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Enzymes: Beyond Digestion with Bec Guild

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Enzymes: Beyond Digestion with Bec Guild

When we think of enzymes, we can often compartmentalise them as being purely for digestive support. However, they have so much more therapeutic potential.

Today we are joined by Bec Guild to discuss the plethora of clinical uses for proteolytic, or protein-digesting enzymes, that are not connected to digestion.

Bec shares how we can use enzymes for inflammation, pain, infection resistance, sinusitis, as a mucolytic and much, much more. Bec expertly highlights the many reasons why enzymes are a safe and essential addition to any dispensary. 

Covered in this episode

[00:56] Welcoming back Bec Guild
[01:30] What are enzymes?
[02:55] Where do we get enzymes?
[05:28] Enzymes: units of measurement
[08:35] Plant-based vs. Animal origin enzymes
[12:18] The clinical uses for enzymes
[14:56] The anti-inflammatory and healing activity of enzymes
[29:32] The utility of enzymes in infections
[30:52] Appropriate dosages and safety aspects


Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook. Joining me again on the line today is Bec Guild who's a dear friend and colleague. She's been a naturopath for over 14 years and is currently the curator for FX Medicine. She studied naturopathy and Western herbal medicine, graduating in 2003. And she has a great respect for the therapeutic actions of enzymes and we thought we'd discuss this topic to give you, our listeners, a heads up about these greatly underutilised therapies. 

Welcome back, Bec. How are you?

Bec: Good, thank you.

Andrew: Now, Bec, I think we have to go right back to the beginning with enzymes. What exactly is an enzyme?

Bec: Right, yes. Well, to put it very simply, enzymes are catalysts, and they are responsible for turning something, into another thing. So the most common way that they're thought of, of course, is in digestion. Because it is essential for us to convert our food into all the very many substrates that we use in our body. 

So, most of probably what we'll end up talking about today is the application of it through oral therapy and, you know, its impact on food and reactions in the body.

Andrew: And, I think one of the important things about enzymes is that with some reactions in chemistry or biochemistry, that enzymes aren't necessary for that reaction to occur but that enzymes help it to happen quickly and indeed this is one of the instances why they're so important for life. Without these enzymes, we just couldn't convert carbon-based atoms into energy fast enough for us to live. So, you know, I think this is one of the key things that people need to understand. It's not that things won't necessarily happen; it's just that these happen quickly. So, I guess the message is you are not only what you eat but what you can absorb and utilise.

So, with these enzymes that we're talking about as an oral therapy, where do we get them from? 

Bec: So, let's just park the idea of where we get them from as therapy. I'll go into that in a second, but where do we get them from in general? As in, if we didn't intervene with therapy? We would get them obviously from our food supply. 

Andrew: Right.  

Bec: So, the problem with that is most of us eat so poorly, that one of the key areas that we get our enzymes from, or the substrates to produce those enzymes in the body, is from food.

Andrew: Yep. 

Bec: And, in particular, fruits and vegetables in their most raw state and often on the skin. More often than not, that's where they're located.

Andrew: Right.  

Bec: Some other examples where we get, you know, really high-yield enzyme products are also in fermented foods. So, you know, one of my personal favourites, kombucha…

Andrew: Yep. 

Bec: Or perhaps sauerkraut. Just the action of fermentation itself produces this wonderful symbiosis of probiotics and enzymes, and I think that's, you know, part of the reason why we all feel so great when we eat them. 

Andrew: Absolutely, and an oft forgotten source of the enzymes. We don't even think about it now, do we? We just think about…we use the term fermentation; we don't think how they were fermented. 

Bec: For sure. And is it any wonder that, you know, the chronically “sad,” - standard Australian diet - that we eat, results in people being immensely fatigued and tired. Well, it's because they're not eating fresh, vital and enzyme-rich therefore, food. 

Andrew: Yes. 

Bec: They're not getting these substrates to catalyse, as you said before, at-speed, these reactions. 

