Pancreatin 4X

Pancreatin 4X

Pancreatin


Supplement	Pancreatin

Description	The term “proteolytic” is a catch-all term referring to enzymes that digest protein. Supplemental forms can incorporate any of a wide variety of enzymes including Trypsin, Chymotrypsin, Pancreatin, Bromelain, Papain, and a range of fungal proteases. In the body, proteolytic digestive enzymes are produced in the pancreas, but supplemental forms of enzymes may come from fungal or bacterial sources, extraction from the pancreas o livestock animals (trypsin/chymotrypsin) or extraction from plants (such as Papain from the papaya and Bromelain from pineapples). The primary uses of proteolytic enzymes in dietary supplements are as digestive enzymes, anti-inflammatory agents and pain relievers.

Claims	Speeds recovery from sports and other minor injuries Aids digestion / Reduces flatulence Anti-inflammatory Reduces pain/stiffness of arthritis

Theory	It is quite logical that proteolytic enzymes would help alleviate a sub-optimal production of the body’s own digestives enzymes (which can occur in various pancreatic conditions). As such, supplemental enzymes can help alleviate gastrointestinal complaints such as gas/bloating, diarrhea, and cramps associated with inefficient/incomplete digestion. There is also some evidence that a small percentage of supplemental enzymes may be absorbed intact (and active) into the systemic circulation, where they appear to have anti-inflammatory and pain relieving actions that can be of benefit to athletes recovering from exercise/injury and to patients recovering from surgery.

Scientific Support	There are a number of clinical trials showing the benefit of using oral proteolytic enzymes as a digestive aid. Proteolytic enzymes are also theorized to help reduce symptoms of food allergies and as a treatment for rheumatoid arthritis and other autoimmune diseases (which are thought by some alternative medicine practitioners to be caused by whole proteins from foods leaking into the blood and causing an immune reaction – sometimes called “leaky gut”). Unfortunately, there is not a great deal of scientific evidence, either from laboratory or clinical studies, to support the use of enzymes fro treating allergies or auto-immune conditions Perhaps the strongest evidence for benefits of proteolytic enzyme supplements come from numerous European studies showing various enzyme blends to be effective in accelerating recovery from exercise and injury in sportsmen as well as tissue repair in patients following surgery. In one study of footballers suffering from ankle injuries, proteolytic enzyme supplements accelerated healing and got players back on the field about 50% faster than athletes assigned to receive a placebo tablet. A handful of other small trials in athletes have shown enzymes can help reduce inflammation, speed healing of bruises and other tissue injuries (including fractures) and reduce overall recovery time when compared to athletes taking a placebo. In patients recovering from facial and various reconstructive surgery, treatment with proteolytic enzymes significantly reduced swelling, bruising and stiffness compared to placebo groups. In one double-blind study, the pain relieving effects of an enzyme blend (Wobenzym) was compared to a common analgesic drug (Diclofenac) in 80 patients suffering from osteoarthritis of the knee. The study lasted 2 months with a 28-day treatment period followed by a treatment-free period of another 28 days. Ain measurements (at rest, on motion, on walking, and at night) showed a significant improvement after treatment in both groups, with a tendency to relapse in the treatment-free period. Of particular interest, was the finding of no significant difference between the treatment-groups – meaning that the enzyme blend was just as effective as the drug in relieving the pain/stiffness or arthritis. Similar findings have been reported for other painful/inflammatory conditions including carpal tunnel syndrome, fibromyalgia, facial bruising, ankle sprains, muscle soreness and others.

Safety	Proteolytic enzymes are generally considered to be quite safe, although mild gastrointestinal side effects (heartburn) may result in some individuals. Those individuals at risk for gastric or duodenal ulcers may want to avoid enzyme supplements which may aggravate ulcerated tissues. In addition, because proteolytic enzyme supplements also tend to produce a modest anti-coagulant (“blood-thinning”) effect, they should probably not be used in conjunction with warfarin or other blood thinning agents.

Value	The scientific evidence supports the use of proteolytic enzyme supplements for enhancing digestive function and for speeding recovery from injury/surgery and reducing swelling/bruising. The benefits in autoimmune diseases and food allergies is less substantial and awaits further study. As such, the moderate price of most proteolytic enzyme supplements ($10-$30/month) would appear to represent a good value for athletes wishing to enhance recovery from exercise/injury and for patients recovering from surgery. Because the vast majority of clinical evidence supporting the use of proteolytic enzymes has been collected on the Wobenzym brand from Mucos Pharma, it is advisable to make Wobenzym your first choice in an enzyme supplement.

Dosage	The dosage or “strength” of an enzyme supplement is typically expressed in “activity units” that refer to the enzymes ability to digest a certain amount of protein. Because the same milligram amount of a particular enzyme may have different activity units based on its processing and blending, it may be advisable to select an enzyme supplement that employs a combination of enzymes with activity at different pH levels. Also, look for a brand that is “enteric coated” – meaning that the formulation is protected from digestion in the stomach for optimal delivery of the enzymes to the intestines where they can perform their actions.

