On April 19, 1995 life in Oklahoma City changed forever. In an instant the front half of the nine-story Murrah Federal Building was reduced to a pile of rubble. Ragged structural fragments dangled from sections of the building that remained standing. In the days that followed I, like many in the area, drove to the site to view the damage firsthand. It is a scene I shall never forget.

A visit to the location today is quite different than in the days following the blast. The debris is gone. In its place stand empty chairs on a grassy hill overlooking a reflecting pond. It is a serene oasis in the midst of the city, a place where healing can take place.

The transition from chaos to beauty did not take place overnight, nor was it the result of chance. The transition was facilitated by clean-up crews that removed the rubble piece by piece until the site was clear and prepared for renovation. Without the work of the clean-up crews restoration of the site could not have taken place.

The Murrah Bombing and the more recent Trade Center attacks are examples of what is taking place within our bodies on an ongoing basis. As long as we are alive the sequence of damage, clean-up, and restoration never ends. It is estimated that each of our cells is attacked by a free-radical 10,000 times a day. It is also said that a cancer, a blood clot, and an arterial plaque begins to form every second of our lives. Injury is an unavoidable reality of life. Inflammatory debris appears whenever an injury occurs. Without clean-up crews this debris would accumulate within the body and healing could not take place. Were it not for the presence of efficient clean-up crews within our bodies we would die in a relatively short period of time.

The body’s clean-up workers are called enzymes. Technically, an enzyme is a substance that initiates a chemical reaction or enables the reaction to proceed more efficiently than would normally be the case. Enzymes are essential to nearly all body processes. Over 10,000 different enzymes have been identified and registered to date. They play a major role in the digestion of our food, break down toxic substances to facilitate their elimination from the body, aid in the building of new cells and tissues, and direct the conversion of stored fat and glycogen to useful energy.

Enzymatic action can be readily observed by placing a freshly picked piece of fruit on a kitchen counter and simply leaving it there. Within a few days the fruit will begin to rot. This is the result of naturally occurring enzymes within the fruit digesting the pulp to release the seed inside.

Enzymes are very sensitive to heat, however. If a piece of freshly picked fruit is heated before it is set on the counter it will never rot. It may mold over time, but it will not decay, since the enzymes it contained have been destroyed. This is why cooked foods are more likely to trigger indigestion than raw ones. Raw foods contain active enzymes to help the body’s digestive processes.

Digestive enzymes may be taken with meals to augment the body’s production of them. Some digestive enzymes include protease, which directs the digestion of protein, amylase, which is needed for carbohydrate digestion, and lipase than facilitates the digestion of fat.

Enzymes that are involved in processes other than food digestion are referred to as systemic enzymes. Many enzymes have multiple roles within the body. The same enzymes that are involved in digestion also act to break down substances throughout the body. Therefore a diet that contains a high percentage of cooked foods can deplete the body’s enzymatic reserves and diminish its ability to perform other tasks essential to health.

As a physician, I was taught that enzymes could not be supplemented. Many physicians still believe that oral enzyme supplements cannot be used effectively. The thought is that the enzyme molecules will be broken down before being absorbed, making the supplements worthless. This has been shown to be incorrect. Enzymes are absorbed and go to work cleaning up debris and performing other tasks within the body when taken orally.

Much of the initial research of systemic enzymes was done in Europe. During the 1960s and 1970s East German athletes dominated world competitions. East German sports scientists were highly advanced in creating training regimens. They were the first to use anabolic steroids for strength enhancement. This practice is now known to be dangerous and has been banned in nearly all sports, major league baseball in the United States being a notable exception.

While the East German’s use of steroids received a great deal of coverage, one of their greatest advances, the use of safe and legal systemic enzymes did not. It was not until the mid 1990s, long after the fall of the Berlin wall, that an East German official explained that a great deal of the country’s athletic success had been due to the use of systemic enzymes, which they had purchased through middlemen in various European cities.

Without the use of systemic enzymes, the anabolic steroid administration would not have been successful. Each time an athlete trains tendons, ligaments, and joints are traumatized to a degree. These daily microtraumas make the athlete more susceptible to major sprains, strains, and similar injuries.

The East German trainers discovered that relatively low quantities of systemic enzymes were capable of protecting athletes from the effects of microtrauma and that higher amounts could significantly shorten the amount of time needed for recovery from major injuries. In addition, they had found that the regular use of systemic enzymes during training enhanced muscle development, strength, and endurance.

