Supplement Forms/Alternate Names
- Digestive Enzymes
- Pancreatic Insufficiency
Proteolytic enzymes (proteases) help you digest the proteins in food. Although your body produces these enzymes in the pancreas, certain foods also contain proteolytic enzymes.
Papaya and pineapple are two of the richest plant sources, as attested by their traditional use as natural "tenderizers" for meat. Papain and bromelain are the respective names for the proteolytic enzymes found in these fruits. The enzymes made in your body are called trypsin and chymotrypsin.
The primary use of proteolytic enzymes is as a digestive aid for people who have trouble digesting proteins. However, proteolytic enzymes may also be absorbed internally to some extent and may reduce pain and inflammation.
You don't need to get proteolytic enzymes from food, because the body manufactures them (primarily trypsin and chymotrypsin). However, deficiencies in proteolytic enzymes do occur, usually resulting from diseases of the pancreas (pancreatic insufficiency). Symptoms include abdominal discomfort, gas, indigestion, poor absorption of nutrients, and passing undigested food in the stool.
For use as a supplement, trypsin and chymotrypsin are extracted from the pancreas of various animals. You can also purchase bromelain extracted from pineapple stems and papain made from papayas.
When you purchase an enzyme, the amount is expressed not only in grams or milligrams but also in activity units or international units. These terms refer to the enzyme's potency (specifically, its digestive power).
Recommended dosages of proteolytic enzymes vary with the form used. Because of the wide variation, we suggest following label instructions.
Proteolytic enzymes can be broken down by stomach acid. To prevent this from happening, supplemental enzymes are often coated with a substance that doesn't dissolve until it reaches the intestine. Such a preparation is called enteric coated.
Some alternative medicine practitioners believe that proteolytic enzymes may help reduce symptoms of food allergies , presumably by digesting the food so well that there is less to be allergic to; however, there is no scientific evidence for this proposed use.
What Is the Scientific Evidence for Proteolytic Enzymes?
Most of the studies described in this section used combination products containing various proteolytic enzymes plus other substances, such as the bioflavonoid rutin.
Osteoarthritis and Other Forms of Chronic Musculoskeletal Pain
Several studies provide preliminary evidence that proteolytic enzymes might be helpful for various forms of chronic pain, including neck pain and osteoarthritis.
Shingles (Herpes Zoster)
Herpes zoster ( shingles ) is an acute, painful infection caused by the varicella-zoster virus, the organism that causes chickenpox. Proteolytic enzymes have been suggested as treatment. However, there is little evidence to support their use.
Several small studies have found proteolytic enzyme combinations helpful for the treatment of sports injuries . However, the best and largest trial by far failed to find benefit.
In studies, proteolytic enzymes are believed to have proven to be quite safe, although they can occasionally cause digestive upset and allergic reactions.
The proteolytic enzyme bromelain might also cause problems if combined with drugs that thin the blood. In addition, there are concerns that bromelain should not be mixed with sedative drugs. Finally, bromelain may increase blood concentrations of certain antibiotics. For more information, see the full Bromelain article.
Interactions You Should Know About
If you are taking:
- The proteolytic enzyme pancreatin: You may need extra folate.
- Warfarin (Coumadin), aspirin , or other drugs that "thin" the blood: You should not take the proteolytic enzymes papain or bromelain except under a doctor's supervision.
- Sedative drugs: Do not take bromelain, except under a physician's supervision.
- Reviewer: EBSCO CAM Review Board
- Review Date: 09/2014 -
- Update Date: 09/18/2014 -