What it is: Bromelain's enzymes aid overall digestion and are particularly adept at breaking down protein. This enzyme comes from pineapple stem and fruit.
How it works: Bromelain's strength is measured in two ways: gelatin digesting units (GDUs) or milk clotting units (MCUs). One GDU equals about 1.5 MCUs. Not surprisingly, products with higher numbers have a stronger impact. Try taking bromelain with a meal, follow any other label directions, and see whether your symptoms improve. If so, the product makes the grade.
Side effects: Bromelain has a natural blood-thinning effect. People taking blood-thinning drugs should probably steer clear—though this remains a theoretical risk; no related problems have been reported.
Pancreatic enzymes
What they are: Think of enzymes as keys that unlock the nutrients in food. Pancreatic enzyme supplements contain a mix of enzymes that help break down proteins, carbohydrates, and fats. Traditionally, pancreatic enzyme supplements (or pancreatin) are porcine-derived, meaning they are made from hog pancreas. Although this type remains significantly more potent—and more appropriate for individuals with serious conditions such as cystic fibrosis—vegetarian options now exist. Derived from fungi, they relieve lesser complaints, such as gas, bloating, and poor digestion.
How they work: As you age, enzyme production in your pancreas often slows, which can cause bloating and gas. Pancreatic enzymes start the digestive process and help break down food into nutrients your body can digest more readily.
To use pancreatic enzymes, follow label directions, and after about three weeks of use judge whether your digestion has improved. If not, you may need a higher dose. Experts used to recommend taking the enzymes before a meal, but just last year researchers in Spain discovered that taking pancreatic enzymes during (ideally) or after a meal was more effective (Alimentary Pharmacology Therapeutics, 2005, vol. 21, no. 8). One final tip: Look for a product that has enteric coating to prevent the enzymes from being inactivated by stomach acid.
Side effects: No side effects in otherwise healthy adults; children with cystic fibrosis shouldn't take them.
Lactase
What it is: The enzyme lactase digests lactose (milk sugar). Lactose-intolerant individuals do not make enough of this enzyme. When they consume dairy products, they end up with gas, cramps, diarrhea, and a generally upset stomach. These symptoms usually develop 30 minutes to 2 hours after eating or drinking foods containing lactose. The lactase in supplements is derived from a fungus.
How it works: As with all enzymes, lactase helps the body digest food (in this case, dairy products). Most people produce less lactase as they reach adulthood. Anywhere from 50 percent to 95 percent of all adults develop lactose intolerance.
Acid lactase units (ALUs) reflect lactase supplement strength. Caplets containing 4,500 ALUs are the most common. Take lactase supplements right before a meal that contains dairy products. You can find lactose-reduced milk, another good option, in most grocery stores.
Side effects: None.
Oregon-based freelancer Victoria Dolby Toews, MPH, is the author of User's Guide to Glucosamine and Chondroitin (Basic Health, 2002).
Bromelain