Mention the word 'enzyme,' and most people immediately think about the little tablets we swallow before eating to make sure all the food we wolf down is properly digested so we don't end up with gas, bloating, indigestion or something even more painful, like gastroesophageal reflux disease (GERD), where stomach acid and food are regurgitated back up through the esophagus.
Enzymes are indeed vitally important for proper and efficient food digestion. But that's only the tip of the iceberg as far as what they do. Enzymes are catalysts produced by the body that accelerate and enhance thousands of biochemical reactions system wide. Almost all the chemical reactions that occur in every cell in our bodies depend on them. They're essential for metabolizing fats, carbohydrates and proteins, and without them, none of the vitamins, minerals or hormones in our bodies could do any work. In fact, without enzymes, all the chemical reactions in the body would be too slow for metabolic processes to occur, and we'd die.
Nobody knows for sure how many different enzymes there are in the human body. Approximately 3,000 have been identified, but it's believed that as many as 50,000 enzymes carry out thousands of metabolic functions controlling our organs—brain, heart, kidneys, lungs, liver, pancreas, spleen, etc.—as well as aiding immune system function and inflammatory responses.
Enzymes are broadly defined as metabolic, digestive or food enzymes depending on where they are active (in the digestive tract or elsewhere) and their source (produced within the body or consumed as part of the diet).
Metabolic enzymes play vital roles inside every living cell, handling everything from cell growth and repair—critical for maintaining organ function—to cell death and scavenging debris from the blood.
Digestive enzymes break down the food we eat—all that meat and vegetables, salad and sandwiches—into nutrients that can be absorbed and utilized by our cells. Created mainly in the pancreas and small intestine, digestive enzymes like proteases, amylases and lipases respectively work to break proteins down into amino acids, carbohydrates into sugars, and fats into fatty acids and cholesterol.
Food enzymes come from raw foods we eat, as well as supplements. They are extremely important because natural enzyme production in the human body starts to decrease somewhere in our twenties and continues to decline by approximately 13 percent every decade. The stomach also produces less hydrochloric acid as we get older, making the digestive enzymes we do produce less effective. In addition, factors such as low-grade inflammation from food allergies, pancreas problems and chronic stress also lead to enzyme deficiencies.
Eating raw foods helps relieve the body of having to make all the necessary enzymes for digestion and general health, and helps make up for enzyme deficiencies as we age. But, unfortunately, because of the increasingly depleted conditions of our soils and the use of pesticides and chemical fertilizers, raw foods are no longer a reliable source of enzymes.
"In order for enzymes to be really active and abundant in the body, you need all the cofactors found in the soil (such as minerals) to be present," says Dr Ellen Cutler of Mill Valley, California, an integrative natural health specialist and author of Micro Miracles: Discover the Healing Power of Enzymes. "Nowadays, people are pretty much enzyme deficient, which is why we see young kids with GERD. I never saw such things in my practice
According to Cutler, if we don't have sufficient enzyme production in our body and aren't getting enough enzymes from external sources, our immune surveillance, tissue repair and hormone production systems become compromised. As a result, a general overall fatigue sets in and other kinds of health issues occur. Typical symptoms of enzyme deficiency are inflammation, joint and myofascial pain, and bacterial overgrowth in the gastrointestinal tract resulting in problems such as bloating and indigestion, GERD, irritable bowel syndrome (IBS), brain fog, headaches, skin rashes, acne and mood swings.
"Enzymes saved my life," she says. "I was diagnosed with ulcerative colitis in my late 20s. I also suffered from severe chronic bloating and constipation. When I tried digestive enzymes, within two weeks I had very few symptoms. I had more energy, my hair and nails were healthier, I needed less sleep, and my immune system was considerably healthier. It was miraculous."
Systemic, proteolytic, fibrinolytic
Considering the incredible number of enzymes in the body and the number of biological systems that depend on them, it's not surprising that things can get a little complicated in the enzyme world. Enzymes are delicately engineered to have effects on specific chemical bonds, so the same enzyme can play a role in many different bodily functions—just making the same atomic-level snip or stitch in each one.
Many practitioners, including Cutler, recommend both digestive and systemic enzymes for people who want to address health issues. Systemic enzymes—also known as metabolic or proteolytic enzymes— are simply certain digestive enzymes that are taken between meals and away from food—at which point they are able to act on other parts of the body.
