Serrapeptase supplement by Ray Sahelian, M.D. Serrapeptase Information

Serrapeptase or Serratiopeptidase, an enzyme isolated from a microorganism in silkworm, is widely used in clinical practice in Japan. Until more is known about the long term benefit and side effects of serrapeptase, we recommend limiting daily dose to 20,000 units.

Serrapeptase 20,000 units 
60 Tablets ( SerratioPeptidase )
Enteric Coated - pH Resistant
Developed by Dr. Ray Sahelian, M.D.
Manufactured by a FDA approved and GMP certified facility.

The silkworm has serrapeptase (also known as Serratio Peptidase or serratiopeptidase), a proteolytic enzyme. This enteric coated serrapeptase product is of the highest quality available. It is manufactured by a FDA approved facility. You can be sure you are getting exactly what you pay for.

Serrapeptase or serratiopeptidase, isolated from the microorganism Serratia E15,  is naturally present in the silkworm intestine which allows the emerging moth to dissolve its cocoon. Clinical use of serrapeptase in Europe and Asia spans over twenty five years.

Serrapeptase Supplement Facts
Serrapeptase - 200mg*
     SerratioPeptidase (20,000 units enteric coated granules -  120,000 units per gram)

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Sign up to a FREE Supplement Research Update newsletter. Twice a month you will receive an email with a review of several studies on various supplements and natural medicine topics, including serrapeptase research, and their practical interpretation by Ray Sahelian, M.D.

Suggested use: The label says one or two serrapeptase once or twice a day, but we suggest you limit your use to one serrapeptase tablet daily until more research is available. Do not exceed 5 tablets a week until more research is published with serrapeptase. We don't suggest using 40,000 units since the benefits and risks on this high dose are not clearly understood. Discuss with your doctor regarding the use of serrapeptase before self-medicating.

* Serratiopeptidase daily value not established.

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Serrapeptase comment by Dr. Sahelian
Serrapeptase appears to be a supplement with some clinical potential, however much more research is needed before we determine what clinical role this enzyme has in medicine. In the meantime, only use serrapeptase under medical supervision until more studies determine the full spectrum of serrapeptase side effects and benefits.

Conditions where serrapeptase has been studied
Chronic airway lung disease
Chronic ear, nose or throat disorders
Carpal tunnel syndrome
Serrapeptase has even been studied in certain cases of edema after an operation or injury.

Serrapeptase side effects - caution
A review of the medical literature indicates rare cases of pneumonitis or allergic skin reactions with the use of serrapeptase. As with any supplement or medicine, rare cases of other side effects are possible. Over the past 3 years we have had four individuals who have mentioned side effects, and these were minor aches and pains after taking serrapeptase daily for a few weeks. For this reason, we suggest limiting to one serrapeptase tablet a day and taking at least 2 days off each week until we find out whether these cases were just coincidence or true side effects from serrapeptase.

Serrapeptase for chronic lung disease and mucus
Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease.
Respirology. 2003 Sep;8(3):316-20.
The proteolytic enzyme serrapeptase is widely used in clinical practice in Japan. We investigated the effect of serrapeptase on sputum properties and symptoms in patients with chronic airway diseases. This study was an open-labeled trial with a non-treatment control group. Patients were randomly assigned to oral treatment and without serrapeptase 30 mg/day for 4 weeks. Patients collected sputum samples for about 4 hours in the morning on the day the trial began and 4 weeks later. Part of each sputum sample was weighed and then completely dried and reweighed. The percentage solid component, viscosity and elasticity of the sputum were measured. Mucociliary transportability index was measured using ciliated bovine trachea ex vivo. After 4 weeks of serrapeptase treatment, sputum weight in the morning, percentage solid component, viscosity and elasticity of sputum, sputum neutrophil count, frequency of coughing and frequency of expectoration significantly decreased. Serrapeptase may exert a beneficial effect on mucus clearance by reducing neutrophil numbers and altering the viscoelasticity of sputum in patients with chronic airway diseases.

