cover

A Message from the Author

Is Isogest the Missing Puzzle Piece for Digestion?

By Jon B. Pangborn, PhD, CCN When we eat carbohydrate foods, we consume complex sugars called disaccharides (two connected simple sugars) and polysaccharides or oligosaccharides (more than two connected together). Our digestive tract must break these complex sugars down into single, simple sugars that our cells need to generate energy, aid metabolism, and help build and repair tissue. The most important of these simple sugars is glucose. The body stores energy by combining phosphate and glucose molecules in long, chain-like structures (glycogen), and it draws on these reserves by disassembling glycogen into single molecules of glucose with attached phosphate. Glucose with its phosphate then can provide chemical energy and hydrogen to form the most important nutrient for combating oxidant stress, the form of vitamin B-3 denoted as NADPH. Glucose can also be transformed into other simple sugars and can participate in many other processes that cells need for health and function. The problem that some of our children have is that they are unable to digest some of the complex sugars in foods. This was discovered and published in the science literature by Horvath et al.,1 Horvath and Perman,2 Kushak and Buie3 and Kushak et al.4 Failure to completely digest complex sugars not only handicaps cellular energy and antioxidant capabilities, it also provides a food supply for unwanted and possibly harmful gut flora (dysbiotic flora). That, in turn, may lead to inflammation, leaky gut and uptake of toxic substances. Our intestines contain seven major enzymes that digest complex sugars. These are sugars that exist mostly in fruits, vegetables, and grains. Several clinical studies by Kushak, Buie and others (cited above) indicate that one of these enzymes, isomaltase, may be deficient in digestive activity for 40% to 64% of our children. Isomaltase, also called palatinase or isomaltulose, digests isomaltose and palatinose sugars that are found in grains, potatoes, and other carbohydrate-containing foods, even honey. Isomaltase deficiency is not uncommon and often is described in nutrition textbooks. It may lead to abdominal pain, cramping, diarrhea and general unhappiness following meals of what are normally thought of as healthy foods. In the human small intestine, isomaltase (palatinase) is combined with the sucrose-digesting enzyme in a complex that grows from the same crypt cells as dipeptidyl peptidase IV (DPP-IV). Sucrase digests sucrose, a complex sugar (glucose plus fructose) found in fruit. DPP-IV, digests opiate-acting peptides from casein and gluten casomorphins and gluteomorphins.

Textbooks tell us that all of these enzymes are inhibited or inactivated by certain toxicants, including mercury, silver, amine chemicals and some organochlorines.5,6 So, deficiency of isomaltase (and sucrase and DPP-IV) is not necessarily of genetic origin and may be acquired temporarily due to toxicity in the small intestine. Detoxification therapy that releases heavy metals like mercury may also lead to temporary impairment of these digestive enzymes.

What does Isogest have to do with all this?

When we design digestive aids for use as nutritional supplements, we do not have human enzymes to work with. What we do have and might use are enzymes extracted from animals, plants or microbes. Of those, we prefer to use plant-sourced material for reasons of purity and human tolerance. Unfortunately, the arsenal of available extracted enzymes does not include isomaltase/palatinase while it does include some other disaccharidases (lactase, maltase). These are also found to be lacking in many of our children.1,2,3,4
1. Horvath K, JC Papadinitriou, et al., J.Pediatrics 135 no.5 (Nov 1999) 559-563 2. Horvath K. and JA Perman Curr Opinion in Pediatrics 14 (2002) 583-87 3. Kushak RI and T Buie Disaccharidase Deficiencies in Patients with Autistic Spectrum Disorders presented at Defeat Autism Now New Orleans Think Tank Jan 2004 4. Kushak RI, HS Winter et al. Gastrointestinal Symptoms and Intestinal Disaccharidase Activities in Children with Autism, Poster Session. N.Am.Society of Pediatric Gastroenterology, Oct 20, 2005 (Drs. Kushak and Winter are at MassGeneral Hospital, Boston) 5. White and White, Source Book of Enzymes, CRC Press, 1997 6. Misumi and Ikehara, Chapt. 128 in Barrett et al. Eds, Handbook of Proteolytic Enzymes, Academic Press, 1998.

References

So at Kirkman we set out to discover if some available, plant-sourced enzyme possessed significant isomaltase and palatinase activities that is, could we find a food-grade enzyme material that digests isomaltose and palatinose sugars without producing any problem by-products. After considerable searching and laboratory testing, we found a plant-based, single-protein enzyme of plant source, highly purified, that digests isomaltose and palatinose. We named it Isogest. It is patent-applied-for and is exclusively available in Kirkmans Isogest products such as EnZym-Complete/DPP-IV II with Isogest formula. My son uses it. Jon B. Pangborn, PhD, Ch.E., F.A.I.C. Co-founder, DAN! Certified Clinical Nutritionist Consultant to Kirkman Group, Inc.

IMPORTANT
The material in this guide is for informational use only. It should not be used as a substitute for advice from a health care professional. Please consult with a health care professional regarding the application of this material to your own personal needs and situation.

This publication is not intented to diagnose, treat, cure or prevent any disease.

2009 Kirkman Group, Inc.

Table of conTenTs
A MessAge fROM The AuThOR Is IsOgesT The MIssINg Puzzle PIece fOR DIgesTION?

2 3 5 7 7 7 8 8 10 11 12 12 13 14 14

IMPORTANT WhAT ARe eNzYMes? DIgesTIVe eNzYMes WhY shOulD I TAKe A DIgesTIVe eNzYMe suPPleMeNT? WhY MIghT I Be lAcKINg The eNzYMes I NeeD?

The PANcReATIc eNzYMes fuNcTIONAlITY Of DIgesTIVe PANcReATIc eNzYMes WhAT ARe sOMe Of The INDIcATORs Of suBOPTIMAl eNzYMe BAlANce? WhAT ARe The POTeNTIAl cONseQueNces Of NOT hAVINg The PROPeR BAlANce Of DIgesTIVe eNzYMes? PlANT BAseD VeRsus ANIMAl BAseD eNzYMes WhAT Is uNIQue ABOuT KIRKMANs fAMIlY Of DIgesTIVe eNzYMes? The IsOgesT fAcTOR IN KIRKMANs BROAD-sPecTRuM eNzYMes

WHY IS ISOGEST SUCH AN IMPORTANT DISCOVERY? WHICH OF KIRKMANS ENZYME PRODUCTS CONTAIN ISOGEST ? HAS ISOGEST BEEN EVALUATED IN ANY CLINICAL STUDIES?

