What to Expect When Starting Digestive Enzymes
last updated 8.25.05
The Good Stuff - Possible Improvements: Feel the Joy!
- Increased eye contact
- Increased language
- Increase in humor
- Improved sleep
- Increase in foods tolerated
- Increase in foods accepted by child’s choiceck.
- Weight gain
- Weight loss and reduction in badgering for food
- Skin color and overall appearance
- Improved transitioning
- Desire for physical activity
- Decrease in general anxiety
- Improvement in socialization
- Increased awareness
- Increase in problem solving
- Improvement with short-term memory
- Less adherence to routine
- Increase in range of interests
- Sound tolerance
- Light and color tolerance
- Improvement in other sensory issues
- Decrease in aggression
- Decrease in hyperness
- Increased affection
- Decrease in self-stimming overall
- Decrease in self-injurious behavior
- The Happy Child Effect
- Decrease in pain
- Improved yeast treatment
- Increase in energy
When starting enzymes, the body may need to adjust in a few different ways. Most of these effects ended by the third week, were considered quite manageable, and not too disruptive. The guideline is that enzymes should be tried for at least three weeks to allow for common adjustments by the body. Probably one additional week should be added for good measure in case you are just starting to see positive effects in the third week. Any course of action, whether biological or behavioral, may have some adverse reactions for at least some people, so it is advisable to find out what they are. If something claims to not have any drawbacks, it is best to research what is not being disclosed.
Researching into the matter of enzymes, it was learned that many of these adjustments are not serious at all and quite common when starting any type of digestive enzyme. Many of the adverse reactions are really the body cleaning out and healing itself. Some side-effects are also the same as those seen when starting a restrictive diet. Most side-effects result from the body adjusting to:
- processing more food and liquid
- gut healing, cleaning out inflammation and waste
- die-off from yeast, bacteria, or other pathogens in the gut
- withdrawal effects from 'addictive' food compounds
- body receiving more nutrition from food or supplements
Hyperactivity, irritability, and withdrawal or allergy-like symptoms can actually be indications the enzymes are working and the body is adjusting. The following is a short discussion of what the common reactions are (however, many people do not see any of these at all).
Several reasons why a person may be more hyperactive with enzymes initially and some suggestions for dealing with it are given below.
1. Hyperactivity may be a reaction from acute withdrawal from grains, dairy, sugar, or other substances. This can happen even though you may already have been on a restrictive diet for these foods or sharply reduced them from your diet. Taking enzymes may be removing the sedative effect of any peptides interacting in the body.Hyperness as well as other undesirable behaviors is also a very common behavior when starting restrictive diets (such as a casein-free, gluten-free), so enzymes would be accomplishing the same thing. In addition, enzymes may be removing other sources of these substances that are unknown or not even possible to eliminate with food eliminations alone (some problematic peptides or proteins can be generated within the body from bacteria, hemoglobin degradation, etc).
2. The person taking enzymes may be trying to adjust to an increase in awareness or sensory input. When there is significant improvement in many areas, there may also be an increase in stimming, hyperactivity, anxiety, and a bit of sound sensitivity. Realize that as the person becomes more aware, socially and otherwise, he has a lot more sensory input to process and interpret. At first, this can be overwhelming and frustrating. It could be that he resorts to the stimming and hyperactivity as a protective behavior to try to calm or organize his system. This appears to be very common or typical.
3. Enzymes are known to help keep yeast and bacteria in check. When digestion starts to work better, you have better nutrient uptake and less malabsorption. This healing can start to kill off any yeast or bacteria overgrowth. In addition, enzymes can break down the yeast, bacteria, and pathogens directly. As the microbes die, they may release neuro-toxins and substances that can produce allergy-like symptoms. This die-off reaction is common with other yeast and bacteria treatments. You may see more frequent bowel movements, increased irritability, increased or decreased appetite, flu-like symptoms, hyperactivity, and behaviors that are more compulsive.
4. Better digestion and overall improvement in health caused by the enzymes may unmask a nutrient deficiency. A common deficiency is magnesium, and symptoms of magnesium deficiency are hyperactivity, anxiety, and muscle spasms. Magnesium is recommended for treating hyperness in many conditions besides autism spectrum or attention deficit conditions. Adding a soluble form of magnesium may be very helpful with no known toxic levels, and is inexpensive to give. Other supplements known to help with hyperactivity are calcium, zinc, folic acid, chromium, and molybdenum. Taking digestive enzymes along with some of these supplements may help the body to make better use of these minerals.
