The Role of Enzymes in Digestive Health: Key Insights for Managing Hashimoto’s and Thyroid Issues

If you have Hashimoto’s disease, you’re likely no stranger to digestive symptoms. Without optimal thyroid hormone, everything in the body slows down. Slow digestion can mean constipation, cramping, bloating, and other symptoms. You may have even heard the terms “hashimoto’s belly” or “thyroid stomach” to describe the distention and discomfort. 

Digestive symptoms of Hashimoto’s disease also frequently include depressed production of digestive enzymes, impacting the ability to absorb the nutrients your body needs to heal.

In today’s article, I will share with you one of my favorite tools for supporting thyroid and stomach bloating: digestive enzyme supplements!

• Keep reading as we explore:
• The thyroid-digestion connection
• How digestion works
• What are digestive enzymes? And examples
• Hashimoto’s triggers and enzymes
• The best digestive enzyme supplements for Hashimoto’s

Before we dive in, if you need some background on what is Hashimoto’s disease? Or how serious is Hashimoto’s disease? I cover this is detail in Our Approach To Hashimoto’s as well as in the many episodes of the Thyroid Mystery Solved Podcast

Why Proper Digestion Matters for Thyroid Health

While Hashimoto’s can affect digestion, digestion is also critical for thyroid health. Strong digestion and abundant digestive enzyme production are necessary for absorption of key thyroid nutrients, including iron, zinc, selenium, vitamin D, and iodine. Poor absorption can lead to nutrient deficiencies. [1]

The thyroid is sensitive to changes in the gut microbiome, which is associated with Hashimoto’s. Imbalances in gut bacteria (dysbiosis) can influence thyroid stomach bloating and disease progression. Additionally, a healthy gut is necessary for the conversion of T4 to T3. T4 is the main thyroid hormone that is produced by the thyroid, however T3 is the active hormone that is needed your cells and for many Hashimoto’s symptoms like weight gain, brain fog, fatigue, digestive issues, hair loss, fertility and much more. T3 is not produced in large amounts by the thyroid and the body gets T3 by converting T4 into T3. The gut is a key player in that conversion process. [2]

Understanding the Digestive Process

The goal of digestion is to break down large food particles into their smallest parts, such as amino acids, fatty acids, and glucose. The breakdown also releases nutrients – vitamins, minerals, and phytonutrients – from the food matrix. In a healthy gut, all these nutrients are absorbed so that what you eat actually nourishes your body and all of your cells. 

Digestion begins in the mouth as saliva begins to break down large carbohydrate (starch) molecules. In the stomach, hydrochloric acid and pepsin begin protein breakdown.

The small intestine is where most nutrient absorption occurs. Digestive enzymes come from the pancreas and brush border cells (the cells that line the small intestine). These enzymes complete the digestion process for protein, carbohydrates, and fat. At the same time, the gallbladder releases bile to aid in fat absorption.

Undigested parts of food, mainly fiber, travel to the large intestine (colon) and become food for the microbiome. The majority of the body’s microbiome is found here. [3]

Types of Digestive Enzymes and Their Functions

Digestive enzymes are proteins the body makes (or found in a supplement) and they are required for food breakdown. They include:

• Amylase – breaks down starch (carbohydrates) into glucose molecules
• Pepsin – breaks down protein in the stomach
• Protease – breaks down protein into smaller proteins and amino acids
• Peptidase – breaks down protein into amino acids · Lipase – breaks down fat into fatty acids
• Maltase – breaks apart maltose into two glucose molecules
• Lactase – breaks down lactose (milk sugar) into glucose and galactose
• Cellulase – breaks down cellulose (the cell wall in plants)
• Invertase – breaks down sucrose (table sugar) into glucose and fructose
• Bromelain – a plant-based digestive enzyme found in pineapple and supplements
• Papain – a plant-based digestive enzyme found in papaya and supplements

Hashimoto’s Triggers and the Role of Enzymes

Hashimoto’s doesn’t just occur in a vacuum; in susceptible people, the immune system mistakes the thyroid for something foreign and starts to attack it. Once the immune system attacks the thyroid, the thyroid becomes damaged and that thyroid destruction is what leads to Hypothyroidism. Hashimoto’s is the number 1 cause of Hypothyroidism. What creates the immune system to get confused and start to attack your thyroid?

There are many reasons which I call triggers I talk in detail about Hashimoto’s triggers on my podcast and in the Thyroid Mystery Solved course.

Intestinal permeability or “leaky gut” is a significant Hashimoto’s trigger because it leads to inflammation which then due to molecular mimicry creates thyroid damage. [4]

Let me explain further:

We have trillions of bacteria in our gut and in an ideal situation, there should be a balance between the bad and the good bacteria. However when that bacteria becomes off balance (this is very common due to the use of certain medications like antibiotics, steroids, PPI’s, NSAIDS) as well as a diet high in sugars and carbohydrates, glyphosates, and stress to name a few) this dysbiosis creates inflammation which opens up the tight junction. Tight junctions are how the cells of the gut lining stay together and when they open up, this creates little microscopic holes as leaks, hence the term leaky gut.

