Enzyme Deficiency: Symptoms And Treatment

The first discussions about the importance of enzymes began thousands of years ago! One of the earliest written references to enzymes is found in the Greek poems of Homer dating from around 800 BC, where it was mentioned that enzymes were used in the production of cheese.

What are enzymes

Enzymes are substances of a protein nature that act as catalysts that speed up chemical reactions. They are active under special conditions:

1. the temperature should be 37-39 C;

2. when boiled, they are destroyed;

3. depend on the environment: saliva and pancreas enzymes are active in a weakly alkaline environment, stomach enzymes - in an acidic one.

It is known that enzymes catalyze about 4000 biochemical reactions in living organisms. The rate of most enzymatic reactions is millions of times faster than the rate of non-catalyzed reactions. They can transform reactions in seconds, and in the absence of enzymes, these processes can take hundreds of years!

Where does the name of certain types of enzymes come from? It's simple - most often the suffix "aza" is added to the name of the substrate with which the reaction occurs, or to the name of the type of reaction that they catalyze. For example, the enzyme urease catalyzes the hydrolysis of urea, while tyrosinase catalyzes the synthesis of melanin and other pigments from their precursor tyrosine. There are exceptions to all rules, and here too - pepsin and trypsin do not have standard suffixes, but also belong to the class of enzymes.

Classification of enzymes depending on the type of catalyzed reaction:

• Oxidoreductases are redox reactions. In turn, they are divided into 17 subclasses. All enzymes contain a protein part and a non-protein part in the form of heme or vitamin derivatives of riboflavin (B2), pantothenic acid (B5). For example, the liver enzyme cytochrome, which belongs to this class, hydroxylates lipophilic xenobiotics (substances foreign to the body).

• Transferases are responsible for the transfer of radicals from one molecule to another. For example, a representative of acyltransferase, coenzyme A, transfers an acyl group and forms the neurotransmitter acetylcholine. 

• Hydrolases - catalyze hydrolysis reactions, that is, the breakdown of substances with the addition of a water molecule. This class includes predominantly digestive enzymes, they do not contain a non-protein part. So, amylase is actively involved in reactions with carbohydrates and breaks down starches to oligosaccharides. And lactase is able to hydrolyze lactose (milk sugar) into two components - galactose and glucose. It is produced by various microorganisms, and is also synthesized in the small intestine of humans and other mammals, helping to fully digest milk.

• Lyases - catalyze cleavage reactions without the addition of a water molecule. These enzymes have a non-protein part in the form of thiamine pyrophosphate (B1) and pyridoxal phosphate (B6).

• Ligases - catalyze the reactions of synthesis of complex substances from simple ones. Such reactions proceed with the expenditure of ATP energy. "Synthetase" is added to the name of the enzymes of this group - ATP synthetase catalyzes the formation of the energy storage molecule adenosine triphosphate (ATP) using adenosine diphosphate (ADP) and inorganic phosphate.

• Isomerases catalyze isomerization reactions.

As we have already found out, the vast majority of enzymes are proteins. But many representatives of enzymes for the manifestation of catalytic activity require the presence of substances of non-protein nature - cofactors. There are two groups of cofactors: metal ions (such as Fe3+, Mg2+, Mn2+ or Zn2+) and coenzymes.

The precursors of many coenzymes are vitamins, which is why we need a balanced diet to constantly maintain the vitamin status at the proper level. So, one of the most important coenzymes - NAD + (nicotinamide adenine dinucleotide) - is derived from niacin (B3). In the absence or deficiency of niacin in the diet, some enzymes (such as dehydrogenases) will not be able to work effectively in the body. Such a person will develop pellagra, a disease caused by a deficiency of vitamin B3.

Deficiency of the enzyme system - genetics or the result of poor nutrition

The enzyme system can suffer as a result of hereditary pathologies, as well as be modified after birth. There are 2 classes of enzymes in the body - metabolic and digestive. 2700 enzymes are synthesized inside us and each of them has a special role!

Metabolic enzyme disorders include widespread clinical manifestations and can involve virtually any organ system: lymphatic, cardiovascular, nervous, endocrine, urinary, hepatic, and reproductive. As a rule, such disorders arise as a result of genetic mutations and are inherited according to a recessive trait. For example:

• Deficiency of porphyrin metabolism enzymes is a group of diseases, which are based on violations of the heme biosynthesis cycle. Each enzymatic reaction in the cycle of heme biosynthesis is catalyzed by a separate enzyme, and the insufficiency of any (except the first) of the enzymes that catalyze a certain stage of heme biosynthesis can lead to the development of the clinical stage of a certain form of porphyria. As a result, either the nervous system or the skin is damaged.

