Definition of an enzyme:
(EN-zime) protein made by the body that brings about a chemical reaction, for example, the enzymes produced by the gut to aid digestion.
One of the functions of the pancreas is to secrete enzymes into the small intestine. Enzymes are critical to the digestion process, because they break down food. In persons with cystic fibrosis, the pancreas is unable to release enzymes because the ducts (i.e. passageways) are blocked by thick sticky mucus.
In order for the body to make use of food, it has to have a way to absorb the nutrients from that food. Protein, carbohydrates and fat are the three sources of calories in food. There are specific types of enzymes that break down each of these. Amylase helps the body absorb carbohydrates. Lipase is effective in breaking down lipids and fats. Protease breaks down protein.
People with CF are prescribed one of the following brands of supplemental enzymes:
Creon ®, Ultrase ®, Ultrase ® Viokase ®, Pacreacarb ® MS, Pancrease ®, Pancrease ® MT
No matter which type of supplemental enzymes a person takes, they all contain a mixture of lipase, protease and amylase. The only difference is in how many units of each is contained in each capsule. The capsule is filled with tiny beads—these are the enzymes.
Enzyme supplements are sold as “enteric coated capsules.” Enteric coating means that the capsule is designed to break down in the small intestine, and not the stomach. This is so that the beads of protease, amylase and lipase are released in a way that mimics the body’s natural digestion process.
The number of enzyme capsules a person must take varies depending on the type of food being eaten. The Cystic Fibrosis Foundation states that foods containing only simple carbohydrates and no fat, do not need to be accompanied by enzymes.  These foods include jelly beans, popsicles, tea and coffee.
The strength of a supplemental enzyme (and sometimes its name) is derived from the number of lipase units. Below is a list comparing amounts of protease, amylase and lipase in some name-brand enzyme supplements. For additional information, check the product manufacturers websites listed at the end of this article.CREON 10 Lipase10,000 USP units
Protease37,500 USP units
Amylase 33,200 USP units
PANCREACARB MS 8
Lipase8,000 USP units
Protease45,000 USP units
Amylase40,000 USP units
Lipase20,000 USP units
Protease65, 000 USP units
Amylase65,000 USP units
-do not let them stay in the sun
-do not let the pharmacy substitute generic for name-brand
-do not skip doses
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