Serrapeptase

(Serratiopeptidase)

Serrapeptase is a proteolytic (protein-degrading) enzyme that is naturally produced by bacteria in the guts of silkworms in order to help them digest their cocoons. However, today it is commercially produced through fermentation. As a systemic enzyme supplement, serrapeptase has been used in Europe and Asia for more than 25 years.

Serrapeptase Supports Healthy Levels of Fibrin*

Serrapeptase has been identified as an exceptional fibrinolytic enzyme that is able to digest and liquefy large amounts of fibrin [1].* By digesting cellular debris, such as fibrin, serrapeptase assists in supporting normal healthy blood flow and viscosity.*

Serrapeptase Supports a Normal Inflammatory Response*

Due to its proteolytic activity, serrapeptase helps purify the blood of Endogenous Blood Particles or EBPs, supporting healthy circulatory function, as well as healthy levels of inflammation [2-7].*

In a multi-center, double-blind, placebo-controlled trial, 174 patients were recruited to evaluate the effects of the anti-inflammatory enzyme serrapeptase following surgery [4]. Eighty-eight patients received 10 mg of serrapeptase three times on the day before their operation, once on the night of the operation and three times daily for five days following the operation; the other 86 received placebo. At the end of the study, the researchers observed that serrapeptase helped support normal levels of buccal swelling better than the placebo [4].* In another study, a group of German researchers found that serrapeptase helped support normal levels of swelling and pain following ankle surgery [5].*

Serrapeptase Increases the Availability and Efficacy of Antibiotics*

At least two separate studies have demonstrated that simultaneous use of serrapeptase and an antibiotic increases the concentration of the antibiotic in the body [8,9].*

Serrapeptase Promotes Normal Secretions from the Mucus Membranes and Healthy Respiratory Function*

In a 2003 clinical trial, Japanese researchers randomly assigned patients to receive oral treatment with or without serrapeptase for 4 weeks. At the end of the study, the researchers found that serrapeptase supported healthy mucus clearance by reducing neutrophil numbers and altering the viscoelasticity of sputum [10].* These results build on a previous study in which serrapeptase was found to reduce the viscosity but not the elasticity of nasal mucus [11].*

Precautions

Side effects from serrapeptase are rare; however, elderly people who use the product over a long period of time may experience gastrointestinal irritation.* As with any supplement, serrapeptase should not be taken before consulting with a qualified health care provider.

 

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

References

  1. Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: A multicentre, doubleblind, randomized trial versus placebo. J Int Med Res. 1990;18:379-88.
  2. Bracale G, Selvetella L. [Clinical study of the efficacy of and tolerance to seaprose S in inflammatory venous disease. Controlled study versus serratio-peptidase.] Minerva Cardioangiol. 1996;44(10):515-24.
  3. Kee WH, Tan SL, Lee V, Salmon YM. The treatment of breast engorgement with Serrapeptase (Danzen): a randomised double-blind controlled trial. Singapore Med J. 1989;30(1):48-54.
  4. Tachibana M, Mizukoshi O, Harada Y, Kawamoto K, Nakai Y. A multi-centre, double-blind study of serrapeptase versus placebo in post-antrotomy buccal swelling. Pharmatherapeutica. 1984;3(8):526-30.
  5. Esch PM, Gerngross H, Fabian A. [Reduction of postoperative swelling. Objective measurement of swelling of the upper ankle joint in treatment with serrapeptase-- a prospective study] [Article in German]. Fortschr Med. 1989;107(4):67-8, 71-2.
  6. Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008;37(3):264-8.
  7. Merten HA, Müller K, Drubel F, Halling F. [Volumetric verification of edema protection with Serrapeptase after third molar osteotomy] [Article in German]. Dtsch Z Mund Kiefer Gesichtschir. 1991;15(4):302-5.
  8. Koyama A, Mori J, Tokuda H, et al. [Augmentation by serrapeptase of tissue permeation by cefotiam.] Jpn J Antibiot. 1986;39(3):761-71.
  9. Okumura H, Watanabe R, Kotoura Y, Nakane Y, Tangiku O. [Effects of a proteolytic-enzyme preparation used concomitantly with an antibiotic in osteoarticular infections [author's transl]. Jpn J Antibiot. 1977;30(3):223-7.
  10. Nakamura S, Hashimoto Y, Mikami M, et al. Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease. Respirology. 2003;8(3):316-20.
  11. Majima Y, Inagaki M, Hirata K, Takeuchi K, Morishita A, Sakakura Y. The effect of an orally administered proteolytic enzyme on the elasticity and viscosity of nasal mucus. Arch Otorhinolaryngol. 1988;244(6):355-9.

Nattokinase

Nattokinase is an enzyme extracted from natto, a popular Japanese breakfast food made from fermented soybeans. To make natto, boiled soybeans are combined with the bacteria Bacillus subtilis natto. For most Westerners, the strong smell and taste of natto is unappealing so supplements like Neprinol utilize nattokinase that has been purified from natto and made into capsules.

