The 6 Best Digestive Enzymes of 2023

Will You Benefit from a Digestive Enzyme Supplement?

“Digestive enzyme” is an umbrella term that includes many types of enzymes, each with its unique function. If you are experiencing digestive issues, you will only benefit from a digestive enzyme supplement if it contains the enzyme or enzymes that are targeted for your specific condition.

The first step in considering whether or not you need a digestive enzyme and, if so, which type you need is clarifying what is causing your symptoms. “It’s hard to identify intolerances like these yourself,” says Shira Hirshberg MS, RDN, LDN. “Meeting with a registered dietitian who specializes in gastrointestinal difficulties can help you identify whether enzyme products might be helpful.”

In addition to diet assessment, a variety of medical tests can be performed by a gastroenterologist to pinpoint the issue.

A digestive enzyme supplement may be beneficial for the following individuals: 

Those with lactose intolerance: Lactase enzyme supplement

• Lactose intolerance is when your body does not produce enough of the enzyme lactase needed to break down lactose (the sugar naturally found in milk and milk products).
• Taking a lactase enzyme supplement can be helpful if you have lactose intolerance and want to eat lactose-containing foods.

Those with dietary fructose intolerance (DFI): Xylose isomerase/glucose isomerase supplement

• To improve fructose digestion, those with DFI can take an enzyme called xylose isomerase (aka glucose isomerase) when eating fructose-containing fruits, vegetables, and sweetened foods.

Those with fiber-rich diets who experience bloating: Alpha-galactosidase supplement

• If you regularly consume legumes (e.g., chickpeas, beans) or cruciferous vegetables (e.g., broccoli, cauliflower, cabbage) and notice bloating afterward, you may be sensitive to certain types of fiber known as galacto-oligosaccharides (GOSs).
• Alpha-galactosidase is a supplemental enzyme derived from yeast that can break down GOS when taken with a meal.

Those with irritable bowel syndrome (IBS): FODMAP enzyme cocktail and/or possible lipase supplement

• If you have IBS and have a sensitivity to FODMAP-rich foods, you may want to try a “cocktail” of FODMAP enzymes such as lactase, xylose isomerase, and alpha-galactosidase when you consume a FODMAP-rich meal.
• A very small amount of research also suggests that lipase supplementation, the fat-digesting enzyme, may also be of help to those with IBS.

Those with active (untreated) small intestinal bacterial overgrowth (SIBO): individual digestive enzymes or FODMAP enzyme cocktail supplement

• If you have active SIBO, the bacteria in your small intestine can interact with FODMAPs and cause a variety of unpleasant symptoms, including gas, bloating, and diarrhea. Low-FODMAP diets are often recommended until SIBO is treated.
• Short-term supplementation with individual digestive enzymes or a “cocktail” mix of multiple enzymes may help with the digestion of FODMAP-rich foods, such as lactose, fructose, or GOS.

Those with histamine intolerance: diamine oxidase (DAO) supplement

• The body relies on an enzyme called diamine oxidase (DAO) to break down histamine, a naturally occurring substance found in certain foods such as aged cheese, canned fish, spinach, and eggplant.
• However, if you have a DAO deficiency or you take in more histamine than DAO can break down, you may experience a variety of digestive symptoms, including diarrhea, bloating, skin reactions, and chest tightness. In some cases, delayed reactions can occur and may be worse during allergy season. Those with MAST cell activation syndrome (MCAS) or those on medications that block DAO are more likely to have histamine intolerance.
• In addition to histamine-blocking medications and dietary histamine avoidance, you may use supplemental DAO to help break down histamine in the body.

Those with fat sensitivity: possible lipase supplement

• If your pancreas is working normally, but high-fat foods (e.g., greasy, oily, fried foods) consistently trigger digestive issues, it is unclear whether enzyme supplementation will improve symptoms.
• Limited research has shown that symptoms may improve if you supplement with lipase before a high-fat meal, though more data is needed to create standardized recommendations.

Those with functional dyspepsia (FD): Potential lipase supplement

• Functional dyspepsia is a condition where you have indigestion without a clear cause. While there is no enzyme deficiency with this condition, a small amount of research has shown the benefit of taking lipase before fat-rich meals.