Hundreds of published studies have now documented the effectiveness of systemic enzymes in reducing inflammation, swelling and internal bleeding associated with athletic injuries. A 1996 report on Ukrainian athletes typifies the results. Thirty-one members of the Ukraine soccer and karate teams suffered severe sprains or strains. Half of them were given systemic enzyme supplements. The others received aggressive medical treatment including compresses, heparin, non-steroidal anti-inflammatory drugs, physical therapy, novocaine and hydrocortisone.

The athletes given systemic enzymes reported significant pain relief within two days and returned to training three and a half weeks post injury. The group given medical treatment did not report pain relief for seven to nine days and did not resume training for six weeks. I have observed similar results in recommending systemic enzyme supplementation to people who have consulted me with injuries ranging from severe sprains to large contusions (bruises).

Systemic enzymes work so effectively in helping the body resolve injuries because they significantly reduce the associated inflammation. They “clean up the debris” so that optimum healing can take place. Their effectiveness in reducing inflammation makes them effective in a wide variety of situations.

Itis is a medical suffix that means inflammation. Any word that ends in itis refers to an inflammation of the entity described. For example, arthro means joint. When the suffix itis is added the word becomes arthritis, which means joint inflammation.

The number of disease states in which itis is a major factor is nearly endless. We speak of colitis (colon inflammation), cystitis (bladder inflammation), laryngitis (voice box inflammation), tendonitis (tendon inflammation), pancreatitis (pancreas inflammation) and the list goes on.

Systemic enzymes are beneficial in any condition that involves inflammation; they are applicable to any malady that ends in itis. Given the amount of pain and suffering associated with inflammatory conditions, this is good news indeed.

I wrote last month about the challenge of iatrogenic illness – injury or death due to adverse effects of medical diagnostic procedures and treatments. NSAIDs, non-steroidal anti-inflammatory drugs, are one of the leading causes of iatrogenic disease. As the name implies, they are the standard medical treatment for conditions associated with inflammation.

Numerous studies have demonstrated that systemic enzymes work as effectively, often more effectively, than NSAIDs in relieving the pain and inflammation associated with arthritis. Unlike NSAIDs, however, systemic enzymes are not associated with significant side effects, and no deaths have resulted from their use. While the American Journal of Medicine reported in 1997 that 16,500 people in the United States die each year from properly prescribed and administered NSAIDs, in 1992 the German Health Service reported 1.4 million prescriptions of systemic enzyme preparations without a single severe adverse effect.

Some conditions that do not end in itis can also benefit from the use of systemic enzymes. The most notable is atherosclerosis, hardening of the arteries, which leads to heart disease, stroke, and other circulatory challenges. Chronic inflammation is now recognized as one of the causes of atherosclerosis in general and heart disease in particular. Elevated levels of C-Reactive Protein, a non-specific indicator of inflammation, are known to represent an increased heart attack risk.

Systemic enzymes effectively counter chronic inflammation and lower levels of C-Reactive Protein. In doing so they may significantly lower heart attack risk.

Systemic enzymes must be taken on an empty stomach to be effective. They will go to work cleaning up the first debris they encounter, which, if taken at mealtime, will be the food in your stomach. I recommend that systemic enzyme supplements be taken at least one hour before or two hours after eating. I also suggest drinking at least eight ounces of water with the enzymes to facilitate their passage through the stomach.

Two to four tablets or capsules twice daily are adequate to control chronic inflammation and to allow the body to repair the microtrauma associated with physical exercise. Six tablets or capsules three times daily is often sufficient to bring resolution of injuries or to bring improvement in conditions such as arthritis. As many as ten tablets or capsules four times daily have been used for management of severe injuries and major inflammatory conditions.

A change in color, consistency, and odor of stools occurs occasionally, but these effects are harmless. A few individuals have reported nausea or diarrhea, conditions that resolved by lowering the dosage or distributing it into numerous doses throughout the day.

It is recommended that individuals with a blood-clotting disturbance avoid systemic enzymes. People who are taking blood thinners such as Coumadin or platelet drugs such as aspirin should monitor their situation closely when introducing systemic enzyme supplements as the medication dosage may need to be lowered. Enzyme supplements should be discontinued 48 hours prior to major surgery, but they may be started immediately following the procedure and can significantly decrease post-operative pain and accelerate the healing process.

Systemic enzymes are remarkably safe and effective in helping the body respond to inflammation. We are learning that they also play a role in modulating the body’s immune response. As such they should be a part of every family’s emergency chest and used liberally when injuries occur or inflammatory conditions arise. They are another way to optimize the body’s intrinsic healing mechanisms and bring about health by design.