Last fall, I was stuck in a bad relapse of unknown origin of my ME/CFS (myalgic encephalomyelitis / chronic fatigue syndrome), and I was desperate to feel better. I consulted with my ME/CFS specialist, and after running some blood tests, she suggested I try digestive enzymes, based on recent research and the experiences of her and her colleagues in treating both ME/CFS and long-COVID patients. They helped!
I'll provide some details below, but I want to emphasize that this was not a treatment for gastrointestinal (GI) symptoms. I really haven't had any GI symptoms as part of my ME/CFS since I discovered I was intolerant to dairy (like 30% of ME/CFS patients) and eliminated it from my diet.
Why Would Digestive Enzymes Help Those with ME/CFS and Long-COVID?
Many scientific studies, over many decades, have shown evidence that people with ME/CFS have dysfunctional immune systems. It's estimated that 70-80% of the immune system is in the gut. In addition, patients often have GI issues as a part of ME/CFS or long-COVID. In recent years, many studies on ME/CFS have focused on the role that the gut microbiome plays in the disease. Cort Johnson of the excellent Health Rising website and blog explained this in an article on the gut microbiome and ME/CFS. You can read the original study that Cort based that article on here.
So, there is plenty of evidence showing that people with ME/CFS and long-COVID have dysfunctional gut microbiomes and that this can affect many aspects of the disease.
Testing
Last year, one of the tests my ME/CFS specialist ran for me was a full amino acid profile, which tests for the levels of various amino acids in the bloodstream. Amino acids are the building blocks of proteins, which are essential for a wide range of functions in every system of the body. There are two kinds of amino acids: essential that your body gets from foods and non-essential that your body makes itself.
My lab test results showed high levels of many of the amino acids. My doctor explained that this is likely because my body is unable to metabolize or break them down effectively. This is very, very common in ME/CFS and long-COVID. It leads to all kinds of issues because if we can't break our food down into the nutrients we need to function, that affects every system in the body. This is why so many of us need to supplement certain vitamins and minerals and other nutrients: our bodies aren't effective at breaking down the foods we eat to extract those necessary nutrients.
Treatment
Based on my test results, and the experience of my doctor and her colleagues (all part of the US ME/CFS Clinician Coalition) in treating other patients, she recommended I start taking digestive enzymes. In particular, she recommended two approaches: a prescription called Creon, which contains the digestive enzymes protease, amylase, and lipase, and/or a supplement from Pure Encapsulations called Digestive Enzymes Ultra.
When I picked up the Creon prescription and read the label, it turned out to have the exact same ingredients as a supplement I was already taking, Pancreatic Enzymes (Vital brand), though the supplement had much higher doses than the prescription! My functional medicine specialist had recommended them to me the year before, based on stool testing results that showed the same thing as my blood test results: that I wasn't fully digesting or breaking down my food.
So, I never took the Creon and instead stuck with the Pancreatic Enzymes, and I also started taking the Digestive Enzymes. To save money, I get these and other supplements through Amazon and, once I'm sure I'm going to stay on something, I sign up for their Subscribe and Save option. Most of my supplements are delivered this way, once a month (you set your own timing for each item), so I get a 15% discount on all of them. That helps a lot.
Results
I think that starting the Digestive Enzymes helped me to recover fully from the COVID infection I got last July. When I started them in late August, I was already recovering but still had very low stamina, and after adding Digestive Enzymes, I was able to fully return to my "normal" ME/CFS baseline (which is pretty good and fairly active, thanks to many treatments).
In addition, I think there is plenty of evidence that taking these enzymes is likely to be beneficial, given the studies indicating that most people with ME/CFS and long-COVID have trouble fully metabolizing our food, that our gut microbiomes are often dysfunctional, that the gut has a direct effect on the immune system, and my own personal lab results from both stool and blood tests (plus the experts' experience in seeing these issues in many patients and seeing good results from adding enzymes).
I still take both of them every day - one Pancreatic Enzyme capsule and two Digestive Enzymes capsules (they're tiny) with each meal, three times a day. My son was also already taking Pancreatic Enzymes, but I told him what I learned, and he also added Digestive Enzymes to his regimen (he's doing very well and is working full-time!).
NOTE: For an overview of all the new treatments I tried last year and what helped (and what didn't), see my 2024 Year in Review).
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