Those unable to restrict their diet: Appropriately selected enzyme for intolerance

• While the surest way to feel your best after a meal is to avoid the foods that are known to trigger your digestive symptoms, there are a variety of reasons why diet restriction is not possible. In these cases, an appropriately selected enzyme for your intolerance can offer a key tool for dietary freedom. 
• For some people, a limited diet while eating out, traveling, or at social functions may be impractical or stressful, while for others, long-term dietary restriction is not recommended. For example, those with food intolerances that are in recovery from an eating disorder may benefit from having a digestive aid instead of cutting foods out of their diet. Those who have strong cultural ties to certain foods may also benefit from a supplement to help digest a food that is an important part of their diet and heritage.

Who May Not Benefit from [Over-the-Counter] Digestive Enzymes

If you do not have digestive symptoms, an enzyme supplement is unlikely to provide a noticeable benefit. Although many products are marketed as improving digestion, there is no evidence for general health or for those who are symptom-free.

Some medical conditions require treatment beyond over-the-counter products. Additionally, certain digestive enzyme supplements may not be safe for:

• Those with a genetic condition called galactosemia (avoid alpha-galactosidase)
• Those who take diabetes medications, such as Precose (acarbose)
• Those who are pregnant or lactating

Some conditions require prescription enzyme replacement therapy. “True enzyme replacement therapy is a prescription medication that is FDA approved and tested and contains much higher doses of the requisite enzymes,” notes gastroenterologist Yevgenia Pashinsky, MD. If you have any of the following conditions, work with a healthcare provider to determine the best treatment option: 

• Pancreatic insufficiency: The pancreas makes key digestive enzymes—protease, amylase, and lipase. A condition called exocrine pancreatic insufficiency causes a deficiency in these enzymes, resulting in poor nutrient digestion, particularly of fat. Pancreatic insufficiency can also arise from cystic fibrosis, diabetes, chronic pancreatitis, pancreatic cancer, and pancreatic surgery, among other conditions. If you have pancreatic insufficiency, prescription pancreatic enzyme replacement is needed. 
• Congenital sucrase-isomaltase deficiency (CSID): A known sucrase-isomaltase enzyme deficiency calls for a prescription-only enzyme called sacrosidase in order to adequately digest sucrose-containing meals. Temporary sucrase-isomaltase deficiency can also arise from conditions affecting the small intestine, such as untreated celiac disease or active Crohn’s disease. 

In addition, there is no evidence of digestive enzymes to help with the following: 

• Sugar alcohol intolerance: There are currently no digestive enzymes with a proven ability to aid tolerance to sugar alcohols (i.e., ingredients ending in “ol” such as erythritol, xylitol, sorbitol, and mannitol). If you experience digestive upset with these foods, an over-the-counter enzyme is unlikely to provide relief. 
• Food allergies: If you have mild to severe reactions to foods that are related to a food allergy, a digestive enzyme supplement is not an effective treatment or preventative strategy. For example, a lactase enzyme supplement will not help with a milk allergy. Promptly consult your healthcare provider if you have symptoms such as swelling, difficulty breathing, itching, rashes, or blood pressure changes after eating certain foods. 
• Celiac disease: The only treatment for celiac disease—an autoimmune condition that results in intestinal damage in response to gluten—is a lifelong gluten-free diet. Despite some product marketing claims, there is no digestive enzyme or supplement that makes gluten safe for consumption for people with celiac disease. Products containing dipeptidyl peptidase IV (DPP IV) or those marketed as “glutenase” are not proven aids for gluten consumption, nor for the treatment of symptoms related to gluten exposure, in people with celiac disease. 
• Inflammatory bowel disease (IBD): Active IBD, such as Crohn’s disease and ulcerative colitis, necessitate medical treatment and specific dietary therapies. Digestive enzymes are not indicated for IBD management. However, in some cases, temporary lactose sensitivity is associated with active IBD and may be helped by lactase enzymes if consuming lactose.

How We Select Supplements

Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here. 

We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products.

It’s important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.