15 15 16 17 22 23 24 25 26 27 28 29 30 31 32 33 34 37 38 39

WhO shOulD cONsIDeR TRYINg eNzYMes cONTAININg IsOgesT ?

effecT Of IsOgesT ON IsOMAlTOse AND PAlATINOse The cOMPleTe fAMIlY Of KIRKMANs DIgesTIVe eNzYMes ENZYME GUIDE COMPARISON CHART ENZYM-COMPLETE/DPP-IV ENZYM-COMPLETE/DPP-IV II WITH ISOGEST CARB DIGEST WITH ISOGEST

MAxIMUM SPECTRUM ENZYM-COMPLETE/DPP-IV FRUIT FREE W/ ISOGEST ENZYMAID MULTI-ENZYME COMPLEx DPP-IV FORTE MULTI-ENZYME FORMULA PEPTIDASE COMPLETE PHENOL ASSIST BIOCORE DAIRY

QuesTIONs AND ANsWeRs NOTes ABOuT The KIRKMAN fAMIlY OuR cusTOMeR seRVIce sTAff

WhaT are enzymes?

Enzymes are protein-based constituents of living organisms, plant and animal, that regulate the activities of all living cells. Without enzymes, there would be no life. The human body contains in excess of 3,000 different enzymes that function in chemical reactions, metabolism, digestion, immune response and many other body processes. Enzymes are considered catalysts of biochemical reactions. Each enzyme in the body has a very specific job to accomplish and rarely has multiple functions. If the enzyme necessary to catalyze a given reaction is deficient or not available, that reaction cant take place.

DIgesTIve enzymes
Digestive enzymes are those enzymes found in the body that function as biological catalysts to begin the breakdown of foods so that the important nutrients in the food can be properly absorbed and utilized. All food contains nutrients and potential nutritional value; however, until enzymes start the digestive process, the nutrients are locked up in the cellular structure and are not yet available to be absorbed by the body. For example, the fiber and vitamins in your breakfast cereal provide no value until your digestive enzymes start the digestion process and unlock the nutrients. Similarly, the meat or fish you consume does not deliver the protein necessary for growth and development until protease enzymes digest the protein.

Why shoulD I Take a DIgesTIve enzyme supplemenT?

Proper and complete digestion is essential in maintaining good health because without digestion, the nutrients you consume from the food you eat wont be adequately absorbed. Digestive enzymes also play a key role in gastrointestinal health because they can exert a powerful effect in addressing a full range of commonly recognized gastrointestinal disturbances, including intestinal irritation, maldigestion, malabsorption, intestinal hyperpermeability, gut dysbiosis, and food allergies and sensitivities. Clinical experience with the use of digestive enzymes has shown that these conditions can be supported by the use of broad-spectrum enzyme formulations.

The body contains in excess of 3,000 different enzymes.

Why mIghT I be lackIng The enzymes I neeD?

The human body naturally produces digestive enzymes; however, the following situations can leave an individual lacking in necessary enzymes: nutritional deficiency adversely impacts enzymes enzyme production can decrease with age cooking of foods destroys naturally occurring enzymes that work with human digestive enzymes stress can deplete enzymes 8 illness can inhibit enzyme production injury can tax enzyme levels

The pancreaTIc enzymes

When we talk about supplementing with digestive enzymes, we mean the pancreatic enzymes. These are the enzymes that have specific jobs and act only on specific types of food substrates. When digestive enzyme supplementation is called for or recommended by a health professional, it is imperative that the proper combination of enzymes is chosen in order to address the particular digestive issues present. For example, lipase only digests fats; it does not act on protein or sugar. Sucrase only digests sugars; it has no effect on fat or protein. Proteases and peptidases act on protein, casein, and gluten. Other enzymes do not. A specific enzyme combination must be selected based on an individuals specific needs. There are many different enzyme products in the marketplace including: lipase - specifically addresses fat digestion lactase - specifically aids lactose intolerance peptidase/protease - digest proteins and peptides including casein and gluten DPP-IV (peptidase) - targets casein and gluten multi- or broad-spectrum enzymes that digest all food groups carbohydrate digesting enzymes If you know specifically that a person needs a particular enzyme, such as lipase for fats, you can look for that specific enzyme in the product you choose. Usually, however, individuals are not sure which enzymes are need-

Many situations can cause enzyme deficiency.

ed. In that case, a multi- or broad-spectrum enzyme product would be the best choice. Broad-spectrum enzyme products help digest all food groups including proteins, fats, starches and other carbohydrates, sugars, celluloses, and fiber. Kirkman has advanced digestive enzyme products containing Isogest, a patent pending enzyme component with isomaltase activity. No other commercially available enzymes contain the Isogest fraction. Kirkmans EnZym-Complete/DPP-IV II with Isogest and Maximum Spectrum EnzymComplete/DPP-IV Fruit Free w/Isogest are the two products of choice. The latter product is fruit-free, which is important for individuals who are sensitive to pineapple or papaya fruit. A chart describing all of the components of typical digestive enzyme products follows along with what specific function they perform in the digestive process. This is a complete list of pancreatic enzyme ingredients; all enzyme products will not contain all of these because many digestive enzyme products are formulated to carry out specific functions. Wide- or broadspectrum enzyme products may contain nearly all of the components explained in the chart with the exception of Isogest because only Kirkmans enzyme products contain that unique ingredient. 9

functionality of Digestive Pancreatic enzymes

Ingredient
proteases

acts on
Protein

food groups Digested

Meats, nuts, eggs, milk, cheese, soy, some grains Casein, gluten

peptidases

Peptides, amino acids proteins Casein, gluten Proteins Proteins Fats

Dpp-Iv

Dairy products and grains Meats, fish, dairy, soy, some grains Meats, fish, dairy, soy, some grains Oils, fat soluble vitamins, essential fatty acids, butter, margarine, fat in meats, prepared foods, nuts, and seeds Lactose Vegetables and fruit fibers, grains, cellulose, cereal Legumes and cruciferous vegetables

10

bromelain papain lipase

lactase cellulase

Milk sugar Cell membrane of plants

xylanase (also known Plant protein and fiber as hemicellulase) Invertase (sucrase) amylase alpha-amylase, gluco-amylase Sucrose, sugar Starches and carbohydrates

Beet and cane sugar Starches, potatoes, corn and polysaccharides

alpha-galactosidase Vegetable starch and legumes phytase Phytic Acid

Beans, legumes, and cruciferous vegetables

Present in plants such as wheat, corn, oats, and soybeans (phytic acid adversely affects the absorption of minerals) Maltose Pancreatin contains lipase, amylase, and protease Select carbohydrates

maltase pancreatin

Maltose Proteins, fats, starches

Isogest

Isomaltose, Palatinose

WhaT are some of The InDIcaTors of subopTImal enzyme balance?

