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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

And A Question About Enzymes
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I’ve been reading about how digestive enzymes are manufactured, and my big question is wether or not celiacs should take enzymes. The answer could be yes, no, or SOME (which is what i suspect the answer is).

In the U.S., every enzyme company gets their enzymes from 3 source distributors, all of which use gluten-containing cereal grains and a form of mold/fungus like aspergillus orzae or aspergillus niger in the production of some digestive enzymes. the fungal organism is placed on trays of fermenting stuff that most always includes grains, they secrete enzymes, and then the whole mixture is put through a separation process which usually involves some of the following (none of which i understand): alcohol precipitation of the enzyme proteins, centrifugation, gel filtration, molecular sieving. So, there are many fungi-grain enzymes and I believe these are known as “plant-based”. But there are also some fruit-based enzymes extracted straight from food, and some animal-based enzymes like from the pancreas of pigs. At some point in the process MALTODEXTRIN is used when deriving and stabilizing the enzymes. This contains gluten and many celiacs react to it. Companies don’t have to include it on their ingredients lists because it’s not an “additive,” it’s just part of the process of deriving the enzymes. But some maltodextrin probably ends up being part of the enzyme matrix. ALL the raw enzymes distributors in the U.S. use maltodextrin in the process of obtaining MICROBIALLY-DERIVED enzymes.

The enzyme producers adhere to strict extraction guidelines and claim that none of the mold or grain is left in the finished product. But is a fact that people with a mold allergy react negatively to the “plant-based” enzymes including phytase and alpha-galactosidase made from aspergillus niger, so I don’t know if I believe the companies’ claims that none of it remains. There could, however, be some other thing happening in those people’s bodies when they take the enzymes such as a cross reaction with the enzyme itself if their immune systems have somehow associated the enzyme protein with the mold it came from. I don’t know.

This all leads me to suspect that a very sensitive celiac (me) who reacts to the slightest amount of gluten, including maltodextrin, might not be safe taking enzymes that were produced on and in big vats of gluten, then processed using maltodextrin.

So... zyme

Is there a chance that any part of the grains is in the enzymes, either because it could still remain after the extraction process or because the enzymes themselves might have some component of the grain somehow?

Would it be safer to only take fruit and animal-derived enzymes, or would they have just as likely a chance of containing grain stuffs?

Let me know your opinion, and feel free to forward to any enzyme experts you might know. Thank you so much!!

Would you kindly state your source. The bolded (by me) statement is untrue and I have serious concerns about the remaining statements.

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I am definitely interested in learning more about this.

About 18 months ago I was put on a digestive enzyme because of some nutritional deficiencies. I thought I was tolerating it O.K. I started seeing a naturopath who said I didn't need it so I discontinued it. About six months ago I had GI panel done that suggested low pancreatic exocrine output. My doctor had me start the digestive enzyme again. This time around, it really bothered me with lots of gurgling, gas and pain. My doctor told me to quit using it.

The digestive enzyme I was using states it is formulated to be free of allergens derived from gluten, yeast, artificial colors and flavors. The brand is Ortho Molecular Products and contains pancreatin, betaine hcl, pepsin, ox bile and bromelain and papain. So does it or does it not contain gluten and yeast? Did I react to the digestive enzymes themselves, gluten or yeast?

It is tough knowing what to do. My GI panel indicates that I need digestive enzymes. Is taking them (any brand0 going to add to my problems? For the time being, I will not take them.

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When I initially took digestive enzymes (early into my gluten free diet) I could not handle it. I gave it up for a while and discovered one without dairy and I handled it quite well.

Many people highly recommend them.

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i'm sorry i forgot to state the source!

one website is:

http://www.enzymestuff.com/discussionmaltodextrin.htm

I believe there is more current, more reliable information out there.

http://www.enzymestuff.com/disclaimer.htm

You might find this interesting:

Specific Enzymes Produced by the Body to Aid Digestion

Our bodies produce numerous digestive enzymes. The following are enzymes and their actions:

* Amylase for carbohydrate digestion or breakdown into simple sugars

* Protease for large chain protein molecules to make smaller protein molecules

* Peptidase for small protein molecules to make amino acids

* Lipase for fat (triglycerides) breakdown

* Lactase for milk sugar (lactose) breakdown

* Cellulase for breaking down the fibrous plant matter cellulose

* Maltase for the breakdown of malt sugar

* Invertase for the breakdown of sucrose (table sugar)

* Chymotrypsin for large protein chains

* Trypsin for large protein chains

* Pancreatin for the breakdown of protein, carbohydrate, and fats

* The enzymes that have affect protein molecules are proteolytic enzymes.

