Как правильно принимать препарат Вобэнзим? (оптимальный курс приема Вобэнзима) Здравствуйте.
Лекарственный препарат следует принимать внутрь, не менее чем за 30 минут до еды, не разжёвывая, запивая водой. Продолжительность курса лечения определяется врачом в зависимости от заболевания.
Традиционно препарат назначают в минимальной терапевтической дозировке по 3 таблетки 3 раза в день курсом от 2-х до 5-ти недель. При средней активности заболевания препарат назначают в дозе 5 таблеток 3 раза в день, курсом от 2-х до 5-ти недель. При улучшении состояния пациента доза препарата со 2-й недели может быть снижена до 3 таблеток 3 раза в день. Для достижения долгосрочного эффекта рекомендуется проводить повторные курсы препарата 1,5-2 месяца с двухнедельным перерывом

Длительность лечения определяется врачом. При высокой активности заболевания препарат назначают в дозе 7 таблеток 3 раза в день, курс 2-3 недели. При улучшении состояния доза препарата может быть снижена со второй недели до 3 таблеток 3 раза в день с продолжением курса до 1,5 месяцев. Для достижения долгосрочного эффекта рекомендуется проводить повторные курсы препарата 1,5-2 месяца с двухнедельным перерывом. Количество курсов лечения определяется врачом. При хронических, часто рецидивирующих и длительно текущих заболеваниях препарат применяется по показаниям курсами от 3-х до 6-ти месяцев с перерывами 2-4 недели. Для достижения долгосрочного эффекта рекомендуется проводить повторные курсы препарата 1,5-2 месяца с двухнедельным перерывом. Количество курсов лечения определяется врачом. Для повышения эффективности антибиотиков и уменьшения выраженности нежелательных побочных эффектов антибиотиков препарат назначают на весь курс антибиотикотерапии в дозе по 5 таблеток 3 раза в день. При применении препарата с профилактической целью для снижения риска развития заболеваний, препарат рекомендуется применять по 2-3 таблетки 3 раза в день. Курс от 3-х недель до 1,5 месяцев с повторением 2—3 раза в год.

Специалистам | Вобэнзим

Научное издание		Показания	Схема лечения	Эффект
	Клинические рекомендации Российскоговобщества онкомаммологов под редакцией акад. РАЕН Семиглазова В.Ф. 2016 г.	Диффузная мастопатия	3-5 таблеток 3 раза в день. Курс в зависимости от активности заболевания	Фибринолитический, противоотечный, противовоспалительный и вторично-анальгезирующий.Уменьшение размеров кист,сокращение частоты рецидивов и оперативных вмешательств.
		Фиброзно-кистозная мастопатия
	Национальное руководство “Гинекология” под редакцией акад.РАМН Г.М. Савельевой, акад. Г.Т.Сухих, проф. И.Б.Манухина, 2013г.	Урогенитальный микоплазмоз, хламидиоз	3-5 таблеток 3 раза в день в течение 14 дней	Повышение эффективности антибактериальной терапии, противовоспалительный эффект, нормализация иммунопатологических нарушений, сокращение частоты рецидивов.
	Национальное клиническое руководство по гинекологии под редакцией В.И. Кулакова, Г.М. Савельевой, И.Б. Манухина, 2009 г.	Урогенитальный микоплазмоз, хламидиоз	3-5 таблеток 3 раза в день в течение 14 дней	Повышение эффективности антибактериальной терапии, противовоспалительный эффект, нормализация иммунного статуса, сокращение частоты рецидивов.
		Хронический сальпингоофорит	5 таблеток 3 раза в день не менее 2-3 недель
		Подготовка к операции	5 таблеток 3 раза в день — 14 суток до операции	Профилактика послеоперационных инфекционных осложнений, развития спаечных процессов
	Рациональная фармакотерапия в акушерстве и гинекологии под редакцией В.И. Кулакова, В.Н. Серова, 2005 г.	Инфекционные заболевания у беременных: бактериальный вагиноз, генитальный герпес, гонорея, сифилис, урогенитальный микоплазмоз, трихомониаз, хламидиоз, цитомегаловирусная инфекция	3-5 таблеток 3 раза в день 1 месяц.	Повышение эффективности антибактериальной терапии, противовоспалительный эффект, нормализация иммунопатологических нарушений, сокращение частоты рецидивов.
		Привычное невынашивание беременности инфекционного генеза, истмико-цервикальная недостаточность	3-5 таблеток 3 раза в день 2 недели
		Сальпингит и сальпингоорфорит	3-5 таблеток 3 раза в день до 3-6 месяцев.
		Доброкачественные опухоли и опухолевидные образования яичников	3 таблетки 3 раза в день 14 дней, далее 8 таблеток 3 раза в день 8 дней	Противовоспалительное, противоотечное и анальгезирующее действие
	Национальное руководство по акушерству под ред. Савельевой Г.М., Сухих Г.Т., 2018 г.	При образовании ретрохориальных и ретроплацентарных гематом	По 5 таблеток 3 раза в день, курс 14-28 дней	С целью ускорения регресса гематомы и снижения риска повышенного тромбообразования в маточно-плацентарном русле
		Гематомы мягких тканей родовых путей
	Национальное руководство по акушерству под редакцией Э.В. Айламазяна, В.И. Кулакова, Г.М. Савельевой, В.Е. Радзинского, 2009г.	Антифосфолипидный синдром	15 таблеток 3 раза в день, 6-8 недель во II и III триместрах	Снижение количества антител к кардиолипину и ЦИК в плаценте, снижение риска прерывания беременности, улучшение плацентарной функции
		Гематома мягких тканей родовых путей	3-5 таблеток 3 раза в день не менее 2-3 недель	Ускорение регресса гематомы
	Руководство для врачей акушеров-гинекологов, анестезиологов, неонатологов, Э.К. Айламазян, Е.В. Мозговая, 2008 г.	Гестоз	5 таблеток 3 раза в день, начиная с 20-й недели беременности не менее 2-3 недель. Необходимость повторного курса зависит от активности очагов инфекции в организме и частоты рецидивов.	Нормализация тромбоцитарного и коагуляционного гемостаза, улучшение плацентарного кровотока, сохранение беременности и повышение частоты благоприятных исходов родов для матери и плода.
	Формуляр лекарственных средств в акушерстве и гинекологии под редакцией профессора В.Е.Радзинского, 2013г.	Хронические воспалительные заболевания женских половых органов	3-5 таблеток в день, курсом от 2 до 5 нед.	Противовоспалительное, иммуномодулирующее, фибринолитическое, противоотёчное, антиагрегантное и вторично-анальгезирующее действие
	Монография для врачей акушеров-гинекологов “Послеродовая инфекция” под редакцией РАМН Г.Т. Сухих, 2012 г.	Послеродовая инфекция	3-5 таблеток 3 раза в день на весь период антимикробной терапии и далее по 3 таблетки 3 раза в день в течение 2 недель после окончания применения антибиотиков. С целью профилактики с 1-х суток после родов по 3-5 таблеток в день в течение 2 недель.	Повышение эффективности антибактериальной терапии, противовоспалительный эффект, иммуномодулирующее действие, сокращение частоты рецидивов.