Serrapeptase or Serratiopeptidase research update
The effect of proteolytic enzyme serratiopeptidase in the treatment of experimental implant-related infection.
J Bone Joint Surg Am. 2006 June. Animal Research Laboratory, Marmara University School of Medicine, Istanbul, Turkey.
Infection around an implanted orthopedic device is a devastating complication, and the treatment of infections involving slime-forming bacteria is especially difficult. The purpose of the present study was to evaluate the effectiveness of a proteolytic enzyme, serratiopeptidase, in the eradication of a periprosthetic infection in an in vivo animal model. In sixty Sprague-Dawley rats, the medullary canal of the right femur was drilled through the intercondylar notch and was inoculated with a Staphylococcus epidermidis strain with a high slime-producing capacity. The cavity was filled with polymethylmethacrylate cement, and a Kirschner wire that had contact with the knee joint was inserted. None of the animals received any treatment for two weeks. One group received serratiopeptidase enzyme injections into the knee joint in addition to antibiotic therapy for four weeks, and the other group received intra-articular saline solution injections together with the same antibiotic therapy. Serratiopeptidase was effective for eradicating infection caused by biofilm-forming bacteria in this experimental animal model. The antibiofilm property of the enzyme may enhance antibiotic efficacy in the treatment of staphylococcal infections.

A preliminary trial of serratiopeptidase in patients with carpal tunnel syndrome.
J Assoc Physicians India. 1999 Dec;47(12):1170-2.
This study was planned to assess the response of serratiopeptidase ( serrapeptase ) in patients with carpal tunnel syndrome. Twenty patients with carpal tunnel syndrome were evaluated clinically. After baseline electrophysiological studies, these patients were given serrapeptase 10 mg twice daily with initial short course of nimesulide. Clinical and electrophysiological reassessment was done after 6 weeks. Sixty five percent of serrapeptase cases showed significant clinical improvement which was supported by improvement in electrophysiological parameters. Recurrence was reported in four cases. No significant side effect was observed. Serrapeptase therapy may proved to be a useful alternative mode of conservative treatment. Larger study may be further helpful to establish the role of serrapeptase in carpal tunnel syndrome. Serratiopeptidase therapy.

Intestinal absorption of serrapeptase in rats.
Biotechnol Appl Biochem. 1994 Aug;20 ( Pt 1):101-8.
A sensitive sandwich enzyme immunoassay for serrapeptase, an orally available anti-inflammatory proteinase, was established. Serrapeptase in the plasma was determined after its oral administration (100 mg/kg) to rats. The peak concentration was observed between 30 min and 2 h after administration. These results indicate that orally administered serrapeptase was absorbed from the intestinal tract and transferred into the circulation in an enzymically active form.

Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo.
University of Naples, Italy.
J Int Med Res. 1990 Sep-Oct;18(5):379-88.
The efficacy and tolerability of serrapeptase were evaluated in a multicentre, double-blind, placebo-controlled study of 193 subjects suffering from acute or chronic ear, nose or throat disorders. Treatment lasted 7-8 days, with the drug or placebo being administered at a rate of two tablets three times a day. After 3-4 days' treatment, significant symptom regression was observed in serrapeptase treated patients. There was also a significant reduction in symptoms after 7-8 days for patients in both treatment groups but the response was more marked in those patients receiving the active drug. Statistical comparison between the two groups confirmed the greater efficacy and rapid action of the serrapeptase against all the symptoms examined at both stages. Tolerance was found to be very good and similar for both groups. It is concluded that serrapeptase  has anti-inflammatory, anti-edemic and fibrinolytic activity and acts rapidly on localized inflammation. Serratiopeptidase is anti-inflammatory.

A case of pneumonitis due to serrapeptase
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Oct;27(10):1231-6.
A case of pneumonitis due to serrapeptase is described. A 69-year-old man was treated with serrapeptase for 16 days because of common cold, then fever, nonproductive cough and dyspnea developed and chest X-ray revealed diffuse fine granular shadows in bilateral lung fields. Once the administration of serrapeptase was halted, symptoms, chest X-ray abnormalities and laboratory data improved markedly. The fraction of lymphocytes increased in bronchoalveolar lavage fluid and OKT4/T8 decreased. Microscopic examination of transbronchial lung biopsy showed interstitial pneumonia. Both leukocyte migration inhibition test and sensitized hemagglutination test were positive for serrapeptase. Based on these findings, we diagnosed this case as serrapeptase -induced pneumonitis.

