Digestive Enzymes & Disease w/Focus on Autism

Digestion: we all do it though most take it for granted unaware that improper digestive enzymes and subsequent digestion is the root cause of most disease which is epidemic at the moment:

Disease Epidemic_PNG file
Slide source: biomeonboardawareness.com

Those with digestive dysfunctional symptoms (GERD, heartburn, bloat, gas, bowel Bristol Chart type issues…) don’t take it for granted.  Neither should you.

Any blimp in the digestion trek, from brain to elimination, has upstream and downstream ramifications particularly affecting the microbiome community bacterial species balance.   Most, if not all disease, is now being connected to microbiome community shifts.

This post focuses on autism specifically only because there are many current studies documenting the autism digestion dysfunction.  The overall message however applies to all of us.

The slides below summarize Digestion 101.  Basically, large food molecules are broken into smaller for absorption.   Different enzymes are needed for metabolizing carbohydrates, fats and proteins.

Impaired digestion (such as due to lack of effective digestive enzymes) contributes to abnormal gut flora.  Improperly digested food feeds the bacteria in your gut shifting the community balance in a detrimental manner.  Consequences of improper digestion include:

  • Chronic malabsorption and micronutrient insufficiency leading to Leaky gut.
  • The body does not have the basic nutritional building blocks it needs; health and ability to recover from illness will be compromised.
  • Besides breaking down food, enzymes (particularly the proteases) can help with gut healing, controlling pathogens, and immune support.
  • Your immune system begins in your gut— if you have enzyme and digestive issues, chances are your immune system isn’t functioning as well as it should be.

Studies unequivocally find enzyme deficiencies in autistic children and autistic adults:  A 2011 Harvard Medical School large study (intestinal biopsy of 199 children and adults with autism [ages 22 months to 28 years]) found disaccharidase enzyme deficiencies that persisted into adulthood.  These enzymes are needed to digest sugars.

The Pearl:  For autism, one does NOT out grow these disaccharidase enzyme deficiencies:  

    • 62 percent have lactase deficiency.  Needed to digest milk sugars.  One deficient would not be able to digest lactose containing dairy.  Quoted from this study, Most autistic children with lactose intolerance are not identified by clinical history.”
    • 16 percent have sucrase deficiency.  Needed to digest sucrose into glucose and fructose.
    • 10 percent have maltase deficiency.  Needed to digest malt formed from grains found in beverages, beer, cereal, pasta, potatoes and in many processed products which have been sweetened,  as well as β-amylases found in plants, sweet potatoes, soybeans, barley and wheat.

Other relevant studies finding enzyme deficiency in autism are:

  1. Thirty-six children underwent upper gastrointestinal endoscopy with biopsies, intestinal and pancreatic enzyme analyses, and bacterial and fungal cultures, Gastrointestinal abnormalities in children with autistic disorder”, Horvath, et al, 1999 :
    •  Grade I or II reflux esophagitis in 25 (69.4%),
    • Chronic gastritis in 15, and
    • Chronic duodenitis in 24.
    • The number of Paneth’s cells in the duodenal crypts was significantly elevated in autistic children compared with non-autistic control subjects.
    • Low intestinal carbohydrate digestive enzyme activity was reported in 21 children (58.3%), although there was no abnormality found in pancreatic function.
    • Seventy-five percent of the autistic children (27/36) had an increased pancreatico-biliary fluid output after intravenous secretin administration.
    • Nineteen of the twenty-one patients with diarrhea had significantly higher fluid output than those without diarrhea.

2.  Ninety autistic children endoscopic biopsies:   “Autistic disorder and gastrointestinal disease”, Horvath et al, Current Opinion in Pediatrics 2002, 14:583–587.

    • Fourty-nine percent had at least one deficient enzyme activity, and
    • Twenty percent or more had deficiencies in two or more disaccharidase enzymes.
    • The most common deficiency was lactase and maltase deficiencies followed by low activity sucrase, palatinase, and glucoamylase.
    • All of the children having low enzyme activity had loose stools and/or gaseousness.

Note:  If one lacks these enzymes, digestive enzymes are taken in addition to special diets that eliminate that food group (SCD, GAPS, PALEO…);  digestive enzymes should not be used instead of special elimination diets. Digestive enzymes are taken as a precaution against unknown exposures.  Enzymes can be naturally increased in the body.  This post does not address such but a later post will.

The slide below demonstrates the success of eliminating certain food groups for autism:

diet and autism NDsite
“Autism – Part 4: Digestive Function”,Dr. Nicholas Anhorn, BSc, ND. http://www.ndaccess.com/MonctonNaturopathic/Page_Detail.asp?PageID=22&CommentID=20
When the biome is abnormal, micronutrient deficiencies occur since the biome bacteria produces vitamins (and many other compounds, see comment below). One such example is low biotin and Vitamin K levels:
“1st International Symposium on the Microbiome in Health and Disease with a Special Focus on Autism”, Little Rock, Arkansas, June 2014.
Lastly, I want to point out that heavy metals and pesticides, herbicides, and insecticide exposure also can contribute to enzyme deficiency.