	Монография для акушеров-гинекологов, урологов, терапевтов, неонатологов “Беременность и роды при заболеваниях мочевыводящих органов” под редакцией академика РАМН Г.Т.Сухих, 2009г.	Инфекции мочевых путей беременных родильниц	3-5 таблеток 3 раза в день в течение 30 дней.	Повышение эффективности антибактериальной терапии, снижение частоты, длительности и тяжести инфекционно-воспалительного процесса, иммуномодулирующее действие, снижение частоты развития плацентарной недостаточности и гестоза.
	Пособие для врачей акушеров-гинекологов под редакцией акад.РАМН Э.К. Айламазяна	Гестоз (преэклапсия)	5 таблеток 3 раза в день 2-3 недели	Нормализация тромбоцитарного и коагуляционного гемостаза, улучшение плацентарного кровотока, сохранение беременности с повышением частоты благоприятных исходов родов для матери и плода.
		Невынашивание беременности инфекционного генеза, на фоне АФС	5 таблеток 3 раза в день 2-3 недели. Повторение во II и III триместрах.	Снижение количества антител к кардиолипину и ЦИК в плаценте, снижение риска прерывания беременности, уменьшение клинических проявлений гестоза, улучшение плацентарной функции.
		Планирование беременности в случаях привычного аборта	5 таблеток 3 раза в день 3-4 недели.	Снижение риска прерывания беременности, нормализация иммунного статуса.
		Гестационный пиелонефрит	5 таблеток 3 раза в день 2-4 недели.	Повышение эффективности антибактериальной терапии, снижение частоты, длительности и тяжести инфекционно-воспалительного процесса, нормализация иммунного статуса, снижение частоты развития плацентарной недостаточности и гестоза.
		Послеродовые гнойно-септические осложнения	5-7 таблеток 3 раза в день 2-5 недель.	Повышение эффективности антибактериальной терапии, противовоспалительный эффект, нормализация иммунопатологических нарушений, сокращение частоты рецидивов.
		Оперативное родоразрешение	5 таблеток 3 раза в день 2-3 недели после операции	Профилактика послеоперационных инфекционных осложнений, развития спаечных процессов
	Пособие для врачей акушеров-гинекологов под редакцией акад.РАМН Э.К. Айламазяна	Острые и хронические воспалительные заболевания придатков матки	5-7 таблеток 3 раза в день 2-4 недели	Повышение эффективности антибактериальной терапии, противовоспалительные эффект, нормализация иммунопатологических нарушений, сокращение частоты рецидивов.
		Герпетическая инфекция	5-7 таблеток 3 раза в день 6-10 недель, 2-кратные повторные курсы	Противовоспалительное действие, улучшение иммунного статуса, профилактика инфекционных осложнений
		Трубно-перитонеальный фактор бесплодия (незначительная длительность процесса)	5-7 таблеток 3 раза в день 8-10 недель, 2-3 кратные повторные курсы	Иммуномодулирующий эффект ,улучшение кровотока в области половых органов, подготовка к выполнению вспомогательных репродуктивных технологий
		Мастопатия	7 таблеток 3 раза в день 8 недель. Повторные курсы (5 таблеток 3 раза в день 4 недели)	Уменьшение размеров кист, сокращение частоты рецидивово и оперативных вмешательств, противоотечное, противовоспалительное, иммуномодулирующее и анальгезирующее действие
		Пери-, постменопауза, ЗГТ	5 таблеток 3 раза в день 8-10 недель. Повторные курсы 2-3 раза в год.	Уменьшение болевого синдрома, ограничение спаечного процесса, иммуномодулирующий эффект.
		Эндометриоз	5 таблеток 3 раза в день 10-12 недель. Повторные курсы 2-3 раза в год.	Уменьшение болевого синдрома, ограничение спаечного процесса, иммуномодулирующий эффект
		Оперативное лечение гинекологических заболеваний	5 таблеток 3 раза в день 4-5 недель после операции	Профилактика послеоперационных инфекционных осложнений, развития спаечных процессов.
	Клинические рекомендации по акушерству и гинекологии, 2017 г.	При воспалительных заболеваниях органов малого таза (эндометрит, сальпингит, оофорит, тубовариальный абсцесс, пельвиоперитонит)	По 5 таблеток 3 раза в день, курс 14-28 дней	Противовоспалительное, иммуномодулирующее, фибринолитическое, противоотёчное, антиагрегантное и вторично-анальгезирующее действие
		При образовании ретрохориальных и ретроплацентарных гематом
		Хронический эндометрит
	Клинические протоколы (гинекология), Санкт-Петербург, 2018 г.	Хронический эндометрит	По 5 таблеток 3 раза в день, курс 14-28 дней	Противовоспалительное, иммуномодулирующее, фибринолитическое, противоотёчное, антиагрегантное и вторично-анальгезирующее действие
		Воспалительные заболевания придатков матки
		Миома матки

90000 Wobenzym N supplement health benefits, 200 and 800 tablets, side effects 90001 Wobenzym N supplement health benefits, 200 and 800 tablets, side effects 90002 Wobenzym enzyme use, safety, side effects and benefits, research studies 200 tablets and 800 tablets per bottle by Ray Sahelian, M.D. 90003 90004 September 15 2016 90005 Wobenzym N is the product name of a German preparation of several enzymes.Several decades of studies have been conducted with this enzyme formula, almost all in Europe or Russia. This page reviews the latest research with this nutritional supplement. How effective are these pills to treat inflammation and provide pain relief? 90006 90005 As of March 2016 no new human studies could be found. 90006 90005 90002 Benefits and uses 90003 90004 After reviewing some of the studies, it is still not completely clear to me what medical conditions most appropriately respond to this supplement.It appears this enzyme complex has benefit in having anti-inflammatory properties and perhaps may have a role in certain musculoskeletal disorders. It may also have some anti-coagulation properties. 90003 90002 90003 90004 90017 Dosage, how much to take: 90018 90003 Q. You recommend taking small amount when taking first dose. the manufacturer recommends taking 3 tablets twice a day l hour before meals. i have had 3 heart attacks and take Plavix and 81 mg aspirin to thin blood.Should i take l tablet twice a day before meals to start and then how should i graduate to 3 tabs 2 times per day. i noticed that my pulse was up steady all night. I do not want another heart attack. I also have high blood pressure and take meds for that. 90003 A. We can not make specific recommendations but as a general rule it is a good idea, particularly in those who have health problems or taking medicines, to take a low dose of a new supplement to see how the low dose affects the body before increasing it.If there are side effects even on the low dose, then there is no point in taking additional tablets. 90006 90005 90017 N Wobenzym side effects, adverse reactions 90003 90018 No major Wobenzym side effects have been reported in the medical literature. It is not clear how it would interact in those who are taking medicines to thin the blood. Discuss with your doctor before using it, particularly if you are taking prescription medicines. 90006 90027 90017 High Quality products formulated by a medical doctor 90018 90002 90003 90004 90017 90034 90018 90002 90037 90004 90002 90040 90004 90017 Mind Power Rx 90018 for better mental focus, concentration, and mood 90017 90003 Eyesight Rx 90018 for better vision, often within days 90017 90003 Joint Power Rx 90018 for healthy joints 90017 90003 Prostate Power Rx 90018 for a healthy prostate gland.90006 90005 90002 Research studies and benefit, medical conditions in which this product may be of benefit 90004 90006 90005 90002 Anti-inflammatory medication, naturally 90003 90004 The use of Wobenzym in the comprehensive treatment of patients with digital flexor tendon injury 90003 Klin Khir. 2000. 90003 The results of treatment of 56 patients with tendons of digital flexors were analyzed. In 28 of them in complex of treatment Wobenzim was included, and an early active mobilization as well.Considerable antiinflammatory, antioedematous, secondarily analgetic effect of preparation, its application in early period permitted to realize active movements, to reach high functional result of treatment of patients ‘were noted. 90006 90005 90002 A 90004 90002 therosclerosis influence 90003 90004 The effect of Wobenzym enzymes on the atherogenic potential and inflammatory factors at the rehabilitation stage for patients who have had a myocardial infarct 90003 Lik Sprava.2000. 