Nattokinase Supports Healthy Levels of Fibrin*

The ability of nattokinase to breakdown fibrin has been tested in more than 12 studies [1], and nattokinase has been shown to be the most potent fibrin-degrading enzyme out of more than 200 foods tested [2]. Researchers have found in laboratory studies that nattokinase works much in the same way as plasmin [2], which means that nattokinase has the potential to literally dissolve fibrin [3].* In laboratory studies using animal models, nattokinase's fibrinolytic potential has been calculated to be four times more potent than plasmin itself [4].*

Nattokinase also blocks the activity of plasminogen activator inhibitor 1 (PAI-1), which boosts its fibrin-degrading capacity even more [4,5].* Plasminogen is naturally converted into plasmin, the body's fibrin-dissolving enzyme. However, this conversion process is inactivated by PAI-1, which is why high levels of PAI-1 reduce fibrin breakdown and removal [6]. By blocking PAI-1, nattokinase increases the amount of plasmin produced, reducing the risk of fibrin over-accumulation.*

Nattokinase Supports Normal Blood Viscosity*

Nattokinase has been shown to aid in the breakdown of clotting factors like fibrinogen, factor VII and factor VIII in healthy humans [7].* At least two clinical studies have concluded that supplementation with nattokinase could be beneficial for people who are interested in supporting healthy blood values and clotting times [8,9].*

Nattokinase Supports Cardiovascular Health*

Besides aiding in the support of healthy blood values, nattokinase helps support healthy lipid profiles and blood pressure measurements [10,11].* In a randomized, double-blind, placebo-controlled trial, 2,000 fibrinolytic units of nattokinase helped support healthier blood pressure measurements than placebo [11].*

Nattokinase Supports Healthy Cognitive Function

Nattokinase supports normal levels of inflammation, as well as healthy levels of fibrin and beta-amyloid, all of which have been shown to support cognitive function [1-4,12-15].*

Precautions

No significant side effects of nattokinase have been reported. However, nattokinase should not be used by patients with conditions associated with bleeding or be combined with blood thinning agents such as warfarin (Coumadin), aspirin or other blood thinners.* Combining nattokinase with anticoagulants may lead to internal bleeding in some patients.* As with any supplement, nattokinase should not be taken until after speaking with a qualified health care provider.

 

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

 

References

  1. Pais E, Alexy T, Holsworth RE Jr, Meise HJ. Effects of nattokinase, a pro-fibrinolytic enzyme, on red blood cell aggregation and whole blood viscosity. Clin Hemorheol Microcirc. 2006;35:139-42.
  2. Milner M, Makise K. Natto and its Active Ingredient Nattokinase: a potent and safe thrombolytic agent. Alt Comp Therap. 2002;8(3):157-64.
  3. Sumi H, Hamada H, Nakanishi K, Hiratani H. Enhancement of the fibrinolytic activity in plasma by oral administration of nattokinase. Acta Haematol. 1990;84:139-43.
  4. Fujita M, Hong K, Ito Y, et al. Thrombolytic effect of nattokinase on a chemically induced thrombosis model in rat. Biol Pharm Bull. 1995;18:1387-91.
  5. Suzuki Y, Kondo K, Matsumoto Y, et al. Dietary supplementation of fermented soybean, natto, suppresses intimal thickening and modulates the lysis of mural thrombi after endothelial injury in rat femoral artery. Life Sci. 2003;73:1289-98.
  6. Hamsten A, de Faire U, Walldius G, et al. Plasminogen activator inhibitor in plasma: risk factor for recurrent myocardial infarction. Lancet. 1987;2:3-9.
  7. Hsia CH, Shen MC, Lin JS, et al. Nattokinase decreases plasma levels of fibrinogen, factor VII, and factor VIII in human subjects. Nutr Res. 2009;29(3):190-6.
  8. Cesarone MR, Belcaro G, Nicolaides AN, et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: the LONFLIT-FLITE randomized, controlled trial. Angiology. 2003;54(5):531-9.
  9. Tai MW, Sweet BV. Nattokinase for prevention of thrombosis. Am J Health-Syst Pharm. 2006;63(12):1121-3.
  10. Wu D-J, Lin C-S, Lee M-Y. Lipid-Lowering Effect of Nattokinase in Patients with Primary Hypercholesterolemia. Acta Cardiol Sin. 2009;25:26-30.
  11. Kim JY, Gum SN, Paik JK, et al. Effects of nattokinase on blood pressure: a randomized, controlled trial. Hypertens Res. 2008;31(8):1583-8.
  12. Hsu RL, Lee KT, Wang JH, Lee LY, Chen RP. Amyloid-degrading ability of nattokinase from Bacillus subtilis natto. J Agric Food Chem 2009;57(2):503-8.
  13. Paul J, Strickland S, Melchor JP. Fibrin deposition accelerates neurovascular damage and neuroinflammation in mouse models of Alzheimer's disease. J Exp Med. 2007; 204(8):1999-2008.
  14. Merkle DL, Cheng CH, Castellino FJ, Chibber BA. Modulation of fibrin assembly and polymerization by the beta-amyloid of Alzheimer's disease. Blood Coagul Fibrinolysis. 1996;7(6):650-8.
  15. Cortes-Canteli M, Paul J, Norris EH, et al. Fibrinogen and beta-amyloid association alters thrombosis and fibrinolysis: a possible contributing factor to Alzheimer's disease. Neuron. 2010;66(5):695-709.