With this, it is also common to be low in digestive enzymes and other digestive “juices” like stomach acid and proper flowing bile. When the small intestine becomes “leaky,” and the digestive process if hindered, instead of absorbing the smallest particles of food, larger particles, such as proteins, toxins, and pathogens can get out and leak into the bloodstream. This triggers an immune response that leads to inflammation. There is a process called molecular mimicry (another name for this is cross reactivity) and when the immune system goes on the offense against the toxins and pathogens that got through the leaky lining, it can accidentally mistake those pathogens for your thyroid and attack the thyroid. This then leads to thyroid tissue damage.

As you can see, healing the gut is critical for Hashimoto’s healing and slowing or halting thyroid damage.

Incorporating Enzymes into Your Routine

As you work on the root causes of leaky gut and Hashimoto’s disease treatment, it is very helpful to use enzyme supplementation to enhance digestion and support symptoms.

Here are the best digestive enzymes I use personally, as well as in my practice and with our course participants over the last 20 years:

Digestzymes - This synergistic enzyme combination from Designs for Health has comprehensive digestive enzyme support for protein (including gluten and casein), carbohydrates, and fat. What I love about this one is that it also contains betaine HCl (hydrochloric acid) to help in protein digestion in the stomach and ox bile to help in fat digestion, as many of us with Hashimoto’s can often be deficient in digestive enzymes as well as HCl (stomach acid), and have issues with more sluggish bile production.This one has all of these factors and can be helpful with gas, bloating, distention and even acid reflux.

Digestzyme-V - This is a plant-based, vegetarian formula from Ortho Molecular Products with comprehensive digestive enzymes to support protein, carbohydrate, and fat breakdown. It’s very gentle and well-tolerated and a great choice for anyone experiencing gas, bloating and slower digestion and looking for a vegetarian option. This does not contain Betaine HCl and can be great for anyone that is sensitive to Betaine or has a history of stomach ulcers in which cases Betaine is typically contraindicated.

Betaine HCl This formula by Designs for Health has 750 mg Betaine HCl as well as 40mg pepsin to support protein breakdown in the stomach. Because so many people with Hashimoto’s and Hypothyroidism are low in stomach acid, they can often experience digestive issues, the feeling of fullness after meals and some even describe feeling like there is a brick in their stomach, especially after they eat a higher protein meal such a steak or chicken. Adding Betaine HCl can be very helpful in these instances and for some people, this may be needed in addition to a digestive enzyme supplement. I personally take an enzyme and then an extra Betaine HCl, especially with meals that contain meat. 

Beta TCP - This is a formula from Biotics Research that helps with fat digestion. It promotes healthy bile production and as well as better bile flow. Our thyroid is responsible for our gallbladder function. Hypothyroidism can negatively affect gallbladder function and therefore how well we produce bile and contribute to bile stagnation which in turn can create many digestive issues like poor bowel function, gas bloating and discomfort, especially after eating meals that contain more fat. Beta TCP can be a great addition to help with fat digestion as well as absorption of fat soluble vitamins.

While digestive enzymes aren’t a magic pill to ease all your Hashimoto’s woes, they are an incredibly beneficial tool to support not just the digestive symptoms but also overall gut healing, allowing for more nutrient absorption and comfort with meals. Consider digestive enzymes a must-have bridge while you address your Hashimoto’s triggers and support your thyroid type.

Want to learn more? Join our next Free Thyroid Type Training

This information is for educational purposes only and is not intended to diagnose, treat, or cure. Please speak with your healthcare provider before beginning new supplements, especially if you take any medication or have a medical condition. Do not take HCl if you have a stomach ulcer or use NSAIDs.

References:

1. Knezevic, J., Starchl, C., Tmava Berisha, A., & Amrein, K. (2020). Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?. Nutrients, 12(6), 1769. https://doi.org/10.3390/nu12061769
2. Virili, C., Fallahi, P., Antonelli, A., Benvenga, S., & Centanni, M. (2018). Gut microbiota and Hashimoto's thyroiditis. Reviews in endocrine & metabolic disorders, 19(4), 293–300. https://doi.org/10.1007/s11154-018-9467-y
3. Patricia, J. J., & Dhamoon, A. S. (2022). Physiology, Digestion. In StatPearls. StatPearls Publishing.
4. Kharrazian, D., Herbert, M., & Lambert, J. (2023). The Relationships between Intestinal Permeability and Target Antibodies for a Spectrum of Autoimmune Diseases. International journal of molecular sciences, 24(22), 16352. https://doi.org/10.3390/ijms242216352