90003 Effects were studied of wobenzyme on atherogenicity of blood serum and immunoinflammatory reactions in patients with myocardial infarction during the rehabilitation stage over six months. The basis therapy when supplemented with wobenzyme was found out to facilitate normalization of the atherogenic potential and to have a positive action on the mediators of the inflammatory process. 90006 90005 90002 Bronchitis treatment 90004 90003 Wobenzym in treatment of recurrent obstructive bronchitis in children.90003 Georgian Medical News. 2005. Tbilisi State Medical University; M. Guramishvili Pediatric Clinic, Tbilisi, Georgia. 90003 A total of 27 patients with recurrent obstructive bronchitis (at least 3 episodes of obstructive bronchitis per year) of 5-15 years of age were studied. Serum IgE level (by ELISA method) and pulmonary function indices were determined together with the full clinical examination. The systemic enzyme preparation Wobenzym was administered with a dosage of 1 tablet for 6 kg weight.Wobenzym was administered for 3 months. Analysis of the data, obtained after treatment, demonstrated decrease of the Daily Symptom Score and an increase of Symptom Free Days, as well as an improvement in spirometric indices (FVC, FEV, PEF). 90006 90005 90002 Exercise and physical activity 90003 90004 BMC Sports Sci Med Rehabil. 2014 Feb 22. The effects of oral hydrolytic enzymes and flavonoids on inflammatory markers and coagulation after marathon running: study protocol for a randomized, double-blind, placebo-controlled trial.Marathon running due to its strenuous and prolonged nature results in immune perturbations with a major increase in pro-inflammatory markers and subsequent increased incidence of upper respiratory tract infection URTI. Furthermore, marathon running results in muscle damage and changes in hemostasis that promote a pro-thrombotic state. Naturally occurring hydrolytic enzymes and flavonoids have antioxidant, anti-inflammatory and fibrinolytic effects, and may serve as countermeasures to exercise-induced inflammation, immune dysfunction and URTI.The aim of this study is to determine whether the ingestion of oral hydrolytic enzymes and flavonoids before and after a marathon attenuates post-race muscle damage and inflammation, counters pro-thrombotic changes in hemostasis and decreases URTI incidence. The Enzy-MagIC-study (Enzymes, Marathon runninG, Inflammation, Coagulation) is a randomized, double-blind, placebo-controlled, monocenter phase I trial. 160 healthy males (age 20-65 years) will be randomized to receive either placebo or treatment (Wobenzym, MUCOS Pharma, Berlin, Germany) which contains the hydrolytic enzymes (bromelain, trypsin) and the flavonoid rutoside.One week before the marathon race, participants will begin daily ingestion of the investigational product (3×4 tablets). Intake will be continued for two weeks after the race (3×2 tablets per day). Clinical and laboratory measures will be collected 5-weeks and 1-week before the race, and immediately-, 24-h, 72-h, and 2 weeks after the race. The primary endpoint is the influence of the treatment on the pre-to-post marathon race plasma concentration change of the inflammatory marker interleukin-6 (IL-6).Secondary endpoints include the effect of treatment on salivary IgA concentration and the frequency of upper respiratory tract infections (URTI) for two weeks post-marathon as determined by the Wisconsin Upper Respiratory Symptom Survey (WURSS-24). Furthermore, changes of muscular and rheological parameters will be measured before and after the marathon race. We hypothesize that marathon-induced inflammatory perturbations and the incidence of subsequent URTI, muscular damage, and changes of hemostasis can be positively influenced by the anti-edematous, anti-inflammatory, antioxidant, and fibrinolytic effects of oral hydrolytic enzymes and flavonoids Wobenzym.90006 90005 Glomerulonephritis benefit 90003 Antioxidant effect of wobenzym applied for patients with chronic glomerulonephritis 90003 Lik Sprava. 2007. 90003 There is formation of free radicals in mesangial cells in patients with chronic glomerulonephritis which increases destruction of renal tissue and enable autoimmune inflammation. The unbalance between activity of oxidizing and antioxidazing starts developing. It accelerates the progression of the disease.The article presents the assessment of influence of enzyme medication Wobenzym on main indices of oxidizing and antioxidant systems. It was established the presence of antioxidant effect in Wobenzym medication. 90006 90005 Lymphedema treatment 90003 Wobenzyme and diuretic therapy in lymphedema after breast operation 90003 Wien Med Wochenschr.1996. 90003 The authors of this clinical study report the results of a controlled clinical trial in randomized parallel groups (Wobenzym vs.diuretics) of 55 female patients suffering from brachial arm lymph edema subsequent to ablatio mammae. All patients received manual and machine lymph drainage as well as gymnastics as concomitant therapy. After 7 weeks of therapy the results of the volometric assessments of the arm, the circumference of the arm and the skinfold thickness showed significant improvements compared to diuretics. In addition, the patients receiving Wobenzym reported a significantly higher proportion of patients free of pain compared to the diuretics patients.Overall safety assessment results are satisfactory thus resulting in a superior benefit / risk relation of the Wobenzym group. 90003 Comments: Weight training the upper body is also helpful as a treatment for lymphedema after breast cancer surgery. 90006 90005 90002 N Wobenzym research — absorption and distribution 90004 90003 Intestinal resorption with 3H labeled enzyme mixture (wobenzyme) 90003 Acta Med Austriaca. 1979. 90003 Lhe labeled mixture of enzymes was absorbed from the intestine and was demonstrable in significant amounts in plasma, urine, heart, kidney, liver and skeletal muscle.90006 90005 90002 Side effects, safety, risk, danger 90004 90003 As of 2011 no major side effects have been reported in medical journals that I am aware of. 90006 90005 Wobenzym red 90003 Regarding the availability of Wobenzyme Red. As of May 2007 Naturally Vitamins stopped the manufacturing of Wobenzyme Red. The reason given is that coating the red tablets involves heat which could potentially damage the enzymes, and solvents which are environmentally unfriendly.The Wobenzyme Clear is the natural alternative. 90006 90005 Interaction with medications 90003 Do you have any information about the use of Wobenzym N while taking tamoxifen hormonal treatment? I took this enzyme complex for a month prior to surgery for tumor removal. 90003 Sorry, I have not come across any studies regarding the interactionwith tamoxifen. 90006 90005 90002 Questions 90004 90003 Some sources say that Wobenzym is good for arthritis because it markedly reduces the levels of tumor necrosis factor alpha, which is the agent that causes arthritic pain and swelling.Yet other sources say that it activates natural killer cells to produce more tumor necrosis factor alpha in order to help fight cancers. Which is it? It can not be both. 90003 I can not find any studies regarding its influence on natural killer cells. The human body has countless substances and chemicals, hormones, enzymes, that influence natural killer cell activity and influence arthritis and cancer. One should not focus on one blood chemical study result.Please send us a link regarding any studies that have evaluated the role of Wobenzym and natural killer cells in humans. 