By Vicki Yawn, September 11, 2011
PSOEs are used for a variety of reasons, most commonly for systemically cleansing the body. The first PSOE of its type was Wobenzym, which was created in Berlin, Germany by WobeMucos Pharma over 50 years ago for dissolving tumors and cysts associated with cancer. Wobenzym is even listed in the Physician’s Desk Reference (PDR), the “Bible” of most doctor’s offices! During the process of hundreds of clinical trials Wobenzym also was found to aid in dissolving and resolving the various causes of inflammation throughout the body, including organs, tissues, joints and blood, when used in therapeutic amounts (up to 60-90 tablets per day), when used in conjunction with natural anti-microbials, immune system enhancement products, etc. in specific quantities and efficacies.
Thanks to MucosPharma and decades of studies and trials performed throughout the world using their signature product, WobenzymN, there are some Wobenzyme-like formulations created here in the U.S. that do not require Customs clearance like the product imported from Germany, which was often unavailable for months at a time, being continually held-up for FDA and Customs scrutiny. Further, many people find that the PSOEs (Proteolytic Systemic Oral Enzymes) we recommend, FIGTreeVitamins’ ULTRA PROTEO-ZIMES, while similar and with the same enzymes, the clean formulation of Ultra Proteozimes are more forgiving on the gastrointestinal tract for most people and typically work equally well as WobenzymN when taken at a lower dosage for most health issues, so FIGTreeVitamins’ PSOEs are often more cost-effective.
CAUTION: NOTE: PSOEs (Proteolytic Systemic Oral Enzymes), like ULTRA PROTEO-ZIMES , can cause a Herxheimer die-off, particularly when taken at higher amounts (over 30 per day), which is normally short-lived. However, it can cause a loose stool and other effects – read about a Herxheimer die-off by linking here: HERXHEIMER Die-Off.
When combined with certain supplements, such as those listed in our ANTIFUNGAL ROTATION REGIMEN, PSOEs can bind to and expel any toxin in the body, including fungus, parasites, bacteria, viruses, fibrin, metal and chemical toxins. Nowadays, there are proteolytic systemic oral enzymes produced in the U.S., such as FIGTreeVitamins.com ULTRA PROTEO-ZIMES Enteric Proteolytic Systemic Oral Enzymes PSOEs which can also be an excellent adjunct remedy for those who have been through chemotherapy, radiation therapy, surgery under general anesthesia and much more. For systemically cleansing the body of chemicals and residues after these surgeries and therapies, we suggest FIGTree Vitamins SYSTEMIC CLEANSING Package.
NOTE: For bacterial infections, please use the Antifungal Rotation Regimen, as above. For parasitic infections, please consider following our ANTI-PARASITE ROTATION REGIMEN AND for viral infections, please consider using our ANTI-VIRAL ROTATION REGIMEN, with the Systemic Cleansing Package. IT IS ESSENTIAL TO FOLLOW ANY OF THESE REGIMENS AS OUTLINED!
However, whether or not you can use them depends upon your health history, medications taken, etc. There are some medications (blood thinners, certain blood pressure, immunosupressants, etc.) that preclude the use of PSOEs.
In general, in clinical trials with Wobenzym, patients began taking 5 tablets upon rising, 5 midday and 5 at bedtime EMPTY STOMACH for 1-2 weeks, then increased to 10-15 upon rising, 10-15 midday and 10-15 at bedtime EMPTY STOMACH. Some patients took more, depending upon the health issue. EMPTY STOMACH means taken a minimum of 30 minutes before or 2 hours after any food consumption.
The newer generation of PSOEs often require fewer tablets per day and are easier on the stomach. These include products such as FIGTree Vitamins ULTRA PROTEO-ZIMES Enteric Proteolytic Systemic Oral Enzymes (3-5 upon rising and 3-5 tablets at bedtime EMPTY STOMACH; some people also benefit from an additional dose midday EMPTY STOMACH), or as recommended by your healthcare practitioner.
Some of the reasons people take PSOEs: They aid in healing inflammation from injuries and surgeries, sprains, strains, dissolving plaque in veins and arteries, even the brain, and are a great alternative to an aspirin per day (aspirin has severe side-effects, even the lowest dose, when taken long-term). PSOEs dissolve plaque, tumors, cysts and break the cell walls of bacteria, fungus, parasites and viruses so that medications and supplements work better.
RECOMMENDED USE FOR SYSTEMIC CLEANSE PRODUCTS:
FIGTree Vitamins SYSTEMIC CLEANSING Package contains 2 bottles each of FIGTree Ultra Proteozimes and FIGTree Spirulina, plus 1 bottle FIGTree Alpha Lipoic Acid. Recommended Usage: Take all at the same time on an empty stomach: FIGTree Ultra Proteozimes (3-5 upon rising and 3-5 at bedtime) WITH FIGTree Spirulina (3-5 upon rising and 3-5 at bedtime) AND Alpha Lipoic Acid (1 upon rising and 1 at bedtime). Ordinarily, people find improvement within 3-6 months. THIS IS A ONE MONTH SUPPLY OR MORE, depending upon how much of each product is used; description outlines therapeutic amounts but each person’s needs are different and you may need to take less for a longer period of time. FIGTree Vitamins PROBIOTIC ENTERIC, 35 Billion CFU (1-2 at bedtime EMPTY STOMACH), is also a benefit when cleansing and rebuilding the body.
GREAT COMBINATION FOR CLEANSING SYSTEMICALLY AND RESOLVING HARMFUL MICROBIAL OVERGROWTH:
GREAT IDEA! Combine both the FIGTree Vitamins SYSTEMIC CLEANSING Package, which contains contains 2 bottles each of FIGTree Ultra Proteozimes and FIGTree Spirulina, plus 1 bottle FIGTree Alpha Lipoic Acid., with FIGTree Vitamins ANTIFUNGAL PACKAGE contains 1 bottle each of FIGTree’s highly potent Enterically-coated Garlic, FIGTree Olive Leaf and FIGTree Probiotic, PLUS 2 bottles of FIGTree Pau d’Arco.
We also recommend following our ANTI-FUNGAL FOOD CHOICES List / Diet for optimal results.
FIGTREE LIVE listeners and members, please be sure to use COUPON CODE FTL10 (or other temporary coupon code, as heard on the show) during checkout to save 10% during checkout.
CALL THE SHOW AND SAVE EVEN MORE $$$$ !
Get 15% off PLUS free shipping, for three months, on all products that FIGTree Vitamins sells every day by calling the show, Wednesday through Saturday (844-855-2006) and get your own private/personalized Coupon Code to use during checkout; use the product links, or see all products at the FIGTREE VITAMINS STORE, or call Gary to order by telephone ~ 210-504-9906!
MORE ARTICLES SUPPORTING THE USE OF PROTEOLYTIC SYSTEMIC ORAL ENZYMES:
The Science of Optimizing Health
by Alex Vasquez, DC, ND
Molecular and Physiologic Mechanisms of Systemic Enzyme Therapy: A Review for Clinicians
For reasons that are both political and clinical, doctors of chiropractic need to have a complete understanding (preferably molecular or genomic) of the interventions they use, whether dietary, nutritional, botanical or manual/manipulative.
This is important politically because we have a need to explain the mechanisms of our treatments to our patients, as well as to policy-makers, researchers and other clinicians;1 failure to explicate and articulate the mechanisms of their treatments makes otherwise effective and brilliant clinicians appear ignorant and unprofessional. Clinically, mechanistic and molecular understandings of our interventions helps us to fine-tune and synergize our treatments for the best possible clinical outcomes by guiding which patients will be treated and which additional therapeutics will be co-administered.