Lipase

Lipase is a water-soluble enzyme that breaks down the chemical bonds that hold together water-insoluble lipids and fats. Endogenous lipase is primarily produced by the pancreas and is mainly used during digestion to break down fats in foods so they can be absorbed in the intestines. When used systemically, this enzyme supports the conversation of fats in the bloodstream into fatty acids [1], which have the potential to be utilized as a substrate in energy metabolism or stored.*

Precautions

Side effects from lipase are generally mild and may include nausea and stomach upset. High doses of lipase may exacerbate symptoms of cystic fibrosis. Lipase may also interact with some medications, so do not use lipase until you’ve spoken with a qualified health care professional.

 

 

 

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

 

Reference

  1. Olivecrona G, Olivecrona T. Triglyceride lipases and atherosclerosis. Curr Opin Lipidol. 2010;21(5):409-15.

Protease

 

Proteases are enzymes that help break down proteins. They are also called proteolytic enzymes or proteinases. Proteases are widely used in biotechnology, mainly in the food, leather and detergent industries, as well as to produce compounds that help support human health.*

Proteases Support Healthy Levels of Fibrin*

Fungal proteases have well characterized fibrinolytic properties, as demonstrated by their ability to breakdown fibrin and fibrinogen [1,2].* By digesting cellular debris, such as fibrin and other proteins, proteases assist in supporting normal healthy blood flow and viscosity, as well as overall circulatory health [3].*

Proteases Support a Normal Inflammatory Response*

While acute inflammation helps promote healing, unregulated inflammation can take a serious toll on overall health and wellbeing. In a 2009 study, researchers found that 21 days of supplementation with a proteolytic combination of fungal proteases, bromelain, and papain helped promote normal levels of leukocyte activity and inflammation [4].* This included lower levels of pro-inflammatory proteins in the bloodstream [4].*

Proteases Support Muscle Recovery Following Exercise*

Due to their anti-inflammatory characteristics, supplementation with proteases may help support muscle recovery following intense exercise [4,5].* In a study published in the Journal of Sports Science, protease supplementation helped support normal levels of muscle soreness and healthy muscle function following downhill running [5].*

Precautions

There are few, if any, serious side effects linked to protease supplementation.* However, as with any supplement, products containing proteases should not be taken until after speaking with a qualified health care provider.

 

 

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

 

References

  1. Selezneva AA, Babenko GA, Bol’shakova MD, Rozhanskaia TI, Margolina NA. Preparative isolation of terrilytin components and study of their enzymatic properties. Prikl Biokhim Mikrobiol. 1976;12(3):416-20.
  2. Selezneva AA, Bol’shakova MD. Proteolytic complex from Aspergillus terricola. Prikl Biokhim Mikrobiol. 1986;22(1):3-11.
  3. Meletis CD, Barker JE. Therapeutic Enzymes: Using the Body's Helpers as Healers. Alt Comp Ther. 2005;74-7.
  4. Buford TW, Cooke MB, Redd LL, Hudson GM, Shelmadine BD, Willoughby DS. Protease supplementation improves muscle function after eccentric exercise. Med Sci Sports Exerc. 2009;41(10):1908-14.
  5. Miller PC, Bailey SP, Barnes ME, Derr SJ, Hall EE. The effects of protease supplementation on skeletal muscle function and DOMS following downhill running. J Sports Sci. 2004;22(4):365-72.

Amla

The amla fruit, also known as the Indian gooseberry, comes from a small tree that grows throughout India and the Middle East. It is a popular ingredient in dietary supplements, as well as an essential ingredient in various Ayurvedic medicines, because it not only contains tannic acid, glucose, cellulose and calcium [1], but also has the highest concentration of any naturally derived vitamin C, making it a potent antioxidant [2].*

Amla Supports Cardiovascular Health*

A recent study investigated the effects of amla (Emblica officinalis Gaertn.) supplementation on blood glucose and lipid levels [3]. After 21 days of supplementation, the researchers reported that amla helped support normal blood glucose and lipid levels in both healthy individuals as well as those concerned about their cardiovascular and glycemic health [3].*

At least two other studies have also demonstrated the ability of amla to support a healthy lipid profile [4,5], further solidifying its role in supporting a healthy cardiovascular system.*

 

Precautions

There are few, if any, known side effects of amla.* However, as with any supplement, products containing amla should not be taken until after speaking with a qualified health care provider.

