If you have to avoid gluten because you have celiac disease or are otherwise sensitive to this protein in wheat (as well as rye and barley), you know how hard that can be. Gluten seems to be in just about everything, and even tiny amounts can be harmful for celiac sufferers. It’s no wonder then that some people turn to so-called gluten enzyme (glutenase) supplements, such as GlutenEase, Digest Gluten Plus, and Gluten Cutter. These contain a variety of enzymes, including amylase, glucoamylase, and DPP4 (dipeptidyl peptidase-4), sometimes along with “digestion-friendly” ingredients such as ginger, peppermint oil, probiotics, and licorice. It’s claimed that they work like products containing lactase (the enzyme that breaks down lactose—that is, milk sugar), which are used by people with lactose intolerance. Should you swallow the claims?
Alas, the answer is no. We couldn’t find any clinical trials showing that the glutenase supplements on the market are effective and safe for people with celiac disease or other gluten sensitivity (which is less clearly defined). According to Dr. Stefano Guandalini, medical director of the University of Chicago Celiac Disease Center, none of the currently available supplements can be trusted to adequately digest gluten in the stomach before it reaches the small intestine, which is the claimed benefit. “They are totally ineffective in reducing the fractions of gluten that are toxic for celiac patients,” he said.
One problem is that even if the enzymes break down some of the gluten, the remaining proteins could harm people with celiac disease and may provoke symptoms in those with nonceliac gluten sensitivity.
The basic concept of taking enzymes for gluten problems is sound, however, even if the current products don’t live up to the promise. Hundreds of millions of dollars are being spent on research. It’s a difficult task, partly because the enzymes have to survive the acidic environment of the stomach. But down the road there will probably be enzyme-based products that allow some gluten-intolerant people to consume at least small amounts of foods containing the protein, or serve as insurance for people on gluten-free diets in case there’s some hidden gluten in foods they eat.
Bottom line: If you’ve been diagnosed with celiac disease or other gluten sensitivity, avoiding gluten is the only option—don’t expect these supplements to help. Unfortunately, many people are not properly diagnosed for gluten problems and go on highly restrictive diets unnecessarily. If you have chronic undiagnosed digestive problems or other symptoms for which you think gluten avoidance might help, consult your health care provider and get tested before going on a gluten-free diet or trying supplements. Avoidance of gluten can interfere with the diagnostic tests for celiac disease.