Enzyme Levels and Enzyme Digestive Support for CSID

Small Bowel Biopsy Results and Suggested Supplements

Here are the results from my own children’s small bowel biopsies. This is the test that confirmed their CSID diagnosis. If your child has had the small bowel biopsy, ask your doctor for the results so that you can compare them to normal levels.

Function of Lactase

Lactase’s primary function is to break down a type of sugar called lactose. Lactose is a sugar found in milk and other dairy products. As a large sugar compound, lactose cannot be absorbed naturally by your body. In order to metabolize this form of sugar, your body needs lactase to break down lactose into two smaller particles called glucose and galactose. These smaller sugar molecules are more easily absorbed by the cells in your intestine. Without lactase, lactose remains in your digestive tract and cannot be used by your body. http://www.livestrong.com/article/390563-what-are-the-functions-of-the-enzyme-lactase/#ixzz1khYBw3Sn

Functions of Maltase and Sucrase

There are a series of special enzymes that are necessary for the breakdown of specific things. Maltase, invertase, sucrase and diastase are all enzymes that break down specific sugars we ingest. Maltase and diastase break down malt sugar—the kinds of sugars you find in malt liquor and other malted foods. Invertase and sucrase also break down sugar but are better able to break down sucrose or table sugar. Those of us with a high sugar intake especially need these enzymes available. If they can’t do their job, the bacteria in our gut are the only things that have the advantage. Stomach cramps, bloating and gas can result if the sugar-digesting enzymes are inadequate.
Read More: http://www.beta-glucan-info.com/digestive_enzyme_facts.htm

Normal and Abnormal Ranges for Each Enzyme

Lactase: Normal Range 16.5- 32.5, Abnormal is less than 16
Sucrase: Normal Range 29-79.8, Abnormal is less than 25
Maltase: Normal Range 98-223.6, Abnormal is less than 100
Palatinase: Normal Range 4.6-17.6, Abnormal is less than

My son, Parker’s test results at 18 months old (2005):
Lactase: 30.4
Sucrase: 6.6
Maltase: 39.0
Palatinase: 0

My daughter Elora’s test results at age 15 (2008)
Lactase: 21.1
Sucrase: 2.3
Maltase: 50.4
Paltinase: 2.3

Currently, they are both able to tolerate some starch from various sources but an excess of grain-based starches or legumes eventually leads to signs of inflammation and struggling immunity. Only when they are taking digestive and systemic enzymes on a regular basis, are they able to succeed including small portions of high-starch-based foods without symptoms.

Enzymes our Family Has Used with Success Include:

Digestive Enzymes

Carb Digest with Isogest appears to assist with the digestion of disaccharides, the primary deficient enzymes for those with CSID. I have contacted an expert from their company about determining the safety of this product for children. If you have used this product, please let me know if it works! This could be a great Sucraid substitute or complimentary enzyme therapy.

Vital-Zymes™ Chewable contain a full-spectrum of digestive enzymes focused on carbohydrate digestion plus enteric-coated serratia peptidase, a systemic enzyme that may help with supporting various healthy inflammation responses.

Vitazym Digest for those who will and can swallow capsules, or if needed, sprinkle half to one capsule on food. This formula includes a total of 18 enzymes to support digestion of proteins, carbohydrates, and fats.

Consult your medical practitioner regarding proper dosing for children.

Systemic Enzymes

For more on Systemic Enzymes, see the blog post I wrote for Energetic Nutrition HERE.

Vitalzym Extra Strength™



15 thoughts on “Enzyme Levels and Enzyme Digestive Support for CSID

  1. Ansley says:

    What test did they do to find his results? My palitinase was found to be low functioning, but they found that result through a biopsy. They told me that was the only way to find it. But my level is 8.6. It registered as low on the biopsy results. I see your scale is different. So how did they test for it… blood test?


    • Roanne L. King says:

      Hi Ansley,

      The test they did was called a “small bowel biopsy” or scope, which sounds like what you had done. It was done in out-patient surgery at the children’s hospital in Boise, ID. The scale is what my children’s GI gave me along with the results. I suppose in the 12 years since my son had his done, they may have new information or testing methods that I’m unaware of. Sorry I can’t help you more on this topic!


  2. Roanne King says:

    From my latest assessments of enzyme level tests, each case presents different symptoms. As you can see my own two children, from the same parents, have different enzyme levels and different symptoms. A while back, parents on the Facebook community attempted to correlate their child's “mutation” with enzyme levels/apparent tolerance to certain foods, but to no avail. For example, two children with apparently the same “type”– one could not have bananas at all (regardless of ripeness) while another appeared to tolerate bananas without a problem.