 

 

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

References

  1. Krishnaveni M, Mirunalini S. Therapeutic potential of Phyllanthus emblica (amla): the ayurvedic wonder. J Basic Clin Physiol Pharmacol. 2010;21(1):93-105.
  2. Chen TS, Liou SY, Chang YL. Supplementation of Emblica officinalis (Amla) extract reduces oxidative stress in uremic patients. Am J Chin Med. 2009;37(1):19-25.
  3. Akhtar MS, Ramzan A, Ali A, Ahmad M. Effect of Amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients. Int J Food Sci Nutr. 2011;62(6):609-16.
  4. Antony B, Merina B, Sheeba V. Amlamax in the management of dyslipidemia in humans. Indian J Pharm Sci. 2008;70(4):504-7.
  5. Jacob A, Pandey M, Kapoor S, Saroja R. Effect of the Indian gooseberry (amla) on serum cholesterol levels in men aged 35-55 years. Eur J Clin Nutr. 1988;42(11):939-44.

Papain

Papain is a proteolytic enzyme found in the unripe papaya fruit. For centuries people in Latin America have taken advantage of papain's protein-degrading properties. The oldest known historic use of papain is as a meat tenderizer. This enzyme helps break down the tough bands between fibers in muscle tissue, making tough meats fall apart during the cooking process. Because of its potent proteolytic properties, papain is also widely used as a digestive and systemic enzyme supplement.

Papain Supports a Healthy Immune Response*

Clinical studies have linked the immunomodulatory effects of papain to its ability to inactivate TGF-beta [1].* TGF-beta is a key regulator of immune responses, including innate immunity, the mucosal immune system, autoimmunity and inflammation [2]. It has been demonstrated that proteolytic enzymes reduce TGF-beta levels in serum by converting the protease inhibitor alpha2 macroglobulin (alpha2M) from the "slow" form into the "fast" form, whereby the "fast" form binds and inactivates TGF-beta irreversibly [1].

Papain Supports Respiratory Health*

In combination with bromelain, papain has been shown to support healthy respiratory function in both adults and children [3,4].*

[link to bromelain article]

Papain Supports Joint Comfort and Health*

Recent medical breakthroughs have led researchers to use systemic enzymes like papain to aid in producing analgesic and anti-inflammatory effects in people concerned about the health and flexibility of their joints [5].* In a double-blind trial, 28 days of supplementation with a systemic enzyme combination that contained both bromelain and papain was shown to support joint comfort and flexibility as well as an anti-inflammatory medication [5].

Precautions

There are few side effects linked to papain, although it can cause irritation of the throat and stomach. People who are allergic to papaya, latex, pineapples, kiwis or cashews may also be allergic to papain. As with any supplement, papain should not be taken until after speaking with a qualified health care provider.

 

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

 

 

References

  1. Desser L, Holomanova D, Zavadova E, Pavelka K, Mohr T, Herbacek I. Oral therapy with proteolytic enzymes decreases excessive TGF-beta levels in human blood. Cancer Chemother Pharmacol. 2001;47(Suppl):S10-5.
  2. Chen W, Weiner HL, Flavell RA. TGF-beta in Immune Responses: From Bench to Bedside. Snowbird, UT; Jan 7-12, 2011.
  3. Shved MI, Dubkova GI. Therapeutic efficacy of Wobenzym in patients with focal pneumonia. Visnik Naukovych Doslidzenij. 1999(2):79-82.
  4. Lanchava N, Nemsadze K, Chkhaidze I, Kandelaki E, Nareklishvili N. Wobenzym in treatment of recurrent obstructive bronchitis in children. Georgian Med News. 2005;(127):50-3.
  5. Singer F, Oberleitner H. [Drug therapy of activated arthrosis. On the effectiveness of an enzyme mixture versus diclofenac] [Article in German]. Wien Med Wochenschr. 1996;146(3):55-8.

Bromelain

Bromelain, which is derived from the stem and juice of the pineapple, was first isolated in the late 1800s. It contains a mixture of protein-degrading (proteolytic) enzymes and has been used for centuries in Central and South America to support healthy digestion and a healthy inflammatory response.* Supplements containing bromelain are currently used for a variety of purposes, but they are particularly effective at supporting a healthy inflammatory response following surgery or injury [1-10].*

Bromelain Supports a Normal Inflammatory Response following Surgery or Injury*

In the laboratory, bromelain has been shown to block some of the chemicals that promote and accelerate the process of inflammation [11-13].* This may include reducing COX-2 activity, decreasing prostaglandin and thromboxane synthesis, lowering circulating fibrinogen levels and reducing cellular adhesion of pro-inflammatory white blood cells to the sites of inflammation [14].* Laboratory research has also shown that bromelain helps decrease the migration of neutrophils, a type of white blood cell, to inflamed areas [15].*