90006 90005 In conducting an on-line search for information I found your website. A reader sent in a question regarding Wobenzym affecting cancer cells. I am currently reading an on-line book by Lee Euler called «The Missing Ingredient for Good Health.» The entire book tells about the tremendous success with enzymes in relationship to curing (or at least improving) cancer.One product he recommends for curing cancer (as well as being an effective pain therapy) is Wobenzym. He also referenced Dr. Max Wolf. 90003 We prefer seeing actual clinical studies to determine the role of Wobenzym in treating cancer or cancer pain. 90006 90005 I wanted to know if wobenzym supplement would be effective in dealing with the spent phase of Polycythemia Vera. That would be where the red count is below normal, the platelet and other myloid series are very high, lymphoid series are fairly normal.This would include edemic lower legs, fibrotic lungs and no cardiac issues such as congestive heart failure. 90003 A search on Medline did not reveal any studies regarding the use of Wobenzym supplement and polycythemia vera. 90006 90005 Is there any danger for one to take digestive enzymes or Wobenzym while also on prednisone? And if not, how much should one take if they are trying to manage rheumatoid arthritis due to Lyme Disease? 90003 Prednisone is a powerful hormone and its potency depends on the dosage used.One has to be careful mixing prednisone with certain supplements due to unexpected side effects. Studies are lacking in terms of the interactions of digestive enzymes and Wobenzym supplements in conjunction with the use of prednisone. Your doctor would have to make the final decision regarding the potential benefits versus risks of these combinations in your particular case. 90006 90005 I want to buy Wobenzym supplement. I was recently in Germany and stopped at an «Apotheke» (Apothecary) to ask questions about this product.I was told by one of «Apotheker» who was very knowledgeable about Wobenzym supplements and other products and he told me that when taking the pills, you have to take a rest period of 3 months sometime after taking it. Have you heard about this? 90003 Each person is different in the required dosage of Wobenzym pills, how often to take it, and how often to take breaks. There is no rule that it has to be 3 months, but, as a general guideline, it is a good idea to take breaks from use.Much depends on the person taking the Wobenzym supplement, their overall health, and the reason the Wobenzym supplement is being used. 90006 90005 I am a doctor and have a practice in Prescott, Az. Do you find that you get better results from WobenZym N than the new VitalZym X? I am not liking what I see with regard to reduction of CRP levels. 90003 I have not used Vitalzym X, so I do not have an opinion about this enzyme supplement.90006 90005 I purchased a bottle of 800 Wobenzyme n and have just ran out. Reading an article i purchased serrapeptase. I have started taking that in place of Wobenzym N. Are these two items similar or same basic use. what is the real difference of the two. Was this product developed for one purpose and serrapeptase for another? 90003 These two enzymes are completely different. Serrapeptase is one form of enzyme whereas Wobenzym N is a combination of several enzymes.The web pages discuss the studies with each product. 90006 90005 How long does one have to take Wobenzym N to feel less pain? I started a month ago two tablets twice daily for 15 days and three tablets twice daily for 14 days. Am I impatient to feel results? I’ve had fibromyalgia for about 20 years and have pain wherever you touch me, as well as having Scoliosis and Lordosis diagnosed at 14 years old. I’m a 73 year old female, 5 feet eight inches tall work out three times a week, in comparable good health and take a lot of vitamins.I occasionally take Advil when I’m desperate. I’d appreciate your comments. 90003 It is not possible for us to predict or forecast whether a particular supplement will help a person, and if it does what the dosage would be and how it would take. Each person is unique in terms of their pain and pain threshold an response to medications or natural pills. 90006 90005 I just recently started taking Wobenzym-N for fibromyalgia and inflammation due to Sjogrens Syndrome.Ive had miraculous results so far. Most of my pain is gone, especially the headaches! And I used to take up to 10 Advil a day and STILL had a little pain. I feel like a new person. Well, I had 2 questions for you but they are somewhat related. I started on a smaller dose of the Wobenzym, but noticed I started to get diarrhea as I upped the dose gradually. I then started taking it with a small amount (15 mg) of Calcium citrate, or even iron, because that tends to constipate me, thinking it would offset the diarrhea.It seems to be alleviating the severity of the diarrhea somewhat. Are there any recommendations you can make other than taking calcium along with it, to reduce the risk of diarrhea (and gas)? Also, will taking other nutritional supplements along with Wobenzym-N (such as calcium, iron, probiotics, etc.) affect the absorption of Wobenzym? 90003 I have not seen studies regarding the absorption of this product when done so together with calcium, iron or probiotics, so I do not know.Psyllium is a fiber that can absorb a lot of water and may be used during a meal or at another time during the day to reduce diarrhea. 90006 90005 I am currently taking Neprinol. Can I take Wobenzym N with this product? 90003 Neprinol contains Systemic and Lipolytic Enzyme Blend: Serrapeptase, Nattokinase, Lipase: 15,000 FU Neprinol Protease Blend: Protease (derived from Serratia), B. subtillis and A. oryaze) Neprinol Enzyme and Cofactor Blend: (Alma, Papain, Bromelain, Rutin, Coenzyme Q10), Magnesium).It is not easy to give a clear answer since a physician has to know your whole medical history before determining which products, or combinations, are appropriate for your medical condition. 90006 90005 90017 I have Polymyalgia and have been on prednisone for 10 years. Every time i lower my dose and try to get off I sieze up and have unbearable pain so have to increase my dose again. The highest is only 10 mg a day but I find that I amstill in quite a bit of pain with that dose.I had a friend with polymyalgiaand she was able to get completely off her prednisone with Wobenzym. Here is my problem. I had a heart attack two years ago and am now on all these medications. I have two stents also. I want to take this product but I am scared. My doctor and my cardiologist both retired in June and I got anew doctor and am getting a new cardiologist. I feel alone and would appreciate if you have any information on this. 90003 A. I wish I could help but I have not seen any studies combining Wobenzym with prescription medications.90018 90006 90005 90017 Q. Where can I purchase Wobenzym? Is it the same as Intenzyme Forte? 90003 A. Biotics Researchs Intenzyme Forte contains proteolytic enzymes derived from both animal and plant sources. The major ingredients in Intenzyme Forte include: Pancreatin Bromelain, Papain, Trypsin and Alpha-Chymotrypsin. The ingredients are different than the former, which is sold online. 90018 90006 90005 March 2009 To: Wobenzym Retailers 90003 Mucos LLC, exclusive U.S. master distributor of Wobenzym N, has partnered with Net Enforcers to monitor the Internet in order to protect its brand equity and support its valued dealers. Mucos LLC sells Wobenzym N through authorized dealers. Mucos has unilaterally adopted a Retail Pricing Policy. Mucos reserves the right to unilaterally cease doing business with any reseller that does not follow this policy. If your company does not wish to become an Authorized Internet Dealer, Mucos LLC requests the removal of all Intellectual Property belonging to Mucos LLC.This property includes all copyrighted product images, copyrighted text, statements of offers of manufacturers warranty (fraud), display of trademarked client logos, and / or any other property belonging to Mucos LLC. Mucos LLC intends to resolve your use of Mucos LLCs intellectual property in the most positive way: by authorizing you to sell Mucos LLC products with the full use of Mucos LLC intellectual property; however, Mucos LLC reserves the right to enforce its intellectual property rights against any unauthorized dealer.Thank you for your consideration. 