Andrew: There's a little point here, I guess. I remember one practitioner years ago criticised the inclusion, let's say, of cellulase in a proteolytic enzyme formula saying basically that humans don't produce cellulase, and that is true. We're not a ruminant animal like a cow who needs cellulase to release the plant starches. However, we eat plants, and plants have cellulases. So, this sort of notion that just because we don't produce it, we therefore have no use for it as an oral therapy isn't quite true. Particularly when we consider the true diet that we should be eating rather than the packaged food, as you say, in the standard Australian diet. 

What about measuring them though? You know, we're talking about vitamin B6 and you measure it in milligrams, but enzymes aren't the same, right? 

Bec: No, in fact there are so many different acronyms for the various units of measurements for your different types of enzymes. So, for example, lactase is measured by ALU, and cellulase will be measured in CU which is a ‘cellulase unit’, the digestion of fibre. Amylase is known as DU units; for digesting carbs. I think that's called an alpha-amylase dextrinizing unit because, you know, important information there. 

And then proteases are probably the most common, you know, application of enzyme in a therapeutic way that we apply. And they're measured in HUT units. Well, you would never have a clue as to why they're called that, but it's a way I suppose to measure the activity or the amount of catalyst that's happening, if that makes sense. 

Andrew: Yeah, its catalyst potential. I think the real learning objective, if you like, from this is it gives us a way of saying, "This is a centimetre. That's a centimetre." We're not talking about, "I've got a cubit,” which is an elbow to the wrist…sorry, elbow to fingertip. “I've got a cubit. You've got a cubit but my arm's longer than yours so that cubit's different," and that's the problem with milligrams when we're talking about activity. 

Bec: Yeah, it's a measure of concentration. Like, if we are talking about bromelain, for example, where you could have 100 milligrams of bromelain, and you could have 200 milligrams of bromelain. And depending on how that basic source material has been grown, treated, concentrated…

Andrew: Crap pineapples.

Bec: Yeah. Right, it might affect the yield of the HUT units that are displayed on a label.

Andrew: So, this is one of the issues I think we have with labeling in Australia about what you're allowed to say on supplements. And this is an interesting thing, you know, people want this, practitioners want this. This is the truth, but you're not allowed to say that because the restrictions in Australia with the therapeutic goods administration disallow that form of measurement. 

So, bromelains, I think, are measured in GDU units but we're not allowed to say that in Australia on the label. You can say that in America, which is weird because normally their labeling is far inferior to Australian labeling. Sorry for our listeners who are based in the U.S. But in this instance, the TGA really does have the upper hand. But I think it's one area which the TGA needs to move so that we can actually get a measure of activity to be able to allow manufacturers to state that on the label.

Bec: Yeah, I suppose as we increasingly become one global economy for the use of these kinds of things, some uniformity would be good, wouldn't it?

Andrew: Yeah, it'd be nice. What I think is interesting though is that…I think it was in 2004, the TGA did a flip. And that is that before that time, you were not allowed plant-based enzymes, and you were only allowed animal-based, that is pig-based or porcine-based enzymes for oral therapy. 

However, in 2004, there was a flip because of basically the stability of over-the-counter supplements. And so they then preferred plant-based enzymes which are stable, over porcine-based which are not. They have to be refrigerated except for a couple of drug examples there. 

So I think this is just interesting how the market moves and what we're allowed compared to or versus what works in therapy. 

Bec: Yes. Well, we're always going to have changes, too, because I mean you can have amazing things available, but they've also got to be made commercially accessible and also safe. 

Andrew: Yeah. 

Bec: So, I mean that's part of what we hope at least our regulators are keeping their finger on the pulse of. Part of that reason is that by making it more freely accessible to access veggie enzymes, which don't degrade at… in as a restricted temperature window, and they're really widely available through a wide pH in the body that's therefore making them quite effective. And, you know, they're not going to break down, degrade, or anything like that in the capsule before they're used or employed therapeutically, then, you know, it all comes down to safety, ongoing safety, and the commercial availability of products. 

Andrew: You made two brilliant points there, and the first one is safety and that is indeed what the TGA is famous for worldwide that the Australian medicine is really well-regulated in that respect.

The other point you make is the stability of the plant-based enzymes over porcine-based. It's a got much wider pH range, so they're active whether people underproduces, or indeed overproduces, or indeed inappropriate produces of acid. 

Bec: Absolutely. 

