Outcome
    Limited

    Digestive Enzymes for Stomach Acid Production

    Digestive enzymes are unnecessary unless you have documented pancreatic insufficiency.

    Overview

    Digestive enzymes are unnecessary unless you have documented pancreatic insufficiency.

    Verdict

    Insufficient evidence

    How It Works

    Supplement pancreatic protease, lipase and amylase activity in the small intestine.

    Dosing & Protocol

    Typical dose

    Recommended dose
    No established dose — evidence is insufficient. Betaine HCl is often sold at 300-750 mg per meal for this purpose, without evidence that it corrects low stomach acid.
    Expected timeframe
    Not established

    Protocol

    dose
    Not established
    form
    Betaine HCl and enzyme blends are marketed for this; neither restores physiological acid secretion
    steps
    Evidence is insufficient: supplemental enzymes do not increase gastric acid production, and the popular home baking-soda or betaine-challenge tests are not validated diagnostics,True hypochlorhydria is diagnosed with gastric pH studies or inferred from atrophic gastritis, H. pylori infection, pernicious anaemia or long-term PPI use — all of which need proper assessment,Never add betaine HCl on top of ulcer disease, gastritis or an active PPI prescription; adding acid can cause pain and harm,If you suspect low acid, ask for B12, ferritin and H. pylori testing rather than self-treating
    timing
    n/a
    duration
    n/a

    Evidence

    What the studies say

    Prescription pancreatic enzyme replacement is clearly effective in exocrine pancreatic insufficiency. Over-the-counter enzymes lack evidence in people with normal digestion.

    Digestive enzyme supplementation in functional dyspepsia: a randomized double-blind placebo-controlled trial

    Score: 5/10
    2018
    rct
    n=40

    Majeed M, Majeed S, Nagabhushanam K +3 more

    Enzyme supplementation significantly reduced bloating, fullness and epigastric discomfort compared with placebo

    View source

    Safety

    Caveats

    Insufficient evidence. Betaine HCl is dangerous with peptic ulcer disease, gastritis or on NSAIDs and can cause burning and erosion. Do not use in pregnancy without medical advice. Persistent dyspepsia with weight loss, vomiting, black stools or anaemia needs urgent assessment.

    Less likely to help if

    Unknown — no effect on acid production has been demonstrated.

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.