Question: Can digestive enzymes save you from the symptoms of gluten exposure?
None of the over-the-counter products on the market right now have been proven to protect you from nasty celiac symptoms if you accidentally or purposely ingest gluten. However, various researchers are investigating different forms of digestive enzymes as a potential drug treatment for celiac disease, so it's possible we might eventually see a prescription product for celiac that uses these enzymes.
Some OTC Digestive Enzyme Products Hail From Autism Market
Over the past couple of years, I've seen several products come on the over-the-counter supplement market that purport to allow people who get symptoms from gluten exposure to eat gluten — or at least foods that are slightly cross-contaminated with gluten — without getting their usual array of symptoms.
Initially, these enzymes were marketed mainly to the autism community, where some parents use the gluten-free casein-free (GFCF) diet to treat their autistic children.
However, as awareness of celiac disease and gluten sensitivity has grown, sparking much greater interest in the gluten-free diet, these manufacturers began targeting the celiac/gluten sensitivity market along with the GFCF diet market.
Enzyme Claims Don't Include Celiac Disease Treatment
These products don't specifically claim to treat celiac disease — they'd run afoul of U.S. Food and Drug Administration rules governing marketing of unapproved drugs if they did.
However, they do claim to provide enzymes that allow your body to better break down the gluten protein, and they allude to the possibility of allowing you to consume "more foods."
FDA regulations don't prevent consumers from touting the alleged benefits of these digestive enzymes on celiac/gluten intolerant forums and discussion groups, and that's where I've seen them mentioned (and promoted) the most frequently.
No Proof Exists That Enzymes Prevent Gluten Symptoms
Digestive enzymes formulated and marketed specifically to help people digest gluten base their science on the concept that gluten symptoms result when your body fails to break down the gluten protein properly.
Adding certain types of enzymes — enzymes your body might lack — enables more complete digestion, and will help to prevent symptoms from food intolerance, according to the enzymes' marketing materials.
But while there's some evidence that this theory may eventually pan out, there's no evidence that the enzymes marketed over-the-counter right now have some sort of special action against gluten.
Researchers Work on Enzymes As Potential Celiac Treatment
Scientists are exploring the possibility of using enzymes as a celiac disease treatment.
In May 2011, Alvine Pharmaceuticals was awarded four patents for gluten-specific proteases (enzymes). Alvine's lead potential product, ALV003, is a mixture of two enzymes that may be able to break down gluten into fragments too small to cause a reaction. That product has been awarded "Fast Track" status by the U.S. Food and Drug Administration, meaning that it could be approved quickly if it pans out in clinical trials (now ongoing).
Scientists at Stanford University conducted the initial research on these enzymes, and Alvine has an exclusive worldwide license for the patents. Other researchers, notably Dr. Frits Koning at Leiden University Medical Center in The Netherlands, also are exploring the idea of digestive enzymes in celiac disease.
Should You Try OTC Digestive Enzymes?
I confess that I bought into the hype surrounding digestive enzymes early on, and tried them in an effort to curb some of the nasty gluten cross-contamination symptoms I got when eating out.
They didn't do a darn thing for me. The only way I got rid of the symptoms was to learn how to avoid gluten when dining out.
Other people claim to have better luck with them, but I'd take their testimonials with a huge grain of salt —it's easy to psych yourself into believing something works, especially if your symptoms are subtle and you really want it to work.
It's especially dangerous to think you can use digestive enzymes to replace the gluten-free diet as your treatment for celiac disease. Cheating on the gluten-free diet can carry some severe health repercussions down the road.
I wish there was a quick-and-easy pill to take to avoid gluten symptoms, but there's not... yet. Until there's an FDA-approved treatment on the market -- enzyme-based or not -- we'll have to stick with the gluten-free diet.
Ehren, J. et al. A Food-Grade Enzyme Preparation with Modest Gluten Detoxification Properties. PLoS ONE. 2009; 4(7): e6313.
Gass J. et al. Combination enzyme therapy for gastric digestion of dietary gluten in patients with celiac sprue. Gastroenterology. 2007 Aug;133(2):472-80. Epub 2007 May 21.