Pain Management Using Systemic Enzyme Therapy

 In Pain Medicine

Tina Marcantel, RN, NMD

Pain is one of the most common and challenging complaints doctors are called upon to treat. Most patients present with some type of chronic pain from a long-term illness such as fibromyalgia, diabetes or rheumatoid arthritis; back injuries; or many may also complain of acute pain from sports injuries or trauma. In my practice I have found that the use of systemic enzyme therapy (usually used in conjunction with other therapies such as acupuncture) can at times be an effective natural alternative to pharmaceuticals for controlling pain, promoting healing and boosting the immune system.

Research has shown that inflammation is usually a component of pain. By reducing inflammation in the affected area, pain is often alleviated. Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen used for this purpose are known to have ill effects on the liver, kidneys, stomach and intestines. The use of proteolytic enzymes offers a healthier alternative.

Systemic Enzymes

When referring to enzymatic supplements, it is important to distinguish between their use as digestive aids vs. systemic aids. Digestive enzymes are taken orally with meals to help break down food for improved digestion. When taken orally between meals, systemic enzymes can break down proteins in the body that cause inflammation and scar tissue.

The timing of the medication is a crucial component of its success: The medication must be taken one hour or more before or after eating to obtain its full systemic effectiveness to reduce inflammation and pain. This allows the enzymes to be absorbed in substantial enough quantities into the bloodstream to promote the desired effects.

Inflammation is the primary cause of pain in arthritis, sciatica, chronic back pain and sports injuries like muscle sprains.

Proteolytic enzymes also speed healing and increase the body’s defense mechanisms by modulating the immune system. Another benefit is that they help maintain blood circulation throughout the body.

Two important ingredients that may be included in systemic enzyme blends are bromelain and papain. Bromelain is a protease derived from the pineapple plant, and its actions help to prevent swelling and edema, promote smooth muscle relaxation, inhibit platelet aggregation and enhance antibiotic absorption. Papain, derived from the Carica papaya, is effective for the reduction of edema, inflammation and cytotoxin binding. It is also noted for acceleration of wound healing.

As with any type of medication or supplement, systemic enzyme therapy should be monitored by a physician and assessed regularly for changes in appropriate dosages. The physician and patient should also be aware of any potential interactions among various medications being taken.

Tina Marcantel, RN, NMD practices in Gilbert, Ariz. She worked in Louisiana, Texas and Arizona as a registered nurse before graduating from SCNM in 2003. Her experience includes diabetes and weight management, women’s health, bioidentical hormone therapy, detoxification and pain management. Dr. Marcantel’s articles and interviews have appeared in Lifestyle and Woman’s World magazines and on numerous websites. She maintains an extensive health-related website at


Transformation Enzyme Corporation: Transformation Professional Protocol, 2004.

Case Study

Mary is a 34-year-old woman who first presented to my office in 2007. Her chief complaint was warmth, redness and swelling of the joints of the hands, fingers and feet for the previous six months. Four months before seeing me, she had been diagnosed with rheumatoid arthritis by a rheumatologist. She had been taking NSAIDs such as aspirin and ibuprofen for approximately five months. She was taking two aspirin tablets (325mg/tab) QID but was recently advised to increase the dosage for sufficient pain relief. She was also told by her doctor that she would be placed on stronger drugs for pain in the future. Mary was looking for an alternative therapy for pain relief and inflammation.

I started Mary on systemic proteolytic enzymes administered orally, two caps TID, one to two hours away from meals. She remained on this dose for approximately three weeks, then reduced the enzymes to one cap BID-TID for a maintenance dose to control pain and inflammation.

In conjunction with enzyme therapy, I scheduled Mary for ten weeks of acupuncture for pain control (one treatment/week). We also performed a food sensitivity panel and eliminated those foods that may have contributed to the inflammation.


Mary reported that she no longer used aspirin or ibuprofen regularly. She only needed NSAIDs approximately two doses/week, instead of her previous four doses QD. Pain and swelling of the joints had decreased by 70%.

I did not see Mary in my office until six months later. She had been on the maintenance dosage of systemic enzymes, taking one cap BID since I last saw her, but her pain was slowly starting to increase. I told her to begin again, taking two caps TID x ten days, then return to the maintenance dose. Four weeks after this visit I had a telephone conference with her, and she reported improvement with a 70%-80% decrease in pain and swelling.

Another reported benefit for Mary from the systemic enzymes was relief from chronic sinusitis due to seasonal allergies. My patient was both relieved and pleasantly surprised by this unexpected benefit of treatment for her arthritis.

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