90006 90005 November 2009 90003 Wobenzym runs over Pharmacies 90003 Berlin — Only two weeks have pharmacists time, their holdings of the enzyme preparation Wobenzym N returned to the manufacturer. Because Mucos Pharma has withdrawn an application for reregistration, the goods must be up to 13 November 2009 disappear from the pharmacies. The product with the enzymes from the pancreas, pineapple, papaya and the flavonoid Rutoside to be withdrawn from the market.Faxed informed Mucos all pharmacies on the short-term returns initiated action. Simultaneously, the secondary product is advertised, that is since Monday on market: Under the name Wobenzym P Mucos Pharma now sells a product with bromelain, papain and Rutoside. Here too quick action is needed: Already in December Mucos wants to raise the price. Wobenzym is the most important product of the House: 80 percent of its revenue last around 70 million euros, the company makes with the enzyme preparation.A «broad and intensive television campaign in prime time «is to ensure that consumers remain brand loyal. In addition, the manufacturer distributes Wobenzym Phlogenzym the enzyme preparation and nutritional supplements Wobe Mucos. Approximately 100 employees work at the production site in Berlin and in the administration of the Bavarian Geretsried. After the death of longtime company owner Karl Ransberger Mucos was acquired two years ago by the Canadian company Atrium Innovations.PHARMA ADHOC, Wednesday, 04 November 2009. Wobenzym N is a combination of 5 different enzymes used for inflammation. Wobenzym PS (professional strength) is a combination of 3 enzymes in a higher concentration used specifically for arthritis. 90006 90005 90017 buy Wobenzym N 800 or 200 or 400 tablets 90003 90018 Buy wobenzym enteric coated tablets 200, 400, or 800 90006 90171 90172 90173 90017 Supplement Facts 90018 90176 90177 90172 90173 90017 Serving Size: 90018 3 Tablets 90176 90177 90172 90173 90017 Servings Per Container: 90018 133 90 176 90177 90172 90191 90176 90191 90017 Amount Per Serving: 90018 90176 90191 90017% Daily Value 90018 90176 90177 90172 90191 Pancreatin ** 56,000 USP units protease (pancreas) Sus scrofa 90176 90191 300 mg 90176 90191 90176 90177 90172 90191 Papain ** 492 FIP-units *** Carica papaya 90176 90191 180 mg 90176 90191 90176 90177 90172 90191 Bromelain ** 675 FIP-units Ananas comosus 90176 90191 135 mg 90176 90191 90176 90177 90172 90191 Trypsin ** 2160 FIP-units (pancreas) Sus scrofa and / or Bos taurus 90176 90191 72 mg 90176 90191 90176 90177 90172 90191 Chymotrypsin ** 900 FIP-units (pancreas) Bos taurus 90176 90191 3 mg 90176 90191 90176 90177 90172 90191 Rutoside trihydrate ** (Rutin) Sophora japonica 90176 90191 150 mg 90176 90191 90176 90177 90172 90173 ** From dried purified aqueous extracts.90003 *** FIP is the measurement of enzyme activity according to the methods of the International Pharmaceutical Federation. 90003 90176 90177 90256 90005 Supplement Facts: 90003 Each tablet has: 90003 Pancreatin 300 mg 90003 Papain 180 mg 90003 Bromelain 135 mg 90003 Trypsin 72 mg 90003 Chymotrypsin 3 mg 90003 Rutosid 150 mg 90002 90003 90004 90006 90005 90006 .90000 90001 Buy Wobenzym Home 90002 90003 90004 90005 90006 90007 90005 90007 90010 The Lowest Price • Expert Advice • Outstanding Support 90011 90012 Have questions? Our experts are here for you. 90013 90012 Phone 800-560-2943 • Email Us 90013 90012 Wobenzym Questions and Answers • Our Low Price Guarantee 90013 90018 Wobenzym is the authentic systemic enzyme formula trusted by millions worldwide to provide clinically demonstrated support for joint and inflammation health.The key benefits of Wobenzym N include: 90019 90020 Supports the Body’s Natural Inflammation Response 90021 90020 Increases Flexibility and Mobility 90021 90020 Supports Joint and Tendon Health 90021 90020 Temporary Relief from Aches, Pains and Muscle Soreness due to Everyday Activity 90021 90020 Clinical Studied Formula 90021 90030 90031 First introduced in Germany as a pharmaceutical over 40 years ago, Wobenzym N has been updated but still features the time-tested, synergistic combination of plant-based enzymes, pancreatic enzymes, and antioxidants.These powerful yet delicate enzymes are protected by a vegetable-based enteric coating which ensures optimal absorption and utilization in the bloodstream. 90032 90033 90034 For Healthy Joints 90032 90036 90032 90038 Study after study has proven that Wobenzym branded products help to maintain healthy joints on a daily basis, as well as to alleviate occasional symptoms associated with joint pain following physical stress or intense activity. * 90032 90031 If you experience joint pain, you know how frustrating it can be.It slows you down, interferes with your daily routine, keeps you away from your training. 90032 Maintaining healthy joints is crucial, prevention is key. Pain in one joint will force your body to compensate and shift its weight, ultimately putting stress on another. This can throw your whole body off kilter and lead to other joint issues. 90033 90043 For Everyday Aches and Pains 90044 Taken daily on an empty stomach, the systemic enzymes in Wobenzym provide temporary relief from everyday aches, pains and muscle soreness.* S we age, 90005 90007 many of us may experience aches and pains on a daily basis, and it may not always be from extensive training. It may be because we have a few more years on the calendar or spend long hours in front of a computer or in the garden. 90031 Taken daily on an empty stomach, the systemic enzymes in Wobenzym provide temporary relief from everyday aches, pains and muscle soreness. 90033 90031 Because we all want to stay active and mobile, now and for years to come. 90033 90018 90043 For Mobility & Flexibility 90044 Wobenzym helps maintain healthy joints after exertion and effort — and that means it also helps provide good mobility and flexibility.* 90032 When your joints and muscles are healthy, you have a greater range of motion, you’re a little lighter on your feet, and bending over to pick up a pencil is not such an ordeal. 90032 90032 Wobenzym contains a highly concentrated enzyme compound of natural origin that helps to balance the natural inflammation response. Substances known as cytokines are directly involved in the inflammation process. Some cytokines promote inflammation, while others inhibit it, and Wobenzym helps flush out excess cytokines so immune balance is restored.90018 90034 For Recovery 90036 Wobenzym helps to prevent the symptoms of sports injury and soreness in your muscles, ligaments, tendons, and joints after a vigorous workout or competition. * 90032 Wobenzym helps to prevent the symptoms of sports injury and soreness in your muscles, ligaments, tendons, and joints after a vigorous workout or competition. And the sooner the pain is gone, the sooner you’re back out there, taking on new challenges. 90031 When you push your physical limits, you probably feel soreness in your muscles.That is caused by micro tears in the muscles tissue. Wobenzym’s unique enzyme action supports the natural healing process and recovery. 90033 90063 90064 90065 90066 90005 Alex, 90007 90032 Fl. U.S.A. 90070 90003 90072 This product is a winner. It actually does reduce inflammation as advertised. I had heard of it from a friend who was very excited about it and since then I have heard from other people who have used it and all of the reviews are positive.Finally something that does what it says it does 90032 90070 90075 90076 90077 90063 90064 90065 90066 90005 Robert, 90007 90032 NJ 90070 90003 90072 I never review anything I purchase but other reviews always help with my decision making when I do purchase items. So here is my review of this product I have fibromyalgia thyroid problems adrenal fatigue and lived in constant pain. I have received botox injection to help with pain and spasms for almost 5 years until I started taking this product.I wake up pain free and without headaches I can not believe I do not need the botox injections anymore either. For me and I’ve read others get an upset stomach when taking it but the benefits I get far out way the small amount of stomach upset. Anyone who has inflammation problems should try this product to see for themselves. 