Enzymes are proteins that make things happen. They are natural catalysts that accelerate activity and change, without being changed themselves. They can do this over and over again. Enzymes are critical to all biological processes and are required for the body to function. Without enzymes, there is no life.
There are a wide variety of enzymes playing an active role in virtually every system in the body, but there is not a single enzyme that does it all. Enzymes are very specific, acting on what is called a substrate. Not all types of enzymes are located in all parts of the body. Areas become specialized according to need, so that the enzymes in your mouth that start to break the bonds in starches to reduce them to sugars are different from the enzymes in your eyes, designed to protect you from irritation and infection. Enzymes only work on a specific substrate.
In a delightful chemistry education website, (chem4kids.com), the authors refer to enzymes as assembly line robots. There are many types of robots: ones that lift the car chassis; some attach doors; others install a transmission. The authors explain that enzymes work in that manner. They grab some particle in the body, do something to it, release it when their action is complete, and move on to the next particle to do the same thing all over again. And like assembly line robots, their actions are not interchangeable. The tire robot cannot install a transmission and vice versa. Because these enzymes are so very specific, if one part breaks, they might not work.
Some enzymes work alone and some need ongoing assistance. Enzyme helpers are called coenzymes—small organic molecules that can bind to an enzyme. You may be able to name one coenzyme—coenzyme Q10, which is a highly effective dietary supplement. However, you may be surprised to learn that riboflavin, thiamine and folic acid, which you recognize as B vitamins, are also coenzymes.
Enzymes can be taken as supplements for a variety of health concerns. Some of the most clinically studied are the digestive enzymes made in the pancreas and released in a specific ratio as pancreatin. Pancreatin contains protease (digests proteins), amylase (digests carbohydrates) and lipase (digests fats). Enzymes from pancreatin are from an animal source, usually porcine, and are more similar to what occurs in the human body. There are also plant-based enzymes in which the protease, lipase, and amylase are extracted from a fungal source. Though they have the same names (protease, lipase, amylase), plant-based enzymes are vegetarian and resistant to changes in the pH (acidity) of the digestive tract. The down side is that they are less like the enzymes in the human body.
Plant-based enzymes are good for digestion as they exert their activity longer. Enzymes have an optimal pH range, and the digestive tract transitions from a very acidic stomach to a very alkaline small intestine. Since plant-based enzymes can function in a wider range of pH, they can actively digest food during a broader time span. Using enzymes for digestion can help with leaky gut (which is associated with autoimmune diseases) and even autism and autism-spectrum disorders. There are a surprising number of conditions associated with poor digestion, and those are just a few.
Animal-based enzymes also improve digestion. However, many practitioners believe their best application is for inflammation and malignancies. The theory is that since they are more like human enzymes, they increase systemic enzymes that are used by the inflammation and immune systems of the body. White blood cells use enzymes as tools to destroy abnormal cells, and the resolution of the inflammatory process includes the removal of debris and restoration of healthy circulation using enzymes.
Enzymes, whether plant or mammal-based, should be taken with meals when used to improve digestion. Enzymes used for pain, inflammation, and cancer should be taken on an empty stomach so as not to exert their energy on digestion. Some enzymes are enteric coated, meaning they do not dissolve until they reach the small intestine, to better assure the enzymes are not “used up” by digestion, but studies have shown that taking enzymes on an empty stomach, (defined as 30 to 60 minutes before eating, or two hours after eating), is highly effective for systemic benefits and enteric coating may not be necessary.
Enzymes and Digestion
When food is first ingested, chemicals present in the saliva along with the physical process of chewing begin breaking down large food particles. As food enters the stomach, hydrochloric acid and pepsin (a protein-digesting enzyme) are secreted to continue digesting the food. Next, food travels to the small intestine, where it will spend several hours being digested. The pancreas releases pancreatin, which contains three key digestive enzymes (protease, lipase, and amylase) to provide comprehensive digestion of all food types.