Given that the oral administration of pancreatic/proteolytic enzymes for systemic benefits (“systemic enzyme therapy”) is one of the most common nutritional/botanical treatments used by doctors of chiropractic, this article will provide a review of this treatment’s clinical benefits and molecular mechanisms, with emphasis on the latter. In this discussion, systemic enzyme therapy or the use of “oral enzymes” will be specified to mean the oral, between-meal administration of supplements containing pancreatin, bromelain, papain, amylase, lipase, trypsin and alpha-chymotrypsin; according to the research literature and clinical experience, polyenzyme preparations are more effective than the use of single enzymes.
Past and Current Use
Systemic enzyme therapy has been used clinically for more than a century, beginning with the early publications of Beard2 and Cutfield,3 who both showed the anti-cancer effects of orally administered enzymes in animals and patients, respectively. Although these and other early reports4-6 showed impressive efficacy and lack of toxicity in the treatment of cancer, they generally were ignored due to enthusiasm surrounding interventional radiation, since “X-rays” had been discovered by Roentgen just a few years earlier and radiation’s cancer-causing effects were then unknown.
Current clinical uses of pancreatic/proteolytic enzymes are varied, ranging from improved digestion (when taken with meals) to systemic benefits (when taken between meals). Briefly, systemic enzyme therapy commonly is used in the treatment of cellulitis, diabetic ulcers, sinusitis, bronchitis,7-8 injury-related disorders (including contusions, sprains, lacerations, and muscle injuries)9-10 and osteoarthritis (OA).11-12 Use of systemic enzyme therapy in the treatment of cancer is well-supported by experimental and clinical studies.13-18
Physiologic mechanisms of systemic enzyme therapy have been discussed in several of my recent reviews19-21 and will be briefly listed here before advancing to the more detailed molecular mechanisms. Briefly, proteolytic enzymes are well-absorbed from the gastrointestinal tract into the systemic circulation22-23 to exert anti-tumor, anti-inflammatory, anti-edematous and immunostimulatory actions, which are the result of different and synergistic effects, including the following:24-27
dose-dependent stimulation of reactive oxygen species production and anti-cancer cytotoxicity in human neutrophils;
a pro-differentiative effect;
reduction in PG-E2 production;
reduction in substance P production;
modulation of adhesion molecules;
fibrinolytic effects; and
an anti-thrombotic effect mediated at least in part by a reduction in 2-series thromboxanes.
Molecular Mechanisms: New Data
Patients with degenerative and inflammatory arthropathies (e.g., osteoarthritis and rheumatoid arthritis [RA]) have increased synovial concentrations of tissue-destroying proteases such as the matrix metalloproteinases (MMP) and cathepsin B; normally, these proteolytic enzymes are inhibited by endogenous proteinase inhibitors, such as alpha-1-antitrypsin and alpha-2-macroglobulin. Oral administration of pancreatic/proteolytic enzymes such as trypsin and chymotrypsin has been shown to increase serum levels of alpha-1-antitrypsin and alpha-2-macroglobulin, and in this way, oral administration of therapeutic proteases/proteinases stimulates the body’s production of endogenous proteinase inhibitors, which then inhibit endogenous joint-destroying proteinases. Stated more simply, systemic enzyme therapy stimulates internal defenses to protect against joint destruction.
Systemic enzyme therapy also modulates cytokine levels and thereby shifts “immune balance” away from the autoreactive cell-mediated Th-1 response and more toward a Th-2 response. Significant reductions in tumor necrosis factor-alpha, interleukin-1b, and autoreactive T-cells have been reported following the administration of oral enzymes in experimental and/or clinical settings. Importantly, systemic enzyme therapy can result in reductions in circulating immune complexes in patients with RA that are directly related to the degree of clinical improvement – the greater the enzyme-induced reduction in immune complexes, the greater the clinical response. This clearly suggests a mechanistic cause-and-effect benefit from systemic enzyme therapy in immune-complex- mediated disease.
However, we also know that RA is a prototype of dysbiosis-induced systemic inflammation28 and thus the recent article by Biziulevicius,29 proposing that the immunostimulatory action of proteolytic systemic oral enzymes may be derived from direct and indirect intra-intestinal bactericidal and antimicrobial actions, raises an alternate hypothesis that the anti-rheumatic and immune-complex-lowering benefits of systemic enzyme therapy may result not only from intravascular proteolysis of preformed immune complexes, but also primarily from a reduction in de novo immune complex formation due to antimicrobial and thus anti-dysbiotic effects. These effects of systemic enzyme therapy in summary:
Molecular and Physiologic Mechanisms of Systemic Enzyme Therapy
Dose-dependent stimulation of reactive oxygen species production and anti-cancer cytotoxicity in human neutrophils
A pro-differentiative effect
Reduction in PG-E2 production
Reduction in substance P production
Anti-thrombotic effect, mediated at least in part by a reduction in 2-series thromboxanes
Modulation of adhesion molecules
Modulation of cytokine balance
Induction of endogenous proteinase inhibitors (e.g., alpha-1-antitrypsin and alpha-2-macroglobulin)
Reduction in circulating immune complexes
Possible antimicrobial effect in the gastrointestinal tract, thereby alleviating dysbiosis and reducing de novo immune complex formation
The molecular and physiologic mechanisms of action by which systemic enzyme therapy exerts its various safe and significant benefits are numerous and are increasingly well-defined. Armed with this understanding, clinicians can more effectively treat their patients and more convincingly explain the mechanisms and merits of their treatments to policy-makers, researchers and other clinicians. Clinicians are wise to avail themselves of the benefits of proteolytic/pancreatic enzymes, which deserve – based on impressive safety records and diverse clinical applications – to be a routine component of patient care.
Vasquez A. “Molecular Cell Biology and Interventional Proteogenomics. Part Three: New Implications for Naturopathic Medical Education, Clinical Practice and Naturogenomics.” Naturopathy Digest, 2006 December.
Beard J. The action of trypsin upon the living cells of Jensen’s mouse-tumour. Br Med J, 1906 (Jan 20);4:140-1.
Cutfield A. Trypsin treatment in malignant disease. Br Med J 1907;5:525.
Wiggin FH. Case of multiple fibrosarcoma of the tongue, with remarks on the use of trypsin and amylopsin in the treatment of malignant disease. Journal of the American Medical Association 1906;47:2003-8.
Goeth RA. Pancreatic treatment of cancer, with report of a cure. Journal of the American Medical Association 1907 (March 23);48:1030.
Campbell JT. Trypsin treatment of a case of malignant disease. Journal of the American Medical Association 1907;48:225-226.
Taussig SJ, Yokoyama MM, Chinen A, et al. Bromelain: a proteolytic enzyme and its clinical application. A review. Hiroshima J Med Sci 1975;24(2-3):185-93.
Taub SJ. The use of bromelains in sinusitis: a double-blind clinical evaluation. Eye Ear Nose Throat Mon, 1967 Mar;46(3):361-5.
Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;30:647-52.
Walker JA, Cerny FJ, Cotter JR, Burton HW. Attenuation of contraction-induced skeletal muscle injury by bromelain. Med Sci Sports Exerc, 1992 Jan;24(1):20-5.
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.
Brien S, Lewith G, Walker A, Hicks SM, Middleton D. Bromelain as a treatment for osteoarthritis: a review of clinical studies. Evidence-Based CAM 2004;1(3)251-257.
Saruc M, Standop S, Standop J, Nozawa F, et al. Pancreatic enzyme extract improves survival in murine pancreatic cancer. Pancreas 2004;28(4):401-12.
Batkin S, Taussig SJ, Szekerezes J. Antimetastatic effect of bromelain with or without its proteolytic and anticoagulant activity. J Cancer Res Clin Oncol 1988;114(5):507-8.
Gonzalez NJ, Isaacs LL. Evaluation of pancreatic proteolytic enzyme treatment of adenocarcinoma of the pancreas, with nutrition and detoxification support. Nutr Cancer 1999;33(2):117-24.