Andrew: And this to me is where plant-based enzymes come in.

Bec: I totally agree. That is by far where and why I think that vegetarian enzymes are a superior choice.

Andrew: Yeah. 

Bec: Because particularly in the field that we're working in in, you know, naturopathic medicine, integrative medicine, functional medicine, whichever you're calling it, you know, most of the people that are coming to see us, have disrupted digestion. They don't have this wonderful, you know, pH happening with the stomach acid, and they’ve usually got a preexisting digestive disorder whether they know it or not. And so you can't guarantee that that's a minor window, and I meant to look this up but it is a really minor window. It's like 2.2 to 2.4 or 2.6, something like that is your therapeutic window of pH for animal-derived enzymes. Whereas a vegetarian a enzyme has a really wide pH range. It's something like right down from 2 and right up to as high as, you know… 

Andrew: I think it's 12.

Bec: …8 or 9. Yeah, I thought it was really quite alkaline that it'll go through.

Andrew: Even the proteases, you can break them apart. Like, you get neutral proteases and it's like, "Well…" It gets really confusing, so you've got to sort of say, well, you can make a broad-brush stroke and say 2 to 12, but some of them are sort of active at the higher end i.e. more alkaline, and some of them are active at the more acid end.

Bec: It's the shotgun versus the machine gun approach. It's probably going to hit more stuff with a machine gun just because it's rapid fire. 

Andrew: I’ve got to say and this is where I constantly pigeonhole digestive enzymes for use. I constantly do it. Except for a couple of examples like sprained ankles, oedema. But, I constantly pigeonhole them to digestion, but they've got far wider-ranging applications.

Bec: You're not the only one who pigeonholes them to digestion. I think that's pretty common.

Andrew: Moving on from that, what about these other uses for proteolytic enzymes or indeed other parts of the enzyme spectrum, you know, the amylases, the lipases? Where else can we use them?

Bec: Okay. Well, since you've raised it, amylayse… let's go right back to the beginning. Amylase is typically for our carbohydrate digestion. You've covered earlier cellulase; it's for cellulose. 

But we also have a couple of other main enzyme actions. Lactase digests lactose. Lipase digests our fats. And protease or proteolytic enzymes are typically for proteins, and they're essential for breaking proteins down, you know, protein from digestion or even endogenously in the body into singular or smaller amino acids which then might get reassembled for used elsewhere in the body.

Andrew: Yeah. So, you know, the most common sort of digestive complaint that we'd be thinking of would be, you know, the burping, bloating, even burning, the reflux conditions, but you move on from there about pancreatic insufficiency. What interests me here is the signaling between the two organs, you know, in the digestive processes, but there's so much more what we can use the proteolytic enzymes for. 

So, do you concentrate on the digestive aspect first or do you just go for these various other uses no matter what's happening with their digestion?

Bec: No, I must say I rarely use, personally, rarely need to use enzymes in a digestive capacity. I tend to try as much as I can to do that side of it with dietary interventions, and you know I love my fermented stuff – my apple cider vinegar, raw foods that we crunch up using our teeth, and that kind of thing. So realistically I'm applying the use of enzymes…I'm using it in a capacity that is outside of digestion typically. 

So, probably the most common thing I would apply proteolytic enzymes for is for injury, pain, and inflammation. 

Andrew: Right. 

Bec: They are outstanding, proteolytic enzymes are outstanding performers in this space. You know, I think we can talk about your personal experience with it, falling down the stairs. And I don't think that you had as much, shall we call it, faith in enzymes when I was, like, "No, you need to take your, you know, proteolytic anti-inflammatory enzymes right now and do it constantly throughout the day to keep the swelling down." And when you got home and sort thought, I’ll swap that out….

Andrew: I got cocky.

Bec: Yeah, and how quickly your ankle blew up into a balloon.

Andrew: It was a salient lesson in arrogance. 

Bec: Mm-hmm, mm.

Andrew: For our listeners, just to recap, what happened was I was actually at a seminar, and I went to get something out of the car in this lovely, luxurious hotel had this grand staircase. Descending the grand staircase, I decided to take the last five or six steps in one bound; bang. I just slipped. 