“One digestive enzyme, DPP4, is easily deactivated by small amounts of toxins including mercury and organophosphates (pesticide sprays).”  DPP4 is needed to digest some peptides from casein, gluten, and other substances that can have an opioid-like effect.   Children with higher urinary dialkyl phosphate concentrations, especially dimethyl alkylphosphate (metabolites of organophosphates) concentrations, were more likely to be diagnosed as having ADHD.   

Of significance:  EWG specifically added three organophosphates (collards, kale,  and red peppers (summer squash and zucchini were added in 2013) to their 2014 list so that it is now considered the “Dirty Fifteen” guide for buying organic vs non organic to eliminate significant pesticide, herbicide, and insecticide exposure.   

To read more detail about organophosphate and autism, check out  “Continuing the pesticide theme that is affecting the children – Autism and organophosphate exposure: now definitely part of the puzzle.”:  

Questioning Answers: … I’m talking today about the paper by Janie Shelton and colleagues [2] (open-access) and their results strengthening “the evidence linking neurodevelopmental disorders with gestational pesticide exposures, and particularly, organophosphates”.  “Pesticides and autism: chapter II”, June 2014

UC Davis’ recent study: “The message is very clear: Women who are pregnant should take special care to avoid contact with agricultural chemicals whenever possible.” Women who were exposed to pyrethroid insecticides just prior to conception or in their third trimester faced a greater risk for delivering babies who developed autism, according to the study.

The biggest population of the women in the study lived in the Sacramento Valley, which is part of California’s food basket, but others lived in the San Francisco Bay Area. “More Evidence Links Agricultural Pesticides to Autism A new study finds women who live near where ag chemicals are sprayed are at greater risk of having babies with autism and developmental delays.” June 2014.



The key message of this post for all of us is that enzyme deficiency is pervasive and real and results in micronutrient deficiency.   Micronutrient deficiency leads to chronic disease.  Addressing enzyme deficiencies naturally, or via supplements, increasing enzymes within the body, dramatically improves symptoms.  One enzyme that is SCD legal is ProZymes by GiProHealth.  This post does not address “How To Naturally Increase Enzymes Within the Body” but a later post will address such.Digestion3

In health,


5 thoughts on “Digestive Enzymes & Disease w/Focus on Autism”

  1. More on digestive enzyme supplementation with beneficial results for autism at: http://questioning-answers.blogspot.com/2015/08/digestive-enzymes-and-autism.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+QuestioningAnswers+%28Questioning+Answers%29

    …randomised, placebo-controlled clinical trial published by Khaled Saad and colleagues [1] (open-access available here) on the use of a specific digestive enzyme supplementation called Neo-Digestin. Looking at outcomes from about 100 children diagnosed with an ASD (by DSM-IV-TR), about half in receipt of Neo-Digestin (n=47) and half receiving a placebo of sucralose syrup, researchers reported something potentially to see based on CARS (Childhood Autism Rating Scale) scores and another measure called the Global Behavior Rating Scales (GBRS). The GBRS was incidentally used an an outcome measure during one of the trials of secretin with autism in mind [2] so has some history when it comes to pancreatic digestive enzyme functions.

    Saad et al reported that compared to placebo, the Neo-Digestin group showed some significant positive changes in scores between baseline and intervention albeit restricted to the emotional response aspect of CARS and an overall reduction in autistic behaviours (“general autistic impression score”). Likewise on the GBRS, children in the enzyme supplement group “had significant improvement in two parameters including general behavior and gastrointestinal symptoms (quality of stools, abdominal pain, vomiting and food variety).” Importantly, whilst some side-effects were reported by the enzyme supplement group – “skin rashes, itching and abdominal pain” – we are told that these were mild and transient.

    As always, these are interesting results.

  2. The host gains products from microbial fermentation conversion of host indigestible components (dietary fibres) into short-chain fatty acids (SCFA; mainly acetate, propionate and butyrate) contributing to an estimated 10% of our energy requirement [4], vitamin K and B12 production [5, 6], and protection against potential pathogens through competitive exclusion [7, 8]. ~ “The first thousand days – intestinal microbiology of early life: establishing a symbiosis,” June 2014 at: http://onlinelibrary.wiley.com/doi/10.1111/pai.12232/full

    Additionally, “For the most part, the microbes inhabiting our bodies are either beneficial ones or unobtrusive freeloaders. They help us digest our food and absorb nutrients. The manufacture vital vitamins and anti-inflammatory proteins that our own genes cannot produce, and they train our immune systems to combat infectious intruders. Resident bacteria on our skin secrete a sort of natural moisturizer, preventing cracks that could allow pathogens to penetrate. We get our first dose of these microbial co-conspriators as we pass through our mother’s vaginal canal, where the bacterial population changes dramatically during pregnancy.” – Nathan Wolfe, “Small, Small World,” http://ngm.nationalgeographic.com/2013/01/125-microbes/wolfe-text

Now I'd like to hear your thoughts... comments are always welcome!