    My conclusion is that each individual has many other factors aside from enzymes that may or may not determine their ability to digest a set amount of starches or sugars or a specific food. The best approach is to remove all sucrose (sweet fruits included), lactose, and starch-based grains and vegetables until symptoms subside for a minimum of 3-weeks.

    Knowing your child's “type” really on provides a general idea of “if” he or she might be able to tolerate small amounts of dairy, sucrose, or starch in the future. I wish I had a more definite answer, but it is my personal experience that regardless of “type/mutation” or symptoms, avoiding GMO foods, processed foods, and high-starch or sugar in the regular diet is best. Please read through my 2013-2014 posts for more on my recent approach with myself and my son.


  3. Jennifer Blackmer says:

    I have identical twin sons both displaying the same symptoms of CSID and responding to the same inclusion diet and sucraid use. However their biopsy results were so different.

    Owens results are:
    lactase 17.2
    Sucrase 26.9
    maltase 68.6
    Palatinase 9.3

    Ethan's results are:
    lactose 38.3
    Sucrase 70.8
    maltase 207
    Palatinase 19


  4. Kristi says:

    What does it mean if your levels are high? Example- maltase 336.5? Clearly outside of the normal range, but not low which is what I keep finding when I google enzymes. Nearly all of my son's are higher than the normal range given.


    • MELANIE DANN says:

      I’m having the same issue with my 4yr old. His maltase, lactase and palatinase are alot higher than normal
      Did you ever find an answer?
      I realize this post was from a long time ago.
      Thank you:/


      • Roanne L. King says:

        I’m sorry that I haven’t had time to research this. I’m in the process of re-establishing doctors in Idaho due to our recent move and will try to remember to ask Parker’s GI when he has his next appointment.


  5. Amber Perez says:

    My daughter Chloe was diagnosed with CSID 4 years ago. However her biospy results were, what the GI doctor described as unusual. All of her enzymes were extremely low, Maltase, sucrase, and lactase. We immediately began a sucrose free diet (we as in her and I, which has been good for me too). ANyway the insurance company has been denying the diagnosis because the biospy was atypical, so we did a $4000 genetic screening and her diagnosis was confirmed and she is now the first to display a fifth genetic variation of the disease. We have been prescribed Sucraid, however although I work very hard, my small company has poor coverage and prescriptions are not covered. Sucraid is $3000/bottle she would need 3 bottles a month. I have been researching probiotics with high levels of invertase and I am ready to try it. I am a nurse and highly pharmacological, I understand the pharmacokinetic of an enzyme such as this and I feel confident trying it, sooo I just ordered an enzyme with high levels of invertase, I am going to play with the dose, starting conservatively. I can let you know, Sucraid has the patent on the medication now and we are being held hostage if we begin depending on it. I am open to finding another supplement and dietary option. In addition Chloe had 4 antibodies that were off the charts high when we started and now, since we have eliminated sucrose and have gone organic, she only has high GAD.


  6. Anonymous says:

    The GI didn't say anything about sucraid or starch or even talking to a dietician. He acted like it was no big deal and then handed me a packet on CSID for “light” reading when I got home! I have been doing some reading on my own and there is a lot of talk about diarrhea, but that's never been a problem for my son. I have fructose malabsorption so I understand the feeling of eating things you can't digest. I appreciate your offer to email you and I definitely will. Unfortunately, I've missed the link if there is one for your email. Please let me know where to look!



  7. Roanne King says:

    Email me:) You will need to eliminate starches as well. Did the GI mention prescribing Sucraid to help with sucrose digestion? Your son may need longer than 3 months to recover from 2 years of undigested food causing damage to his digestive system. Hang in there!


  8. Anonymous says:

    My son (now 28 months) had reflux as an infant and was put on zantac and prevacid, it really helped. However, he would frequently gag when eating, drinking, sitting around, and just looking at food. So finally our Dr reccomended we go to a Pediatric GI. He ordered and endoscopy. I just got the results and don't know what to think.

    Lactase: 2.8
    Sucrase: 16.8
    Maltase: 60.3
    Palatinase: 2.8

    The GI said that his enzyme levels were low (called and got the actual results and posted them above). He said to just switch him to lactose-free milk, reduce sugary foods, and follow up in 2-3 months. As I'm leaving he handed me a packet on CSID…with no explanation. As I”ve been reading up on it, I'm feeling really overwhelmed and lost with such little explanation from the GI. Any thoughts, suggestions, recommendations are welcome.

    Thanks, Liz


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