Sweet Relief - Expert Advice on Sucraid (Sacrosidase)

Sweet Relief: When and How to Take Sucraid® (Sacrosidase)

Sacrosidase (Sucraid®) is a digestive enzyme specially designed to aid in the breakdown of sucrose, exclusively for folks with sucrase-isomaltase deficiency – aka “sucrose intolerance”.

Whether you have congenital sucrase-isomaltase deficiency (CSID) or an acquired sucrase intolerance, Sucraid® (in combination with a sucrose intolerance diet) may potentially be a game-changer for your quality of life.

As a CSID-informed gut health dietitian, I’m going to explain exactly what Sucraid® is, how it works in the body, and what you should know before integrating it into your sucrose-ismaltase deficiency treatment plan.

Disclaimer:  This article was written for general education purposes, not to replace medical/nutritional advice. Make sure you’re working with a CSID-informed gastroenterologist and registered dietitian to make sure you’re receiving custom advice tailored to your individual needs!

Disclosure: This article contains affiliate link*.  As an Amazon Associate, I may earn a small commission on qualifying purchases at no extra cost to you!

Understanding sucrase-isomaltase deficiency

Sucrase-isomaltase deficiency is a condition in which your body is lacking certain key enzymes (sucrase and isomaltase) responsible for the digestion and breakdown of sucrose and starch in your intestines.

This inability to digest sucrose and starch molecules has an “osmotic” effect in the colon, which is very similar to what happens when an individual with lactose intolerance drinks a glass of regular milk. 

  • The large particles which don’t belong in the colon cause lots of water to get pulled in, in efforts to “dilute” the molecules!  Unhealthy microbes will also have a feast on the undigested sugars, leading to an aftermath of fermentation.

Inevitably, eating “normal” when you have a sucrase-isomaltase deficiency usualy leads to a range of uncomfortable symptoms, including abdominal pain, bloating, diarrhea, and gas.

(You can read more about sucrase-isomaltase deficiency and sucrose intolerance here.)

While avoiding foods high in sucrose and starch is generally helpful in reducing the likelihood of unwanted symptoms, trying to survive and thrive on this very restrictive diet long-term can still feel debilitating and very challenging.

Enter: Sucraid®!

What is Sucraid®?

Sucraid® (sacrosidase) is a prescription medication specifically designed to alleviate the symptoms of sucrose intolerance.  

It is a type of digestive enzyme (in liquid form) made from a combination of baker’s yeast and glycerine (via an enzyme called papain). (1, 2)

Sucraid® has been clinically proven to aid in the breakdown of sucrose in the gut.  It is currently the only Food and Drug Administration (FDA) approved treatment for sucrase-isomaltase deficiency.  

It’s been FDA-approved for use in the United States since 1998, specifically for sucrase-isomaltase deficiency if this has been confirmed via an intestinal biopsy and/or a sucrose intolerance breath test.

How does it work?

Sucraid® is to sucrose intolerance what lactase enzymes are to a lactose intolerance. Sucraid® essentially provides the body with the enzyme it lacks, allowing for the proper digestion of sucrose. 

It aids in the break down the disaccharide sucrose into glucose and fructose, which the body can then absorb and utilize for energy – without triggering the usual discomfort associated with sucrose intolerance.

For maximum benefit, your unique prescribed dose of this liquid substance is ideally to be taken orally at the very beginning of each meal.

Getting started with Sucraid

Taking Sucraid effectively involves collaboration with a healthcare professional to determine the appropriate dosage and administration. 

Below are some key steps for how to get started.

1:  Consultation and diagnostic testing

If you suspect you have sucrose intolerance, consult your primary care doctor and a gastroenterologist. 

Your doctors will conduct tests (such as the disaccharide biopsy or hydrogen breath test) to confirm the diagnosis and determine if Sucraid® enzyme replacement therapy is a suitable treatment option for you.

2:  Get a prescription approved

If Sucraid® is recommended, your healthcare provider will prescribe the appropriate dosage based on your individual needs.

3:  Receive your dosage and administration

Sucraid® is a liquid medication that needs to be taken orally, with meals or snacks. 

The dosage is provided in single servings per meal. This dose may be customized based on bio-individual factors like weight and age.

4:  Make dietary modifications (as needed)

While Sucraid® can help alleviate symptoms of sucrose intolerance, it’s still important to make dietary adjustments via a customized sucrose intolerance diet, to minimize the intake of sucrose and manage symptoms effectively.

Note that this enzyme is designed for aiding in the breakdown of sucrose but not starch, so you may also need a low maltose / low starch diet, and/or starchway.

5:  Clinical monitoring, supervision, and follow-up

Regular communication with your medical team (doctors and a registered dietitian) is crucial!

They can monitor your progress, adjust your Sucraid® dosage if needed, and address any concerns you may have.

Potential benefits of Sucraid®

Symptom relief

In many cases, Sucraid® can significantly reduce the discomfort associated with sucrose intolerance, enabling you to enjoy a wider variety of foods without fear of adverse reactions.

While sucrase-isomaltase deficiency varies case-by-case due to bio-individuality, and more research is  needed, it’s promising so far!