In at least nine clinical trials, bromelain has been shown to support a normal inflammatory response following surgery or injury [1-9].* A group of 60 patients were followed after undergoing surgery to fix fractures of the long bones [16]. Thirty were given systemic enzymes while the remaining thirty received standard antiedematic drugs. The results of the study demonstrated that the systemic enzymes helped promote healthy levels of swelling and inflammation following trauma [16].* Supplementation with bromelain has also been shown to support normal levels of swelling and pain following less traumatic blunt injuries to the locomotor system [17].*

In a randomized clinical trial published in 2009, a group of Canadian researchers investigated the effects of naturopathic care on rotator cuff tendinitis – irritation of these tendons and inflammation of the bursa (a normally smooth layer) that lines them [10]. Seventy-seven patients were divided into two groups: half received a systemic enzyme supplement containing bromelain and rutin as well as other complementary therapies, while the other half participated in a standardized physical exercise program. After 12 weeks, the researchers found that naturopathic treatment, including systemic enzymes, provided greater assistance in supporting normal levels of pain and healthy joint function [10].*

Bromelain Supports Healthy Levels of Fibrin and Normal Blood Viscosity*

Bromelain contains a number of fibrin-degrading (fibrinolytic) enzymes [13,18], as well as enzymes that enhance this fibrin-dissolving action [19]. Bromelain has also been shown to increase the conversion of plasminogen into plasmin [20-22], as well as prevent the conversion of fibrinogen to fibrin [13]. However, unlike nattokinase, bromelain is not able to dissolve fibrin clumps that have already formed [13].* Bromelain has also been identified in animal and human studies to have properties that support normal blood viscosity, such as preventing the aggregation of platelets [23-25].* Therefore, bromelain could be potentially beneficial for people who are interested in supporting healthy blood values and clotting times.*

Bromelain Increases the Availability of Antibiotics*

Bromelain may increase the amount of antibiotics absorbed by the body, particularly amoxicillin and tetracycline [26-28]. According to researchers from Sacco Hospital, Department of Obstetrics and Gynecology, at the University of Milan, Italy, "bromelain favors the absorption and tissue penetration of antibiotics by mechanisms that are not shared by other anti-inflammatory agents [28]."*

Bromelain Supports Respiratory Health*

Bromelain has been shown in at least seven clinical trials to help support healthy respiratory function [29-35].* In a double-blind study, six days of bromelain supplementation, in combination with antihistamines, analgesics and antibiotics, helped support healthy levels of sinus inflammation and normal breathing patterns better than placebo [29]. Benefits were also seen in other studies that involved individuals with respiratory inflammation [30,31].

Bromelain Supports Joint Comfort and Health*

Because inflammation is a primary cause of joint issues in older adults, bromelain may help support analgesic and anti-inflammatory effects in people concerned about the health and flexibility of their joints [36-43].* In a blinded study conducted in 2006, German researchers divided 90 patients with age-related hip joint issues into two groups: half receiving an oral enzyme preparation containing rutin and bromelain, and the other half receiving the anti-inflammatory drug diclofenac. After six weeks, the researchers reported that the enzyme preparation helped support normal levels of pain, stiffness and physical function better than diclofenac [39].*

These results were supported by another study that compared a standardized enzyme preparation containing both bromelain and rutin with diclofenac. The study reported that the systemic enzyme supplement helped support healthy levels of joint tenderness, pain and swelling, as well as supporting normal range of motion [43].*

Precautions

Side effects from bromelain are generally mild and include nausea, vomiting, diarrhea, and excessive menstrual bleeding. People who are allergic to pineapples, wheat, celery, papain, carrot, fennel, cypress pollen or grass pollen may also be allergic to bromelain. Pregnant women and people with bleeding disorders, high blood pressure, and liver or kidney disease should not take bromelain. Bromelain may also interact with some medications so do not use it until you’ve spoken with a qualified health care provider.