Sakalova A, Bock PR, Dedik L, et al. Retrolective cohort study of an additive therapy with an oral enzyme preparation in patients with multiple myeloma. Cancer Chemother Pharmacol, 2001 Jul;47 Suppl:S38-44.
Popiela T, Kulig J, Hanisch J, Bock PR. Influence of a complementary treatment with oral enzymes on patients with colorectal cancers – an epidemiological retrolective cohort study. Cancer Chemother Pharmacol 2001;47 Suppl:S55-63.
Leipner J, Saller R. Systemic enzyme therapy in oncology: effect and mode of action. Drugs, 2000 Apr;59(4):769-80.
Vasquez A. Reducing pain and inflammation naturally – Part 3: Improving overall health while safely and effectively treating musculoskeletal pain. Nutritional Perspectives 2005;28:34-38, 40-42.
Vasquez A. “The Importance of Integrative Chiropractic Health Care in Treating Musculoskeletal Pain and Reducing the Nationwide Burden of Medical Expenses and Iatrogenic Injury and Death: A Concise Review of Current Research and Implications for Clinical Practice and Healthcare Policy.” The Original Internist 2005;12(4):159-182.
Vasquez A. Integrative Orthopedics, 2nd edition; 2007 (in press)..
Gotze H, Rothman SS. Enteropancreatic circulation of digestive enzymes as a conservative mechanism. Nature 1975;257(5527):607-609.
Liebow C, Rothman SS. Enteropancreatic circulation of digestive enzymes. Science 1975;189(4201): 472-474.
Zavadova E, Desser L, Mohr T. Stimulation of reactive oxygen species production and cytotoxicity in human neutrophils in vitro and after oral administration of a polyenzyme preparation. Cancer Biother 1995;10(2):147-52.
Maurer HR, Hozumi M, Honma Y, Okabe-Kado J. Bromelain induces the differentiation of leukemic cells in vitro: an explanation for its cytostatic effects? Planta Med 1988 Oct;54(5):377-81.
Gaspani L, Limiroli E, Ferrario P, Bianchi M. In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats. Pharmacology 2002;65(2):83-6.
Vellini M, Desideri D, Milanese A, Omini C, et al. Possible involvement of eicosanoids in the pharmacological action of bromelain. Arzneimittelforschung 1986;36(1):110-2.
Vasquez A. “Integrative Rheumatology.”
Biziulevicius GA. Where do the immunostimulatory effects of oral proteolytic enzymes (“systemic enzyme therapy”) come from? Microbial proteolysis as a possible starting point. Med Hypotheses 2006;67(6):1386-8.
The Healing Power of Proteolytic Enzymes
by Dr. Michael T. Murray
Proteolytic enzymes are indicated in anti-inflammatory conditions and to support the immune system. Proteolytic enzymes (or proteases) refer to the various enzymes that digest (break down into smaller units) protein. These enzymes include the pancreatic proteases chymotrypsin and trypsin, bromelain (pineapple enzyme), and papain (papaya enzyme. Preparations of proteolytic systemic oral enzymes have been shown to be useful in the following situations:
• Digestion support
• Fibrocystic breast disease
• Food allergies
• Hardening of the arteries (atherosclerosis)
• Hepatitis C
• Herpes zoster (shingles)
• Inflammation, sports injuries and trauma
• Pancreatic insufficiency
• Multiple sclerosis
• Rheumatoid arthritis and other
• Sinusitis, asthma, bronchitis, and autoimmune disorders chronic obstructive pulmonary disease
How do the proteolytic enzymes help autoimmune conditions like rheumatoid arthritis?
The benefits in some inflammatory conditions appears to be related to helping the body breakdown immune complexes formed between antibodies produced by the immune system and the compounds they bind to (antigens). Conditions associated with high levels of 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. 4-6
How are Proteolytic enzymes used in cancer therapy?
Proteolytic enzymes have a long history of use in cancer treatment. In 1906, John Beard, a Scottish embryologist, reported on the successful treatment of cancer using a pancreatic extract in his book The Enzyme Treatment of Cancer and its Scientific Basis. Proteolytic enzymes have been promoted by numerous alternative cancer practitioners for many years, but most recently by Nicholas Gonzalez, M.D., who is evaluating the benefit of proteolytic enzymes in patients with advanced pancreatic cancer in a large-scale study, funded by the National Institute of Health’s National Center for Complementary and Alternative Medicine, with collaboration from the National Cancer Institute. This larger trial is a follow-up to a smaller study that showed dramatic improvements in these patients.
How do Proteolytic enzymes work to fight cancer?
Once absorbed the body prevents digestion of proteins in the blood and other body tissues producing antiproteases. The production of these antiproteases is critical to the mechanism of action of proteolytic enzymes. These antiproteinases block the invasiveness of tumor cells as well as prevent the formation of new blood vessels (angiogenesis). Proteolytic enzymes exert a number of other interesting anticancer mechanisms including the inhibition of metastasis (the spread of cancer) and the enhancement of the immune response.1
What clinical research has been done with proteolytic enzymes in cancer? The clinical research that currently exists on proteolytic enzymes suggests significant benefits in the treatment of many forms of cancer.2
Specifically these studies have shown improvements in the general condition of patients, quality of life, and modest to significant improvements in life expectancy. Studies have consisted of patients with cancers of the breast, lung, stomach, head and neck, ovaries, cervix, and colon; lymphomas and multiple myeloma. These studies involved the use of proteolytic enzymes in conjunction with conventional therapy (surgery, chemotherapy and/or radiation) indicating that proteolytic enzymes can be used safely and effectively with these treatments. Proteolytic enzymes are not recommended for at least two days before or after a surgery as they may increase the risk of bleeding. Proteolytic enzymes have been shown to be quite helpful in speeding up post-surgical recovery and relieving a complication of surgery and radiation known as lymphedema.
What other conditions might proteolytic enzymes be helpful for?
The list of conditions benefited by pancreatic enzyme supplementation seems to be growing all the time. For example, one potential use is in the treatment of viral related illness including hepatitis C and herpes simplex infections. For example, 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).8 In a study in patients with hepatitis C, proteolytic enzymes were shown to be slightly superior to alphainterferon in improving laboratory values and symptoms.9 Proteolytic enzymes also appear to be quite helpful in recovery from surgery, fibrocystic breast disease, acute and chronic sinusitis and bronchitis, and chronic obstructive pulmonary disease and asthma.10-13
Can taking proteolytic enzymes actually improve digestion?
Yes, in fact, using enzyme preparations to support proper digestive function is used in conventional medicine in cases of pancreatic insufficiency and cystic fibrosis (a rare inherited disorder). Pancreatic insufficiency is characterized by impaired digestion, malabsorption, nutrient deficiencies, and abdominal discomfort.
Are proteolytic enzymes actually absorbed?
Yes. One of the outdated arguments against the effectiveness of orally administered proteolytic enzymes was that they either got digested or they were too large to be absorbed. Absorption studies with the various proteolytic enzymes have confirmed that they are absorbed intact. In fact, they appear to be actively transported across the gut wall.3 Since stomach acid can destroy proteolytic enzymes, the best formulas are “enteric coated” –meaning that the pills have a coating around them to prevent the pill from being broken down in the stomach. An enteric-coated pill passes into the small intestine, where due to the pH change it will break down there.
Do the proteolytic enzymes digest blood proteins?
NO! There are special factors in the blood that block the enzymes so that they do not digest blood proteins.
Are proteolytic enzymes preparations safe?
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 did it reduce the capacity for these subjects to produce their own pancreatic enzymes.14 However, my recommendation is to utilize these preparations only when there is apparent need.
Although no significant side effects have been noted with any of the proteolytic enzymes, allergic reactions may occur (as with most therapeutic agents). Pancreatic enzymes should not be used by anyone allergic to pork; bromelain should not be used in anyone allergic to pineapple; and papain should not be used in anyone sensitive to papaya.