• Damage to the nervous system also occurs with a decrease in the activity of arylsulfatase, resulting in a violation of myelin metabolism and the accumulation of cerebroside sulfatide in myelin sheaths within the central and peripheral nervous system - metachromatic leukodystrophy.

• Galactosemia refers to hereditary diseases of carbohydrate metabolism and combines several genetic forms. The disease is based on a deficiency of one of the three enzymes involved in the metabolism of galactose: galactose-1-phosphate uridyltransferase (GALT), galactokinase (GALA) and uridine diphosphate (UDP)-galactose-4-epimirase (GALE).

• Fructosuria is an increased level of fructose in the urine as a result of a deficiency of the enzyme fructokinase.

People with such features are shown only symptomatic therapy, which cannot be said about problems with the digestive enzyme system.

How Digestive Enzymes Work

Nutrient absorption occurs when adequate levels of digestive enzymes are present. As we know, the process of digestion begins with the oral cavity - the first activity of the enzymes amylase and maltase, which break down carbohydrates and are synthesized by the salivary glands, immediately manifests itself. But here the action of enzymes does not end, they continue to be secreted in the stomach, pancreas, liver, and small intestine. Normally, the entire system works smoothly and the gastrointestinal tract performs its function 100% without taking exogenous enzyme supplements. However, if you are experiencing digestive issues such as acid reflux, irritable bowel syndrome, inflammatory bowel disease, or malabsorption of nutrients (malabsorption syndrome),

Intolerance to certain types of foods can also be associated with enzyme deficiency. So, for example, with lactase deficiency, intolerance to dairy products will be observed, pain and rumbling in the abdomen, flatulence, diarrhea with the release of watery foamy feces will appear.

Today, more and more people are taking digestive enzymes, especially those who have certain health problems - gastrointestinal diseases, which include ulcerative colitis or Crohn's disease, hypochlorhydria (too low levels of stomach acid) or pancreatic insufficiency (too low production of pancreatic enzymes).

Digestive enzyme supplements are a broad class that includes pancreatic enzymes, plant-derived enzymes, and fungal-derived enzymes. Such supplements can help relieve gastrointestinal problems by helping to break down food properly. They help convert macronutrients, i.e. larger food molecules (proteins, fats and carbohydrates) into easily digestible particles (amino acids, fatty acids, cholesterol, simple sugars and nucleic acids) that the body can later use for normal functioning and energy. The human body produces special digestive enzymes that promote the absorption of various types of food.

Digestive enzymes are divided into three classes:

1. proteolytic enzymes necessary for the digestion of proteins;

2. lipases necessary for the digestion of fats;

3. amylase needed for the digestion of carbohydrates.

Benefits of Digestive Enzymes:

• Prevents malabsorption of nutrients (malabsorption syndrome). This syndrome is observed both due to low levels of gastric acid, and with enzymatic deficiency.

• Reducing symptoms of acid reflux and irritable bowel syndrome (IBS).

• Minimizing symptoms such as bloating, gas, abdominal pain, diarrhea, and fatigue.

• Helps treat leaky intestines by relieving pressure on the organs of the gastrointestinal tract.

• Prevention of symptoms of food intolerance, for example by breaking down certain proteins and sugars - gluten, casein and lactose.

What digestive enzymes are produced in the human body

• trypsin, chymotrypsin, erypsin, elastase, transamidinase, carboxypeptidase, collagenase - a proteolytic function - are involved in the breakdown and digestion of proteins, resulting in the formation of amino acids;

• ribonuclease, deoxyribonuclease - nucleolytic function - cleave nucleic acids to nucleotides;

• amylase, maltase, lactase, glucosidase, fructofuronidase - glycolytic function - are involved in the breakdown and digestion of carbohydrates, resulting in the formation of sugars;

• lipase, phospholipase, cholesterolesterase, lipoprotein lipase, esterase - lipolytic function - are involved in the breakdown and digestion of fats, resulting in the formation of fatty acids and glycerol.

Yes, yes, vegetables contribute to the normal function of not only gastric, but also pancreatic juice!

Pancreas - fermentation station

The pancreas plays an important role in both digestion and nutrient absorption, as it secretes pancreatic enzymes that facilitate the breakdown of food into smaller molecules and promote the absorption of proteins, fats, carbohydrates, vitamins, and minerals. It is the main enzyme station in our body.