The treatment of breast engorgement with Serrapeptase (Danzen): a randomised double-blind controlled trial.
Singapore Med J. 1989 Feb;30(1):48-54.
We evaluated an anti-inflammatory enzyme drug Danzen ( Serrapeptase : Takeda Chemical Industries ) on 70 patients complaining of breast engorgement. Serrapeptase was noted to be superior to placebo for improvement of breast pain, breast swelling and induration and while 85.7% of the patients receiving serrapeptase had "Moderate to Marked" improvement, only 60% of the patients receiving placebo had a similar degree of improvement. "Marked" improvement was found in 22% of the treatment group and 3% of the placebo group. These differences were statistically significant. No adverse reactions were reported with the use of serrapeptase. Serrapeptase is a safe and effective method for the treatment of breast engorgement.

A case of serratiopeptidase-induced subepidermal bullous dermatosis.
Br J Dermatol. 1999 Dec;141(6):1139-40. No abstract available.

Reduction of postoperative swelling. Objective measurement of swelling of the upper ankle joint in treatment with serrapeptase -- a prospective study
Fortschr Med. 1989 Feb 10;107(4):67-8, 71-2.
Using a quantitative standardized procedure, the swelling of the ankle produced by supination trauma was measured. In the 66 patients with fresh rupture of the lateral ligament treated surgically at our Department between December 1986 and April 1987, a prospective study of the effect of serrapeptase (Aniflazym) on post-operative swelling and pain was carried out in 3 randomized groups of patients. In the group receiving serrapeptase, the swelling had decreased by 50% on the third post-operative day, while in the other two control groups (elevation of the leg, bed rest, with and without the application of ice) no reduction in swelling had occurred at that time. Decreasing pain correlated for the most part with the reduction in swelling. Thus, the patients receiving the test substance more rapidly became pain-free than did the control groups. On the basis of these results, serrapeptase would appear to be an effective preparation for the post-operative reduction of swelling, in comparison with the classical conservative measures, for example, the application of ice.

The effect of an orally administered proteolytic enzyme on the elasticity and viscosity of nasal mucus.
Arch Otorhinolaryngol. 1988;244(6):355-9.
We have evaluated the effect of serrapeptase, a proteolytic enzyme, on the elasticity and viscosity of the nasal mucus in adult patients with chronic sinusitis. Serrapeptase was administered in a dose of 30 mg/day orally for 4 weeks. Nasal mucus was collected from the nasal cavities of each patient before and 4 weeks after the start of the medication. Serrapeptase reduced the viscosity but not the elasticity of the nasal mucus. Serratiopeptidase and mucus.

A multi-centre, double-blind study of Serratiopeptidase versus placebo in post-antrotomy buccal swelling.
Pharmatherapeutica. 1984;3(8):526-30.
A multi-centre, double-blind, placebo-controlled trial was carried out to investigate the clinical efficacy of the anti-inflammatory enzyme serratiopeptidase in a total of 174 patients who underwent Caldwell-Luc antrotomy for chronic empyema. Eighty-eight patients received 10 mg serratiopeptidase 3 times on the day before operation, once on the night of the operation and 3 times daily for 5 days after operation; the other 86 received placebo. Changes in buccal swelling after operation were observed as a parameter of the response to treatment. The degree of swelling in the serratiopeptidase treated patients was significantly less than that in the placebo-treated patients at every point of observation after operation up to the 5th day. Maximal swelling throughout all the post-operative points of observation was also significantly smaller in size in the sSerratiopeptidase treated group than in the placebo-treated group. No side-effects were reported.

Serrapeptase emails and questions
Q. Can serrapeptase cause adverse reactions when taking meds for high blood pressure such as Norvasc and Avapro? Because my mom takes those and they really afflict her badly. And what is the ideal serrapeptase dosage for me to take serrapeptase for chronic sinusitis. I've had that all my life. I need relief and not drugs.
   A. We personally do not have enough experience with this nutrient to have an answer to these questions. Serrapeptase has been used in Japan but very little in the US so we really don't know much about the ideal dosage or what conditions it is likely to benefit, or how serrapeptase interacts with medicines.

Q. My father has found benefit using serrapeptase for his leg claudication. He can now walk twice as far, but still not much, about 400m, but he is 81! There is mention of serrapeptase breaking down plaque. If the effect of that is to clear the arteries, wouldn't you expect it to reduce blood pressure?
   A. This is a good questions but I prefer to wait for a serrapeptase studies are done regarding its influence on blood pressure before going out on a limb and making a statement that may turn out not to be accurate.