But the interesting thing was I had some digestive enzymes there. I had some bromelain, and I took a lot of them during the seminar. Like, I was in pain. But the interesting thing was that the next morning I could walk through, I could weight-bear, it was tender, but I could weight-bear on that joint and walk through my ankle. Not limp and put it out to the side like you normally do. And that really amazed me. 

Indeed at first I thought I was being a little bit of a sissy, and so I went, "Ah, you didn't do any damage. It's fine," so I stopped taking the enzymes. Wow. 

Bec: Yep. 

Andrew: And so, yeah, it blew up like a balloon. Both sides bruising, ankle up like an absolute softball, about as softball size, and incredible pain yeah. It was a big lesson. 

Bec: That just goes to show, doesn't it, the kind of almost multifaceted way that that was working upon your injury. 

Andrew: Yeah. 

Bec: You know, this is what I love about enzymes. Is that not only are they strongly anti-inflammatory, working along pathways that some of our strongest pain-relieving drugs work on, such as non-steroidal anti-inflammatories to keep inflammation down and reduce the formation of, you know, blood clotting. And that's an important attribute in injury-healing. 

Andrew: Yes. 

Bec: Because it's like a highway. 

Andrew: Yeah. 

Bec: There's trucks coming and going from there to bring in supplies of healing nutrients, to bring in, you know, all sorts of things that are going to initiate the healing response. And it's a part of why we get red and inflamed is because that helps induce, you know, circulation to the area. But when it gets to be too much, then that impedes the process and slows down the healing. 

So, by taking enzymes at the very onset of an injury, you can speed up the healing considerably, and that's being shown time again in studies. 

Andrew: That's an important point you make, though, Bec, in that we're not talking about blocking the natural production and resolution of a wound.

Bec: No. 

Andrew: Indeed it's assisting in the resolution of that wound. It's not stopping it from happening. So this is one of the issues with, you know, NSAIDs and the inhibition of COX, particularly COX2. You know, we've seen these inhibitors and they work great because they don't give you stomach ulcers but, guess what? They produce increased thromboxanes and give you heart attacks. There are class actions still ongoing with that class of drugs in Australia. And this is not the case with these proteolytic enzymes. 

Bec: Yes. They reduce cyclooxygenase-2. But the other thing that your enzymes will work on as well from a pain perspective is…there's sort of two main substances that produce pain in the body; one is substance P and the other is bradykinin. And so the great thing with proteolytic enzymes is not only are they working in a similar way but more a supportive way, than an NSAID. But they're also working by a similar mechanism as some of our analgesics. Like, even paracetamol, its mechanism is through substance P and shutting down that response to pain. 

So, what we're getting is in an anti-inflammatory and inducing the healing, a reduction in, you know, problems arising from an injury or an inflammation and a reduction in pain. And you can get that from any injury. A broken bone, a sprain, a strain, a sore tooth. Even the pain, and this is also reflected in the evidence, but the pain and the swelling with something like sinusitis, because it's still tissue inflammation.

Andrew: Okay. So, let's talk about some of these uses. Do you want to start with sinusitis? Because there was a really interesting trial; small, yes, but very, very applicable

Bec: Yes. Are you referring to one in children? 

Andrew: Yep, that was the one.

Bec: With antibiotic therapy?

Andrew: Yep.

Bec: Yeah. What I liked about that study is a lot of the things that you read about bromelain is that it says that no safety has being determined in children. That particular study, it's 2005, but it showed some really great results. So what they were using, I think they had a group with just monotherapy; as in just, the only intervention was bromelain. Then, a group of with intervention of bromelain and other therapies, ancillary therapies. And then just standard intervention on acute sinusitis. And this is across a range of general practices in Germany. 

Andrew: Yep. 

Bec: So, what was interesting in the outcome was it was the monotherapy group that ended up with, A) less secondary infection, and also that they show a statistically significant faster recovery time with their symptoms than the other intervention groups. So we can see that, even when it's combined, it's still just as effective, if not possibly superior, in its application for that. 