90032 90070 90075 90076 90077 90031 90032 These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.90032 90018 90032 90033 90099 90065 90101 90102 90065 90003 Wobenzym, Wobenzym N, 400 Enteric-Coated Tablets Healthy Inflammation and Joint Support 90070 90106 90107 90070 90003 Wobenzym Plus Systemic Enzymes 240 Tablets 90070 90075 90065 90003 90114 90065 90003 90117 90070 90119 90120 90070 90075 90077 90070 90003 90114 90065 90003 90117 90070 90119 90120 90070 90075 90077 90070 90075 90065 90139 90070 90139 90070 90075 90065 90003 90019 90020 Increases Flexibility and Mobility 90021 90020 Supports Joint and Tendon Health 90021 90020 Temporary Relief from Aches, Pains and Muscle Soreness due to Everyday Activity 90021 90030 90070 90003 The most potent Wobenzym yet with its increased activity compared to Wobenzym N and the more convenient 4-tablet-a-day dose, which means fewer pills to consume than other Wobenzym formulations.90032 90019 90020 Increases Flexibility and Mobility 90021 90020 Supports Joint and Tendon Health 90021 90020 Temporary Relief from Aches, Pains and Muscle Soreness due to Everyday Activity 90021 90030 90070 90075 90065 90168 90107 90070 90075 90065 90003 Wobenzym, Wobenzym N, 200 Enteric-Coated Tablets Healthy Inflammation and Joint Support 90070 90106 90107 90070 90003 Wobenzym, Wobenzym N, 800 Enteric-Coated Tablets Healthy Inflammation and Joint Support 90070 90075 90065 90003 90114 90065 90003 90117 90070 90119 90120 90070 90075 90077 90070 90003 90114 90065 90003 90117 90070 90119 90120 90070 90075 90077 90070 90075 90065 90139 90070 90139 90070 90075 90065 90003 90019 90020 Increases Flexibility and Mobility 90021 90020 Supports Joint and Tendon Health 90021 90020 Temporary Relief from Aches, Pains and Muscle Soreness due to Everyday Activity 90032 90021 90030 90070 90003 90019 90020 Increases Flexibility and Mobility 90021 90020 Supports Joint and Tendon Health 90021 90020 Temporary Relief from Aches, Pains and Muscle Soreness due to Everyday Activity 90021 90030 90070 90075 90065 90168 90107 90070 90075 90065 90003 Wobenzym, Wobenzym N, 100 Enteric-Coated Tablets Healthy Inflammation and Joint Support 90070 90106 90107 90070 90003 Wobenzym Plus Systemic Enzymes 120 Tablets 90070 90075 90065 90003 90114 90065 90003 90117 90070 90119 90120 90070 90075 90077 90070 90003 90114 90065 90003 90117 90070 90119 90120 90070 90075 90077 90070 90075 90065 90139 90070 90139 90070 90075 90065 90003 90019 90020 Increases Flexibility and Mobility 90021 90020 Supports Joint and Tendon Health 90021 90020 Temporary Relief from Aches, Pains and Muscle Soreness due to Everyday Activity 90021 90030 90070 90003 The most potent Wobenzym yet with its increased activity compared to Wobenzym N and the more convenient 4-tablet-a-day dose, which means fewer pills to consume than other Wobenzym formulations.90032 90019 90020 Increases Flexibility and Mobility 90021 90020 Supports Joint and Tendon Health 90021 90020 Temporary Relief from Aches, Pains and Muscle Soreness due to Everyday Activity 90021 90030 90070 90075 90065 90168 90307 90070 90075 90077 90034 Bellow Featured Products 90036 90070 90075 90077 90070 90003 90070 90077.90000 Wobenzym N: A closer look at «systemic» enzyme therapy 90001 90002 90003 90002 One of the recurrent themes in alternative medicine is the practice of simplifying complex medical conditions, and then offering up equally simple solutions which are positioned as still being within the realm of science. This approach allows the practitioner to ignore all of the complexity and difficulty of practicing real medicine, yet offer nostrums that, on first glance, can sound legitimate. Science-y, even.90003 90002 I’ve discussed this before in non-science-based approaches to food intolerances, whether it’s using clinically useless IgG blood tests, or declaring the universal dietary enemy to be gluten. David Gorski elaborated on the same theme recently at Science-Based Medicine in the context of cancer treatment, contrasting the simplistic views of alternative medicine purveyors with the facts of cancer research. Cancer is stunningly complex — each of the hundreds of different variants of the disease.I’m always amazed when I speak with oncologists about how treatment regimens have been established. They describe how the results of dozens of clinical trials, led by different trial groups around the world have each contributed to establishing the current «best» regimens for each cancer: the appropriate drugs, doses, intervals and treatment intensities. Good evidence speaks all languages, and as new data emerges, practices change quickly to build upon whatever new evidence has emerged. The complexity of treatments continue to increase.Overlay the genetic and genomic complexity David described, and you get a sense of the challenges (and opportunities) cancer researchers face in order for science continue to improve outcomes for patients with cancer. 90003 90002 So it’s a bit of a shock when you shift your attention to the alternative medicine «literature», where simple solutions abound. One that’s popular among patients I speak with, particularly those with European backgrounds, is the use of what are called systemic enzymes — enzymes, consumed orally, with the intent of whole-body effects.These products are not used as part of «conventional» medicine but are popular supplements recommended by alternative practitioners. I was recently asked about a product called 90009 Wobenzym N 90010, a product with German roots which is advertised with the following claims [PDF]: 90003 90012 90002 Taking Wobenzym®N as directed will assist several of your body’s key systems. This product supports the musculoskeletal system by promoting health and mobility in joints and muscles, and has been used for many decades.Wobenzym®N supports the circulatory system by promoting vein health. This product also supports the respiratory system and sinus health. Wobenzym®N is used by many people in the support of a balanced immune system and assists in promoting healthy aging. Wobenzym® is safe and effective and has been used by over 100 million people for over 40 years all around the world. 90003 90015 90002 Vague and non-specific claims, and there’s the Quack Miranda warning there, too. But what does Wobenzym N actually 90017 do 90018? Other sites promoting its use go much further in their treatment statements, describing use for conditions ranging from Alzheimer’s and angina to multiple sclerosis, prostatitis, respiratory infections and right through the alphabet to uveitis.Some mention utility in treating cancer. What ties all of these disparate conditions together? There is, as is popular in alternative medicine, One True Cause of All Disease. When you’re using systemic enzymes, the OTCOAD is is inflammation. 90003 90002 90017 90009 Rubor, calor, dolor, tumor 90010 90018 90003 90002 Inflammation is our body’s response to infection and injury and is part of the healing process. Diseases with an inflammatory component are common, and have a huge health impact — think of asthma, arthritis, and inflammatory bowel disease, all common, chronic illnesses affecting millions.Low grade inflammation associated with obesity may be the trigger of a number of obesity-related complications. But «inflammation» does not come in one form. There are multiple mediators, such as cytokines and ecosanoids. There’s a wide variety of cellular responses. As Peter Lipson at Science-Based Medicine has observed: 90003 90012 Inflammation is a medical term that refers to a host of complex physiologic processes mediated by the immune system. Inflammation gets its ancient name from the obvious physical signs of inflammation: 90017 rubor, calor, dolor, tumor 90018, or redness, heat, pain, and swelling.As the vitalistic ancient medical beliefs bowed to modern science, inflammation was recognized to be far more complex than just these four external characteristics. In addition to being a response to injury and disease, the cellular and chemical responses of inflammation can cause disease. For example, in asthma and food allergies, a type of immune reaction called type I hypersensitivity elicits a harmful type of inflammation. Coronary heart disease, the biggest killer of Americans, is believed to have a significant inflammatory component.90015 90002 While there can be inflammatory components to many different diseases, it is a gross oversimplification to think that we can treat all forms in the same way, until there’s evidence to show that’s the case. Asthma and arthritis both have inflammatory elements, but they are different diseases with different treatments. But simplify the conditions to just be «inflammation» and you can introduce an equally simple solution. That solution? Systemic enzyme therapy: 90003 90012 90002 Wobenzym®N works by providing «systemic enzyme support,» which describes a process that uses enzymes to assist the body’s various regulatory and communication systems, specifically the immune system.