Proteolytic enzymes are excellent for reducing inflammation that is accompanied by pain.
Question: I have had chronic tendinitis in my shoulder for years. I've been on many anti-inflammatory medications and have had physical therapy, with no relief. What do you suggest?
A.A., Boca Raton, Florida

Answer: I first recommend that you follow up with your primary care physician or orthopedist to determine if you need an X-ray or MRI of your shoulder. Beyond that, I advise treating your tendinitis with proteolytic enzymes. These are excellent for reducing inflammation that is accompanied by pain, warmth, swelling and redness.

Proteolytic enzymes occur naturally in our bodies--they are produced in the pancreas--to break down proteins into individual amino acids (one of the 20 "building blocks" of protein). As we age, however, our ability to produce enzymes in general decreases. Thus, alternate enzyme sources may be needed.

Animals and plants both are sources of proteolytic enzymes. The enzymes can be grown in a laboratory on a culture medium as well. Most supplements of the pancreatic form of the enzyme are animal-based and are prepared from fresh porcine (pig) pancreas.

The strength of pancreatic enzymes is rated by an X factor. A pancreatin of 10X (the highest) is 10 times stronger than 1X.

Biozyme from Phytopharmica is one of the very few in the 10X category. I generally recommend two or three tabs of it three times a day between meals.

Unripe papaya and pineapple are excellent plant sources of proteolytic enzymes. Papain is a proteolytic enzyme derived from the papaya plant, and bromelain contains a collection of the enzymes taken from pineapple juice and the stems of pineapples.

You can also get proteolytic enzymes from fresh foods, but enzymes in general are very sensitive to heat from cooking. When food is heated above 118 degrees Fahrenheit, most of the enzymes are destroyed. The enzyme content in fresh fruits and vegetables decreases as soon as they are harvested.

Proteolytic enzymes that are available in supplemental form generally will include trypsin, chymotrypsin, pepsin, rennin and pancreatin.

One of the newer proteolytic enzymes is serrapeptase. This powerful enzyme acts as an anti-inflammatory and pain reliever similar to aspirin. It has not been shown to cause ulcers or GI bleeding, as aspirin has.

Serrapeptase digests all nonliving tissue, including soft plaque in arteries, cysts, blood clots and even thickened mucus from chronic sinusitis. As well as being used to treat sprains, strains and tendinitis, it has been used to treat atherosclerosis, phlebitis, cysts (including fibrocystic breast disease), post-op swelling and autoimmune diseases.

The recommended dose of serrapeptase is 10 milligrams to 30 milligrams a day. It is important to take it on an empty stomach at least 30 minutes before meals or two hours after a meal. Ten milligrams is equivalent to 20,000 units.

Only a few companies currently are marketing serrapeptase. World Nutrition markets it as Vitalzym and Cardiovascular Research Ltd. as Serraflazyme. Both are excellent products.

Physicians commonly recommend or prescribe anti-inflammatory medications called NSAIDs for tendinitis. Some of these include aspirin, naproxen (Aleve), ibuprofen (Motrin, Advil), Vioxx and Celebrex.

These medications, however, can damage the GI tract and may cause ulcers or GI bleeding. Vioxx and Celebrex (known as Cox-II inhibitors) are less likely to cause bleeding compared with the other NSAIDs.

These drugs can also damage the liver or the kidneys. Each year about 75,000 people are hospitalized because of GI complications caused by NSAIDs. In fact, approximately 20,000 Americans die each year from using these medications.

I personally take proteolytic enzymes, and I use combinations of them to treat diseases associated with inflammation. I do not recommend them if you are pregnant, nursing, have hemophilia or have taken Coumadin, heparin or any other anticoagulants.

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