And I think, you know, we could glean from what we've read on bromelain that it's because of its multiple mechanisms of action. You're getting a reduction in inflammation. You're getting a thinning out of the mucus. You're getting an ability therefore, for the body to enact upon whatever the invading virus is. Because you're keeping things flowing, keeping things moving. You're allowing a lot of things in the body to keep happening that are essential to immunity. 

Andrew: Yeah. 

Bec: And then keeping inflammation down therefore reducing the pain and the discomfort that we get from sinusitis. So, I really did like that study. 

Andrew: I think one of the things I'd always play on if you like or think about is just how safe bromelains are. You know, when you consider that…I think echinacea has 2000 milligrams per kilogram LD50 and that's the measure of lethal dose in 50% of rats or mice. Bromelain is 10,000 milligrams per kilogram in mice.

Bec: Mind you, if you're going to use it in that dose, your tongue would probably start falling apart!

Andrew: Well, look, the interesting thing that I note is just how quickly these things work. Like, I really was amazed with that ankle episode just how well it worked. To the point where I thought I was being a sissy and I didn't actually do any damage and bang. As soon as I stopped taking it. And I was taking massive doses.

Bec: You know how quickly, when you eat fresh pineapple that you've cut up, not the stuff from the tin. But when you eat a fresh pineapple that's cut up, you immediately feel the tingling sensation on your tongue and that is those enzymes getting to work right away. And people always look at me like I have five heads when, you know, kids around me are sick and I'm like, "Go and get a fresh pineapple and eat it as much as you can or make it into juice." 

Andrew: Okay, so we've spoken about, you know, the sprained ankle, that edema. For me, that leads into one of its way under-utilised medical uses, which I believe medicos should be thinking of this. And that is post-surgery wound healing. Or indeed even in the flavor-of-the day now. What about cosmetics surgery?

Bec: Absolutely. It's got so much potential in the space of surgery. I was just having a bit of a read on some of the ways perhaps that it's being looked at medically, because I know I would use it pre and post-surgically for anything just because I know that it helps with healing. And personally, having to have an emergency cesarean, I most definitely was using a bromelain proteolytic enzyme formula in lieu of pain killers. Because I think we have enough postnatal depression and baby blues without adding to it the burden of how down we can feel as mothers with some of those analgesic interventions. So, you know, I think that if we can use something that's natural and it improves healing and, you know, isn't going to have an impact on mood and attentiveness for babies, then brilliant. And I was interested to find that it is reflected in the literature that it can be used for women who've had an episiotomy as well. To reduce sort of that swelling and bruising in women. 

So, you know, these things are obviously starting to get a bit of sort of spotlight in surgical areas, and I think…I don't remember the study design but it's old from, you know, reading about it. But if you're an athlete, you can take your enzymes as a prophylactic to, you know, make sure that, if you did sustain an injury, that, you know, you've got the best resources or capacity internally to heal from that wound really quickly. So, you don't have to wait until you're injured. If you're in a sport or in a type of job where, you know, injuries and that kind of thing is quite common, it wouldn't hurt to kind of take it prophylactically as an option. And, like you said, super safe. So those are some other things.

I also was reading about how it's got some potential for the debridement of wounds when used topically. I'm assuming that that's some kind of pharmaceutical grade. I think it said about 35% bromelain in a lipid base when I read the study.

Andrew: Yep, have to be. 

Bec: But that's fascinating. How great is that? And that's been healing horrible burns. And healing them better.

Andrew: Exactly. Indeed, you know, what I'd love to see and I've got to say I haven't looked at that research but it would be really interesting to see if it had an action on reducing scar tissue in severe burns? 

Bec: It just well might. I feel like it did say something along those lines, and I will send it to you so have it.

Andrew: Well, let's put it up on the FX Medicine website, yeah? 

Bec: Sure.

Andrew: I remember just recently reading a smaller trial but very interesting on delayed onset muscle soreness in athletes. So DOMS. And, what struck me was that it wasn't a hugely massive dose in this. It actually had quite a good effect at a reasonably low dose.

Bec: Yeah. But, like I said, if you're an athlete, you're looking for anything that's going to help with your performance and, in particular, performance is dictated by how quickly you recover from the intense sessions that you are undergoing through your training. So, that makes sense to me in terms of an intervention. 

