Preparations of proteolytic enzymes (or proteases) are without question one of the most versatile dietary supplements in providing significant health benefits. Clinical studies have documented they are effective in a wide range of benefits in supporting people with a number of health challenges including:

  • Asthma 
  • Atherosclerosis
  • Autoimmune disorders
  • Bronchitis
  • Cancer
  • COPD 
  • Digestion support
  • Fibrocystic breast disease
  • Food allergies
  • Hepatitis C
  • Herpes zoster (shingles)
  • Sports injuries and trauma
  • Pancreatic insufficiency
  • Multiple sclerosis 
  • Osteoarthritis
  • Rheumatoid arthritis 
  • Sinusitis

Despite scientifically documented benefits in these conditions and others, proteolytic enzymes are still significantly underused.

What are Proteolytic Enzymes?

Proteolytic enzymes breakdown proteins by basically adding water or hydrolyzing the bonds between specific amino acids which are the building blocks of proteins. The individual proteolytic enzymes differ in their ability to breakdown the various amino acid bonds. Each type of protease has a specific kind of amino acid bond that it breaks. Examples of proteolytic enzymes include fungal proteases; bacterial proteases such as serrapeptase and nattokinase; plant proteases such as bromelain and papain; and proteases from hog stomach (pepsin) and pancreas (trypsin and chymotrypsin).

Orally administered proteolytic enzymes are absorbed intact when taken on an empty stomach, especially when they are taken in gastric acid resistant capsules. If taken with meals, the proteolytic enzymes are primarily utilized in the digestion of dietary proteins. When proteolytic enzymes are absorbed there are special factors in the blood and body fluids that block the enzymes so that they do not digest bodily proteins.

Proteolytic Enzymes Exert Anti-inflammatory Action

Perhaps the most popular use of proteolytic enzymes is as a natural anti-inflammatory agent. This use is certainly well-documented in the medical literature with numerous double-blind studies showing effectiveness in relieving pain and inflammation due to sports injuries, trauma, sprains and strains, surgery, as well as in osteoarthritis. However, the effectiveness of protease products in these areas has led to what I believe is an unconscious limitation of their clinical use. These products are much more than natural alternatives to drugs like ibuprofen and aspirin as they exert far more diverse and clinically meaningful effects.

For example, the benefits of proteolytic enzymes in some inflammatory conditions appear to be related to helping the body breakdown complexes formed between antibodies produced by white blood cells and the compounds they bind to (antigens). Conditions associated with high levels of these immune complexes in the blood are often referred to as “autoimmune diseases” and include such diseases as rheumatoid arthritis, lupus, scleroderma, and multiple sclerosis. Higher levels of circulating immune complexes are also seen in ulcerative colitis, Crohn's disease, and AIDS. 

Proteolytic Enzymes Help Keep the Airways Clear

Proteolytic enzymes can break down airway clogging mucus. It does so by acting on the proteins in the mucin to help reduce the viscosity (stickiness and gel-like nature). This makes proteolytic enzymes extremely helpful in supporting clear airways especially in cases of sinusitis, bronchitis, asthma, and chronic obstructive pulmonary disease (COPD). Serrapeptase appears to be especially helpful in this support.

Proteolytic Enzymes in other Health Conditions

The list of conditions benefited by proteolytic enzyme supplementation is growing all the time.  For example, one potential use is in the treatment of a viral-related illness including hepatitis C and herpes simplex infections. In one study in the treatment of herpes zoster (shingles) an orally administered proteolytic enzyme preparation was more effective than the standard drug therapy (acyclovir). In a study in patients with hepatitis C, proteolytic enzymes were shown to be slightly superior to alpha-interferon in improving laboratory values and symptoms. Proteolytic enzymes also appear to be quite helpful in acute and chronic sinusitis and bronchitis, and chronic obstructive pulmonary disease and asthma. 

Dosage

Though products containing individual enzymes, such as nattokinase and serrapeptase, most often proteolytic enzymes products consist of multiple types of enzymes to provide the greatest range of activity and benefit. The key is to provide high enough proteolytic activity. The strength or activity of enzymes is not based solely on weight, instead, it is based on the laboratory analysis of its enzyme activity. Different units of measurements specific for each type of protease are used based upon the Food and Chemical Codex. This reference work is used by the Food and Drug Administration (FDA) as the standard method of expressing the strengths of enzymes. For example, the strength of bromelain is based upon gelatin digesting units (GDU) after exposing gelatin to bromelain in a laboratory assessment. 

Here are the dosage recommendations for each individual protease as a rule of thumb to gauge the strength of a proteolytic enzyme product. If using a complex mixture, lower levels of each individual protease should be expected. For use other than improving digestive function, proteolytic enzymes should be taken on an empty stomach between meals.

Safety 

Proteolytic enzymes are generally well-tolerated and are not associated with any significant side effects. Even in people with presumably normal pancreatic function, taking proteolytic enzymes produced no untoward side effects nor does it reduce the capacity for these subjects to produce their own pancreatic enzymes. 

Although no significant side effects have been noted with any of the proteolytic enzymes, minor allergic reactions may occur (as with most foods). 

Proteolytic enzymes are not recommended for at least two days before or after surgery as they may increase the risk of bleeding.