Many enzyme imbalances require laboratory testing for verification, but there are some visual or sensory signs that may be useful to physicians or individuals in spotting a problem or suggesting an enzyme issue. The following chart summarizes some of these.

enzyme
Protease

InDIcaTIons
incomplete breakdown of proteins can result in the development of food allergies as molecules enter the bloodstream and the body sees these substances as foreign, resulting in allergic/adverse reactions opiate peptide excess resulting from incompletely broken down casomorphin and gluteomorphin peptides deficiency of lactase to breakdown lactose (milk sugar) long-term malabsorption of fat caused by deficiency of the lipase enzyme results in malabsorption of fats, fat-soluble vitamins and essential fatty acid deficiencies incomplete breakdown of carbohydrate containing foods high sugar intake resulting in not enough enzyme to optimally break down sugar inability to break down fiber foods; only enzyme that is not naturally produced in the body and as a result it must be supplemented orally

sympToms
presence of ammonia smell can be detected in urine, with incomplete digestion, meat fibers may be present in stool along with a foul odor

11

DPP-IV/ Peptidase

may present with a number of physical and/or behavioral issues

lactase lipase

abdominal bloating, gas, cramping, occasional diarrhea oily (greasy) stools which can contribute to a rancid and foul smell of the stool, tan or gray colored stools are also an indication of fat malabsorption problems as well as foamy stools intestinal gas (flatulence) and bloating fermentation in the intestinal tract with a potential for overgrowth of bacteria or yeast noticeable undigested food fiber in the stools (e.g. undigested vegetable parts)

Amylase/ Disaccharidases Invertase/ sucrase cellulase

WhaT are The poTenTIal consequences of noT havIng The proper balance of DIgesTIve enzymes?
malabsorption of nutrients can lead to malnutrition, abnormal growth patterns, improper organ development and immune system impairment malnutrition can result in vitamin and mineral deficiencies, poor or impaired wound healing, skin conditions, behavioral problems, intestinal flora imbalances, and lack of immune system support leading to frequent illness 12 feeling of fullness or bloating after meals gas, diarrhea, constipation, and/or foul smelling stools poor health and conditions of the digestive system, colon, or rectum

planT-baseD versus anImal-baseD enzymes

Animal derived pancreatic enzymes from cows and pigs have been used successfully to aid digestion for decades. Some drawbacks do exist, however, in animal derived enzymes. Of concern are: 1. Some individuals can be sensitive to the animal derived ingredients. 2. Animal derived enzymes are not stable in the pH of stomach acid, thereby requiring special coating or processing so they go through the stomach undamaged. This special processing adds to costs. 3. The source, health and environmental history of the animals is a concern. Kirkman uses only plant-based enzymes. Plant-based enzymes are derived from cultivated plant sources, most often the Aspergillus oryzae species of plant mold, though other species of Aspergillus are used for certain enzymes. These enzymes go through extensive purification processes and offer safe and effective alternatives to the animal products. An extensive filtering process separates the pure enzyme from its original substrate, which makes these products suitable even for the extremely sensitive individual. Plant based enzymes offer these advantages over the animal enzymes: better tolerated by the sensitive individual no concern of the animal source or environment stable and effective at a full range of pHs, so they are not inactivated in the acid pH of the stomach

Kirkman uses only plant-based enzymes.

 no special coatings are needed, which makes plant enzymes far more economical than animal based enzymes starts the digestive process in the stomach, which makes the intestinal digestive functions easier and more efficient

WhaT Is unIque abouT kIrkmans famIly of DIgesTIve enzymes?

All of Kirkmans enzyme products are made from plant derived enzymes and are encapsulated in all vegetable capsules manufactured from pine cellulose. Our enzymes are: casein free gluten free soy free sugar free preservative free color free free of other common allergens free of sulfites free of fish and tree nuts

13

The IsOgesT fAcTOR IN KIRKMANs BROAD-sPecTRuM eNzYMes

Enzymes that digest carbohydrates are a major component of broadspectrum enzymes. The human digestive tract contains seven carbohydrase enzymes that split dietary disaccharides into free monosaccharides. Prior to Kirkmans introduction of Isogest, commercially available digestive enzyme products contained enzyme ingredients that had the activity of only some of these disaccharidase enzymes. A very important enzyme called sucroseisomaltase was only partially represented in these commercial products. The invertase or sucrase portion of the enzyme was present, but the isomaltase fraction was not - and for a good reason: there is no commercially available form of isomaltase available in the world. Rafail Kushak, Ph.D. and Timothy Buie, M.D. of MassGeneral Hospital for Children in Boston confirmed the importance of this missing enzyme fraction in January 2004. This was done by an intestinal biopsy study involving 100 special needs children. The study showed that 60% of these patients had weak lactase activity and 25-40% had weak isomaltase/palatinase activity. Similar results were noted in an October 2005 paper in the Journal of Pediatric Gastroenterology and Nutrition published by Kushak, Winter, Farber, and Buie of MassGeneral Hospital for Children. This study indicated a need for additional carbohydrase enzymes in special needs situations. These studies were evidence for the need of an enzyme providing isomaltase/palatinase activity to fill a void in commercially available digestive enzyme products. These studies provided the impetus for Kirkman to begin searching for an enzyme that had this isomaltase/palatinase activity. Kirkman, in conjunction with the National Enzyme Company of Forsyth, MO, found such an enzyme that Kirkman registered as the trademark Isogest. Isogest has the ability to split isomaltose into two molecules of glucose and to split palatinose into one molecule of glucose and one molecule of fructose. This is a revolutionary ingredient in the world of enzymology since commercially available enzyme products never had this isomaltase enzyme capability. Only Kirkmans enzymes contain Isogest, for which Kirkman has a patent pending.

14

Why Is IsogesT such an ImporTanT DIscovery?

When there is weak isomaltase/palatinase activity in the body as found in the studies cited, enzyme supplementation is called for. Prior to Isogest there was no means through commercially available enzyme products to get that

supplementation. When insufficient isomaltase/palatinase activity is present, isomaltose and palatinose, two complex sugars, remain partially undigested. Isomaltose is found in corn syrups, candies, and in complex starches. Palatinose is produced in the body primarily as a by-product of bacterial breakdown of other sugars and starches. When isomaltose and palatinose remain partially undigested, gas, bloating, constipation or diarrhea, and other intestinal disturbances can result that can contribute to gastrointestinal pain. Kirkmans broad-spectrum enzyme products containing Isogest finally provide a solution to the missing isomaltase enzyme fraction.