  • For example, in a 2021 case study published by Cureus, a woman with CSID was able to completely resolve symptoms of bloating, diarrhea, flatulence, and burping after taking Sucraid® alongside working with a registered dietitian to follow a customized variation of a low sucrose diet over the course of ~6 months. (1)

Improved quality of life

With proper use, Sucraid® may be able to help you lead a more normal and comfortable life.

For example, some folks have reported having more dietary variety and flexibility, which helps reduce the negative impact of sucrase-isomaltase deficiency on daily activities.

However, it’s important to note that Sucraid® is not a cure for sucrose intolerance.  and it doesn’t address starch intolerance.

It helps reduce symptoms for most people by aiding in the breakdown of sucrose…

But in more complex cases, additional medical and nutritional considerations and interventions may still be necessary in order to feel better.

Potential limitations of Sucraid®

Starch

Sucraid® doesn’t break down some of the sugars that come from starch (amylose) molecules – like maltose.

If you notice you still aren’t feeling well on a low sucrose diet in combination with Sucraid®, I recommend assessing your starch intake and consulting your treatment team about an enzyme called Starchway (by Intoleran). 

  • Starchway is another type of digestive enzyme which is designed to help break down sucrose and starch from the foods you eat.

You may also benefit from sticking to a low-starch or no-starch elimination and reintroduction diet, to determine your unique starch threshold. 

(The degree to which you can tolerate starch is something that I’ve noticed varies greatly from one person to another.) 

When in doubt, keep a detailed food-symptom journal and always listen to your body!

Other food intolerances 

It’s important to keep in mind that sucrase-isomaltase deficiency exists on a wide spectrum, so not all cases will be resolved by taking Sucraid®.

This is especially if you’re navigating other types of food intolerances such as to lactose, fructose, other FODMAPs, or high sulfur foods.

If you notice you aren’t feeling close to 100% better on a low sucrose diet and Sucraid® enzyme replacement therapy, consider working with a CSID-informed gut health dietitian and keeping a food-symptom journal to rule out the possibility of other food intolerances.

Food allergies and sensitivities 

Enzyme replacement (such as Sucraid®) is not going to be effective for food sensitivities or food allergies.

(In my clinic, lots of clients with food intolerances also have food sensitivities!)

This may seem confusing to navigate, because at the surface-level, some symptoms of food allergies/sensitivities may present very similarly to food intolerances,  

However, each of these types of adverse food reactions has different underlying mechanisms and will require different types of medical/nutritional interventions.

(Read more about how to understand the key differences between food allergies, food intolerances, and food sensitivities here.)

Microbial imbalances

Digestive symptoms of gas, bloating, abdominal pain, and/or diarrhea can also be caused by underlying microbial imbalances such as dysbiosis, small intestinal fungal overgrowth (SIFO), and/or small intestinal bacterial overgrowth (SIBO). (3, 4)

These types of issues cannot be resolved by taking digestive enzymes, even if you have a sucrose intolerance and are taking Sucraid® correctly.

In most cases, microbial imbalances cannot be eradicated by diet alone; these types of conditions usually require herbal antimicrobials and/or medical intervention in order to resolve.

Inflammatory bowel disease (IBD)

If your sucrose intolerance is secondary or acquired (versus genetic or “congenital”),  it’s possible that your small intestinal brush border was damaged due to inflammation caused by a type of inflammatory bowel disease (IBD) such as:

  • Celiac disease
  • Crohn’s disease
  • Ulcerative colitis

Make sure to work with your gastroenterologist to rule out the possibility of IBD, especially if your sucrose intolerance developed later in life.  

  • In these cases, you’ll need additional medical interventions and nutritional therapy (beyond Sucraid® and the sucrose intolerance diet, respectively) in order to properly manage the inflammation in your bowels.
    • IBD left unchecked will continue to contribute to ongoing symptoms of diarrhea and abdominal pain/cramping no matter how much Sucraid you take!

Potential side effects and contraindications

Side effects

The most common reported side effects of taking this enzyme replacement therapy can include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Gas and bloating (per a few of my 1-1 private practice clients with acquired sucrase-isomaltase deficiency)
  • Worsened abdominal pain

If you experience any of these side effects following Sucraid®, it’s important to communicate this to your treatment team ASAP! 

Other less common reported side effects of Sucraid® can include:

  • Constipation
  • Insomnia
  • Anxiety/nervousness
  • Headaches
  • Dehydration

Contraindications and safety concerns

Pregnancy/lactation

Not enough research has been done to confirm the safety of Sucraid® during pregnancy and lactation.  

Whether or not to take Sucraid® while pregnant/nursing is something your doctor will help you determine on an individual basis.

Soy, corn, or yeast allergy/sensitivity

Speaking as someone with a food allergy to soybeans and a sensitivity to corn, my understanding is that in most cases, vegetable glycerin (a key ingredient from which Sucraid® is derived) is in most cases made with corn and/or soybeans.

If you have an allergy or sensitivity to corn, soy, or yeast, you may be more likely to have an adverse reaction to Sucraid®.