1. Rubinstein E, et al.: Antibacterial activity of the pancreatic fluid. Gastroenterol 1985;88:927-32.
2. Ambrus JL, et al.: Absorption of exogenous and endogenous proteolytic enzymes. Clin Pharmacol Therap 1967;8:362-8.
3. Kabacoff BB, et al.: Absorption of chymotrypsin from the intestinal tract. Nature 1963;199:815-7.
4. Martin GJ, et al.: Further in vivo observations with radioactive trypsin. Am J Pharm 1964;129:386-92.
5. Avakian S: Further studies on the absorption of chymotrypsin. Clin Pharmacol Therap 1964;5:712-5.
6. Liebow C and Rothman SS: Enteropancreatic circulation of digestive enzymes. Science 1975;189:472-4.
7. Oelgoetz AW, et al.: The treatment of food allergy and indigestion of pancreatic origin with pancreatic enzymes. Am J Dig Dis Nutr 1935;2:422-6.
8. Carroccio A, et al.: Pancreatic enzyme therapy in childhood celiac disease. A double-blind prospective randomized study. Dig Dis Sci 1995;40:2555-2560.
9. Innerfield I: Enzymes in Clinical Medicine. McGraw Hill, New York, 1960.
10. Mazurov VI, et al. Beneficial effects of concomitant oral enzymes in the treatment of rheumatoid arthritis. Int J Tiss React 1997;19:91.
11. Ransberger K: Enzyme treatment of immune complex diseases. Arthritis Rheuma 1986;8:16-9.
12. Steffen C, et al.: Enzyme therapy in comparison with immune complex determinations in chronic polyarteritis. Rheumatologie 1985;44:51-6.
13. Ransberger K and van Schaik W: Enzyme therapy in multiple sclerosis. Der Kassenarzt 1986;41:42-5.
14. Gonzalez NJ and Isaacs LL: Evaluation of pancreatic proteolytic enzyme treatment of adenocarcinoma of the pancreas, with nutrition and detoxification support. Nutr Cancer 1999;33:117-24.
15. Leipner J and Saller R: Systemic enzyme therapy in oncology: effect and mode of action. Drugs. 2000;59:769- 80.
16. Kleine MW, Stauder GM and Beese EW:The intestinal absorption of orally administered hydrolytic enzymes and their effects in the treatment of acute herpes zoster as compared with those of oral acyclovir therapy. Phytomedicine 1995;2:7-15.
17. Kabil SM and Stauder G: Oral enzyme therapy in hepatitis C patients. Int J Tiss React 1997;19:97-8.
18. Schneider, MU, Knoll-Ruzicka ML, Domschke S, et al: Pancreatic enzyme replacement therapy: Comparative effects of conventional and enteric-coated microspheric pancreatin and acid-stable fungal enzyme preparations on steatorrhea in chronic pancreatitis. Hepatogastroenterol 1985;32:97-102.
19. Friess H, et al.:Influence of high-dose pancreatic enzyme treatment on pancreatic function in healthy volunteers. Int J Pancreatol 1998;23:115-23.
Enzymes: The Heart Defender
Michael W. Loes M.D. M.D. (H)
So you just heard from your doctor that your cholesterol is out of this world, your blood pressure is celestial, and that the beating, that ticking you feel in the left part of your chest is a time bomb.
Is now the time to speak heart to heart – about enzymes? Better it be now than when it’s too late. Even though heart disease is still considered the number one killer in the United States, it should not be considered inevitable. Heart disease should not be expected as in “you gotta die of something, someday”. Even though a few of us may be predisposed to high cholesterol or elevated blood pressure, the emphasis should be on “predisposed” and what that means. It means “tendency toward”, not a forgone conclusion. Heart disease is not genetic, except in rare cases and even then, the recently completed Danish studies on identical twins concluded that only 20% of genetic disease are expressed in the phenotype 1 This means that just because your father, or another close member of your family died abruptly from “the big one”, doesn’t mean the red fire engine is headed for you if you know how to stay out of the way.
Here is some important practical advice on preventing heart disease:
Don’t smoke because smoking decreases oxygen, constricts blood vessels, dehydrates you, and acidifies the blood. It also wrecks your sleep and quadruples your daily output of adrenalin because once you are a smoker, every 2-3 hours your body goes into withdrawal and further stresses your adrenal glands.
Reduce your red meat because beef increases arachidonic acid which is a major precursor, or building block for inflammation
Lose weight because obesity upsets your metabolism in major ways, including your sugar, and lipids.
Learn to handle your stressor because out-of-control stress causes vasoconstriction through by its effects on the adrenals.
Take vitamin B2, niacin, in that this substance help blood vessels vasodilate
Take magnesium, preferably sustained release magnesium chloride because heart cells need it and magnesium helps blood vessels stay wide open and lessen your chance of an arrhythmia – life threatening heart skipping problems
Take anti-oxidants such as vitamin C, D.E., selenium and pycnogenol in that it is oxidized cholesterol that damages the blood vessels.
Take Systemic Oral Enzymes because heart disease, in large part is caused by chronic inflammation.
What does Dr. Garry Gordon, noted medical doctor have to say:
“With systemic oral enzymes, I can save the life of virtually every one of my heart patients, For thirty years, I have specialized in keeping people with the serious and often seemingly hopeless heart problems alive. In fact, I say if you die of a heart attack or stroke your doctor isn’t doing his job because he didn’t tell you about enzymes.” 5
Inflammation and Heart Disease
A recent report in The New England Journal of Medicine journeys us into the controversy, and newly discovered relationship between heart attacks and the role of inflammation. 2 No longer is high cholesterol the sole sniper to our heart survival. It may be dangerous, but this risk factor is only one, and perhaps not the most important enemy working overtime to shatter our lives with the life ending heart attack.
It is inflammation from causes other than high lipids that is being shown to be a major factor. This knew field of knowledge is like “exploring the hidden side of the moon” 2. The controversy was swirled to a higher level with the cutting edge nutrition magazine Nutrition Action Health Letter highlighting this theory as an “about time” recognition from many clamoring voices. 3 The scientists at Harvard Medical School concur with their supporting data from the landmark Physicians’ Health Study that chronic inflammation leads to heart disease and stroke. These doctors conclude that safe methods of curbing inflammation may be at the “heart” of a sensible cardiovascular health program.4 The Physicians’ Health Study involved 22,000 male doctors. The investigation was abruptly halted in 1988 when the researchers discovered that aspirin, a classic anti-inflammatory drug, lowered heart disease risk among men. The findings were so significant that the researchers conducting the study believed it was no longer moral or ethical to deny the non-aspirin group this important protective agent.
What is of interest is that many interpretations of this study highlighted the effect of aspirin’s effect to decrease platelet adhesion as the reason for the decreased in heart disease likely due to their bias that heart attacks were caused by clots – i.e. coronary thrombosis. Surely, they reasoned, it was this anti-clotting effect of aspirin that was the saver of hearts.
While data demonstrated reduced inflammation by noted decreased in C-reactive protein, the relationship between heart disease and inflammation was largely ignored – until now.
In 1999, David Steinman and I authored the book The Aspirin Alternative on systemic oral – proteolytic – enzyme therapy.5
Particular care was taken in this text to avoid undermining the importance of aspirin therapy to prevent heart attacks in patients at high risk for heart disease. We were reverent to this mainstream doctrine, but at the same time, underscored the potential side effects of aspirin and other non-steroidal anti-inflammatory agents (NSAIDs), which account for nearly 16,000 deaths per year, mostly because of gastro-intestinal bleeding problems.6 Aspirin is an NSAID! When you are using aspirin to prevent heart disease, you are not protecting yourself from the serious known side of effects of NSAIDs.
Might it not be time to look at an aspirin alternative? Might not there be something that can help us here without subjecting us to the serious side effects of these agents? The answer is enzymes – a special class, called proteolytic, or protein cleaving enzymes. The enzymes of highest therapeutic action are bromelain, papain, trypsin, and chymotrypsin, In combination, we refer to this therapy as systemic oral enzyme therapy.