However, digestive enzyme production in the body slowly declines with age and in certain conditions (cystic fibrosis, chronic inflammation, pancreatic cancer). Dietary intake may also be reduced as a result of current cooking and processing practices, which can inactivate digestive enzymes. When there are insufficient digestive enzymes available in the body, oversized, undigested food particles can trigger the release of chemicals, which in turn can cause symptoms of gas, bloating, belching, constipation, diarrhea, nausea, etc. Supplementing with digestive enzymes can overcome inadequate enzyme production by the body or intake from the diet.
Digestive enzymes can be useful for healthy digestion and assimilation of nutrients, and to reduce the symptoms associated with incomplete or less than optimal digestion, such as gas, bloating, indigestion, constipation and loose stools.
Enzymes and Inflammation
When injury occurs, the body responds by initiating the inflammatory response. During the initial phase of inflammation, blood flow to the injured area is increased, leading to classic signs of redness and warmth. The increased circulation also causes the characteristic edema (swelling) and associated pain.
While the inflammatory response is necessary to aid in the healing process, chronic inflammation can actually retard the process of healing. Proteolytic enzyme supplementation has been clinically shown to reduce pain and stiffness associated with inflammation. It is believed that proteolytic enzymes, when taken on an empty stomach, can be absorbed by the intestine and re-secreted by the pancreas. Proteolytic enzymes appear to activate plasmin production from plasminogen and reduce kinin by inhibiting its conversion from kininogen. Proteolytic enzymes are also involved in the degradation of cytokines and cytokine receptors, which are key triggers in the inflammatory process. Enzyme supplementation may also help break down circulating immune complexes, further controlling chronic inflammation.
Increasing the body’s pool of systemic enzymes is useful for reducing inflammation, and enhancing the body’s repair mechanisms, meaning quicker recovery. Clinical studies have shown that they reduce inflammatory pain and stiffness.
Enzymes and Allergies
Research suggests that allergies can be triggered by the presence of partially undigested proteins. When the intestines are exposed to undigested proteins, histamine and other inflammatory compounds are released. Further supporting this connection, some studies have shown that individuals with pancreatic insufficiency are more likely to suffer allergies. Because proteolytic enzymes can break down protein allergens and block the process that causes an allergic reaction, supplementation has been suggested as a preventive and treatment option. Preliminary evidence has found that pancreatic enzyme supplementation can benefit individuals with a variety of food allergies as well as those with eczema.
Enzymes and Autoimmune Diseases
As mentioned previously, when undigested protein molecules erroneously enter the bloodstream, histamine and other inflammatory compounds are released. Inflamed intestines can allow these proteins to pass into the bloodstream, where the body identifies them as foreign invaders (forming antibody/antigen immune complexes). The immune system responds by mounting an unnecessary attack, which can eventually develop into an autoimmune condition.
As enzymes can help break down immune complexes formed between antibodies produced by the immune system and the compounds to which they are bound, supplementation can address both the inflammatory and immune components of autoimmune conditions, such as rheumatoid arthritis, lupus, scleroderma and multiple sclerosis.
Enzymes and Cancer
Clinical research suggests that proteolytic enzymes can assist in the prevention and treatment of many forms of cancer, including pancreas, colon and lung. Research has demonstrated that enzyme supplementation improves cancer patient immune system function by breaking down abnormal proteins generated during the course of the disease.
Studies have shown that supplementation can significantly improve quality of life and reduce disease symptoms (e.g., nausea, vomiting, changes in appetite, stomach pain or stomach disorder, tiredness, depression, memory or concentration disorder, sleep disturbance, dizziness, irritability, dyspnea at rest, dyspnea during activity, headache, tumor pain, cachexia, skin disorders and infections). Some studies suggest that pancreatic enzyme supplementation may also prolong patient survival. Furthermore, supplementation has been associated with reduced adverse reactions to chemotherapy and radiation treatment.
Enzymes and Dosing
Some of the clinically studied enzymes include bromelain (from pineapple) and papain (from papaya) from the plant world and pancreatic enzymes (protease, amylase, lipase) from the animal world, unless sourced from a cultivated fungus. Enzyme strength is generally measured in units, and this can be very confusing, even if you have a degree in chemistry, because each enzyme’s activity might be measured by a different test, and the units may not be equivalent. For example, and this is not a real measurement, 1,000 ABC units may actually have far less activity than 250 XYZ units. This is because the enzyme is tested by how much and long is needed to digest its particular substrate.