Andrew: Yeah, I think what's needed now and this is the ongoing issue that, you know, complementary therapies have is that they're often lambasted by the naysayers saying there's not enough good evidence. Well, great. Let's do some more good evidence. But don't shut it down. Look at it. Because this stuff has merit. Indeed, I was looking at a review where it was looking at tendinopathies saying, you know, further research is warranted. This stuff has merit. 

Bec: Yeah. 

Andrew: So we really need to be looking further into it. Where I'm going with this is, you know, you think about the money. We're talking millions of dollars that are spent with, say, foot players. Netball, cricket, there's so many other sports, cycling, where tendinopathies and other sports injuries occur where, if you could find a nice, cheap intervention that would prevent, treat, or reduce the issues with these pathologies of their muscles', their tendons'. Inflammation. Then you can get these athletes back on the paid roster if you like for what they're paid to perform with.

Bec: Yep, again comes right back to how quickly they can recover, how resilient they are to injury. And, yeah, bromelain certainly shows a lot of merit in that sphere. 

Andrew: So I've got to say you've exposed my little thing about my ankle. I know that you play hockey. Have you actually had any instances where you've used it? 

Bec: For sure. So I have broken my ankle and also my husband seems to break things often. 

Andrew: Often.

Bec: Yeah, often. So, obviously I'm not using it in isolation but, you know, when I combine what I would combine for a broken bone or a sprain or a strain, which is usually proteolytic enzymes, perhaps some mineral formulation that's got some magnesium, calcium, and we're looking at employing, like, MSM, and glucosamine, and things like that, as in a whole healing complex of nutrients. 

Andrew: Yep. 

Bec: Then I know for a fact I can reduce the expected medical healing time down to about, you know, three-quarters easily. But sometimes by half. So where I was told, it was going take, you know, 6 to 8 weeks minimum for my ankle injury to heal, it would heal in 3 to 4 weeks instead. So, I mean that's pretty great. 

And obviously that's going to depend on somebody's level of health first, but it's not uncommon to be able to shorten the duration and speed up that healing time. 

Andrew: Now you've also...and this is another area which I constantly forget about and you constantly remind me about. The use of proteolytic enzymes with viral infections. 

Bec: Yes. So, we know we can't employ…antibiotics are chronically ineffective for a viral infection, but the interesting thing with proteolytic enzymes and bromelain is that they seem to, again, through their multitude of actions, A) thinning out mucus if there’s, you know, a cough or sinus or what have you. And in fact, bromelain itself has been shown to be very effective as a cough syrup alternative, just as an aside. 

But also I know that this doesn't specifically talk about, you know, individual viral infections. But some evidence is suggesting even that bromelain can counteract the effects of the intestinal pathogens. So things that give us, like, the tummy bugs, or the Bali Belly, or the runs, or food poisoning such as E. coli and they cause that diarrhea. 

So in a similar mechanism, the idea is that bromelain helps with an anti-adhesion effect, or therefore making it less likely for those pathogens to invade. And that's where I think it becomes an important application.

Andrew: Okay. So, just to move on because we are running out of time here, some appropriate dosages? And what I'd like to also cover, what about safety issues or cautions that we need to be aware of? Like, for instance, cystic fibrosis from nursing. You know, my memory of the use of proteolytic enzymes was cystic fibrosis and, you know, things like biliary obstruction, and pancreatic surgery, chronic pancreatitis, things like that. Can we go through some doses first and then can we cover some safety issues?

Bec: So, I mean as we've kind of indicated before, there's a pretty massive window of safety on bromelain in terms of dosages. If you're talking 10 grams per kilo, you've got a pretty large window that you can prescribe that in. 

Andrew: Indeed. 

Bec: However, in saying that, you know, like a lot of things, I find using it in divided doses tends to be better. So anywhere from 1000 milligrams to 3000 milligrams usually in divided doses every few hours is what I find most effective. 

And, one important thing that we probably haven't covered off is also, if we're going to be using enzymes in this capacity. As in using them for their mucolytic or anti-inflammatory type application, then we must definitely be using them outside of eating food. So that means at least half an hour before food or two hours after food. Because if we use them inside that window, they're going to act as a digestive substrate instead of, you know, in the manner that we wish employ them otherwise. 