The health of the pancreas depends on the state of the body as a whole - its work may deteriorate against the background of pathological conditions of the liver, gallbladder, intestines, and stomach.

What factors affect the state of the fermentation station?

1. Inflammatory processes in the digestive tract - pancreatitis, gastritis, enteritis.

2. The presence of stones in the gallbladder, resulting in a violation of the outflow of pancreatic secretion.

3. Low acidity of the stomach, against which the production of digestive enzymes and hydrochloric acid decreases.

4. Cystic fibrosis.

5. Infections lead to excessive secretion of pancreatic enzymes, which begin to digest their own pancreas.

6. Dysbacteriosis - pathogenic microorganisms damage the enzymes of the intestinal juice. The amount of lactase, maltase and trehalase is reduced.

7. Avitaminosis (lack of vitamins B, C, E, PP, nicotinic acid).

8. Overeating, as a result of which the gastrointestinal tract cannot cope and cannot produce enzymes in the right amount.

9. Poor nutrition and strict diets.

10. Parasitosis and helminthic invasions.

11. autoimmune disorders.

12. Frequent alcohol intake.

13. Surgical operations on the gastrointestinal tract.

14. Long-term use of drugs that destroy pancreatic cells.

Here are some examples of foods to include in your meal to keep your pancreas healthy:

• Foods rich in antioxidants are raw vegetables, berries, and unsweetened fruits.

• Healthy fats – coconut, olive, avocado, ghee, MCTs;

• fermented foods.

• Quality protein - wild fish, eggs from free-range birds, meat from free-range animals.

• Seeds and nuts (preferably pre-soaked);

• Sprouts.

• Herbs and spices.

Top 15 Foods Rich in Enzymes

1. a pineapple;

2. papaya;

3. kiwi; 

4. kefir; 

5. yogurt; 

6. bananas; 

7. mango; 

8. miso; 

9. tempe;

10. homemade sauerkraut; 

11. kimchi; 

12. avocado; 

13. bee pollen;

14. Apple vinegar;

15. raw honey.

What foods harm the ferment station?

• Alcohol.

• Sweet fruit juice.

• Fried, smoked, salted.

• Trans fats and fast food.

• Processed and refined foods.

Symptoms of Enzyme Deficiency

• Flatulence.

• Nausea and vomiting.

• Fetid diarrhea - an increase in the frequency of bowel movements, feces with excess fat, which are poorly flushed from the toilet, become gray and putrid stench.

• Dehydration of the body.

• General weakness.

• Bloating and gas formation.

• Feeling of heaviness in the stomach.

• Pain in the lower abdomen, in the umbilical ring. As a rule, they give to the sides.

• Rumbling and rumbling in the stomach.

• Decreased appetite and weight loss.

• Dryness and dullness of the skin.

In children, the signs of deficiency will be similar. You can notice a change in their behavior - lethargy, lack of appetite, but at the same time frequent bowel movements. Similar symptoms can be confused with an intestinal infection, the final result will be shown by laboratory diagnostics.

Tests to assess the level of enzymes

Laboratory diagnosis of enzyme deficiency includes:

1. General clinical analysis of blood.

2. Blood test for sugar, vitamin and fatty acid content,

3. Biochemical blood test to determine the level of pancreatic and stomach enzymes: alpha-amylase and pancreatic amylase, lipase, as well as pepsinogen I and pepsinogen II, pepsin.

4. Coprogram.

5. ELISA elastase test (determination of the level of elastase-1 in feces).

Treatment of enzyme deficiency

In the treatment of enzyme deficiency, the regime and rules of nutrition play a huge role - providing the body with the necessary amount of nutrients, maintaining normal blood sugar levels, sparing effects on the pancreas and eliminating triggers. For this, several important principles must be observed:

• It is recommended to eat in small portions (100–300 g).

• The use of easily digestible protein foods.

• Gentle temperature regime - cold and hot dishes irritate the pancreas, it is necessary to eat warm food.

• Exception from the fried and spicy menu: boiling, steaming or baking is recommended.

• Thorough chewing, because with an enzyme deficiency, it is very difficult for the body to digest large pieces of food.

• Limited salt intake.

• Do not drink immediately after a meal, as it can reduce the concentration of gastric juice and interfere with digestion.

When are enzymes indicated?

A person who does not have digestive problems and does not experience pathological symptoms simply does not need to take enzymes, since the body must produce enough of them on its own. But in other cases, additional enzymes are still needed:

• Chronic pancreatitis.