† A balanced immune system is necessary for maintaining overall health. Active enzyme molecules must be readily available in the small intestine to make sure that the systemic effect of the enzymes is achieved. 90003 90002 Enzymes play a critical role in the body and are involved in an astounding number of metabolic processes. Scientists suspect there may be as many as 15,000 enzymes at work in our bodies on a daily basis. Enzymes are involved in a variety of bodily processes including: breathing, growing, digesting, producing energy, conducting nerve impulses, clotting blood, recovering after exercise, or balancing the complex processes of the immune system.90003 90015 90002 Enzyme supplementation can be science-based. Its use in pancreatic disease is common, as well as diseases like cystic fibrosis. But those are not uses where the enzymes need to be absorbed from the gastrointestinal tract. Systemic enzyme replacement is something different. 90003 90002 I first encountered the idea of ​​massive enzyme superdoses when I learned about the Gonzalez regimen, an alternative cancer treatment regimen discussed at length over at Science-Based Medicine.The treatment includes coffee enemas and hundreds of tablets of pancreatic digestive enzymes daily. The regimen itself was based around the speculation of cancer causes which have now been definitively disproved. A clinical trial of the Gonzalez regimen was funded by the National Center for Complementary and Alternative Medicine (NCCAM), which included a large number of pancreatic enzymes. The results of the trial were remarkable, but not in a positive way for the «alternative» approach: Conventional chemotherapy treatment for pancreatic cancer was three times better than the Gonzalez regimen.90003 90002 Our pancreas secretes enzymes to help in digesting food. Should we expect that consumed enzymes will be absorbed into the body? Enzymes are large proteins that act as catalysts for biochemical reactions throughout the body — many chemical transformations are catalyzed by an enzyme. Many parameters can affect enzyme activity, including pH and temperature, and the presence of activators and inhibitors. Given the importance of enzymes in the body, genetic disorders that affect enzyme production and function can have catastrophic consequences.We’d also expect that the production and distribution of enzymes in the body would be fairly tightly controlled, given the potential effects, and given the food we eat will have its own share of naturally-occurring enzymes in it, too. 90003 90002 The use of proteins as therapeutic agents to influence disease is one of significant research interest. The challenge in introducing proteins into the body is that most are quickly eliminated from circulation, whether it’s by biotransformation by enzymes or renal filtration.Very large doses may be required, increasing the potential for non-specific toxicity and even allergic reactions. The most common therapeutic uses of proteins is by injection, because large chemical molecules are generally either destroyed by our endogenous digestive enzymes or, if they survive, can not cross membranes into the bloodstream. 90003 90002 So the concept of giving enzymes orally, and achieve meaningful therapeutic effects in the body, is one with a considerable number of drug design hurdles.Is that occuring? Looking at Wobenzym N, each enteric coated tablet contains: 90003 90050 90051 Bromelain 45mg 90052 90051 Chymotrypsin 1 mg 90052 90051 Pancreatin 100 mg 90052 90051 Papain 60 mg 90052 90051 Rutin 50mg 90052 90051 Trypsin 24mg 90052 90063 90002 The recommended dosage is 3 tablets, twice daily, 45 minutes before meals. Before digging into the clinical data, I wanted to better understand the formulation and the dosing, keeping the design and administration issues in mind.90003 90002 90009 ADME 90010 90003 90002 Every summary of a drug’s characteristics (the «monograph») will have the same section. It’s abbreviated ADME which stands for Absorption, Distribution, Metabolism and Elimination. This is the section where behaviour of the the chemical in the body is summarized. This is not the clinical section, describing the therapeutic effects. It’s simply characterizing how extensively and how quickly the drug is absorbed from the gastrointestinal tract, where it distributes in the body (the «volume of distribution») how and if it is broken down or «biotransformed» to make it easier to eliminate, and how quickly it is eliminated from the body.(I described this process in more detail in a previous post on generic drugs.) I want to see this graph, or be presented with enough data to understand what it looks like. 90003 90072 90002 Plasma level curve for a drug 90003 90002 It’s the basic pharmacology work that’s done on a drug that gives us the information to understand its characteristics in the body. There is no point in doing clinical trials of a chemical packaged as a tablet, if we can not confirm that the active ingredient is actually absorbed when it’s consumed.Clinical trials 90017 follow 90018 the basic pharmacology work. If the drug is treating different conditions, we may need to study different doses to establish the MEC for each condition. (For example, you need to take a lot more of an anti-inflammatory drug to treat rheumatoid arthritis than you need to treat a headache). 90003 90002 This is the study of pharmacokinetics, and it allows us to determine how the drug should be dosed and delivered in the body. Is it slowly eliminated, so the dosing can be infrequent — daily or even weekly? Is it rapidly eliminated from the body, meaning we need to dose multiple times a day to stay in the sweet spot of the therapeutic range? How is it eliminated from the body? Is it transformed by the liver? What impact does changing the dose have on the elimination of the product? What dose ranging studies have been done on the product that have established the appropriate dose? And how does that dose change, depending on the condition being treated? 90003 90002 My reason for belaboring this points is that understanding the ADME is essential to using drugs, supplements, or chemicals of any kind in a rational way.With herbs, it’s the difference between herbalism and pharmacognosy. Without knowing the ADME, the dosing of any product is empirical — a shot in the dark. Coming back to Wobenzym N, we have a combination product with six different ingredients. The dosing instructions are very specific: 3 enteric coated tablets, twice daily, 45 minutes before meals. It’s the same for all of the different reasons for use described. But why this dose? Why 3 tablets? Why twice daily? What happens if you take more, or less? Different ingredients typically have their own physicochemical characteristics.What effects does each have? I looked at each ingredient first in the Natural Medicines Comprehensive Database (NMCD), and then in the primary literature itself. Here’s what I could find: 90003 90050 90051 90009 Bromelain 90010 is a term used for a collection of enzymes isolated from pineapple. While it’s rated by NMCD as «possibly effective» for osteoarthritis, the data are contradictory with some studies suggesting it has no effect on osteoarthritis. It has not been well demonstrated that bromelain reaches any clincially meaningful concentration in the blood.These are large protein molecules and it’s not clear how effectively they are absorbed — doses of 3000mg / day seem to result in tiny, albeit measurable, blood levels. Blood plasma components may inactivate any bromelain that is absorbed, though a half-life has been described [PDF]. On balance, the data are not impressive. 