Doctors Do Not Routinely Test Inflammation Levels
Most doctors know little, if anything, about inflammation and heart disease. They do not normally consider inflammation a cause of heart disease and do not measure inflammation levels, which can be documented by the sedimentation rate, and C-Reactive Protein (CRP) level in the blood.
In the Physicians’ Health Study 4, CRP was measured in 1,100 men without heart disease and compared to 543 men who suffered a heart attack. The doctors found that elevated levels of CRP predicted a threefold greater risk for heart disease and a twofold increased risk for stroke. Aspirin had the most benefit when the highest inflammation was present. ASK YOUR DOCTOR FOR A C-REACTIVE PROTEIN STUDY AT YOUR NEXT PHYSICAL!
Can You ‘Catch’ Heart Disease?
This is where our story takes an unexpected twist. We know that C-reactive protein is extremely elevated during times of bacterial infection and elevated CRP levels are linked to heart attacks and stroke. Therefore, the daring questions to ask are – Could it be that heart disease is not simply a biochemical but also a bacterial malady? and Could oral systemic enzymes, which are so effective at reducing C-reactive protein and revving the immune system, help us?
There are two bacterial agents and one viral agent that have been shown to be related to heart disease. They each have long names but are common and if you are in the medical or dental field, you have likely heard about them: chlamydia pneumoniae, and porphyromonas gingivalis and cytomegalo virus.
For nearly two decades, Dr. Joseph Melnick of Houston’s Baylor College of Medicine has made a hobby of removing lesions from diseased coronary arteries and testing them for cytomegalovirus (CMV), a common herpes virus,” reports the August 11, 1997 Newsweek. It shows up with surprising frequency-and it’s looking less harmless all the time. Scientists have long known that CMV can spell trouble for people receiving heart transplants; infected patients are roughly twice as likely as others to lose their new organs, or their lives, to arterial disease.7 In 1996, Dr. Stephen Epstein of the National Heart, Lung, and Blood Institute, found that CMV infection increased by four-fold the odds that someone having his arteries reamed out by angioplasty would see them close back up within six months. CMV and heart disease will prove to have an extremely strong link to heart disease, predicts Epstein.8
The airborne bacterium Chlamydia pneumoniae is known more commonly for causing respiratory illness than the damage it does to the arteries. Yet, surprisingly recent research has been published linking this bacterium to heart disease. Over the last year, animal and human studies have pinpointed Chlamydia pneumoniae as a possible factor in triggering the inflammatory responses in the tissue lining blood vessels, and consequently leading to plaque obstructions. British researchers have found that having high antibodies to chlamydia pneumoniae predispose people to a second heart attack. Dr. Sandeep Gupta, of St. George’s Hospital, London reported that in his patients, when there was evidence of chlamydia, heart problems quadrupled over an eighteen month period. The British researcher has found that antibiotics seemed to reduce the incidence of recurrent heart attacks – a three day course of azithromycin, certainly deserving of further study.9
Floss Your Teeth or Die of Heart Disease!
Do you floss your teeth as often as you should? You might want to be sure you do-especially after learning about this third troublemaker, Porphyomonas gingivitis. This bacterial agent is known largely responsible for its role in causing gum disease, but recent data involving its relationship to heart disease deserves attention. Dr. Raul Garcia of the Boston Veteran’s Hospital, as part of the Normative Aging Study, reviewed the cumulative twenty-five year data on over one thousand men. The men with terrible gum disease had twice the incidence of heart attacks compared to healthy peers. Their stroke rate was three times as high. At the scene of the crime was crime was Porphyomonas gingivitis.11
Why might oral systemic enzymes be helpful here?
The science behind enzymes is substantial, especially in relationship to their role as biological response modifiers; enzymes enhance the healing response. In Europe, the posters in the pharmacies read “Fitness for the Immune System”. But you ask, “What do enzymes do? Why do they work? In simple terms, they help cell signaling, assisting cells in knowing what to do and when. The immune system is complicated, but we know a lot, especially in regards to how enzymes speed up healing and prevent edema and scarring processes.
Enzymes are involved in all of the following and more:
Induction of optimal amounts of tumor necrosis factor and interleukins. Systemic oral enzymes lead to a dose-dependent increased formation of tumor necrosis factor (TNF-a), interleukin 1-b and interleukin 6. These tough cops kill dangerous cells and cancer tissues circulating in the body, as well as mount attacks on bacteria and viruses. 12
Macrophage and killer activation. The activity of bacteria-consuming macrophages is increased up to 700 percent within 10 minutes following the start of systemic oral enzyme therapy. 8 The activity of natural killer cells went up 1,300 percent during the same time. 13, 17
Selective Destruction of Infectious Agents. When proteolytic enzymes are added to bacterial cell cultures, loss of bacterial nuclei occur, and loss of cell architecture takes place; the bacteria die and their debris is removed via enzymatic processes. 14, 15
The Master Cytokine – Transforming Growth Hormone, beta factor, is kept in check, being reduced in processes where fibrosis and scarring are likely to occur. 16,17,18
Are you interested in doing what you can to help reduce chronic inflammation as it relates to the heart disease? Of course you are. Defend Your Heart with Systemic Oral Enzymes!
NEJM 343(2) 78-85 2000
2. Maseri, A., Inflammation, atherosclerosis, and ischemic events – exploring the hidden side of the moon” The New England Journal of Medicine, 1997; 336(14) 1014-16
3. Inflammation and the Heart: Nutrition Action Health Letter, June 1997: 14
4. Ridker, P.M., et al. “Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men.” The New England Journal of Medicine, 1997; 336(14); 973-079, 1416-1418
5. Loes, MW., Steinman, D, The Aspirin Alternative, “Escape the Toxicity of NSAIDs, Freedom Press, June 1999, ISBN 1-893910-04-0
6. Lazarou, P. et al. “Incidence of adverse drug reactions in hospitalized patients: meta-analysis of prospective studies.” Journal of the American Medical Association, 1998; 279; 1200-1204
7. Ibid, 5, p151
8. Ibid, 5, p152
9. Ibid, 5, p153
10. Ibid, 5, p155
11. Ibid, 2, p1014
12. Wolf, M. & Ransberger, K. Enzymetherapie. Vienna: Maudrich Verlag, 1970
13. Leskovar, P. “AIDS: Neuartige therapiekonzepte, Dtsch. Zeitschr. Onkol, 1990;2
14. Rosanova, A., “Der gegenwartige stand der enzymtherapie bei malignen tumoren.” Arzt. Praxis, 1974; 16, 1442
15. Wolf, M. & Ransberger, K. Enzymetherapie. Vienna: Maudrich Verlag, 1970
16. Blobe, GD, Schiemann, WP, Lodish, HS, “Role of Transforming Growth Hormone, NEJM, v342, No 18, April, 2000
17. Kunze, R., Unpublished in vivo studies, personal communication, Oct 14, 1997
18. Vinzenz, K., “odembehandlung bei zahnchirurgischen eingriffen mit hydrolytischen enzymen” Die Quintessenz, 1991; 7: 1053
Enzymes and the Pain of Arthritis
Michael W. Loes M.D. M.D.(H)
Health is mobility. If your joints are like “rusty door hinges,” creaking, sticking and not moving, your camping trip will likely not happen because you have arthritis. Other people liken the pain of arthritis to a fire in the joints – burning and constantly inflaming their tissues. Others use words like “gritty,” “grinding” and “popping” to describe the condition of their inflamed joints.
Finally, however, thanks to discovery of systemic oral enzymes and other supporting nutrients we may finally be able to do something dramatic so that these limitations will not be so common. Most importantly, you can and will be helped if you understand their importance and how to use them.