5. Many parents report that adding a broad-spectrum product along with a strong protease product has decreased or eliminated the hyperactivity. No one really knows why for certain. Parents report that not only did the hyperactivity decrease, but the child became very pleasant – the Happy Child Effect. Perhaps the glucose regulating ability of the carbohydrate enzymes in the broad-spectrum product have an effect. Or maybe the enzymes make more nutrients available from food, such as molybdenum, sulfur and magnesium, which are needed in the processing of phenols or chemicals. More magnesium also helps with hyperness in general. One theory is that an all-purpose enzyme product that is not as high in proteases or meals that are not as high in protein may favor an increase in serotonin levels. An increase in serotonin helps with calming in most people.
6. There may be a problem processing phenolic compounds, a certain chemical that occurs in all foods. When these chemicals cannot be processed out, they build up as toxins in the body, and hyperness is a common symptom of this. Many people with autism and attention deficit conditions do not process sulfur adequately. Poor sulfur metabolism leads to problems with processing out phenols and other chemicals. Epsom salts (magnesium sulfate) are very helpful for many people because they supply both magnesium and sulfur in usable forms.
In addition, there are some newer enzyme products showing great results for alleviating the negative reactions seen when sensitive individuals consume highly phenolic foods. Fruit-derived enzymes, such as bromelain, papain, or actinidin, may aggravate this situation as well, so looking for products without these particular enzymes may be helpful if you are very sensitive to phenols. Enzymedica is one company that makes several types of enzyme products without fruit-derived enzymes.
see Epsom salts
see The No-Fenol File
7. There is a principle that too much of something can be as problematic as too little of something. Reducing other supplements or discontinuing them may help with hyperactivity or other adverse reactions. One mom put it this way: When you go to the gas station and you need 10 gallons of gas to top off your tank, putting in 11 gallons is going to cause a big mess. Sometimes nutritional supplements that helped initially seemed to become more problematic after starting enzymes. By withdrawing or reducing the supplements, the physical markings and especially the hyperactivity stopped. This seemed to be particularly common with any high B-vitamin supplements. Some of the oils, such as flax seed oil, fish oil, and borage seed oil, were also identified as culprits causing hyperness or aggression.
Overall, most parents with a child showing hyperness when starting enzymes saw that this resolved itself (went away) over time, or as they pursued one of the above recommendations for resolving it. If the hyperness is at an unacceptable level, then decreasing the dose may help. Starting as low as one-eighth of a capsule or even a few sprinkles of enzyme per meal or snack may help. This allows the body to recover and adjust at a more tolerable pace. Having the person stressed, intensely uncomfortable, or ‘toughing it out’ is not necessarily the fastest way to improvement.
Many people notice increased thirst when they start enzymes. This is perfectly natural. The body is metabolizing more food, so more water may be needed to process the food. It is most likely a sign that the body is functioning better and absorbing more nutrients. Just give more water. A very small minority see increased wetting or urination. The body usually adjusts within a week. It can even be a benefit if you are detoxifying the body since the idea is to move the toxins out with the urine and stools.
Having looser stools for the first couple of days is very normal with any enzymes. This is because the body is producing more water as the enzymes break bonds – one molecule of water is produced for each broken bond. More food and liquid is being processed as well. The loose stools usually regulate within a few days, but may last up to two weeks. This is not the same as diarrhea, just looser stools. If it persists longer than that, reducing the amount of enzymes you give may help, especially proteases. Or you should probably discontinue the enzymes and seek the advice of your doctor, the manufacturer, or others using enzymes.
Sometimes after starting a strong protease enzyme product, the person may have a stomach ache or pain when eating. The general recommendation is to stop the protease for around four or five days, and then try again. Usually this resolves the problem. Although proteases such as bromelain and papain have been used extensively to heal gastric ulcers, proteases in particular may be irritating the gut a little initially, particularly if the gut is very damaged or inflamed. The proteases may be cleaning out wounds and inflammation, taking toxins and debris away, and this will leave exposed healthy, yet sensitive tissue. Stopping the proteases for a few days allows these cleaned out, but exposed areas time to heal again. The injured areas will not be so sensitive when the proteases are later resumed.
Another strategy would be to start with an enzyme product that is low in proteases (such as a general all-purpose product), which will promote gut healing, and then adding in the stronger protease product after a week or more. If you wait the four to five days, resume the proteases and then see stomach aches again, this may be a symptom of celiac disease or something that requires different measures. You may also try reducing the dose, or stop the strong proteases altogether. There may be more substantial gut injury which needs longer to heal before stronger proteases can be used.