References	1. Adamek J, Prausova J, Wald M. Enzyme therapy in the treatment of lymphedema in the arm after breast carcinoma surgery. Rozhl Chir. 1997 Apr;76(4):203-4. 2. Buck JE, Phillips N. Trial of Chymoral in professional footballers. Br J Clin Pract. 1970 Sep;24(9):375-7. 3. Craig RP. The quantitative evaluation of the use of oral proteolytic enzymes in the treatment of sprained ankles. Injury. 1975 May;6(4):313-6. 4. Desser L, Rehberger A, Kokron E, Paukovits W. Cytokine synthesis in human peripheral blood mononuclear cells after oral administration of polyenzyme preparations. Oncology. 1993 Nov-Dec;50(6):403-7. 5. Duskova M, Wald M. Orally administered proteases in aesthetic surgery. Aesthetic Plast Surg. 1999 Jan-Feb;23(1):41-4. 6. Fisher JD, Weeks RL, Curry WM, Hrinda ME, Rosen LL. Effects of an oral enzyme preparation, Chymoral, upon serum proteins associated with injury (acute phase reactants) in man. J Med. 1974;5(5):258-73. 7. France LH. Treatment of injuries with orally administered Varidase as compared to Chymoral and Tanderil. Praxis. 1968 May 14;57(19):683-5. 8. Gal P, Tecl F, Skotakova J, Mach V. Systemic enzyme therapy in the treatment of supracondylar fractures of the humerus in children. Rozhl Chir. 1998 Dec;77(12):574-6. 9. Gubareva AA. The use of enzymes in treating patients with malignant lymphoma with a large tumor mass. Lik Sprava. 1998 Aug;(6):141-3. 10. Hingorani K. Oral enzyme therapy in severe back pain. Br J Clin Pract. 1968 May 5;22(5):209-10. 11. Hoernecke R, Doenicke A. Perioperative enzyme therapy. A significant supplement to postoperative pain therapy? Anaesthesist. 1993 Dec;42(12):856-61. 12. Kolomoiets MIu, Shorikov IeI. The effect of the preparation Wobenzym on the antioxidant protection indices and on the functional-morphological properties of the erythrocytes in a toxic lesion of the liver. Lik Sprava. 1999 Jul;(5):124-8. 13. Korpan MI, Korpan NN, Chekman IS, Fialka V. The pharmacological action of wobenzym on blood coagulability. Lik Sprava. 1997 Jul-Aug;(4):70-2. 14. Kullich W, Schwann H. Circulating immune complexes and complement fragment iC3b in chronic polyarthritis during 12 months therapy with oral enzymes in comparison with oral gold. Wien Med Wochenschr. 1992;142(22):493-7. 15. Lie KK, Larsen RD, Posch JL. Therapeutic value of oral proteolytic enzymes following hand surgery. Arch Surg. 1969 Jan;98(1):103-4. 16. Love JW. The effect of orally administered proteolytic enzymes on the postoperative course of periodontal surgery. J Periodontol. 1968 Nov;39(6):337-40. 17. Martynenko AV. Wobenzym in the combined pathogenetic therapy of chronic urethrogenic prostatitis. Lik Sprava. 1998 Aug;(6):118-20. 18. McCue FC 3d, Webster TM, Gieck J. Clinical effects of proteolytic enzymes after reconstructive hand surgery. A double-blind evaluation of oral trypsin-chymotrypsin. Int Surg. 1972 Jun;57(6):479-82. 19. Neverov VA, Klimov AV. The pathogenetic basis for and clinical use of systemic enzyme therapy in traumatology and orthopedics. Vestn Khir Im I I Grek. 1999;158(1):41-4. 20. Rammer E, Friedrich F. Enzyme therapy in treatment of mastopathy. A randomized double-blind clinical study. Wien Klin Wochenschr. 1996;108(6):180-3. 21. Rathgeber WF. The use of proteolytic enzymes (chymoral) in sporting injuries. S Afr Med J. 1971 Feb 13;45(7):181-3. 22. Sakalova A, Kunze R, Holomanova D, Hapalova J, Chorvath B, Mistrik M, Sedlak J. Density of adhesive proteins after oral administration of proteolytic enzymes in multiple myeloma. Vnitr Lek. 1995 Dec;41(12):822-6. 23. Salisbury RE, Hunter JM. Evaluation of oral trypsin-chymotrypsin for prevention of swelling after hand surgery. Plast Reconstr Surg. 1972 Feb;49(2):171-5. 24. Sarkisov KR, Protasevich AI. On the use of proteolytic enzymes in the treatment of fractures of the manidble by extraoral supporting ligaments. Vestn Khir Im I I Grek. 1966 Apr;96(4):91-3. 25. Schwinger O. Results of oral enzyme therapy in wounds of muscles, tendons and bones after accidents. Wien Med Wochenschr. 1970 Sep 5;120(36):603-5. 26. Shaw PC. The use of a trypsin-chymotrypsin formulation in fractures of the hand. Br J Clin Pract. 1969 Jan 1;23(1):25-6. 27. Singer F, Oberleitner H. Drug therapy of activated arthrosis. On the effectiveness of an enzyme mixture versus diclofenac. Wien Med Wochenschr. 1996;146(3):55-8. 28. Steffen C, Menzel J, Smolen J. Intestinal resorption with 3H labeled enzyme mixture. Acta Med Austriaca. 1979;6(1):13-8. 29. Steffen C, Menzel J. Basic studies on enzyme therapy of immune complex diseases. Wien Klin Wochenschr. 1985 Apr 12;97(8):376-85. 30. Steffen C, Smolen J, Miehlke K, Horger I, Menzel J. Enzyme therapy in comparison with immune complex determinations in chronic polyarthritis. Z Rheumatol. 1985 Mar-Apr;44(2):51-6. 31. Strafun SS, Tovmasian VV. The use of vobenzym in the comprehensive treatment of patients with digital flexor tendon injury. Klin Khir. 2000;(4):39-40. 32. Suzdal'nitskii RS, Levando VA, Emel'ianov BA, Sokolov IaA. The adaptational properties and immunoregulatory action of a preparation of proteolytic enzymes in experimental stress. Zh Mikrobiol Epidemiol Immunobiol. 1999 Sep-Oct;(5):103-6. 33. Tilscher H, Keusch R, Neumann K. Results of a double-blind, randomized comparative study of Wobenzym-placebo in patients with cervical syndrome. Wien Med Wochenschr. 1996;146(5):91-5.

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