90052 90051 90009 Chymotrypsin 90010 is a protein-digesting enzyme that is synthesized and secreted by the pancreas. I could locate no published efficacy of supplemental single ingredient chymotrypsin for any condition.It’s not clear what a supplemental dose of a few milligrams would have. I could not locate any information that characterizes its ADME. 90091 90009 Pancreatin 90010 is a mix of digestive enzymes including lipase, protease, and amylase, is used as prescription drug to treat pancreatic insufficiency, in conditions like cystic fibrosis. High doses have been linked to increases in blood / urine uric acid levels. There is no well-established use of oral pancreatin for anything other than pancreatic inefficiency.Again, little information exists to describe the ADME. 90091 90009 Papain 90010 is a papaya-derived combination of enzymes. I could find a single study (in German) which compared oral supplements favourably to acyclovir for herpes zoster pain. Given the limited info in the abstract, it’s not possible to evaluate the data more fully. Little data exists to characterize the ADME. 90091 90009 Rutin 90010 is a flavenoid rated as «possibly effective» for osteoarthritis on the basis of a single double-blind trial of an enzyme product (bromelain, trypsin, and rutin) versus diclofenac.Rutin does not seem to be absorbed intact, through it appears to elevate plasma levels of quercetin, and seems to have an effect on the absorption of other drugs. Again, little information exists to understand the pharmacokinetics. 90052 90051 90009 Trypsin 90010 is another enzyme produced in the pancrease for digestion of proteins. Beyond the trial with rutin, I could locate no published trials evaluating efficacy for any other condition. Limited information exists to describe the ADME. 90052 90063 90002 As I noted, getting large proteins like enzymes to be absorbed is a drug design challenge.Even if absorbed, how large molecules would escape rapid metabolism and elimination is not clear, either. With the ingredients in Wobenzym N, there appears to be some data to suggest that some components do reach the bloodstream. And there are some studies with the individual ingredients — but nothing that unequivocally establishes a meaningful effect. With that in mind, I looked for studies using the Wobenzym combination of ingredients. 90003 90002 90009 The studies 90010 90003 90002 I stared a review with the Natural Medicines Comprehensive Database (NMCD).Regarding Wobenzym N, it says, in part: 90003 90012 90002 Wobenzym N is promoted for reducing inflammation and edema, and speeding recovery from certain injuries. Often it is used by individuals with arthritis and by athletes, including some professional and Olympic athletes. Enzymes in this product are thought to activate macrophages that attack inflammation-causing circulating immune complexes. Rutoside, an additional ingredient, acts as an antioxidant. To date there is no convincing clinical evidence that Wobenzym is effective for these uses.Because these enzymes do not affect prostaglandin synthesis, Wobenzym N is also promoted to be free of many of the side effects associated with non-steroidal anti-inflammatory drugs (NSAIDS). Adverse reactions reported after oral administration include loose stools, increased gas, and skin reactions. 90003 90015 90002 NMCD cautions that there is also potential for the product to affect blood coagulation. 90003 90002 Are there clinical trials with Wobenzym? Yes, but few are in English, which complicates the review.I could locate no evaluable trials in PubMed, but other websites list trials in conditions such as pelvic inflammatory disease, cancer, and multiple sclerosis. Some therapeutic improvements have been attributed to the consumption of Wobenzym (e.g., diabetes, post-heart attack) but the studies are preliminary, sometimes unblinded, and do not appear to be duplicated. One of the few English papers appeared in Medical Hypotheses, not a good sign for someone seeking science-based medicine. There’s an uncontrolled trial in bronchitis in children, in a study published in Russian.Other studies are published in Czech, Ukranian, Latvian, and Russian. One German systematic review declared «oral proteolytic enzyme treatment does not offer a justified alternative in comparison with NSAID in the anti-inflammatory treatment of rheumatic disease.» Overall, no large clinical trials with relevant clinical outcomes, and no persuasive evidence to demonstrate clinically meaningful effects for any single condition it is used to treat. On balance, the safety profile of the product seems acceptable, but it’s not clear how extensively safety data was captured in these small trials.90003 90002 There are several trials with a similar product, Phlogenzym (rutoside, bromelain and trypsin). One did not suggest impressive results for ankle strains. A trial studying the same combination for hip osteoarthritis suggests non-inferiority with diclofenac, and an open-label trial for osteoarthritis of the knee found non-inferiority as well. I even found a small trial declaring it effective for treating pediatric sepsis, which left me curious if there are research ethics boards in India.90003 90002 There is also the interesting case of the enzyme serrapeptase, also sold as an anti-inflammatory. Sold by the pharmaceutical company Takeda since 1968 for asthma, bronchitis, and touted as an enzyme anti-inflammatory for a large number of other uses, it was withdrawn from the Japanese market in 2011, after double-blind trials concluded that it had no therapeutic effects. 90003 90002 On balance, looking at the data for systematic enzymes, I was not impressed. Despite the generalized claims of effectiveness, there are so many limitations in the data itself it’s not clear we can infer that the treatment effects are real.And given the lack of data on the absorption, distribution, metabolism and elimination of Wobenzym, it’s not clear that this product is even absorbed to a meaningful extent and available in the body to have systemic effects. Without any objective measure to evaluate efficacy, it’s not clear that supplementation will have any meaningful therapeutic effects for any condition, chronic or otherwise. You may feel better when you take it, but there’s no persuasive evidence yet that it’s having a meaningful effect.90003 90002 90009 This rock keeps tigers away 90010 90003 90002 It would be an amazing discovery — Nobel worthy — if there were an oral therapy with demonstrably beneficial effects on a variety of chronic diseases without evidence of toxicity. Even demonstrating that large protein molecules can be consumed orally and be delivered in significant amounts to the bloodstream would be notable. Unfortunately, neither have been convincingly demonstrated with Wobenzym or other «systemic» enzyme treatments.Science is complicated, and simple solutions may be attractive, but they’re also quite possibly wrong. Given the weak clinical and pharmacokinetic data for this product, I expect that, should more research be done, it will follow the same evidence trajectory of many other supplements with an implausible premise: As the research studies improve in size and methodologic rigor, the treatment effects will disappear. Until better evidence appears to demonstrate the efficacy and safety of systemic enzyme therapy, their use can not be considered science-based.90003 90002 90003 90136 Like this: 90137 90002 Like Loading … 90003 90002 90136 90017 Related 90018 90137 90003.