WhIch of kIrkmans enzyme proDucTs conTaIn IsogesT?

Kirkmans two most popular broad-spectrum multiple enzyme products contain Isogest along with a specialty product specifically formulated to digest carbohydrates. These products are: EnZym-Complete/DPP-IV II with Isogest Maximum Spectrum Enzym-Complete/DPP-IV Fruit Free with Isogest Carb Digest with Isogest

15

has IsogesT been evaluaTeD In any clInIcal sTuDIes?

Yes, prior to marketing enzymes containing Isogest, Kirkman arranged for twelve prominent health professionals, who specialize in patients with special dietary requirements and special needs, to use enzymes containing Isogest in their practices. This was done to verify the efficacy of the products and ensure the absence of undesirable side effects. The following doctors and clinics participated in the study: Dr. Lynne Mielke, East Bay Medical Clinic, Pleasanton, CA Dr. David Berger, Wholistic Pediatrics, Tampa, FL Dr. Andrew Levinson, Vitality Health and Wellness, Miami, FL Dr. John Green, The Evergreen Center, Portland, OR Dr. Miriam Jang, San Rafael, CA Dr. James Neubrander, Edison, NJ Dr. Phillip DeMio, Seven Hills, OH Dr. Stephanie Cave, Baton Rouge, LA Dr. Anju Usman, True Health Medical Center, Naperville, IL Dr. Jaquelyn McCandless, Woodland Hills, CA (now in Honokaa, HI) Dr. Brian Klepzig, Charleston, IL Dr. Brian Jepson, Draper, UT (now at Thoughtful House, Austin, TX)

Doctors and parents of the patients were polled as to the effectiveness of the new products. Results were outstanding and side effects virtually nonexistent. Kirkman immediately went to market with these exciting new products. Below is a brief summary of the benefits that the doctors and parents evaluations of the new products highlighted: less bloating more regular bowel habits less constipation more normal stools 16 better overall digestion with less discomfort firmer stools less gas less diarrhea less sensitivity to dairy and grains fewer odorous bowel movements

Who shoulD consIDer TryIng enzymes conTaInIng IsogesT

There are several situations that could make an Isogest containing enzyme very beneficial. In general, anyone having digestive issues could benefit. Several special situations also may be supported by Isogest containing products including: If you are currently taking any other digestive enzyme product and are not completely satisfied with results. If you are specifically having problems digesting carbohydrates, Carb Digest with Isogest could help with the bloating, gas, and discomfort associated with poor carbohydrate digestion. If you are on the Specific Carbohydrate Diet (SCD) and are still having discomfort, this could be due to the incomplete digestion of isomaltose and palatinose. The late Elaine Gottshall, author of the book titled Breaking the Vicious Cycle, points out this fact in her book. If you are on the SCD and expect some minor infractions to occur (the SCD allows the consumption of monosaccharides only and prohibits the ingestion of disaccharides and polysaccharideinfractions are difficult to avoid, especially when consuming prepared or starchy foods).

effecT Of IsOgesT ON IsOMAlTOse AND PAlATINOse

A Joint Project with NEC and KIRKMAN GROUP

17

ouTlIne
Isomaltose and Palatinose are implicated in exacerbating gastrointestinal conditions Find an enzyme that converts the above sugars to harmless compounds (glucose and fructose) Target enzyme: Isogest

proposeD experImenTs anD resulTs

Test to determine if Isogest converts isomaltose to glucose Make sure Isogest does not convert glucose back to isomaltose Determine if Isogest converts maltose to isomaltose (concentration dependant) Determine if Isogest breaks down palatinose

EFFECT OF ISOGEST ON ISOMALTOSE (0.56M) AT VARIOUS CONCENTRATIONS 100

90
18

Glucose released (ug/ml)

80

70

This graph demonstrates that Isogest converts isomaltose to glucose at a rate exceeding 90%.

60

50

20

40

60

80

100

120

Isogest ug/ml

resulTs
Isogest does not convert glucose back to isomaltose Isogest, at concentrations tested, does not convert maltose to isomaltose Isogest was also tested in combination with maltase using maltose as substrate Conclusion: near 100% conversion of isomaltose

effecT of IsogesT on palaTInose

Check to see if Isogest breaks down palatinose Determine dose required Various concentration of Isogest Various concentration of palatinose 19

LIBERATION OF GLUCOSE FROM PALATINOSE (0.56mM) USING Isogest @ 100 ug/ml

80 70 60 % conversion to glucose 50 40 30 20 10 0
This graph demonstrates that Isogest effectively converts palatinose to glucose.

50

100 150 200 250 300 350 Palatinose (mM)

LIBERATION OF GLUCOSE VS. TIME AT VARIOUS ISOGEST CONCENTRATIONS USING PALATINOSE AT 0.56 mM

100

20

80 % Conversion

60

40

This graph demonstrates that the conversion of palatinose to glucose increases by raising the concentration of Isogest.

20

50

100 150 200 Time Incubated (min)

250

LIBERATION OF GLUCOSE AT VARIOUS PALATINOSE CONCENTRATIONS USING ISOGEST AT 500 ug/ml FOR 90 MINUTES

90 85 80
21

% conversion to glucose

75 70 65 60 55 50 45 0 0.5 1 1.5 2 2.5 3

This graph demonstrates that Isogest is more effective on isomaltose than palatinose, but effective on both substrates.

Palatinose (mM)

conclusIon
Isomaltose is an excellent substrate for Isogest (100% conversion to glucose) Palatinose is not as good a substrate as isomaltose for Isogest Need higher concentration of Isogest to break down palatinose Dose depends on palatinose concentration