• Other chronic, autoimmune diseases.

• Pancreas cancer.

• Tumors of the pancreas or duodenum.

• High levels of inflammation.

• High triglyceride levels.

• parasitic infections.

• Alcoholism.

• Recent surgery to remove the pancreas.

• Age-related enzyme deficiency.

• The presence of heartburn, bloating, increased gas formation, malabsorption, constipation and diarrhea.

• Reduced immunity.

• If you can't gain weight for a long time.

• After poisoning.

• With intense physical activity.

• Elderly age.

Types of Enzyme Supplements

Pancreatic enzyme supplements are obtained from both plant and animal sources - papaya, pineapple and livestock.

Most variants contain pancreatin, which is a combination of all three groups of pancreatic enzymes.

Types of enzymes:

1. Amylase is an enzyme that breaks down carbohydrates.

2. Lipase is an enzyme that promotes the breakdown of fats.

3. Protease and peptidase are enzymes that help break down proteins.

4. Papain is involved in the digestion of meat.

5. Alpha-galktosidase is an enzyme that helps digest complex carbohydrates with a high gas-forming potential (legumes, grains, oilseeds, root vegetables).

6. Beta-glucanase - helps to digest the fiber of grains and yeasts.

7. Beta-galactosidase (lactase) is an enzyme that catalyzes the breakdown of lactose.

8. Pectinase - breaks down pectins from fruits.

9. Phytase - breaks down phytic acid.

10. Invertase - breaks down sucrose.

11. Cellulase - breaks down plant fiber.

The choice of treatment regimen for enzyme deficiency is determined by the attending physician, since each case requires an individual comprehensive approach.

Much of the choice depends on:

• Type of underlying disease.

• nature of enzyme deficiency.

• Expression of pain.

• The results of laboratory tests.

Only taking into account all these factors, you can choose an adequate treatment and achieve a positive result.

Enzyme Recommendations

• Digestive enzymes are not a generic supplement.

• If you have gallbladder problems, get digestive enzymes with lots of lipase and bile salts. But do not forget that there is no magic pill and the health of the gallbladder must be restored with the help of a balanced diet.

• If you are lactose intolerant, in rare cases, you can take a lactase supplement to help your body break down milk sugar.

• If you have an autoimmune or inflammatory condition, talk to your healthcare professional about taking proteolytic enzymes, which help digest proteins. 

• Look for sustained release capsules that are coated with a special enteric coating to prevent intestinal and pancreatic enzymes from breaking down in the stomach.

• The dosage of enzymes is individual and depends on factors such as medical history and body weight.

• Be sure to store enzyme products in a cool, dry place and keep an eye on their expiration dates.

When should I take digestive enzymes?

Take digestive enzymes about 10 minutes before a meal, or with the first meal of the day. Proteolytic supplements can be taken between meals to supplement digestive enzymes. Start with a low dose of enzymes, such as one dose per day, and adjust the dosage as needed based on your response.

What dose of digestive enzymes should I take?

The dosage depends on the specific product being taken. Always read labels carefully, as taking large doses of enzymes can cause side effects.

Pancreatic enzymes are dosed according to lipase units. Adults are advised to start taking pancreatic enzymes at doses of 10,000 to 20,000 lipase units with snacks or 20,000 to 40,000 lipase units with main meals. To avoid side effects, do not exceed 2500 units of lipase per kilogram of your body weight per meal.

Don't forget that some foods (especially those that are raw or fermented) can provide you with natural digestive enzymes. Try including raw, unprocessed foods in your diet.

Is it safe to take digestive enzymes?

In most cases, yes, most people tolerate them well, however, side effects of digestive enzymes are still observed. This can happen at too high dosages and manifest itself as follows:

• Indigestion, abdominal pain and abdominal cramps.

• Diarrhea.

• Nausea.

• Gas and bloating.

• Headache and dizziness.

• Changes in blood sugar levels.

• Chair changes.

• Allergic reactions.

In this case, you should immediately stop taking supplements and find another option that is more suitable for you in conjunction with your doctor or nutritionist.

As for the interaction of digestive enzymes with drugs, they, as a rule, do not pose a danger when taken simultaneously. However, some interactions of digestive enzymes are possible, including with the following drugs: Warfarin, Miglitol and Acarbose.

Take digestive enzymes separately from calcium-containing or magnesium-containing antacids, as taking them together may reduce the effectiveness of the enzymes.

It is important to remember that enzymatic deficiency is not independent. It is always a symptom of some disease. Therefore, it is very important to take care of your health!