THE FIVE MOST COMMON FORMS OF ARTHRITIS
1. Osteoarthritis: This is most common form of arthritis. Osteoarthritis, also known as OA affects 15 to 20 million Americans – usually over age 45.
Rheumatoid arthritis: Also known as RA, rheumatoid arthritis is an intense auto-immune inflammatory disease of the small joints, most the hands. RA affects about 2.1 million people – usually women.
Gout: This type of arthritis has been linked to lifestyle and diet – especially to the high quantity alcohol consumer. Gout affects nearly one million people – usually men, an the most common joint affected is the great toe.
Ankylosing spondylitis (spinal arthritis): This inflammatory arthritis disorder causes extreme immobility of the back, sometimes involving the shoulders and neck. Ankylosing spondylitis affects more than 300,000 people – usually men.
Systemic Lupus Erythematosus: This disease, also known as lupus is not technically an arthritis. It is an auto-immune mediated form of joint pain often affecting which leads to systemic joint pain – all joints. Lupus affects about 131,000 individuals – usually women.
FIVE ARTHRITIS MYTHS
1. You’ll get osteoarthritis if you live long enough.
This is false in that osteoarthritis is not inevitable. You can alter your diet, exercise, and use nutritional supplements that will dramatically reduce your risk of ever suffering a debilitating joint disease.
There’s nothing you can do about arthritis once you have it.
This is also false, in that systemic oral enzymes, when used in combination with other bone building nutrients control inflammation and provide a safe, natural and proven method for relieving pain and controlling the pain of arthritis, while at the same time helping to rebuild your joints.
Pain killers relieve pain without side effects.
Doctors who treat pain, known as “algologists” will often use strong pain drugs but generally will be cautious and will carefully observe for various side effects such as nausea, sedations and shortness of breath. With narcotics, the strongest of the pain drugs, there can be problems with dependence and in some cases addiction.
Only people who’ve had traumatic injuries or who work in professions like professional football get osteoarthritis.
You and I can get arthritis. I was never a professional athlete, but yet, on cold damp mornings, I can feel of hint of arthritis especially in my knees from those days of youth basketball. Concert pianists, who spends days hunched over the keyboard, may suffer the pain of arthritis, and ballet dancers are also known to have high incidences. The overwhelming key point here is that anyone can get arthritis – including you.
If I have osteoarthritis I will have to give up an active life.
The reality is that most people with osteoarthritis are fairly active. It’s unlikely that they play rugby or ski off black diamond slopes, but overall, a happy joyful live is compatible with arthritis.
Salubrity with Systemic Oral Enzymes
In The Healing Response and Healing Sports Injuries Naturally, the miracle of German Enzymes is discussed. The gold metal achieved, the sought after prize was to obtain “salubrity” – the state of enviable health. This was the competitive edge that kept them winning.
The clinical studies behind systemic oral enzymes are indisputable; enzymes work and they work fast. Enzymes are able to quickly quell redness, swelling and heat, and return movement to normal quickly in damaged joints, especially from sports injuries in otherwise healthy individuals.
For arthritis, enzymes work by targeting various tissues and organs in the body and help to restore a healthy balance between anti-inflammatory and pro-inflammatory cytokines – “kinetic messenger cells’. When your body is trying very hard to get better, cells must work smart, do the right things, and do them in the right sequence. They must also have sufficient stamina to complete the job. A type of systemic oral enzymes called “proteolytic” have a communicating line with the master cytokine, also known as TGF-beta (transforming growth factor). It is for this reason that systemic oral enzymes, in the European medical community, are known as “biological response modifiers”; they aid healing, They have positive effects on inflammation and they help in pain control, but their overriding and most notable effect is that they enhance the healing response. They do so by their interactions with a number of cell systems.
Enzymes Accelerate Elimination of Circulatory Immune Complexes
Rheumatoid arthritis is an auto-immune inflammatory disease. While progress has been made by the introduction of several new disease modifying – anti-rheumatic – agents, also known as DMARDs, complete remissions or cures are few and far between. Their mechanisms of action are best described as combat drugs; they do not bolster healing, they only quell the revolution for a while. They don’t treat the underlying problem that is immune dysfunction that is often caused by multiple underlying factors. These factors may include antigens, bacteria, toxins, or general dysbiosis in the gastrointestinal tract. Systemic oral enzymes address these issues; they stimulate rather then suppress cellular healing responses.
In naturopathic and homeopathic philosophy, when you pound down an illness, as is frequently seen in various forms of arthritis, especially rheumatoid, you drive the illness inward and begin to experience a new set of problems Many of these problems are subtle at first, but with time result in opportunistic problems which occur when total body balance is lost. The immune system needs to be supported and enzymes, through their interactions with cytokines, do this and do it effectively. Cytokines quench inflammation and revs up immunity, producing a cleansing effect, by cleaving and breaking up circulating immune complexes. These nasty clumps are at the center of the damage that occurs with rheumatoid arthritis because when they are not cleared, they end up lumping themselves into the joint tissues. The sufferer will see them and feel them in their joints.
Enzymes and Rheumatoid Arthritis
Because systemic oral enzyme therapy is relatively new in the United States, we must rely on studies done in Europe, mostly in Germany. Mind you, these are excellent studies, as perfected as the engine in your Mercedes or Volkswagen, should you be inclines to be buying these masterfully built vehicles.
One such study, a small but well controlled one was published in 1985 using a combination formula enzyme formula for the treatment of rheumatoid arthritis. Sixty two percent of the patients improved dramatically.1
In 1988, another study addressing the issue of circulating immune complexes was completed. The levels of these immune complexes were followed and their decreasing levels correlated with the levels of pain and function in patients with rheumatoid arthritis. The expected happened. The pain levels went down, the function improved as the circulating immune complexes went down.2
The benefits of oral enzymes were assessed in another investigation where the effects of systemic oral enzymes was compared to that of gold therapy. The results were dramatic. Improved patient function was confirmed without the toxicity known to be associated with gold therapy.3
The Russians have been involved in enzyme research over the past twenty years, intensively at the Ukrainian Research Center in Kiev. One of their studies evaluated seventy-eight patients with severe, crippling rheumatoid arthritis who were already on standard therapy but were not improving. Half of these patients had chronic fevers and twenty three percent had rheumatic nodules. The majority of this group had notably low hemoglobin levels. When systemic oral enzyme therapy was introduced, every patient showed a decrease in their circulating immune complexes. On average this drop was between twenty-eight and forty-two percent. Rheumatoid factors also decreased in these patients and so did their concurrent drug use with twenty percent reducing their NSAID doses by fifty to seventy-five percent. One patient was able to stop taking methotrexate and experienced a clinical remission of the disease.4
In a smaller study, ten children with juvenile rheumatoid arthritis were given five enzyme tablets three times a day, while continuing the non-steroidal agent of their choice. The number of actively inflamed joints was reduced from forty-four to fifteen by the second month. One of these patients had psoriatic lesions in addition to juvenile rheumatoid arthritis, and experienced a significant reduction in the number of dermal lesions.5
Systemic Oral Enzymes Therapy has been used for more than 20 years now. In one study, eighty patients on enzymes were pitted against the non steroidal anti-inflammatory agent diclofenac.6 This was a carefully controlled study designed in such a way to assure that the patients did not know what they were taking. An evaluation of all principle criteria for pain and function were carefully assessed. The result was that the effectiveness of the two groups could not be distinguished. Both therapies rendered equal results – i.e., enzymes v diclofenac were both equally effect. But, the side effects in the NSAID group were much higher, most notably stomach upset, and liver dysfunction.
Systemic Oral Enzymes Benefit Persons with Systemic Lupus
Systemic Lupus Erythematosus also called “lupus” most often strikes young women between the ages of 20 to 40. Lupus is not technically an arthritis in that no “fire in the joints” can be demonstrated, but it is an “arthralgia” which means that the joints hurts; they hurt a lot. Like rheumatoid arthritis, circulating immune complexes are generated. More often than not, there is morning stiffness and severe associated fatigue. The deposition of the immune complexes is more likely in the kidney and liver than in the joints, but the overriding symptoms of the disease is truly systemic – everything hurts.