Cutler says that when they're ingested at least an
hour away from food consumption (early morning, after eating and late at night before bed is best), proteolytic enzymes can go to work system wide, combating inflammation, joint pain, bacterial overgrowth, immune system issues and other
Proteolytic enzymes are a subset of digestive enzymes ('proteolytic' means they specifically digest protein—and not just protein from foods). When proteolytic enzymes are taken systemically, they enter the bloodstream and start to break down abnormal proteins in circulation. Notably this includes viruses, which the enzymes recognize as foreign proteins to be eliminated, and a protein called fibrin that's involved in blood clotting and also linked to heart disease and other chronic illnesses.
Each fibrin molecule is shaped like a long thread. When an injury occurs, fibrin aggregates at the site, going to work with platelets and red blood cells to clot and seal the wound. After a few days of successful repair work, enzymes are normally directed to dissolve the excess fibrin in the muscles, blood and nerves.
But fibrin production can also get out of control. If the pain from the wound is blocked by taking painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs, like ibuprofen), the signal to stop fibrin production is overridden. If the body's enzyme reserves are depleted or there are other health issues, sometimes the enzymes that would ordinarily clean up the excess fibrin never get deployed. When this happens, excess fibrin in the body builds up, contributing to inflammation and other fibrin-related problems such as fibromyalgia, atherosclerosis (fibrin-based plaque buildup in the arteries) and endometriosis.
Enzymes that specifically target fibrin throughout the body are known as 'fibrinolytic.' "Nattokinase, seaprose (seaprose-S), serrapeptase (serrapeptidase or serratiopeptidase) are all huge fibrinolytic anti-inflammatories," says Kevin Nelson, a chiropractor in Minnesota with a PhD in holistic nutrition who specializes in gut health and systemic enzyme therapy. "They eat nonliving tissue and deal with scars and plaques in your gut and in your nerves and blood."
So far, enzyme therapy using proteolytic and fibrinolytic enzymes has proven clinically effective in the treatment of a wide assortment of conditions. Fibrinolytic enzymes produced by the bacteria in fermented foods have shown particular promise for slowing down the accumulation of fibrin in the blood vessels,1 which has been implicated in blood clots, myocardial infarction and other cardiovascular diseases. One such enzyme, nattokinase, is a potent fibrinolytic that can speed up the breakdown of fibrin in the body after an oral dose.2
The proteolytic enzyme serrapeptase has been used to treat infections from joint replacements, an often devastating complication.3 Seaprose-S reduces inflammatory venous disease, which leads to varicose veins and venous ulcers.4
Bromelain, a proteolytic enzyme derived from the pineapple plant, is widely used in for its anti-inflammatory and fibrinolytic effects.5 In the treatment of osteoarthritis, bromelain has also been demonstrated to show anti-inflammatory and analgesic
properties while being safer than standard NSAIDs and other painkillers.6
Systemic enzyme therapy has been found clinically effective in treating rheumatic disorders.7 And enzyme supplementation has shown promise in helping to mitigate digestive disorders related to pancreatic insufficiency and lactose intolerance.8
Enzyme therapy may even hold promise in treating various cancers. According to Nelson, fibrinolytic enzymes are effective for cancers because they eat away at the tough, protective fibrin coating of cancer cells, leaving them vulnerable to attack by the patient's immune system.
According to Cutler, proteases can be very useful for people suffering from cancer. "People who have cancer tend to have more coagulative blood," she says. "And enzymes address that. It's also helpful to take if you're going through radiation or chemotherapy—usually enzymes are not contraindicated."
Systemic enzyme therapy has also been clinically proven to decrease the side-effects caused by tumors and their treatment in patients with breast or colorectal cancer, including nausea, gastrointestinal problems, fatigue and weight loss.9 Most clinical studies of systemic enzyme therapy have investigated a combination of papain, trypsin and chymotrypsin, which has been shown to reduce the side-effects caused by radiotherapy and chemotherapy. With some types of tumors, systemic enzyme therapy may even prolong survival.10
Who needs enzymes?
