Fiber, enzymes and glandular products: a plain-language guide

The Digestive Support section of the shop covers three quite different groups of products: dietary fibers, digestive enzymes such as lactase and bromelain, and glandular or organ extracts. They sit together because they relate to food and digestion, but they are made differently, labeled differently, and call for different questions. This guide takes each in turn.

Dietary fiber

Fiber is the part of plant foods that the body does not digest. It comes in two broad types that behave differently:

• Soluble fiber dissolves in water and forms a gel. Oats, beans, apples and psyllium husk are typical sources.
• Insoluble fiber does not dissolve and adds bulk. Wheat bran, nuts and many vegetables are typical sources.

The Daily Value for fiber on US labels is 28 grams. Many people eat less, and fiber supplements, usually powders, capsules or chewables, are a way of adding to what food provides. They are not a substitute for fruits, vegetables and whole grains, which also supply vitamins, minerals and other plant compounds.

Practical points

• Start low and go slow. Adding a lot of fiber at once can cause gas and bloating. Increase the amount gradually over days or weeks, following the label.
• Drink enough fluid. Fiber works by holding water. Most labels tell you to take each serving with a full glass of water, and for good reason.
• Space it from medicines. Fiber can slow or reduce the absorption of some medicines when they are taken at the same time. A common suggestion is to separate them by a few hours, but the right gap depends on the medicine, so ask your pharmacist.
• Check the sweeteners. Powders and chewables often contain sugar, sugar alcohols or flavorings. They are listed in "other ingredients".

In the shop, fiber products live in Dietary Fibers.

Digestive enzymes

Enzymes are proteins that speed up specific chemical reactions. The body makes its own digestive enzymes, and supplement makers sell additional ones, usually extracted from plants, fungi or microbes. Each enzyme works on a particular type of food component:

• Lactase breaks down lactose, the sugar in milk and many dairy products. Lactase products are sold for people whose own lactase is low.
• Bromelain is a group of protein-digesting enzymes obtained from pineapple. Anyone with a pineapple allergy should avoid it.
• Broad-spectrum enzyme blends typically combine protease (for proteins), amylase (for starches) and lipase (for fats), sometimes with others.

Reading the units

Enzyme amounts are rarely given in milligrams, because what matters is how active the enzyme is, not how much it weighs. Look for units such as FCC lactase units, which refer to standard Food Chemicals Codex activity tests. A higher number means a more active serving; it is the number to compare between products, not the tablet weight. Many lactase labels advise taking a dose with the first bite of a dairy food; follow the directions on your label.

Enzymes in the shop are found in Lactase, Bromelain and Digestive Supplements.

Glandular and organ extracts

This is the group that needs the most careful reading. Glandular products, also described as organ extracts or desiccated organs, are made from the tissue of animals, such as liver, adrenal or thyroid glands. The tissue is dried, ground and put into capsules or tablets, sometimes after extraction.

• Source. The label should say what animal the tissue comes from. If you avoid certain animal products for dietary, religious or personal reasons, check this first.
• Not interchangeable with ordinary supplements. Glandular tissue can contain naturally occurring hormones and other active substances. Products made from thyroid or adrenal tissue are a particular case. Anyone with a thyroid or adrenal condition, or anyone taking medicine related to those glands, should talk to a clinician before using them.
• Liver extracts. These are generally sold as concentrated or defatted liver products. As with any animal-derived product, check the source and the serving size.
• Quality. Because these are animal-sourced products, the manufacturer's quality practices and the information they publish about sourcing matter more than usual. When the label is sparse, you can ask the manufacturer.

You will find these in the shop under Liver Extracts, Adrenal Extracts and Thyroid Extracts.

Things that apply to all three groups

1. Read the serving size first. Fiber servings can run to several capsules, and enzyme doses depend on the product.
2. Introduce one new product at a time. If your digestion changes, you will know the cause.
3. Tell your clinician. Digestive symptoms that persist or get worse are worth discussing with a professional; a supplement is not a way to put off a medical check.
4. Check for allergens. Enzymes derived from pineapple, soy or milk-based carriers, and fibers that include gluten-containing grains, are listed in the "Contains" statement.

What these products are not

This guide describes what the products are and how to read their labels. It does not suggest that any of them treats a condition. Product names and details in the shop are supplied by manufacturers and suppliers, and some contain the brand's own wording; that wording is the brand's, not a statement by us. If you have a concern about digestion, a healthcare professional is the right place to start.