What to Look for in a Digestive Enzyme Supplement

Risks of Digestive Enzymes

There are few risks associated with enzyme supplementation. Known side effects include gastrointestinal discomfort, particularly with increased dosage. As with any commercially available supplement, digestive enzyme products are minimally regulated and can include contaminants and doses that do not match the label or vary across brands. 

Products with ox and bovine ingredients may present risk of disease transition, including bovine spongiform encephalopathy (aka mad cow disease). 

Form

Digestive enzyme supplements can be formulas containing:

• Broad digestive support: A blend of multiple different digestive enzymes in one (e.g., FODMAP enzyme products)
• Individual digestive enzymes: A single enzyme that targets a single nutrient (e.g., lactase for lactose digestion, xylose isomerase for fructose, etc.) 

Over-the-counter digestive enzymes typically come in one of the following physical forms:

• Capsules
• Tablets
• Chewables
• Powder 

There is no research suggesting greater efficacy of one form of the supplement over another; however, keep in mind that some chewable and flavored products may contain additional ingredients, such as sugar alcohols, that can cause extra symptoms. 

Ingredients & Potential Interactions

It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included relative to the recommended daily value of that ingredient. Please bring the supplement label to your healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking.

Digestive enzymes may be derived from plant or animal sources. If you are vegan, vegetarian, or avoid certain animal products for religious reasons, read product labels carefully. Key ingredients to be aware of: 

• Porcine (pig): Commonly found in enzyme products targeting fat digestion, such as over-the-counter pancreatic enzymes.* Those who do not eat pork may choose to avoid this ingredient.
• Ox (cow): Commonly found in enzyme products targeting fat digestion (e.g., ox bile supplements), as well as pancreatic enzyme products.* Those who do not eat beef may choose to avoid this ingredient. 
• Aspergillus niger: A plant-based mold. Those who are vegan can consume this source. 
• Trichoderma: A plant-based fungus. Those who are vegan can consume this source. 

*Over-the-counter pancreatic enzymes are not the same as the high-dose prescription enzyme replacement needed for pancreatic insufficiency.

Some digestive enzyme products may also contain added ingredients such as prebiotics, which can worsen gas and bloating in digestively sensitive people, or sugar alcohols, which can worsen diarrhea. Chewable supplements are more likely to contain one of these ingredients as a sweetener. 

Prebiotics (avoid for gas and bloating) include:

• Fructo-oligosaccharides (FOS) 
• Inulin (chicory root fiber)

Sugar alcohols (avoid for diarrhea) include: 

• Sorbitol
• Mannitol
• Xylitol  
• Erythritol

Digestive Enzyme Dosage

Digestive enzyme dosage is not standardized across products, and many enzymes do not have research-based guidelines. However, of the enzymes that have been studied in human digestion, the following dosages have been shown to improve symptoms: 

• Alpha-galactosidase supplements: At least 300 GalU units of alpha-galactosidase enzyme at the start of a meal.
• Lactase supplements: At least 3,000 ALU (acid lactase units) of lactase enzyme at the start of a meal, though larger portions of lactose-containing dairy may need 6,000-9,000 ALU.
• Xylose isomerase supplements: 130 milligrams has been shown to help digest 25 grams of fructose (about two medium apples or one can of soda).
• Diamine oxidase: 4.2 grams of DAO has been shown to reduce symptoms of histamine intolerance.

Note that products that contain enzyme blends may contain lower amounts of each enzyme compared to products that contain only one type of enzyme. If you have poor digestion of a single nutrient, such as lactose or fructose, you may benefit most from a product that contains only the necessary enzyme. If you have multiple intolerances (e.g., lactose and fructose), look for an enzyme that contains adequate doses of each enzyme. 

How Much Is Too Much?

There are generally no established upper limits for over-the-counter enzymes. Unlike prescription enzymes, there is no standard dosing for commercially available digestive enzymes, and guidelines may vary across different products. Additionally, many products contain ingredients that have not been studied in human digestion and therefore have unknown health risks.