According to many practitioners, just about everybody in the Western world needs enzymes. We eat highly processed foods that are enzyme deficient. We cook most of our food, and all the enzymes that are actually left in our food are deactivated at a water temperature of about 120°F or an air temperature of about 150°F. What raw food we do consume is raised in depleted soils contaminated with pesticides and pollutants. On top of all that, we've stressed the ability of our pancreas to produce enzymes by eating refined sugars and carbs to excess. Is it any wonder the Western world suffers from so many illnesses?
In addition, millions suffer from chronic pain that is driven by inflammation. According to Tina Marcantel, RN, NMD, a naturopathic doctor in Gilbert, Arizona, proteolytic enzymes assist in mitigating chronic pain, speeding healing and increasing the body's defense mechanisms by modulating the immune system. She says they also help maintain blood circulation throughout the body and reduce inflammation—the primary cause of pain in arthritis, sciatica, chronic back pain and sports injuries like muscle sprains.
Nelson agrees that enzymes are one of the major "go-to" remedies for people suffering from chronic pain. "Look, everything starts with digestion," he says. "You've got to fix that first. If you're in chronic pain you've got to heal the gut. If you eat something and then get symptoms afterward, that's because the food is basically sitting in your gut, undigested and rotting. And if you have an inflamed gut, you can end up with a leaky gut—and the inflammation goes anywhere in the body it wants to. Big protein molecules called circulating immune complexes end up swarming around in your body, and then they just get stuck somewhere—in your low back, in your left elbow, in your gallbladder, in your right knee—wherever they want to land. Then, all of a sudden, you've got a problem."
Most of this can be avoided in the first place by taking digestive enzymes with your food. If you're already in chronic pain, however, the approach is different. Using digestive enzymes to aid digestion is still vital. But if you're in chronic pain, you also need to start taking them systemically as well.
"Protease and serrapeptase [both proteolytic enzymes] are especially effective because they help break up inflammatory mediators," says Cutler. "It's harder to deal with systemic things like fatigue or headache or back pain and inflammation. With digestive issues, you'll see an improvement almost immediately. When things have gotten chronic, it takes longer. Everybody has some inflammation, and enzymes help reduce pathogens that the body has an auto-aggressive response to. They even help people with airborne allergies like hay fever. But the digestion of the foods is just as important. People just have no idea how important proper food digestion is."
Another enormous piece in the chronic pain picture is medications. Cutler says any medication is going to put stress on the liver and kidneys and impact proper digestion of food. In addition to that, most medications have additives and fillers in them that would surprise you—including gluten. "Frankly, I'm pretty obsessive when it comes to using enzymes," she adds. So are my patients. And I hear miracle stories all the time."
What enzymes do what?
The following are the main enzymes or enzyme classes used in most commercial enzyme products.
Amylase, secreted by the salivary glands and the pancreas. Aids in digestion, breaking down carbohydrates into simple sugars
Bromelain, a proteolytic enzyme that aids in digestion by breaking down food proteins, improves absorption of nutrients, aids circulation, treats inflammation and attacks arterial plaques that contribute to heart attacks
Catalase breaks down hydrogen peroxide within cells into water and oxygen
Cathepsin aids in digestion by breaking down meat
Cellulase aids in digestion by breaking down fiber and cellulose in fruits, vegetables, grains and seeds
Glucoamylase breaks down the sugar in grains (maltose)
Invertase helps the body utilize sucrose
Lactase breaks down lactose, the complex sugar in milk products, excellent for people who are lactose intolerant
Lipase breaks down fats into fatty acids and vitamins A, D, E, and F, aids metabolism and helps with cardiovascular
Nattokinase, another proteolytic enzyme that inhibits fibrinolytic activity, with positive effects for thrombosis, myocardial infarction and other cardiovascular diseases
Pancreatin, a mixture of amylase, lipase and protease enzymes used to treat conditions in which pancreatic secretions are deficient, such as surgical pancreatectomy, pancreatitis and
Papain aids in digestion, breaks down food proteins into smaller peptide chains
Pectinase aids in digestion by breaking down fruits and other pectin-rich foods such as carrots, beets, potatoes and tomatoes
Protease aids in digestion by breaking down protein into amino acids, acts on pathogens such as bacteria, viruses and cancer cells
Seaprose-S, another proteolytic that has an anti-inflammatory effect in conditions including arthritis, edema, pleurisy (inflammation of the lung lining) and peritonitis (inflammation of the lining of the abdomen) as well as inflammatory venous disease, which leads to varicose veins and ulcers
Serrapeptase can be used to treat infections and helps to mitigate against blood clots, plaque build-up and the side-effects of radiation and chemotherapy
Enzymes against arthritis
Tina Marcantel, a nurse and naturopathic doctor in Gilbert, Arizona, had a 34-year-old woman called Mary come into her office presenting with warmth, redness and swelling of the joints of the hands, fingers and feet. She had been diagnosed with rheumatoid arthritis by a rheumatologist and had been taking NSAIDs (aspirin and ibuprofen) for approximately five months without receiving sufficient pain relief. Her doctor assured her she could be put on stronger drugs for pain in the future.
