klaire Labs, https://klaire.com
Nutritional Fundamentals for Health, https://nfh.ca