Of the most researched enzyme products, documented side effects include gastrointestinal upset, such as gas, bloating, and nausea. Products should be used under the guidance of a healthcare provider to minimize the risk of excessive use. High-dose lipase intake, in particular, has been shown to cause damage to the colon walls. When it comes to digestive enzymes, there is no “adjustment period,” so if you find one is not working, or especially if you have an allergic reaction to any supplement, stop taking it. 

Digestive Enzymes We Do Not Recommend

Numerous digestive products advertise enzymes derived from raw fruits and vegetables, as well as some from animal sources, for digestion enhancement. Although these ingredients may facilitate a chemical reaction (breakdown) outside of the human body, the following enzymes lack evidence as digestive remedies in humans: 

• Trypsin/chymotrypsin
• Peptidase 
• Dipeptidyl peptidase IV (DPP IV)
• Invertase
• Cellulase
• Hemicellulase
• Phytase
• Bromelain
• Papain
• Ox bile 

Tips for Using Digestive Enzymes Effectively

Digestive enzymes require specific conditions to do their job. A product is most likely to be effective with the following considerations:  

1. Identify the issue: Before adding a digestive enzyme, work with a healthcare provider to assess your digestive problem. If a dietary intolerance or deficiency has been identified, experiment with small amounts of a problem food to test your tolerance. You may find you tolerate a small amount of food without any problems. For example, some people can have small amounts of FODMAP-rich foods without any problems, but a large amount over the course of a meal or day triggers discomfort.
2. Match the problem: Digestive enzymes work to target specific nutrients. Ensure that the product you’ve selected works for the food component you have trouble with. If you adequately select and dose an enzyme but still have symptoms, it’s worth considering whether you’re intolerant to another component of the meal. For example, a lactase enzyme can effectively digest the lactose in ice cream, but it will not help with a fructose issue. Additionally, watch out for added ingredients such as prebiotics and sugar alcohols in supplement products that could add to your symptoms.
3. Time it appropriately: Enzymes must make contact with food to break it down. Enzymes taken too far in advance or after digestion will be ineffective. Most enzyme supplements should be taken within a few minutes of eating. Note: If you have known slow motility (food tends to move slowly through your digestive tract), you may need to experiment further with timing and dosage. For example, taking a digestive enzyme pill at the start of a meal and halfway through to ensure it can work later on. 
4. Look for enteric coating: Enzymes are pH-sensitive, meaning their effectiveness will be affected by the acidity of the environment. Enteric coating is an acid-resistant barrier on a pill or capsule that allows the enzyme to remain intact before reaching the small intestine, where it helps with digestion. Enzyme supplements that are enteric-coated are most likely to be effective. 
5. Match dosage to food portions: Digestive enzymes have a dose-response relationship to the nutrient they target. For a product to be effective, the dose of the enzyme should be enough to match the amount of the food. Products that are blends of multiple enzymes tend to contain smaller amounts of individual enzymes compared to products that offer a single enzyme.
6. Minimize cost: Commercially available digestive enzymes can come with a high price tag. Look for products that contain the main enzyme(s) needed to help your digestive issue and avoid paying for too many extra ingredients. Consider reserving enzyme supplements for when dietary avoidance is most impractical for you, which might include social events, dining, or travel. Periodically re-test foods without an enzyme to ensure the product is still offering a benefit for you. 
7. Customize your regimen: Even when a digestive enzyme is appropriately selected for a digestive issue, individual responses can vary. It may take some experimentation with dosage relative to food portions and to the speed of your digestive tract to optimize results. Consider consuming a food both with and without an enzyme supplement and with different amounts of the supplement to determine if and how much is helpful. 
8. Timing is key: Remember to take enzyme supplements at the start of the meal, as they must be in contact with the food in your digestive system. If you have a long stretch of eating, it may be worth adding another dose midway.

Why Trust Verywell Health

Suzie Finkel, MS, RD, CDN, is a nutrition consultant specializing in the nutritional management of digestive problems. She holds a master’s degree in nutrition from Columbia University and has trained in numerous clinical gastroenterology settings. As a GI dietitian, she provides evidence-based nutrition services for a wide array of conditions, including enzyme deficiencies. Her goal is to demystify nutrition (mis)information and facilitate digestive comfort.