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

References

  1. Zatuchni GI, Colombi DJ. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29:275-8.
  2. Howat RC, Lewis GD. The effect of bromelain therapy on episiotomy wounds—a double-blind controlled clinical trial. J Obstet Gynaecol Br Commonw. 1972;79:951-3.
  3. Spaeth GL. The effect of bromelains on the inflammatory response caused by cataract extraction: a double-blind study. Eye Ear Nose Throat Mon. 1968;47:634-9.
  4. Seltzer AP. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain): a controlled study of 53 rhinoplasty cases. Eye Ear Nose Throat Mon. 1962;41:813-7.
  5. Inchingolo F, Tatullo M, Marrelli M, et al. Clinical trial with bromelain in third molar exodontia. Eur Rev Med Pharmacol Sci. 2010;14(9):771-4.
  6. Kamenícek V, Holán P, Franĕk P. [Systemic enzyme therapy in the treatment and prevention of post-traumatic and postoperative swelling] [Article in Czech]. Acta Chir Orthop Traumatol Cech. 2001;68(1):45-9.
  7. Masson M. [Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice] [Article in German]. Fortschr Med. 1995;113:303-6.
  8. Blonstein JL. Control of swelling in boxing injuries. Practitioner. 1969;203:206.
  9. Kerkhoffs GM, Struijs PA, de Wit C, et al. A double blind, randomised, parallel group study on the efficacy and safety of treating acute lateral ankle sprain with oral hydrolytic enzymes. Br J Sports Med. 2004;38(4):431-5.
  10. Szczurko O, Cooley K, Mills EJ, Zhou Q, Perri D, Seely D. Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: a randomized controlled trial. Arthritis Rheum. 2009;61(8):1037-45.
  11. Onken JE, Greer PK, Calingaert B, et al. Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro. Clin Immunol. 2008;126(3):345-352.
  12. Secor ER, Carson WF, Singh A, et al. Oral bromelain attenuates inflammation in an ovalbumin-induced murine model of asthma. Evid Based Complement Alternat Med. 2008;5(1):61-69.
  13. Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci. 2001;58:1234-1245.
  14. Yuan G, Wahlqvist ML, He G, Yang M, Li D. Natural products and anti-inflammatory activity. Asia Pac J Clin Nutr. 2006;15(2):143-52.
  15. Fitzhugh DJ, Shan S, Dewhirst MW et al. Bromelain treatment decreases neutrophil migration to sites of inflammation. Clin Immunol. 2008;128:66-74.
  16. Kamenícek V, Holán P, Franĕk P. [Systemic enzyme therapy in the treatment and prevention of post-traumatic and postoperative swelling] [Article in Czech]. Acta Chir Orthop Traumatol Cech. 2001;68(1):45-9.
  17. Masson M. [Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice] [Article in German]. Fortschr Med. 1995;113:303-6.
  18. Pirotta F, de Giuli-Morghen C. Bromelain: antiinflammatory and serum fibrinolytic activity after oral administration in the rat. Drugs Exp Clin Res. 1978;4:1-20.
  19. Ako H, Cheung AH, Matsuura PK. Isolation of a fibrinolysis enzyme activator from commercial bromelain. Arch Int Pharmacodyn Ther. 1981;254(1):157-67.
  20. Maurer HR, Eckert K, Grabowska E, Eschmann K. Use of bromelain proteases for inhibiting blood coagulation. Patent WO PCT/EP 98/04406. 2000.
  21. De-Giuli M, Pirotta F. Bromelain, interaction with some protease inhibitor and rabbit specific antiserum. Drugs Exp Clin Res. 1978;4:21-3.
  22. Smyth RD, Brennan R, Martin GJ. Systemic biochemical changes following the oral administration of a proteolytic enzyme, bromelain. Arch Int Pharmacodyn. 1962;136:230-6.
  23. Seligman B. Oral bromelains as adjuncts in the treatment of acute thrombophlebitis. Angiology. 1969;20(1):22-6.
  24. Felton GE. Fibrinolytic and antithrombotic action of bromelain may eliminate thrombosis in heart patients. Med Hypotheses. 1980;6(1):1123-33.
  25. Heinicke RM, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia. 1972;28(7):844-5.
  26. Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxycillin. Drugs Exp Clin Res. 1978;4:39-44.
  27. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn. 1972;19:147-53.
  28. Luerti M, Vignali M. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary. Drugs Exp Clin Res. 1978;4:45-8.
  29. Ryan RE. A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache. 1967;7:13-17.
  30. Taub SJ. The use of ananase in sinusitis: A study of 60 patients. Eye Ear Nose Throat Mon. 1966;45:96,98.
  31. Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. Eye Ear Nose Throat Mon. 1967;46:1281-8.
  32. Braun JM, Schneider B, Beuth HJ. Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain-POS in children with acute sinusitis in Germany. In Vivo. 2005;19(2):417-21.
  33. Taub SJ. The use of bromelains in sinusitis: a double-blind clinical evaluation. Eye Ear Nose Throat Mon. 1967;46:361-2.
  34. Shved MI, Dubkova GI. Therapeutic efficacy of Wobenzym in patients with focal pneumonia. Visnik Naukovych Doslidzenij. 1999(2):79-82.
  35. Lanchava N, Nemsadze K, Chkhaidze I, Kandelaki E, Nareklishvili N. Wobenzym in treatment of recurrent obstructive bronchitis in children. Georgian Med News. 2005;(127):50-3.
  36. Wittenborg A, Bock PR, Hanisch J, Saller R, Schneider B. [Comparative epidemiological study in patients with rheumatic diseases illustrated in a example of a treatment with non-steroidal anti- inflammatory drugs versus an oral enzyme combination preparation] [Article in German]. Arzneimittelforschung. 2000;50(8):728-38.
  37. Cohen A, Goldman J. Bromelains Therapy in Rheumatoid Arthritis. Pa Med J. 1964;67:27-30.
  38. Klein G, Kullich W. Short-term Treatment of Painful Osteoarthritis of the Knee With Oral Enzymes. Clin Drug Invest. 2000;19(1):15-23.
  39. Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol. 2006;24(1):25-30.
  40. Walker AF, Bundy R, Hicks SM, Middleton RW. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine. 2002;9:681-6.
  41. Singer F, Oberleitner H. [Drug therapy of activated arthrosis. On the effectiveness of an enzyme mixture versus diclofenac] [Article in German]. Wien Med Wochenschr. 1996;146(3):55-8.
  42. Tilwe GH, Beria S, Turakhia NH, Daftary GV, Schiess W. Efficacy and tolerability of oral enzyme therapy as compared to diclofenac in active osteoarthritis of the knee joint: an open randomised controlled clinical trial. Journal Assoc Phys India. 2001;49:621.
  43. Akhtar NM, Naseer R, Farooqi AZ, Wajahat A, Nazir M. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee - a double-blind prospective randomized study. Clin Rheumatol. 2004;23:410-5.