The cOMPleTe fAMIlY Of KIRKMANs DIgesTIVe eNzYMes

EnZym-Complete/DPP-IV
22

EnZym-Complete/DPP-IV II with Isogest Carb Digest with Isogest Maximum Spectrum Enzym-Complete/ DPP-IV Fruit Free with Isogest EnZymAid Multi-Enzyme Complex DPP-IV Forte Multi-Enzyme Formula Peptidase Complete Phenol Assist BioCore Dairy

eNzYMe guIDe cOMPARIsON chART

enzymAid Multi-enzyme complex enzym-comp/DPP-IV Peptidase complete

Maximum spectrum enzym-complete/ DPP-IV fruit free with Isogest

enzym-complete/ DPP-IV II Isogest

Phenol Assist

Aids digestions of /features

Biocore Dairy

DPP-IV forte

Multi-enzyme formula

carb Digest with Isogest

Proteins carbs / sugars starches fats casein / gluten fiber lactose Dairy Phenolic foods cellulose Isomaltase Activity fruit free scD legal gf / cf

some some

some

casein

some

23

casein

enzym-complete/Dpp-Iv
EnZym-Complete/DPP-IV is Kirkmans highest strength, broad-spectrum digestive enzyme. This proprietary product is formulated to support maximum digestive activity for a full range of foods. EnZym-Complete/DPP-IV is a unique blend of 18 pure, plant-based enzymes that are recognized as essential for the effective digestion of all food groups, including proteins, carbohydrates, fats, sugars and fiber, under a wide range of pH conditions. The addition of the dipeptidyl peptidase-IV (DPP-IV) enzyme analog supports the ability of the body to degrade peptides formed from exposure to casein and gluten. EnZym-Complete/DPP-IV provides a comprehensive foundation of supplemental enzymes to support optimal digestion. Each enzyme works independently, but also in a complementary role to optimally impact digestion of all dietary components. Kirkmans EnZym-Complete/ DPP-IV provides a combination of proteases, amylases, lipases, disaccharides and cellulases that replace the enzymes lost in cooking, thus lessening the burden on the bodys digestive tract so that it can function optimally, while also supporting optimal nutrient absorption.

24

enzym-complete/DPP-IV available in 60 capsules Item #234/60 120 capsules Item#234/120 200 capsules Item#234/200

supplement facts
Serving Size: 2 capsules
Each Serving Contains DPP-IV (activity) Protease (from vegetable pancreatin 4X/NF) Alkaline Protease FP 31 Protease AFP (acid fast protease) Bromelain (Pineapple source/1,280,000 FCCPU) Papain (Sulfite-free Papaya source) Alpha Amylase Glucoamylase Alpha-Galactosidase Lactase Maltase Invertase (sucrase) Cellulase Xylanase (Hemicellulase) Phytase Lipase (from vegetable pancreatin 4X/NF) * Daily Values Not Established. Amylase (from vegetable pancreatin 4X/NF) 38,000 DAPU 50 DAPU 100 HU 100 SAPU 100 BTU 2,000,000 FCCPU 89,000 MWU 100 SKBU 30 AGU 125AGSU 1,000 LAU 200 MWU 400 SU 200 CU 100 XU 10 PU 15,000 LU * * * * * * * * * * * * * * * * * Amount % Daily per Serving Value* 50,000 HUT *

enzym-complete/Dpp-Iv II with Isogest

A revolutionary enzyme product from Kirkman The human intestinal tract contains seven enzymes that split dietary disaccharides into free monosaccharides. Until now, commercially available enzyme products contained enzyme ingredients that had the activity of only some of these disaccharidase enzymes. One in particular, however, sucrase-isomaltase complex, was only partially represented in these products. Invertase is present in these products to hydrolyze sucrose to yield glucose and fructose, and to hydrolyze other complex sugars that contain fructose, so it acts as a sucrase enzyme. The isomaltase fraction of that human enzyme is not represented because there is no commercially available form of isomaltase in the world. The importance of this missing enzyme fraction was confirmed in January 2004 by R. Kushak, PhD and T. Buie, MD of MassGeneral Hospital for Children in an intestinal biopsy study involving 100 children with special requirements and sensitivities. The study showed that 60% of these patients had weak lactase activity and 25-45% had weak isomaltase/palatinase activity, which substantiated their special dietary need for an enzyme providing isomaltase/palatinase activity. This study provided the impetus for Kirkman to search for an enzyme that had isomaltase/palatinase activity. Kirkman found that enzyme and trademarked it Isogest. Isogest has the ability to split isomaltose into two molecules of glucose and to split palatinose into one molecule of glucose and one molecule of fructose. The result of including this new enzyme is better, more complete carbohydrate digestion. Currently, no other enzyme product can offer this added activity. EnZym-Complete/DPP-IV II with Isogest is Kirkmans second generation version of Enzym-Complete/ DPP-IV. It contains all the enzymes present in Enzym-Complete/DPPIV plus Isogest. The presence of Isogest gives this product the equivalent activity of the isomaltase fraction of the sucrase/isomaltase enzyme found in the human digestive system. Individuals currently using Enzym-Complete/DPPIV who are getting partial results and still need some improvement or individuals using other enzymes who are not completely satisfied with the results should try EnZym-Complete/DPP-IV II with Isogest formula. enzym-complete/DPP-IV II with Isogest available in 90 capsules Item #851/90 180 capsules Item #851/180

25

supplement facts
Serving Size: 2 capsules
Each Serving Contains DPP-IV (activity) Protease (from vegetable pancreatin 4X/NF) Alkaline Protease FP 31 Protease AFP (acid fast protease) Bromelain (Pineapple source/1,280,000 FCCPU) Papain (Sulfite-free Papaya source) Alpha Amylase Glucoamylase Alpha-Galactosidase Lactase Maltase Invertase (sucrase) Cellulase Xylanase (Hemicellulase) Phytase Lipase (from vegetable pancreatin 4X/NF) Isogest * Daily Values Not Established. Amylase (from vegetable pancreatin 4X/NF) 38,000 DAPU 50 DAPU 100 HU 100 SAPU 100 BTU 2,000,000 FCCPU 89,000 MWU 100 SKBU 30 AGU 50 Gal U 1,000 LAU 200 MWU 400 SU 200 CU 100 XU 10 PU 15,000 LU 100 mg * * * * * * * * * * * * * * * * * * Amount % Daily per Serving Value* 50,000 HUT *

carb Digest with Isogest

Carb Digest with Isogest is specially formulated for individuals who find it difficult to digest carbohydrates. It is a revolutionary product that contains only disaccharidases and Kirkmans proprietary Isogest enzyme. Kirkman developed Isogest based on the work of R. Kushak, PhD and T. Buie, MD, of MassGeneral Hospital for Children. They studied individuals with special requirements and sensitivities and found that in their test group, 25-45% of their subjects had weak isomaltase/palatinase activity. Our Isogest formulation has the ability to split isomaltase into two molecules of glucose, and to split palatinose into one molecule of glucose and one molecule of fructose. The result of the inclusion of this new enzyme is better, more complete carbohydrate digestion. Currently, no other enzyme product can offer this added activity. Carb Digest with Isogest may also be very useful to those on the Specific Carbohydrate Diet (SCD), because slight infractions of this diet may be counteracted. Physicians and parents who evaluated products containing Kirkmans Isogest reported the following: less bloating more regular bowel habits less constipation more normal stools better overall digestion with less discomfort firmer stools less gas less diarrhea less odorous bowel movements

26

No adverse effects were reported.