Digestive Enzyme Supplements

Digestive enzymes are sourced commercially from animal or plants/fungi. The fermentation of various fungi produces the enzymes amylase, protease, peptidase, lipase, lactase, and cellulase. During production of digestive enzymes, microbial filtration ensures there is no fungal residue. Chymotrypsin, trypsin, and pancreatin are pancreatic enzymes, which are from animal products.

Plant based supplements are more stable and able to survive a greater pH than animal based or pancreatic enzymes. Gastric acid tends to destroy animal derived enzymes more easily than plant based enzymes. Some manufacturers, with the use of enteric-coated enzyme supplements, have overcome this problem. Enteric coating is a coating which inhibits the product from dissolving in the stomach. It dissolves in the intestine where there is less stomach acid. This may affect the clinical use of the product; however, as the enzyme supplement will not be effective for the stomach or upper small intestine. Additionally, plant-based digestive enzymes have a broader range of digestive enzyme activity.

Digestive Enzymes Health Benefits: Aid Digestion and Reduce Food Allergies

The main health benefit of general digestive enzyme supplements is in the support of the digestive process. A human and animal study found both fungal and pancreatic enzymes improved malabsorption and malnutrition, while producing a healthier stool weight and fat excretion. Theoretically, digestive enzymes can also work by breaking down dietary proteins that enter the bloodstream due to inflammatory conditions or a breakdown in the gut mucosa barrier. When these proteins travel from the gut to the bloodstream inappropriately, they can cause an immune reaction such as food allergies. Digestive enzymes may reduce this allergic reaction by breaking down these proteins and reducing an immune response.

Read more at Suite101: The Health Benefits of Digestive Enzymes: Enzyme Supplements Aid Digestion and Food Allergies http://nutrition.suite101.com/article.cfm/...s#ixzz0b2KEM5Qa

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A quick google search turned up nothing to support the claims from that site. And I don't understand....maltodextrin is produced from corn starch, so how could it have gluten?

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thank you guys for your feedback! i'm still checking all this out and deciding what i think :)

yes maltodextrin is corn derived in the US - i react to corn as well as gluten so for me that's an issue...

the gluten would come in to play because the organisms the enzyme companies use to are placed onto a food source mixture which includes grains. then they secrete enzymes which are gathered and mixed with maltodextrin which somehow stabilizes or preserves them. then they're brought through a purification process and theoretically would be just enzymes after that. but some people that have celiac react to them for some reason, and knowing that they've been in direct contact with grains and that the organisms they were gathered from had created them by digesting grains makes me nervous.

i think i will try the animal and fruit - derived enzymes for now. but i plan on finding an enzyme without ox bile because i hear that some people have trouble with that ingredient.

i found a supplement by metagenics that looks like it's derived from pig, but when i emailed to check the company said i have to have my physician write them for that information and purchase it through him. funny because i've ordered things from them online before!? anyway :)

as far as support for the claims of the site, jestgar, were you referring to the claims about how enzymes are made? i contacted an enzyme scientist at a soap company i'm affiliated with and here is what he had to say about the issue: there would be definite contact with gluten at the beginning of the enzyme creation process, but there is a purification process that renders the enzymes gluten free. but he wasn't sure if i would react or not because the organisms had ingested gluten while they made the enzymes. he thinks i would probably not react, but it may be safest to try animal derived.

i feel your pain jackay! i react to *everything* - so i'm nervous to start enzymes. could it be possible you were reacting to the ox bile ... ?

thank u Lisa for more info on the health benefits- i'm excited for the day when i finally find an enzyme i can try, i know they're super helpful!

:)

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one more thought from my enzyme scientist friend-

i THINK he's saying there would be a theoretical way that what the fungi ingests would effect the make-up of the enzyme it creates...

"enzymes will bind additional substrates to themselves at other locations other than the active site, also called allosteric binding sites. These sites, once occupied, will continue to be occupied until the substrate is no longer available--even with purification, the substrate will generally remain attached to the enzyme."

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