In one study of eighteen lupus patients presented at the 1996 Russian Symposium, clinical and laboratory immuno-inflammatory activity was found to decrease quickly when oral enzymes were initiated. It was also noted that the use of adjuvant pain medication and non-steroidal anti-inflammatory agents were reduced. Five of these patients were able to reduce their dose of diclofenac or prednisolone.
Because in lupus, immune complexes are frequently deposited in the kidneys and the liver, the early use of agents that are capable of preventing needs to be encouraged in the preliminary evidence supports this action. according to August Heidland, M.D., and co-investigators reporting in a 1997 issue of Kidney International.7
The Bottom Line is that systemic oral enzymes help sufferers of osteoarthritis, rheumatoid arthritis, gout, ankylosing spondylitis and systemic lupus erythematosis. Enzymes help by slowing the disease process, and reinforcing important immune functions. By their important role as “biological response modifiers”, they enhance the healing response by supporting intelligence cell-to-cell communication. The result will be insurance protection for preserving and improving the quality of life
1) Steffen C., et al Enzymtherapie im vergleich mit immunkomplexbestimmungen bei chronischer polyarthritis. Zeitschr f. Rheumatalogie, 1985, 44:51
2) Streichhan P., et al Resorption partikularer und makromolekularer Darminhaltsstoffe, Nature-und Ganzheitsmedizin, 1988; 1, 90
3) Miehlke, K. Enzymtherapie bei rheumatoider arthritis. Nature-und Ganzheitsmedizin 1988; 1:108
4) Singer, F., Aktiverte arthrosen knorpelschonend behandeln In; Medizinische Enzym-Forschungsgesellschaft e.V. (ed) Systemische Enzymtherapie, 10th Symposium, Frankfurt, 1990
5) Shaiikov, A.V., et al Enzyme combination therapy for juvenile chronic arthritis. Oral Enzyme Therapy, Compendium of Results from Clinical Studies with Oral enzyme Therapy, Second Russian Symposium, St. Petersburg, Russia, 1996, page 28-32,
6) Mazurov, V.I et al Systemic enzyme therapy in combination therapy for rheumatic disease. Oral enzyme Therapy. Compendium of Results from Clinical Studies with Oral Enzyme Therapy, Second Russian Symposium, St. Petersburg, Russia , 1996 p15-24
7) Heidland A., et al, Renal Fibrosis: Role of Impaired Proteolysis and Potential Therapeutic Strategies. Kidney International, 1997; 52 (suppl 62)
Is Aspirin Always the Answer? Unlikely!
(Or, the Case for Enzymes)
By Michael W. Loes M.D. (H)
“Take an aspirin a day,” says your cardiologist, your internal medicine doctor, your family practitioner, and most likely your mother, father and siblings. What is it about aspirin that has made it seem almost like another nutrient for our diet?
In a nutshell, aspirin affects platelets – those small blood clotting elements in your circulation – making them less sticky and lessening their clotting ability. This has some experts convinced that it can help prevent certain diseases such as heart disease and stroke.
So now you might be wondering “Is my blood too thick? If I take a lot of aspirin, could I bleed to death? Should we all be taking aspirin? And if so, why were we all made with this aspirin-requiring defect?”
Before answering those questions, let’s back up for just a moment. The whole story of aspirin began in the late 1940s, when Dr. Lawrence Craven observed that patients who took aspirin shortly before getting their tonsils removed bled a lot more during the surgery than those who did not. Hence, he concluded that aspirin had an anti-clotting effect on blood. Dr. Craven reasoned that perhaps an aspirin a day would reduce or even prevent the number of heart attacks and strokes in his patients. By 1950, some 400 men were using aspirin on their doctors’ advice. None suffered heart attacks. By 1956, the word had spread to 8,000 men and again, there were no reports of heart attacks from this aspirin-taking group.
In March of 1995, the Harvard Health Letter ranked aspirin among the top ten medical advances of the previous year for its ability to decrease blood clots and therefore heart attacks. The publication stated that nearly everyone who has ever had a heart attack, suffered a stroke, felt pain from angina, or had undergone coronary artery bypass surgery should take one-half to one aspirin tablets daily. The article also said that aspirin can reduce the risk of a first heart attack in both men and women.1 It concluded, “Worldwide adoption of this advice by these and other high-risk patients would prevent about 100,000 deaths and twice as many nonfatal strokes and heart attacks each year.”
And in the August, 1991 publication Circulation, P.M. Ridker and a team of co-investigators reported results from a randomized, double-blind placebo-controlled trial of alternate-day aspirin use among 22,071 male physicians from the United States who were followed for over 60 months. The conclusion? “Alternate-day aspirin therapy significantly reduced the risk of a first myocardial infarction.”
However, with good news, there is often subtle bad news, hidden just under the surface of the hype. It has also been noted that for people over the age of 70 who were otherwise at low risk for heart disease or stroke, the danger from aspirin-caused bleeding complications is significant. This fact alone outweighs any benefits from taking aspirin. In the July, 1993 issue of Clinical Pharmacology Therapy, Silagy et al looked at their data on 400 subjects over the age of seventy who received either 100 mg of enteric-coated aspirin daily or a placebo. No one who took the placebo reported any complications, but 3% of the subjects who took the aspirin suffered from serious gastro-intestinal bleeding.
In the research on aspirin, there has also been a small, but concerning number of people that show a significantly increased risk for the most serious kind of disabling stroke that occur not from blood clots, but from massive unannounced bleeding. This condition is known as a “cerebral hemorrhage”.
The concern strengthened when Ridker et al (Annals of Internal Medicine, May 15, 1991) discussed the increased frequency of bleeding strokes with aspirin therapy.2 These results further supported the earlier alarm expressed in the 1988 publication British Medical Journal of Clinical Research. In this case, the reduction in non-fatal strokes was over 25 percent, but disabling strokes were more common among those who given aspirin. In other words, the patients did not die, but were perhaps placing themselves at risk for a “wheelchair kind of stroke”.
So now you’re probably thinking, “Dr. Loes, is aspirin okay? Should I take it? Daily? How much?” Here is my opinion:
Take “baby” aspirin daily only if you have a true “thick blood problem” – i.e., previous heart attacks and strokes, and only at the advice of your cardiologist.
Do not take aspirin if you have a higher than normal risk of bleeding.
Be careful in taking aspirin if you have liver or kidney problems, both of which may be worsened by aspirin.
Exercise extreme caution in taking aspirin if you are on any Non Steroidal Anti-Inflammatory Drugs – known as NSAIDs. Aspirin is a non-selective NSAID and has the potential of being just as dangerous as any other NSAID. Do not take aspirin if you are on “blood thinners”, especially warfarin (Coumadin-®). Do not take aspirin if you have any stomach trouble.
Do not give aspirin to children under the age of two who are suffering from a cold, flu, or chicken pox because of the risk of Reye’s Syndrome, a potentially fatal illness thought to be worsened with aspirin. (This data is somewhat controversial, but generally accepted by the medical community).
What about aspirin alternatives?
Part of the answer here has to do with new information regarding the role inflammation plays in heart disease. A recent report in The New England Journal of Medicine journeys us into the controversy, and this newly discovered connection.3 High cholesterol is no longer considered to be the sole sniper to heart survival. Inflammation (from causes other than high lipids) has also been shown to be a major factor in developing heart disease. Inflammation causes scarring and plaque formation and then a clot occurs in the area of already established damage.