Rutin

Rutin is a plant pigment (flavonoid) that is found in many fruits and vegetables. The richest source is buckwheat, but rutin is also found in citrus fruits, black tea and apples. During digestion much of the rutin found in foods and supplements is metabolized to release quercetin [1], which accounts for much of its antioxidant and anti-inflammatory capacity [2-5].*

Rutin Supports a Healthy Inflammatory Response*

In at least two clinical trials, rutin (in combination with other systemic enzymes like bromelain) has been shown to support a normal inflammatory response following surgery or injury [6,7].* A group of 60 patients was followed after undergoing surgery to fix fractures of the long bones [6]. Thirty were given systemic enzymes while the remaining thirty received standard antiedematic drugs. The results of the study demonstrated that the systemic enzymes helped promote healthy levels of swelling and inflammation following trauma [6].*

In a randomized clinical trial published in 2009, a group of Canadian researchers investigated the effects of naturopathic care on rotator cuff tendinitis – irritation of the tendons and inflammation of the bursa (a normally smooth layer) that lines them [8]. Seventy-seven patients were divided into two groups: half received a systemic enzyme supplement containing bromelain and rutin as well as other complementary therapies, while the other half participated in a standardized physical exercise program. After 12 weeks, the researchers found that naturopathic treatment, including systemic enzymes, provided greater assistance in supporting normal levels of pain and healthy joint function [8].*

Rutin Supports Joint Comfort and Health*

Joint issues in older adults are usually linked to the breakdown of cartilage and subsequent inflammation. Therefore, rutin may help support analgesic and anti-inflammatory effects in people concerned about the health and flexibility of their joints [9-13].* In a blinded study conducted in 2006, German researchers divided 90 patients with age-related hip joint issues into two groups: half receiving an oral enzyme preparation containing rutin and bromelain, and the other half receiving the anti-inflammatory drug diclofenac. After six weeks, the researchers reported that the enzyme preparation helped support normal levels of pain, stiffness and physical function better than diclofenac [10].*

These results were supported by another study that compared a standardized enzyme preparation containing both bromelain and rutin with diclofenac. The study reported that the systemic enzyme supplement helped support healthy levels of joint tenderness, pain and swelling, as well as supporting normal range of motion [13].*

Precautions

Side effects from rutin are generally mild and include headache, flushing, rashes or stomach upset. As with any supplement, rutin should not be taken until after speaking with a qualified health care provider.

 

 

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease. For all conditions or illnesses, see a healthcare professional for a full evaluation, diagnosis or treatment plan.

References

 

