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 low sucrose 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, suitable alternatives to Sucraid, 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 links*. As an Amazon Associate, I may earn a small commission on qualifying purchases at no extra cost to you!
Table of Contents
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 usually 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 – and even a sucrose intolerance – can sometimes be caused indirectly, by underlying microbial imbalances such as dysbiosis, small intestinal fungal overgrowth (SIFO), and/or small intestinal bacterial overgrowth (SIBO). (3, 4)
How it works: In cases of an acquired sucrase-isomaltase deficiency, the above types of infections/microbial imbalances can potentially wear away at the brush border of your intestines. That’s where enzymes like sucrase and isomaltase are supposed to be made and secreted.
These types of issues cannot be directly resolved by taking digestive enzymes, even if you have a sucrose intolerance and are taking Sucraid® correctly.
In most cases, microbial imbalances like SIBO, SIFO and dysbiosis cannot be eradicated by diet alone. These types of conditions usually require antimicrobial herbs and/or medical intervention in order to resolve.
Recommended reading:
- Antimicrobial Herbs: List & Expert Guidance
- How to Treat SIBO Naturally: Anatomy of a Holistic SIBO Treatment Plan
Celiac disease
Celiac disease is an autoimmune disorder which, like SIBO and SIFO, has the potential to damage the brush border of your intestines if left unchecked for too long.
In this case, eating gluten-containing grains like wheat, barley, rye, triticale, or sometimes even oats can stimulate your intestinal cells to become very damaged.
(That’s why celiac is another possible root-cause of acquired sucrose intolerance.)
No matter how much Sucraid you take, if you’re still eating gluten, your intestinal brush border can’t heal, and your ability to digest sucrose will be compromised until you’ve addressed this issue holistically.
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:
- 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 can cost up to $1500 U.S. dollars each month for a 30-day supply, if not covered by insurance. (I know… yikes!)
If your insurance covers it, your cost will vary depending on your individual insurance coverage plan and benefits.
Tips for keeping costs down: suitable Sucraid® alternative options
Starchway
Giving starchway by Intoleran a try may potentially help to reduce costs by minimizing your reliance on Sucraid®.
Starchway isn’t covered by insurance, but it’s exponentially more affordable if you need to go the private-pay route.
Digest Gold
Digest Gold by Enzymatica* features maltase and sucrase (invertase) in their brush border enzyme supplement.
This product has been a game-changer for many of my clients!
THER-BIOTIC® SIBB-Zymes™
Some of my clients have found relief from taking THER-BIOTIC® SIBB-Zymes™*, a digestive brush border enzyme by Klaire Labs.
THER-BIOTIC® SIBB-Zymes™* contains sucrase (invertase) as well as maltase, so it can potentially help to break down both sucrose and starch.
How to take it:
- Take as directed by your healthcare team, OR
- Consider taking 2 capsules at the beginning of each meal, OR
- Take 1 capsule at the beginning and 1 capsule halfway through meals containing sucrose and/or starch
Low sucrose diet
Adhering to a sucrose intolerance diet can help to minimize your reliance on Sucraid®.
- If you’d like some new ideas and recipes, consider checking out my 7-day sucrose intolerance diet meal plan PDF, which also comes with 21 low sucrose recipes! Everything is aspartame-free, sugar alcohol-free, and lactose-free.
- I also highly recommend this CSID Recipe Cookbook* by my amazing CSID dietitian colleague!
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
- Sucrose Intolerance Food List – FREE Download!
- Navigating the Sucrose Intolerance Diet
- What is a Sucrose Intolerance and How Do You Know If You Have It?
- Understanding Congenital Sucrase-Isomaltase Deficiency (CSID): Causes, Symptoms, and Treatment
- Acquired Sucrose Intolerance: How to Navigate Sucrase-Isomaltase Deficiency in Adults
- A Comprehensive List of Foods High In Sucrose
- CSID Diet: 7-Day Meal Plan + 21 Low Sucrose Low Maltose Recipes (PDF)
- CSID Cookbook: Low-Sucrose, Low-Starch Recipes for Sucrase-Isomaltase Deficiency*
- CSID Diet Elimination Workbook*
- CSID Mixology: Crafting the Perfect Sucrose-Free Cocktails*
Other adverse food reactions
- Food Allergy vs Intolerance vs Sensitivity
- Lactose Intolerance vs Dairy Sensitivity – How to Tell the Difference
- 7 Reasons Oatmeal and Oat Milk Can Cause Diarrhea
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
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XX – Jenna
Thanks for the information