To complicate matters further, most enzymes are diluted. This dilution is often measured as 1X (highly diluted) to 10X (often undiluted), and everything in between. So how to choose? One thing to look for is clinical studies associated with the product. Another is whether it is diluted or full strength (often mentioned on the label). A good enzyme product can make an enormous difference in ongoing health. VR
Enzyme tutorial. Available at: www.chem4kids.com/files/ bio_enzymes.html. Accessed 1/18/16.
Wagner AL (1975). Vitamins and Coenzymes. Krieger Pub Co. ISBN 0-88275-258-8.
Nakamura T, et al. Pancreatic dysfunction and treatment options. Pancreas. 1998;16(3):329-336.
Roberts I. Enzyme therapy for malabsorption in exocrine pancreatic insufficiency. Pancreas. 1989;4(4):496-503.
Chintalacharuvu SR, et al. Treatment of collagen induced arthritis by proteolytic enzymes: immunomodulatory and disease modifying effects. J Rheumatol. 2001 Sep;28(9);2049-59.
Miller PC, et al. The effects of protease supplementation on skeletal muscle function and DOMS following downhill running. J Sports Sci. 2004 Apr;22(4):365-72.
Leibow C, Rothman SS. Enteropancreatic circulation of digestive enzymes. Science. 1975 Aug 8;189(4201):472-4.
“Supplemental Enzymes” PDRhealth web site. Available at: www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/sup_0328.shtml.
Heyman M, Desjeux JF. Cytokine-induced alteration of the epithelial barrier to food antigens in disease. Ann N Y Acad Sci. 2000;915:304-11.
Untersmayr E, Vestergaard H, Malling HJ, et al. Incomplete digestion of codfish represents a risk factor for anaphylaxis in patients with allergy. J Allergy Clin Immunol. 2007 Mar;119(3):711-7. Epub 2007 Jan 9.
Untersmayr E, Poulsen LK, Platzer MH, et al. The effects of gastric digestion on codfish allergenicity. J Allergy Clin Immunol. 2005 Feb;115(2):377-82.
Raithel M, Dormann H, Farnbacher M, Weidenhiller M, Hahn EG, Schneider HT. Stimulation of immunoglobulin E formation in chronic pancreatitis by alcohol drinking and exocrine pancreatic insufficiency. Z Gastroenterol. 2001 Apr;39(4):269-76.
Seidman EG, Singer S. Therapeutic modalities for cow’s milk allergy. Ann Allergy Asthma Immunol. 2003 Jun;90(6 Suppl 3):104-11.
Mazurov VI, et al. Beneficial effects of concomitant oral enzymes in the treatment of rheumatoid arthritis. Int J Tiss React. 1997;19:91.
Ransberger K: Enzyme treatment of immune complex diseases. Arthritis Rheuma. 1986;8:16-9.
Ransberger K, van Schaik W: Enzyme therapy in multiple sclerosis. Der Kassenarzt. 1986;41:42-5.
Steffen C, et al.: Enzyme therapy in comparison with immune complex determinations in chronic polyarteritis. Rheumatologie. 1985;44:51-6.
Sakalova A, et al. Density of adhesive proteins after oral administration of proteolytic enzymes in multiple myeloma. Vnitr Lek. 1995 Dec;41(12):822-6.
Popiela T, et al. Influence of a complementary treatment with oral enzymes on patients with colorectal cancers – an epidemiological retrolective cohort study. Cancer Chemother Pharmacol. 2001 Jul;47 Suppl:S55-63.
Wald M, et al. Polyenzyme preparation [brand name] inhibits growth of solid tumors and development of experimental metastases in mice. Life Sci. 1998; 62(3):PL43-8. Leipner J, Saller R: Systemic enzyme therapy in oncology: effect and mode of action. Drugs. 2000;59:769-80.
Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of Scientific Affairs and Education for EuroPharma, Inc.