Carb Digest with Isogest available in 120 capsules Item #852/120

supplement facts
Serving Size: 1 capsule
Each Serving Contains n-zimes (a proprietary blend) Amylase Glucoamylase Lactase Invertase Maltase

Amount per Serving 265 mg 200 DU 100 AGU 2000 ALU 1000 SU 800 DP

% Daily Value* * * * * * * *

Isogest 100 mg * Daily Values Not Established. n-zimes is a trademark of National Enzyme Company

maximum spectrum enzym-complete/ Dpp-Iv fruit free with Isogest

Kirkmans Maximum Spectrum Enzym-Complete/ DPP-IV Fruit Free w/Isogest capsules are free of fruit derived enzymes, such as bromelain, kiwi, and papaya, that can occasionally cause issues for some sensitive individuals. This product differs from Kirkmans EnZym-Complete/DPP-IV II with Isogest by including additional disaccharidase enzyme activity to more completely breakdown complex disaccharides and carbohydrates, such as sugars and starches, to the monosaccharides glucose and fructose. However, like EnZym-Complete/DPP-IV II with Isogest , it is a comprehensive multiple enzyme formulation that acts on all food groups. In addition to the carbohydrase enzymes, it contains proteases, peptidases, lipase, cellulase, phytase, and amylases for complete digestive support. Disaccharidase enzymes in the product with increased concentrations include: lactase for additional lactose digestion; maltase for additional maltose digestion; glucoamylase for polysaccharide and starch digestion; and Isogest, Kirkmans exclusive specialty enzyme for addressing isomaltase insufficiency. Kirkman products are the only commercially available enzyme products that contain this isomaltase activity. The importance of this missing enzyme fraction was confirmed in January 2004 by R. Kushak, PhD and T. Buie, MD of MassGeneral Hospital for Children in an intestinal biopsy study involving 100 special needs children. The study showed that 60% of these patients had weak lactase activity and 25-45% had weak isomaltase/palatinase activity, which substantiated their special dietary need for an enzyme providing isomaltase/palatinase activity. This study provided the impetus for Kirkman to search for an enzyme that had isomaltase/palatinase activity. Kirkman found that enzyme and trademarked it Isogest. Isogest has the ability to split isomaltose into two molecules of glucose and to split palatinose into one molecule of glucose and one molecule of fructose. The result of including this new enzyme is better, more complete carbohydrate digestion. Currently, no other enzyme product can offer this added activity. The presence of Isogest gives this product the equivalent activity of the isomaltase fraction of the sucrase/isomaltase enzyme found in the human digestive system. 27

Maximum spectrum enzym-complete/ DPP-IV Fruit Free with Isogest available in 120 capsules Item #869/120

supplement facts
Serving Size: 2 capsules
Each Serving Contains Peptidase (DPP-IV activity) Protease Protease 6.0 Acid Fast Protease Amylase Glucoamylase Alpha-Galactosidase Lactase Maltase Invertase (Sucrase) Cellulase Xylanase (Hemicellulase) Phytase Lipase Isogest *%Daily Values Not Established Amount per Serving 60,000 HUT 50,000 HUT 10,000 HUT 30 SAPU 200 DU 100 AGU 125 Gal U 2000 LAU 200 MWU 1000 SU 200 CU 100 XU 10 PU 15,000 LU 150 mg % Daily Value* * * * * * * * * * * * * * * *

enzymaid multi-enzyme complex

EnZymAid Multi-Enzyme Complex is a plant-based enzyme formulation designed to address several important digestive functions for individuals with special requirements and sensitivities. This formulation comes in #1 plant cellulose capsules. This exceptional enzyme complex: 28 specifically targets the breakdown (cleaving) of casein, gluten and gliadin and facilitates the breakdown of wheat (gluten) and milk (casein) proteins enhances the absorption and utilization of important minerals (this is accomplished by the addition of the enzyme phytase, which breaks down phytic acid found in grains, beans, soybean, etc., that is known to interfere with the absorption of crucial minerals including calcium, magnesium and zinc) increases the amount of the important dipeptidyl peptidase-IV (DPP-IV) enzyme (this happens when the peptidase enzymes exert DPPIV activity, and by the inclusion of galactose) About our formulation: Ingredients include: Caso-glutenase 10,000 AU* Bromelain concentrate 230 BTU (approximately equal to 4,500,000 FCCPU) Acid Fast protease 100 SAPU Lactase 330 LACU Phytase 125 PU Galactose 100 mg

*This proprietary blend is comprised of a combination of many different proteases and peptidases, assayed with activity units based on acceptable compendial methods of assay. Since a wide variety of different peptidases/proteases are utilized, the overall activity is noted in special Activity Units (AU).

enzymAid Multi-enzyme complex available in 90 capsules Item #043/90 180 capsules Item #043/180

supplement facts
Serving Size: 1 capsule
Each Serving Contains Caso-glutenase (a proprietary blend) Bromelain Concentrate Acid Fast Protease Lactase Phytase Galactose * Daily Values Not Established. Amount per Serving 10,000 AU 230 BTU 100 SAPU 330 LACU 125 PU 100 mg % Daily Value* * * * * * *

Dpp-Iv forte
Kirkmans DPP-IV Forte capsules feature a dipeptidyl peptidase-IV (DPP-IV) analog for comprehensive digestion of protein peptides. This proprietary enzyme from Kirkman works in a unique way to specifically break apart proline-containing peptides (casomorphin, gluteomorphin and gliadomorphin), which are generally known to come from dairy products and cereal grains. The DPP-IV enzyme assists digestion of these peptides, which are generally resistant to being completely broken down by other enzymes. What is DPP-IV? DPP-IV is a protein that has multiple functions in the body. It is known by different names depending on where it is found. When DPP-IV is on the surface of the Tcell (lymphocyte), it is called CD26 and supports immune function. When this enzyme is found on and imbedded on the epithelial brush border mucosal membrane of the intestinal tract lining, it is known as DPP-IV. The importance of DPP-IV is that it has primary function in breaking down casein and side chain activity in breaking down gluten. Thus, the use of a DPP-IV containing enzyme will support the digestion of casein-containing milk products as well as the protein in gluten-containing grains.