In a few rare occasions, a person may start digestive enzymes and spit up or throw up a little in the very beginning. Sometimes this is not due to the enzymes and just happens to be a coincidence. Other times it may be the enzymes. A few people this has happened to offered the following saying the problem went away:
- Stop the enzymes for a few days and then start again just as you do for stomach ache
- Reduce the enzyme dose and start up slower
- If the enzymes were taken on an empty stomach or with a light meal, try taking the enzymes with food, or a more substantial meal, for a few days
One explanation for this was offered by a fellow that has worked many years in the
supplement industry, spent several years selling enzymes, and several years working with a specialist in candida yeast problems. He commented that if there is candida or bacteria in the stomach or throat area, and you take something that helps kill these pathogens, such as enzymes, it can cause some throwing up in the very beginning. It is like you have die-off and your body is trying to expel the crud as quick as possible. If the gut bugs are in the lower intestines and bowel, you may have diarrhea or some very interesting looking stools for a few days. In the upper GI tract, it can come out topside.
This is not diagnostic by any means, and you can take it in light of what else you know to help you determine what may be going on and what to do next.
Reaction to formulation
Some people may react negatively to something in a formulation itself, which is possible with any product. Another possibility is that a person will react to a particular mixture as a whole and no specific item is identified as the offender.
A few people so far have had problems with the enzymes papain (from papaya), bromelain (from pineapple), or actinidin which are in many protease containing products. Papain and bromelain are cross-listed for reactivity along with kiwi, some seeds, and pollens. This may be related to a true allergy. So, if you have problems with one of these, also be cautious with any product containing any of these other ingredients. Papain is also listed as cross-reactive to latex.
There have been no reports among the hundreds in the enzyme group since it began May 2001 until this writing where someone ‘became’ reactive or intolerant of an enzyme formulation itself over time. Several times a child would show regression, but in every case it was later found to be due to some other cause such as yeast infection, a cold, traveling, new therapy, or other supplements. Or regression may happen if enzymes are used with certain foods that they are not adequately forumulated to break down.
see Food Sensitivities
This is not a true side-effect of enzymes, but it may be the cause of some of the negative behavior seen. Hypoglycemia is commonly overlooked, but several parents have found that making adjustments for it evens out the moodiness they see in their children. When you are very sensitive to changes and have a neurological feedback system that may not be in the best working order, changes in blood sugar may produce a big effect.
Do improvements with enzymes wear off over time?
The question of 'do enzymes wear off' was heavily monitored in the first year of the enzymes and autism discussion group. But in over four years and thousands of families passing through (and reports from enzyme users not in the group), this has never been reported. There are no reports of this in any of the clinical literature either. There was also a concern that a person may become 'intolerant' of enzymes over time as they do to many foods. This also has never been reported.
What we see is if an enzyme product is not going to work, that is apparent from the beginning. There is no abrupt regression several months later as does happen at times if you follow a GFCF diet and then quit the diet without enzymes. If enzymes do work from the beginning, the improvements are maintained over time, or continue to improve more over time.
Enzymes can help pro-actively heal tissue. So what you may see is that the longer you use enzymes, the less you need for the same level of improvement. This can be due to gut healing. As the gut heals, you own enzymes can be restored so you don't need supplemental ones as much.
Sometimes a improvements with enzymes seem to 'disappear' after several months. In every case reported, this has been traced to a source that is not enzymes 'wearing off'. It could be a vacation trip, new therapy the person isn't adapting to well, cold or virus going around, or some other source. Once the 'other source' was dealt with, the improvements seen with enzymes came back.
Another possible reason that improvement may appear to wane over time: If you are giving high doses of another supplement or med, that supplement or med may not be needed now after being on enzymes. With gut healing and improved absorption, the dose you were giving before may now be too high and so causing problems. You can try removing or reducing the dose and see if that helps.
This may be due to two things. First, the med was better digested, absorbed, and metabolized so more of the supplement or medication is actually being absorbed and used in your body. Second, the symptoms for which the supplement or medication is taken are no longer there (example: if you take a medication for hyperness, but enzymes and good diet eliminate the hyperness, there is no more need for a medication to control hyperness).
High B6 doses are a very common item that becomes "neuro-toxic" and needs to be eliminated. We reduced our meds by about half with enzymes for the same level of effectiveness.
last updated 11/23/2005