Enzyme therapy is the use of enzymes to treat deficiencies and other medical conditions in the body. An enzyme is a macromolecule that catalyzes (speeds up) processes in the body. Enzymes help to digest food, break down toxins, cleanse the blood, strengthen the immune system, build protein into muscle, contract muscles, eliminate carbon dioxide from the lungs and reduce stress on the pancreas and other vital organs. Enzyme therapy has a wide variety of proposed medical uses, ranging from the treatment of cystic fibrosis and pancreatic insufficiency, to certain cancers or tumors. The therapy may be systemic or non-systemic, and may be administered via multiple routes of administration, most often orally, topically or intravenously.
Enzyme replacement therapy, a subdivision of enzyme therapy, is a medical treatment replacing an enzyme in patients in whom that particular enzyme is deficient or absent. Enzyme replacement therapy is usually administered through intravenous (IV) infusion. It is currently available for lysosomal diseases, such as Gaucher disease and Fabry disease.
Non-specific enzyme therapy, another subtype of the general category of enzyme therapy, does not intend the catalysis(speeding up) of definite steps of metabolism, but claims to stimulate regenerative processes in the body. Initially, non-specific enzyme therapy was considered a promising approach. The growing knowledge in basic research and the lack of evidence for clinical effectiveness rendered the predominantly oral application of enzyme preparations for non-specific treatment outdated by the 1960s. In Germany, however, the absence of strict legal regulations prevented the deregulation of drugs designed for non-specific enzyme therapy, resulting in the continued usage of these therapies.
Bromelain is one of the most popular enzymes used in enzyme therapy. Bromelain is classified as an herb and contains a photolytic digestive enzyme that comes from the stem and the fruit of the pineapple plant. When taken with meals, bromelain may aid in the digestion of proteins. When taken on an empty stomach, it may act as an anti-inflammatory agent.
Trypsin, a proteolytic enzyme, is also used in enzyme therapy. When taken orally, it is often used for digestive enzyme supplementation, often in combination with lipase and amylase. It has also been combined with bromelain and rutin to treat osteoarthritis. Trypsin may be used topically to remove necrotic tissue and debris during wound and ulcer cleaning. Trypsin supplements are derived from fungi or bacterial sources, pancreas of livestock or from plant sources. It may be used to remove dead tissue cells that remain after trauma, infection or surgical procedures. This removal allows new skin or tissue cells to grow.
Chymotrypsin has been used orally to reduce inflammation and edema (swelling) associated with abscesses, ulcers, surgery or trauma. This enzyme is also used as an expectorant in asthma and other pulmonary diseases, and in reducing liver stress. Topically, it is used for inflammatory and infectious disorders. It can also be used as an inhalant, intramuscular injection or opthalmically. It has ingredients that are proteolytic, anti-inflammatory and antioxidant, which are all thought to reduce tissue destruction.
Pancreatic enzymes were reportedly first used to treat cancer in 1902 by John Beard, a Scottish scientist. In the 1920s, Dr. Edward Howell introduced enzyme therapy to the United States. Howell believed that by eating raw meat, people created an enzyme surplus, which resulted in better health and increased resistance to disease. German researchers later used enzyme therapy to treat patients with multiple sclerosis, cancer and viral infections. Some enzyme mixtures are still commonly used in several European countries.
Enzyme therapy is a subject of debate in the medical community, as many physicians and other health practitioners do not accept it. There is little or no scientific evidence that enzyme supplements are successful in treating certain diseases, such as cancer. Because enzyme therapies are promoted as dietary supplements (and not as drugs), manufacturers can market them in the United States without proving they are effective, or even safe, as long as they do not claim they can prevent, treat or cure a specific disease. This leads many physicians to believe that enzyme therapy may be an unsafe treatment for patients. Experts question whether enzymes taken as oral supplements can even reach tumors, or other sites of action, through the bloodstream because they are often broken down into amino acids before being absorbed in the digestive tract. Further well-controlled trials are needed to draw any firm recommendations.
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A health professional should always be consulted before starting enzyme therapy. Enzyme therapy may have harmful interactions with other drugs or supplements.
Bromelain: Interactions have been noted with some antibiotics, blood pressure drugs, anti-cancer drugs, drugs that increase the risk of bleeding (like aspirin, anticoagulants or warfarin (Coumadin®)), anti-platelet drugs (like clopidogrel (Plavix®)), antidepressants, alcohol, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin® or Advil®) or naproxen (Naprosyn® or Aleve®), narcotics (like codeine), potato protein, soybeans, and herbs or supplements with similar effects.
Human studies suggest that bromelain may increase the absorption of some antibiotics, notably amoxicillin and tetracycline, and increase levels of these drugs in the body. Bromelain may increase the actions of the chemotherapy (anti-cancer) drugs 5-fluorouracil and vincristine, although reliable scientific research in this area is lacking. In theory, use of bromelain with blood pressure medications in the "ACE inhibitor" class such as captopril (Capoten®) or lisinopril (Zestril®) may cause larger drops in blood pressure than expected.
A typical dose for adults (18 years and older) is 80-1000 milligram tablets up to three times daily. Dosing for children is not determined. There is not enough scientific research to recommend safe use of bromelain in children.
Some experts suggest that bromelain may cause drowsiness or sedation, and may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Trypsin: According to current available literature, there are no well-documented interactions. However, this does not mean there are no associated risks. Oral dosage in the combination product Phlogenzym®, which contains rutin 100mg, trypsin 48mg, and bromelain 90mg, has been given as two tablets three times daily for osteoarthritis.
Chymotrypsin: This enzyme is contraindicated in ocular surgery cases involving congenital cataracts, high vitreous pressure and a gaping incisional wound, or if the patient is twenty years old or younger. Oral dosages in a 6:1 ratio (trypsin: chymostrypsin) in a combined amount of 100,000 units USP four times daily has been used to treat inflammation, edema, and respiratory secretions. The same ratio of 200,000 units USP has been used four times daily for ten days to treat burns.