29

DPP-IV forte available in 60 capsules Item #230/60

supplement facts
Serving Size: 1 capsule
Each Serving Contains DPP-IV (activity) * Daily Value Not Established. Amount per Serving 60,000 HUT % Daily Value* *

multi-enzyme formula
Multi-Enzyme Formula is Kirkmans moderate potency, multi-spectrum digestive enzyme designed to support digestion of a full range of foods. This product consists of a unique blend of 17 pure plant-based enzymes that are recognized as important for the effective digestion of all food groups, including proteins, carbohydrates, fats, sugars and fiber, under a wide range of pH conditions. 30 Multi-Enzyme Formula includes a combination of proteases, amylases, lipases, disaccharides and cellulases that replace the enzymes lost in cooking, thus lessening the burden on the bodys digestive tract so that it can function optimally, while also supporting optimal nutrient absorption. Each enzyme works independently, but synergistically to optimally impact digestion of all dietary components.

Multi-enzyme formula available in 250 capsules Item #250/250

supplement facts
Serving Size: 1 capsule
Each Serving Contains Amount per Serving 67,320 MWU 68 DU 13.7 AGU 23,562 DAPU 68 SAPU 119 HUT 68 HU 137 CU 68 XU 68 GaIU 226 ALU 1500 FCCLU 343,000 FCCPU 870,000 FCCPU (68 BTU) 137 MWU 274 SU 6.8 PU % Daily Value* * * * * * * * * * * * * * * * * *

Amylase (Pancreatin 4X) Alpha Amylase Glucoamylase Protease (Pancreatin 4X) Protease (Acid Stable) Protease (Alkaline) Protease FP 31 Cellulase Hemicellulase (Xylanase) Alpha-Galactosidase Lactase Lipase (Pancreatin 4X) Papain (Sulfite Free) Bromelain Maltase Invertase (Sucrase) Phytase * Daily Values Not Established.

peptidase complete
Broad spectrum protease/peptidase enzyme formulation with dipeptidyl peptidase-IV activity Kirkmans Peptidase Complete was formulated to provide more activity of the proteolytic/peptidase enzymes than that supplied by EnZymAid. This specialty formulation offers a complete combination of protease and peptidase enzymes for optimal breakdown of animal proteins (meats, fish, poultry, eggs, dairy, gelatin, etc.), plant-based proteins (including soybean, legumes, etc.), as well as peptides derived from milk/casein and grains/gluten. Peptidase Complete is one of the most comprehensive digestive enzyme formulations in the marketplace addressing these dietary components. This unique blend of pure plant-based and fruitbased enzymes provides digestive activity for a full range of proteins under the wide range of pH conditions found in the intestinal tract. Each enzyme in this specialty formulation works independently, but also in combination with the other ingredients present. Peptidase Complete contains a full range of proteolytic/protein digesting enzymes. The use of proteolytic enzymes should not be taken when there is the absence of normal gastric mucosa, such as is found in individuals who have a peptic/duodenal ulcer. Consult with your physician in such cases for specific recommendations.

31

Peptidase complete available in 250 capsules Item #248/250

supplement facts
Serving Size: 1 capsule
Each Serving Contains n-zimes (a proprietary blend) Peptidase Protease (4,5 & 6.0) Protease (Other)** Amount per Serving 355 mg 63,000 HUT 25,000 HUT 2,000,000 FCCPU % Daily Value* * * * *

**Papain (Sulfite Free Papaya Source) - 1,000,000 FCCPU ** Bromelaise (Pineapple Source) - 1,000,000 FCCPU

* Daily Values Not Established.

phenol assist
Phenol Assist is an enzyme designed to help digest part of the cell wall structure of plant cells in fruits, vegetables and grains. Doing so opens the cell and allows the process of phenol digestion to occur. When an apple or a pear is sliced open and is left out for a while, the tissue of the fruit turns brown. That browning process is the result of the natural enzyme present in fruits, phenolase, oxidizing the fruit tissue. This process cannot occur until the cell wall is broken and oxygen gets into the cells. Phenol Assist gets this process going and therefore supports sulfation by reducing the phenolic load on the bodys sulfation capacity. Phenols are compounds with a specific chemical structure of an aromatic ring plus a hydroxyl group. They are found in fruits, vegetables, some grains and nuts, flavorings and spices. A salicylate is a type of phenolic compound. Phenols and polyphenols have antioxidant qualities and protective functions, which make some of them beneficial and desirable for most individuals. An important chemical process that occurs in body tissues is called sulfation. Sulfation is the movement of sulfate (sulfur plus oxygen) ions from one body tissue to another. Sulfating molecules change the molecules character and behavior and how they act in the body. Connective tissue is sulfated for structural reasons and neuron tissue is sulfated to provide a protective sheath. Sulfation also causes molecules to vary in activity, solubility, and mobility. For the body to work properly, these sulfation processes must occur. What is the relationship between phenolic compounds and sulfation? Phenols and salicylates use up a lot of sulfate in the body in order to be broken down. In other words, the phenols and salicylates compete for the bodys sulfate stores. In certain individuals, breaking down phenolic compounds can provide a benefit by supporting the sulfation mechanism. Phenol Assist contains a variety of enzymes to accomplish cell wall digestion, and other enzymes to assist in the total digestion of fruits, vegetables, grains, and spices.

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Phenol Assist available in 90 capsules Item #835/90

supplement facts
Serving Size: 1 capsule
Each Serving Contains Xylenase CereCalase Cellulase Beta-Glucanase Phytase Alpha-Amalase Glucoamylase Alpha-Galactosidase * Daily Values Not Established. Amount per Serving 32,000 XU 1,600 MU 200 CU 20 BGU 60 PU 70 SKBU 30 AGU 80 AGSU % Daily Value* * * * * * * * *

biocore Dairy
BioCore* Dairy addresses both lactose intolerance and dairy intolerance, conditions that most health care practitioners agree are not necessarily interchangeable. This product was developed by National Enzyme Company (NEC) to digest lactose, whey proteins, beta-lactoglobulin and other complex dairy proteins. This product was formerly known as Dairyzimes. Although it was renamed, the ingredients remained the same, as did the efficacy in dealing with lactose intolerance and digesting whey proteins. According to NEC, 70% of the worlds population cannot digest lactose properly. They estimate that between 30 and 50 million Americans are lactose intolerant. Many of these individuals begin avoiding dairy products or turn to lactase over-the-counter enzyme products such as Lactaid** to address the problem. Though this type of product does help in digesting lactose, the entire problem is not really addressed. Dairy products not only contain lactose, but also whey proteins, beta-lactoglobulin and other dairy proteins, which may contribute to sensitivity to dairy products, in general. So, lactose intolerance is only part of the problem, which probably more correctly should be known as dairy intolerance. For some, BioCore Dairy may provide the freedom to enjoy dairy products again. Although milk and dairy products are the only natural sources of lactose and dairy proteins, individuals must be aware that they can be found in many other products made with dairy products. A few examples of hidden lactose and dairy proteins are: various breads and baked goods margarine breakfast cereals lunch meats prepared foods salad dressing candy coffee creamers and whipped toppings

