Part 2 - Digestive Enzymes - For lactose and gluten intolerances

Updated: Jun 23

For lactose and gluten intolerances


Lactose Intolerance

One of the most recognised and common food intolerance is lactose intolerance (not to be confused with milk allergy). Lactose intolerance is caused by low levels of the Lactase enzyme that is required to break down lactose (dairy sugar).


Lactase is a type of beta-galactosidase, as opposed to alpha-galactosidases that digest starchy carbs. Lactase is also part of the the group of enzymes called carbohydrases.

Lactose that remains partially or completely undigested in the intestine causes gas, bloating and diarrhea (1).


Forunately, lactase enzyme supplements are readily available and there is much stronger evidence for their use compared to alpha-galactosidases enzymes.

They are most useful when taken before eating small amounts of dairy, but not as effective for large amounts (2).


Finding the ideal dose takes some experimentation as it varies between individuals. For some it can be largely ineffective, depending on the individual’s level of intolerance (3, 4).


Lactase supplements all contain varying amounts of beta-galactosidase and are expressed as FFC lactase units. You can determine the strength of the supplements by looking for these units on the packaging.


Summary: Lactase supplements may help people with lactose intolerance consume small amounts of dairy without side effects.


Gluten Intolerance and Celiac Disease


Gluten intolerance (also called non-celiac gluten sensitivity) and celiac disease are two very different conditions. But they are both characterised by an inability to digest a protein called gluten.


A number of digestive enzymes on the market (containing protease enzymes) claim to breakdown the protein gluten, which may seem like an attractive option. Unfortunately, there is a lack of evidence to support their effectiveness.


One study analysed five commercially available supplements and found they did not fully breakdown the problematic gluten molecules (gliadin) (5, 6). In saying that, there have been recent advances for a new supplement (GluteGuard) designed for gluten intolerance and celiac disease patients. The active ingredient in GluteGard is the extract from papaya fruit called caricain. In vitro (laboratory) studies have shown that caricain can breakdown gliadin molecules (7).


However, research in humans is lacking . One recent human study concluded caricain may help with gluten digestion, but it only had a small number of participants… a large percentage of whom left the study before its conclusion (8).


The results will need to be replicated at least once in a larger study before health professionals can confidently recommend caricain for gluten intolerance and celiac disease.


Summary: Most available enzyme supplements are ineffective for treating gluten intolerance or celiac disease. In the future, there may be more evidence to support the use of a pill containing caricain to safeguard against inadvertent gluten exposure.



References

1- https://www.ncbi.nlm.nih.gov/pubmed/27522847

2- https://www.ncbi.nlm.nih.gov/pubmed/8223076

3- https://www.ncbi.nlm.nih.gov/pubmed/24967391

4- https://www.ncbi.nlm.nih.gov/pubmed/8223076

5- https://www.ncbi.nlm.nih.gov/pubmed/26030273

6- https://www.ncbi.nlm.nih.gov/pubmed/24124328

7- https://www.ncbi.nlm.nih.gov/pubmed/19156482

8- http://pubs.sciepub.com/ijcd/4/2/2/


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