Would it not be of interest-and extreme importance-to try and stop heart disease before inflammation revs up in the small heart blood vessels? The scientists at Harvard Medical School think so. Their data, obtained from the landmark Physicians’ Health Study suggests that chronic inflammation leads to heart disease and stroke.2
Given this information, there is a compelling argument that systemic oral enzymes are the sensible aspirin alternative for people with arthritis and also for those prone to heart disease due to inflammation. This opinion is bolstered by what is known about trypsin and chymotrypsin, two ingredients usually found in systemic oral enzyme formulas. These enzymes have been shown to have anti-clot properties, and before the introduction of medications like warfarin or heparin they were mainstay therapies for treating blood clots in arteries and veins.
There are many individuals who are either allergic to aspirin or have had a history of gastro-intestinal bleeding. For these individuals, enzymes should be seriously considered. The information contained here is not intended to tell patients on successful aspirin therapy to get off. The message here is to be informed. Look at sensible options when they might just save your life.
Inflammation and the Heart: Nutrition Action Health Letter, June 1997: 14
2. Ridker, P.M., et al. “Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men.” The New England Journal of Medicine, 1997; 336(14); 973-079, 1416-1418
3. Maseri, A., Inflammation, atherosclerosis and ischemic events – exploring the hidden side of the moon” The New England Journal of Medicine, 1997, 336 (14) 1014-1016
Will that Bad Back Put you Under the Knife?
Michael W. Loes M.D. M.D.(H)
You have back pain. It is your pain, and it hurts. It really bothers you and it limits your activities. Today, you have decided that you have had as much pain as you can possibly take. You are ready to get some help. You start wondering if surgery will fix you, or if there is something else you can try first that is not so drastic.
Most importantly, try to stay optimistic. If you have just twisted your back, most of the time it will heal just fine, especially if you make the commitment to help your body’s own healing response.
If you are suffering from back pain, here are some things you should do:
Be well nourished. Include plenty of fresh fruits and vegetables in your daily diet.
Drink lots and lots of water. Everyday you should try to drink half your body weight in ounces of water. For example, if you weigh 144 pounds, you should drink 72 ounces of water a day, or what I like to call the “six pack equivalent”.
Our bodies need several minerals in order to heal properly, and supplementing is a good way to guarantee that we get enough of each one. Zinc is especially important because it is used in nearly every biochemical reaction involved in the healing process. Sulfur is vital because it makes up part of the structural support of collagen and other connective tissues. Magnesium is the crucial mineral for overall muscle health-it helps with something called “muscle spindle function” and its presence ensures that our muscles will contract properly. Additionally, magnesium is essential for normal vascular function, which is a critical part of the healing process. Calcium is necessary for bone repair, and finally, since Boron is part of the bone matrix it should also be present in order for optimal healing to occur.
Be sure to include “branched change” amino acids in your diet or supplement routine (the term “branched change” comes from these amino acids’ unique chemical structure). Arginine is especially important and essential for healing because it stimulates the production of the hormone that is involved in new tissue growth. Cysteine and glycine are needed for the synthesis of the building block starch molecules by the fibroblasts. Fibroblasts are cells that help make up structural fibers and connective tissues and are very important to overall back health.
Take your vitamins! Vitamin C enhances collagen repair and stimulates capillary development. Vitamin A stimulates healthy skin and blood vessels. Vitamin E improves the quality and speed of healing by providing anti-oxidant protection. Vitamin D is absolutely essential for building bones. Vitamin B12 is a key nutrient to help build blood, especially white blood cells. And a lack of Vitamin K will retard blood clotting, which is the first step in wound repair.
Consider taking glucosamine sulfate. This supplement has been found to be an essential building block of cartilage and numerous studies have shown that it can help repair damaged cartilage.
Make sure you are getting enough Essential Fatty Acids like Omega-3. Good dietary sources of Omega-3 are cold-water fish like tuna and salmon, as well as flaxseed. Omega-3 is needed by the body to build neuronal membranes. Neurons are nerve cells and like the other cells in our bodies, they are surrounded by a membrane. When fighting back pain, it is important to keep our nerve cells working as efficiently as possible.
Enzymes, Enzymes, Enzymes! Sometimes referred to as “the aspirin alternative” enzymes are the main way European sports enthusiasts have dealt with their stiff backs and recurrent muscle spasms for years. (For more information, please read “The Healing Response,” or “The Aspirin Alternative,” by M.W. Loes).
Now, for treating your back pain, here are some don’ts!
Do not drink large amounts of coffee or cola “thirstbusters”. Both are diuretics, which means that when you drink them the amount of urine that comes out will be greater than the amount of liquid that has gone in.
Avoid smoking! Patients who do not smoke heal more rapidly than those who do.
Stay away from alcohol. Four to eight ounces of wine a day is probably okay, but beer is a diuretic and hard liquor likely has no health benefit.
Avoid high amounts of sugar in your diet. It is a fact that people with diabetes heal poorly. In my opinion, regardless of whether you have diabetes or not, most of us consume way too much refined sugar and we should all try to cut back.
When you get out of bed in the morning, start moving around right away. If you have a kink in your gait, try walking in chest-high water in a pool. The soothing water should correct your gait, and will likely reduce any residual spasms. If you are limping just a little, try some silicone inserts in your shoes, or switch to Asics Gel shoes. These should reduce the heel strike of each step. Some people find that silicone gel shoes are a little squishy, but in this case it should be a welcome feeling because they should allow you to increase your walking without provoking spasms.
Get motivated! People with families who depend on them heal more quickly than those who do not.
Stay away from anti-inflammatory agents. Non-steroidal anti-inflammatory agents, known as NSAIDs, have a lot of side effects that include gastro-intestinal, kidney and liver problems. If your doctor prescribes one of these drugs you will notice some pain relief and it is likely that the swelling will go down, but please get off them as quickly as possible. In my opinion, they do not stimulate healing, and this opinion is not that of a lone caller in the dark. 1-7
Not every case of back pain will go away by following these suggestions. If you have nerve pain – that scary knifelike sensation of lighting bolts – going down your leg, you may have herniated a disc. This means that you have pressure on a nerve that is the direct result of something pushing on it. Sometimes, an epidural steroid injection can be helpful for this type of pain. This technique involves injecting a small amount of steroid medication near the inflamed area of the disc. If it works, the inflammation will lessen and the pain will ease. If you have any weakness or bowel or bladder problems that accompany your back pain you may need surgery, but there is still some good news here. Minimally invasive spinal surgery is now available in some areas of the country. The technique, known as “selective endoscopic discectomy” uses a small scope, just like a knee surgeon often does, to look at and correct disc problems in the back. This type of surgery is done on an outpatient basis and 85% of the time it boasts good to excellent results for eliminating sharp shooting leg pain, as well as often reducing or eliminating back pain. Should you urgently need to have surgery-either conventional or one of the newer techniques, all of the “do’s and don’ts” listed here still apply. Pay attention to your nutrition and water needs. Take your vitamins, supplements and enzymes, and get moving. Remember, motion heals, and optimal motion heals optimally!
Newman, N.M. & Ling, R.S.M. “Acetabular bone destruction related to non-steroidal
anti-inflammatory drugs.” Lancet, 1985; ii: 11-13
2. Solomobn, L. “Drug induced arthropathy and necrosis of the femoral head.” Journal of Bone and
Joint Surgery, 1973; 55B: 246-251.
3. Ronningen, H. & Langeland, N. “Indomethacin treatment in osteoarthritis of the hip joint.” Acta Orthop Scand, 1979; 50: 169-174.
4. Shields, M., Anti-Inflammatory Drugs and their Effects on Cartilage Synthesis and Renal Function. . European J. of Rheumatology and Inflammation, 1993, Vol 13, #7
5. Müller-Fa*ender, H., et al. “Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee.”
Journal of Osteoarthritis and Cartilage, 1994; 2: 61-69.
6. Spencer-Green, G. “Drug treatment of arthritis. Update: Less Conventional Methods
Post Gradulate Medicine, 1993; 93(7): 129-140.
7. Wallace, MA., Archives on Internal Medicine, May 25, 1998, p158