BioCore Dairy available in 100 capsules 843/100

NEC created BioCore Dairy to help dairy intolerant individuals be able to enjoy dairy products again. How Does BioCore Dairy differ from lactaid or similar products? The active ingredient in Lactaid is a lactase enzyme that acts on and digests lactose. Lactase supplements alone, however, do not offer any help in the digestion of milk proteins. The normal symptoms of dairy intolerance, such as nausea, cramping, bloating, gas, or diarrhea, may be construed by individuals self-diagnosing themselves as lactose intolerance when, in fact, dairy proteins are part of the problem. BioCore Dairy contains not only lactase to digest lactose, but also specific protease enzymes to target the whey protein beta-lactoglobulin. There is scientific data that indicates that this dairy protein is resistant to breakdown by pepsin and pancreatic enzymes in the body. What are the contents of Biocore Dairy? The non-animal-based enzymes present in BioCore Dairy are obtained by the controlled fermentation of Aspergillus niger and Aspergillus oryzae, which means that they are plant-based fungally-derived enzymes. The amount of this proprietary enzyme blend present in one capsule is specifically formulated to digest the lactose (12 grams) and the dairy proteins (8 grams) found in one cup of milk. Of the 8 grams of dairy protein in a cup of milk, 6.4 grams are from casein and 1.6 grams are from whey. The enzyme system in BioCore Dairy will efficiently hydrolyze all milk proteins, including casein and beta-lactoglobulin.
*BioCore is a registered trademark of National Enzyme Company **Lactaid is a registered trademark of McNeil PPC

33

Biocore Dairy available in 100 capsules Item #843/100

supplement facts
Serving Size: 1 capsule
Each Serving Contains Protease (Beta-lactoglobulin Units) Lactase (Acid Lactase Units) *Daily Value Not Established. Amount per Serving 630 BLGU 1000 ALU % Daily Value* * *

quesTIons & ansWers

Q---What do enzymes do?
A---Enzymes act as catalysts in speeding up biochemical reactions. Without enzymes, these reactions could not occur successfully.

Q---What actually are enzymes?

34 A---Enzymes are proteins which act as chemicals in body reactions.

Q---Does one enzyme have several functions in the body?

A---No, each enzyme has one specific job to do. If that specialized enzyme is not present or available, that job does not get done in a timely manner.

Q---Why take supplemental digestive enzymes?

A---Good health depends on proper digestion and absorption of nutrients. Enzymes support proper digestion and as a result, proper absorption.

Q---Are enzymes present in food?

A---Yes food does contain enzymes, but cooking and processing destroy much of that enzyme activity.

Q---When is the best time to take digestive enzymes?

A---The best times are at the very beginning of a meal or just before a meal.

Q---Are digestive enzymes destroyed by our bodies like they are in cooking or processing?
A---Animal enzymes are destroyed to some degree by stomach acids. Plant based enzymes have been tested to show that they are resistant to stomach acids and are effective throughout the digestive tract.

Q---Will digestive enzymes digest all the food I eat?

A---No, digestive enzymes support the overall digestive process and work in concert with the pancreatic enzymes produced in the body.

Q---How do I know what dosage of digestive enzymes to use?

A---The amount of the dose is dependent on how much food one eats for a meal. A small snack or small breakfast may only require half of the enzyme dosage a big dinner may require. A child will eat less and therefore require fewer enzymes than an adult. Usually small portions and childrens portions can get by with one capsule at a meal, while large meals and adults will often require two capsules. One has to experiment individually to determine what the optimal level is for that person. How you feel is the best indicator. Bloating, gas or intestinal discomfort may indicate that a larger dose is required.

Q---since enzymes digest foods, can they be dangerous to use?

35 A---Enzymes are completely safe when ingested, but some precautions need to be taken with the powder inside the capsules. The powder should not be inhaled or rubbed onto the skin or into the eyes because protease enzymes can attack mucous membranes and cause irritation. Enzyme powder should also not remain on the lips for any significant time.

Q---If my child wont swallow capsules, can I open the capsules and mix with food or beverages?
A---Yes, but you should eat the food or drink the beverage immediately, so that digestion doesnt begin. If that is not possible, freezing the mixtures will delay the process but even with freezing, the mixtures should be used by the end of the day.

Q---If I am on the gf/cf diet, do I still need enzymes?

A---Yes, enzymes still aid the breakdown of the food. Though casein and gluten may not be present, there are still other constituents of the food that need digestion. Also, the enzymes guard against casein or gluten infractions which can be common in prepared foods.

Q---If I am on the scD diet, do I still need enzymes?

A---Yes, infractions on the SCD diet can be numerous and unnoticed especially in prepared foods. Furthermore, bacteria in your body often convert certain sugars and starches to palatinose, which isnt digested without an isomaltase (Isogest) type enzyme.

Q---Can enzymes take the place of the GF/CF or the SCD diet?
A---That is not a recommended practice by most physicians using these diets. Because it is not possible to measure exactly how many enzymes would be needed for a given amount of food, it is advised that individuals stay on the diets and use the enzymes for infractions and insurance.

Q---Will I have side effects with digestive enzymes?

A---When you first begin enzymes, there can be an adjustment period, especially if you have sensitivities to casein, gluten, soy or other ingredients. Adjustment symptoms could be hyperactivity, digestive disturbances, stool changes or sleep pattern changes. These usually subside in a few days. Q ---Do

I need a prescription for digestive enzymes?

36

A---Animal based enzymes generally do require a prescription, but plant based enzymes are sold as dietary supplements. You should, however, discuss using enzymes with your health care professional first.

noTes

37

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39 Amy Beth Carrie E. 6400 SW Rosewood Street Lake Oswego, Oregon 97035 Telephone: (800) 245-8282 (888) KIRKMAN (503) 694-1600 FAX: Chris Karijane Kathy V. (503) 682-0838

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Weve Opened the Door . . .

with a revolutionary discovery in enzymes

Isogest

40

Only from Kirkman

the only commercially available enzyme with isomaltase activity the need for this enzyme was established by a clinical study at MassGeneral Hospital for Children in 2004 Isogest has been evaluated by 12 of the countrys leading physicians who specialize in working with individuals with special dietary requirements

Kirkman Group, Inc. www.kirkmangroup.com 1-800-245-8282