So first thing in the morning and before we go to bed, sometimes I will load-dose at those times just because you've got, you know, a really long period of time where they can act. 

And then just because you've raised it, the cystic fibrosis and into the safety side of things, this is certainly not an alternative to the medical therapy of proteolytic enzymes in cystic fibrosis. 

Andrew: Yeah. 

Bec: It may have some merit as an adjunctive therapy but certainly not an alternative.

Andrew: That's right, and I think our listeners need to realise it may not be indeed the proteolytic enzymes that is the difference with regards to what we can access over the counter. But indeed the pancreatic lipase which…I'm going to name the drug because it's a prescribed thing. It's “Creon Forte.” And it's a stabilised product that's in these microcapsules that's available on prescription for cystic fibrosis and, you know, the pancreatic issues.

Bec: But that's not to say it's not got some merit in assisting with the mucus reduction…

Andrew: That’s right. 

Bec: Or, you know, improving the airways and just the fluidity of that through the body. And also resistance to infections as well; I'm sure a lot of people would be using that in that way in cystic fibrosis patients. 

Some of the interesting things are, when you look at the safety of bromelain though, one caution is that it can potentiate antibiotics. So, one of those things, well, is that a good or a bad thing? If you were able to potentiate an antibiotic, make it work more effectively, could you use less? 

Andrew: That’s right. 

Bec: I mean some of these things about antibiotic resistance, this kind of stuff need to be looked at in greater detail. 

And of course, I mean it goes without saying it's having an action on inflammation and fibrinogen formation. So, there's a cautionary warning there with anti-coagulants. I mean, warfarin, you can't take anything with warfarin, and some of those other things, so we probably wouldn't use it in patient groups that are using those. 

Andrew: Yeah. 

Bec: And the other cautionary area for it as well is that it seems to be able to have some kind of potentiating effect on sedatives. So anything from your pain-killing benzodiazepines to some antidepressants like tricyclic antidepressants or even alcohol. I don't know what the mechanism is behind that, but the caution also extends to herbal sedatives as well. So it may make valerian, kava, etc. more potent as well.

Andrew: That's actually a really interesting use rather than a caution certainly, but even perhaps with therapeutic use to make them more effective maybe in some resistant patients? 

We will be putting a couple of papers up on the therapeutic potential, clinical potential, therapeutic applications. There's a few great reviews from, like, Biomedical Reports 2016. And there was biotechnology research. So we'll put those up on the FX Medicine website for our listeners to access there. And they can go through these actions and certainly the cautions and precautions. 

Bec: And hopefully use proteolytic enzymes outside of digestion. All sorts of things…

Andrew: You're telling me again, aren't you?

Bec: Yep, injury, trauma, headaches, migraines, you know, surgery, cough, colds, resistance to infection. I mean the list goes on and on. 

Andrew: Brilliant stuff. I love your therapeutic application and I love the way that you wake me up by shaking me around the neck and going, "Wake up!" So, thank you for taking us through these clinical applications and practical applications of proteolytic enzymes today, Bec. Really appreciate it.

Bec: Thanks for having me.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. 

Additional Resources

Bec Guild
TGA: CMEC 47 Complementary Medicines Evaluation Committee
Extracted Ratified Minutes Forty-seventh Meeting 13 August 2004

Research explored in this episode

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 Mar-Apr;19(2):417-21.

Pavan R, Jain S, Shraddha, et al. Properties and therapeutic application of bromelain: a review. Biotechnol Res Int. 2012;2012:976203.

Lenard L. Systemic Proteolytic Multi-Enzyme Therapies. Nut. Rev. 2014 May 26

Rathnavelu V, Alitheen NB, Sohila S, et al. Potential role of bromelain in clinical and therapeutic applications. Biomed Rep. 2016 Sep;5(3):283-288.

Fusini F, Bisicchia S, Bottegoni C, et al. Nutraceutical supplement in the management of tendinopathies: a systematic review. Muscles Ligaments Tendons J. 2016 Jan-Mar; 6(1): 48–57.

Bromelain Monograph. Alt. Med. Rev. 15(4):361-368


Other podcasts with Bec include:


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