  • Make sure to notify your doctor about any and all food allergies/sensitivities before taking it.

On the other hand, if you’re among the percentage of people who has experienced an adverse reaction, it may be worth consulting an allergist (to rule out food allergies) and a certified LEAP therapist (to rule out food sensitivities) in case you react to corn, soy, or yeast.

Frequently asked questions (FAQ’s)

Does Sucraid® break down starch?

Sucraid is not able to break down all starch or certain derivatives from starch, like maltose.  

You may need to follow a low-starch or no-starch elimination diet, with or without a complementary enzyme called Starchway, by Intoleran.

Can Sucraid® help me digest lactose?

No.  If you’re lactose intolerant, you will either need to follow a lactose-free diet or take lactase enzymes in order to digest lactose from dairy.

Can Sucraid® help me digest FODMAPs?

No.  If you notice that high FODMAP foods trigger symptoms such as gas, bloating, diarrhea, and/or abdominal pain, you may benefit from consulting a dietitian to help you to layer a modified version of the low FODMAP diet in with your sucrose intolerance diet.

Or as an alternative, you may benefit from trying a digestive enzyme powder (such as FODZYME) to help break down the FODMAPs in foods more easily.

Is it safe to take Sucraid® while I’m pregnant or nursing?

Not enough research has been done to determine whether or not Sucraid® is safe for everyone to take during pregnancy and lactation.

This is something your doctor will need to help you determine on a case-by-case basis.

Can I get Sucraid® without going through a doctor?

No.  Unfortunately a doctor’s order is required in order to access this enzyme replacement therapy.

Your doctor may also require you to run a sucrose intolerance breath test and/or a disaccharide intestinal biopsy before you can officially qualify for a Sucraid® prescription.

Is Sucraid® covered by health insurance?

This depends on your insurance company and individual coverage plan.

In some cases, health insurance companies will cover Sucraid®… However, in many cases, it is NOT covered, or only partially covered. (Ugh!)

If your health insurance plan doesn’t cover Sucraid®, and you need to lean on it for symptom relief, it may be in your best interest to get a Health Savings Account (HSA) or Flexible Spending Account (FSA).

I also recommend looking into CareCredit as needed, to help cover these types of monthly expenses in times of financial crisis.

How much does Sucraid® cost?

According to my clients who have a sucrase-isomaltase deficiency, it’s about $1500 U.S. dollars each month for a 30-day supply. (I know… yikes!)

Tips for keeping costs down: suitable Sucraid® alternative options

Adhering to a sucrose intolerance diet and/or giving starchway by Intoleran a try may potentially help to reduce costs by minimizing your reliance on Sucraid®.

CSID Made Simple Cookbook with Amazon affiliate link

Is it necessary to take Sucraid® if I stick to a strict sucrose intolerance diet?

Not necessarily!  Some individuals are able to remain symptom-free on a low-sucrose diet, without taking digestive enzymes.

However, this is not always the case – it varies significantly case-by-case.

If I have a sucrose intolerance, will I need to take Sucraid® for the rest of my life?

It depends!

For example, if you have CSID, and you find that a sucrose intolerance diet (and other interventions) aren’t enough to manage unwanted gastrointestinal symptoms, you’re more likely to want/need to lean on Sucraid® for the rest of your life.

On the other hand, if you have an acquired sucrose intolerance, addressing that at the root-cause level may in some cases allow you to eventually restore the integrity of your intestinal brush border and gut microbiome.

  • When your intestinal brush border and gut microbiome are healthy enough, there’s a chance that your body may be able to make its own brush border enzymes naturally again, someday.  

(However, please keep in mind nothing is ever guaranteed!)

More resources 

Sucrase-isomaltase deficiency

Other adverse food reactions

Conclusion and recap

Sucraid® (sacrosidase) is a special digestive enzyme to help you breakdown of sucrase (table sugar).

It’s currently the only FDA-approved medical intervention for sucrase-isomaltase deficiency. 

But if it isn’t accessible to you, rest assured you’ve got alternative options.  More specifically, starchway (another digestive enzyme) and dietary modification can potentially make a world of difference in your digestion and quality of life.

By working closely with your treatment team, embracing dietary adjustments, and adhering to proper medication usage, you may optimize your chances of finding some “sweet relief” from the day-to-day challenges posed by sucrose intolerance.

While Sucraid® is a valuable ally to lean on, keep in mind it still isn’t a cure for sucrase-isomaltase deficiency.

Sucraid® should complement and enhance, but not replace, ongoing communication with your healthcare team.

For optimal results, consider combining Sucraid® and the sucrose intolerance diet with starchway, dietary modification, and a holistic approach to gut repair.

Next steps

Stay connected

Let’s keep the conversation going! If you’d like to join my “inner circle”, I’ve got a private CSID-friendly Facebook community. And we’d love to have you join us!

Whole-istic Living ("Holistic Living") Facebook Group with Jenna Volpe

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Thanks so much for taking the time to read what I have to say on this topic!

If you found this article helpful, please pin it / share it with others who might need to read it. 

Wishing you all the best on your journey!

XX – Jenna

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