"I started Mary on systemic proteolytic enzymes administered orally, one to two hours away from meals, for approximately three weeks," says Marcantel. "Then I reduced the enzymes by half for a maintenance dose to control pain and inflammation."
She also scheduled Mary for 10 weeks of acupuncture for pain control (one treatment/week) and performed a food sensitivity panel and eliminated all the foods from her diet that may have contributed to the inflammation.
At the end of her treatment plan, Mary no longer used aspirin or ibuprofen regularly. The amount of pain she was experiencing decreased by 70 percent, and the swelling in her joints decreased as well.
After six months, she came back to the office. She'd been on the maintenance dosage of systemic enzymes, doing nothing else for her condition, and said her pain was slowly starting to increase.
Marcantel doubled her enzyme intake back to the original level for four weeks, then cut back again to the maintenance dosage. At that point Mary happily reported her pain levels had diminished by as much as 80 percent and that she had also experienced relief from chronic sinusitis due to seasonal allergies—a condition that had plagued her for years.
A guide to taking enzymes
How much to take:
Taking a few commercial digestive enzymes with a meal is fine. But doctors Ellen Cutler and Kevin Nelson both maintain that you have to have a potent enough dosage for enzyme therapy to be effective.
For digestion: at least 50,000 units per dose.
For systemic uses: at least 150,000 units per dose and a proteolytic blend. Take three times a day, an hour away from food consumption (early morning, after eating and late night before bed).
How to read labels
The internationally recognized and accepted standard for measurement used on enzyme bottle labels is Food Chemicals Codex (FCC) units. These can be expressed in different activity units for each type of enzyme, and so they can be pretty confusing, particularly as some labels instead use milligrams for measurement. Here's a list of the various types of activity units you will find:
U (an enzyme unit)
HUT (hemoglobin units, tyrosine basis)
USP (United States Pharmacopeia)
FU (fibrinolytic units) refers to the ability of nattokinase to break down the blood clotting enzyme, fibrin
MCU (milk clotting units) based on how fast the enzyme digests milk protein
GDU (gelatin digesting units) based on how fast the enzyme digests gelatin
PU (papain units)
SKB (named after the creators of the test, Sandstedt, Kneen and Blish) measures the activity of amylases to break down
DU (used in brewing) equivalent to SKB
LU (lipase units)
FIP units (test methods of the Fédération Internationale Pharmaceutique)
Both Cutler and Nelson advise that reading labels is vital:
• Avoid enzyme products that do not list the amount of units for each enzyme and instead simply mention that they are a 'blend' of one or more enzymes.
• Ideally, opt for plant enzymes, which are far gentler on the body than animal-based enzymes. Says Nelson: "A lot of animal-based enzymes come from old dead horses and cows, which not only have lower amounts of enzymes in their meat, they also have high amounts of adrenaline running through them."
• Keep an eye out for excipients, especially in enzyme blends. "Magnesium stearate and sorbitol sometimes bother people's stomachs," says Cutler. "And the colorings, MSG/natural flavors, sorbitol and other stuff can really inhibit the product's effectiveness."
• Use with care if you are on blood thinners or have a bleeding disorder since proteolytic enzyme formulas work as natural blood thinners. For most other people, overdosing with enzymes is usually not a concern.
• If you start getting nose bleeds, diarrhea or any other kinds of symptoms or discomfort, decrease your dosage until the symptoms stop and your digestive system settles down.