Are papaya enzyme supplements safe during pregnancy?

What does the evidence say about papaya enzyme supplements during pregnancy?

1. Papain is a purified protein extracted from the latex of the unripe papaya, and only unripe fruit contains papain. Ripe papaya juice is poor in papain content, which is why the supplement and the fruit are different exposures. 1
2. In laboratory assays, papain was not cytotoxic to the bacterial strains tested at 50, 250 and 500 micrograms per mL, and no tested concentration showed mutagenic activity. The authors concluded papain is not toxic or mutagenic in bacterial systems. The article contains no discussion of pregnancy or reproductive effects. 1
3. A regulatory safety evaluation of papain as a food enzyme, sourced from the latex harvested from the unripe fruit, concluded it does not give rise to safety concerns under the intended conditions of use, while noting that a risk of allergic reactions upon dietary exposure cannot be excluded, particularly for people allergic to papaya, pineapple, kiwi, soy, fig and pollen. Pregnancy is not discussed in that evaluation. 2
4. Other parts of the papaya plant carry documented reproductive activity in animals. In albino rats given a methanol sub-fraction of Carica papaya seeds, animals receiving 2, 5 and 10 times the contraceptive dose did not become pregnant, while at the lowest dose post-implantation loss was no different from controls and no malformations were seen. 3
5. For the indigestion that usually sends people to enzyme tablets, NIDDK is direct that antacids are for mild symptoms and should not be used every day or for severe symptoms except after discussing that use with your doctor, and that they can cause diarrhea or constipation. 4

Is papaya enzyme supplements safe in each trimester?

• First trimester. The trimester where the distinction matters most, because a ripe papaya and a papain concentrate are different exposures. Ripe papaya juice is poor in papain, while the supplement is a purified extract of the latex from unripe fruit.
• Second trimester. If you are reaching for enzymes because of indigestion, the fact worth knowing is that no pregnancy data exists for papain supplements in either direction. Absence of evidence is not evidence of harm, but it is a reason to ask before starting.
• Third trimester. Allergy risk is the concrete hazard rather than a theoretical one. Dietary exposure to papain carries a risk of allergic reactions for people allergic to papaya, pineapple, kiwi, soy, fig and pollen, which is a group large enough to be worth checking yourself against.