  1. Erlund I, Kosonen T, Alfthan G, et al. Pharmacokinetics of quercetin from quercetin aglycone and rutin in healthy volunteers. Eur J Clin Pharmacol. 2000;56:545-53.
  2. Kostyuk VA, Potapovich AI. Antiradical and chelating effects in flavonoid protection against silica-induced cell injury. Arch Biochem Biophys. 1998;355:43-8.
  3. Escarpa A, Gonzalez MC. High-performance liquid chromatography with diode-array detection for the determination of phenolic compounds in peel and pulp from different apple varieties. J Chromatogr A. 1998;823:331-7.
  4. Cruz T, Galvez J, Ocete MA, et al. Oral administration of rutoside can ameliorate inflammatory bowel disease in rats. Life Sci. 1998;62:687-95.
  5. Galvez J, Cruz T, Crespo E, et al. Rutoside as mucosal protective in acetic acid-induced rat colitis. Planta Med. 1997;63:409-14.
  6. Kamenícek V, Holán P, Franĕk P. [Systemic enzyme therapy in the treatment and prevention of post-traumatic and postoperative swelling] [Article in Czech]. Acta Chir Orthop Traumatol Cech. 2001;68(1):45-9.
  7. Kerkhoffs GM, Struijs PA, de Wit C, et al. A double blind, randomised, parallel group study on the efficacy and safety of treating acute lateral ankle sprain with oral hydrolytic enzymes. Br J Sports Med. 2004;38(4):431-5.
  8. Szczurko O, Cooley K, Mills EJ, Zhou Q, Perri D, Seely D. Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: a randomized controlled trial. Arthritis Rheum. 2009;61(8):1037-45.
  9. Klein G, Kullich W. Short-term Treatment of Painful Osteoarthritis of the Knee With Oral Enzymes. Clin Drug Invest. 2000;19(1):15-23.
  10. Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol. 2006;24(1):25-30.
  11. Singer F, Oberleitner H. [Drug therapy of activated arthrosis. On the effectiveness of an enzyme mixture versus diclofenac] [Article in German]. Wien Med Wochenschr. 1996;146(3):55-8.
  12. Tilwe GH, Beria S, Turakhia NH, Daftary GV, Schiess W. Efficacy and tolerability of oral enzyme therapy as compared to diclofenac in active osteoarthritis of the knee joint: an open randomised controlled clinical trial. Journal Assoc Phys India. 2001;49:621.
  13. Akhtar NM, Naseer R, Farooqi AZ, Wajahat A, Nazir M. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee - a double-blind prospective randomized study. Clin Rheumatol. 2004;23:410-5.

Coenzyme Q10

Coenzyme Q10 is a powerful antioxidant that is essential for enzymes to function in the body. In sufficient doses it has been shown to support cardiovascular health [1-5],* normal blood glucose levels [5]* and healthy cognitive function [6].*

References

  1. Burke BE, Neuenschwander R, Olson RD. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J. 2001;94(11):1112-7.
  2. Keogh A, Fenton S, Leslie C, et al. Randomised double-blind, placebo-controlled trial of coenzyme Q, therapy in class II and III systolic heart failure. Heart Lung Circ. 2003;12(3):135-41.
  3. Tiano L, Belardinelli R, Carnevali P, Principi F, Seddaiu G, Littarru GP. Effect of coenzyme Q10 administration on endothelial function and extracellular superoxide dismutase in patients with ischaemic heart disease: a double-blind, randomized controlled study. Eur Heart J. 2007;28(18):2249-55.
  4. Belardinelli R, Muçaj A, Lacalaprice F, et al. Coenzyme Q10 improves contractility of dysfunctional myocardium in chronic heart failure. Biofactors. 2005;25(1-4):137-45.
  5. Hodgson JM, Watts GF, Playford DA, Burke V, Croft KD. Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr. 2002;56(11):1137-42.
  6. Shults CW, Haas R. Clinical trials of coenzyme Q10 in neurological disorders. Biofactors. 2005;25(1-4):117-26.

Magnesium

Magnesium is the fourth most abundant mineral in the body and is essential for good health. Research has shown that magnesium helps support normal blood viscosity [1],* a healthy cardiovascular system [2-5]* and normal blood glucose levels [6-8].*

References

  1. Shechter M, Merz CN, Paul-Labrador M, et al. Oral magnesium supplementation inhibits platelet-dependent thrombosis in patients with coronary artery disease. Am J Cardiol. 1999;84(2):152-6.
  2. Kass L, Weekes J, Carpenter L. Effect of magnesium supplementation on blood pressure: a meta-analysis. Eur J Clin Nutr. 2012 Feb 8. doi: 10.1038/ejcn.2012.4. [Epub ahead of print]
  3. Jee SH, Miller ER 3rd, Guallar E, Singh VK, Appel LJ, Klag MJ. The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens. 2002;15(8):691-6.
  4. Kisters K. Oral magnesium supplementation improves borderline hypertension. Magnes Res. 2011;24(1):17.
  5. Hatzistavri LS, Sarafidis PA, Georgianos PI, et al. Oral magnesium supplementation reduces ambulatory blood pressure in patients with mild hypertension. Am J Hypertens. 2009;22(10):1070-5.
  6. Song Y, He K, Levitan EB, Manson JE, Liu S. Effects of oral magnesium supplementation on glycaemic control in Type 2 diabetes: a meta-analysis of randomized double-blind controlled trials. Diabet Med. 2006;23(10):1050-6.
  7. Guerrero-Romero F, Tamez-Perez HE, González-González G, et al. Oral magnesium supplementation improves insulin sensitivity in non-diabetic subjects with insulin resistance. A double-blind placebo-controlled randomized trial. Diabetes Metab. 2004;30(3):253-8.
  8. Rodríguez-Morán M, Guerrero-Romero F. Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care. 2003;26(4):1147-52.