Q. I began taking Serrapeptase, 15 mg [30,000 IU] from a company other than Physician Formulas, one a day, approximately 2.5 months ago. I am taking no prescription drugs, but am taking various vitamin and herbal supplements. There were no apparent side effects but nor did I notice any noticeable change in my general wellbeing. My brief history: I have been diagnosed with GERD which had its onset 3 years ago after a 2-day bout with food poisoning. Because I did not want to remain on Nexium 40 mg/day for the rest of my life, I changed my diet and began researching vitamin and herbal supplements to replace the foods I could no longer tolerate. The only other conditions I had/have were:
Very mild elevated B/P - corrected
Very mild hypothyroid - supplemented with Thyroforce
Very mild elevated cholesteol - treated with increase in exercise and barely any fat in diet.
Mild osteoarthritis which, like the GERD, flares up and wanes with changes in the weather. Flares not only result in more GERD symptoms but, when severe, feel like flu - achy all over.
     I added the serrapeptase supplement because local promotions said it would improve digestion, clean plaque out of arteries, etc. Although I did not make any association at first, for the past month or so I began to have increasing pain in leg muscles and knee / ankle joints. Muscles became really tight and this progressed to the point where I could hardly walk and stairs were almost impossible. Spider veins worsened in number. I had physiotherapy which did not afford much improvement and the only thing that helped was a hot shower and massage with A535 liniment. I could not figure out what was going on until I sat down and made notes about chronology. What was startling was that symptoms began to improve dramatically during the past three days, which coincided with the fact that I had run out of serrapeptase and had not been able to go to my usual natural nutrition store for a new supply. Working back the chronology, there it was - the problem had commenced shortly after starting the serrapeptase. I have looked at the data available online and there seems to be no reference to similar side effects....so it's over to you. Is this possible? Obviously, there are other things I could mention, but I don't want to make this any longer than it is already. If you could throw any light on this situation, it would be much appreciated.
   A. Thank you for your email, it is quite interesting. This is the first report we have had regarding a possible link of serrapeptase to these kinds of symptoms. It is difficult to say whether they are related or coincidence, but it is certainly should no be discounted. Serrapeptase has not been used in this country for prolonged periods and hence we do not know the short term and longer term serrapeptase side effects as well as we do for other vitamins and herbs. As a rule, we often recommend taking breaks from supplements, and this is one of the reasons we do so. Perhaps the dosage of the serrapeptase was too high for you, the serrapeptase that Physician Formulas sells is 20,000 units. Or perhaps it interacted negatively with the other herbs or supplements you are taking, or perhaps this particular serrapeptase product was contaminated with a toxin. You may wish to contact the manufacturer directly. Please keep us updated.

Follow Up Serrapeptase side effect ?
     Q. it has been many weeks since we discussed my experience with side effects possibly due to my use of serrapeptase, discontinued at the time I first wrote to you. Eight days ago, I restarted the product taking a single, 30,000 IU capsule of serrapeptase. This time, because I am prone to very early waking, I used that to good effect by taking the capsule on waking and then nothing else for at least an hour. I did that following receipt of the results of my annual check-up - all clear as a bell - BP, ECG, Thyroid, cholesterol, BUN, glucose all within normal limits, although BP is higher at age 71 than it was when I was in my fifties. The three 'conditions' that remain symptomatic are the intermittent episodes of right-sided cramping pain which present like gallstones - not confirmed on ultrasound and blood tests. The other two are GERD - which I now keep under control with diet, Tums and the occasional Pariet - and osteoarthritis, which is painful or not largely in response to the weather and which is deforming some finger-joints and causing pain and 'catching' in the left knee. For the first few days, I had no adverse side-effects at all. Then, with gradually-increasing intensity, I began to experience increased swelling and discomfort in most joints - hands, knees and feet. Walking became extremely uncomfortable, just as it did previously. In short, the condition I most hoped to improve appears to be worsened by taking the product. I have not taken serrapeptase this morning and, unfortunately, it looks as though I'm out of luck in the future. That's really too bad, as it sounded so promising.

Q. I tried serrapeptase swallowed as a pill and did not notice much effect on me. Then I tried it under the tongue, and so far I have very good results. I have noticed a sharp decline in my post-op inflammation. It is impossible to tell if this is a direct result of serapeptase or the result of being almost six weeks recovered from back surgery. Please note that using this serrapeptase product of yours under the tongue is like chewing sandpaper. If it proves to be beneficial you may want to reformulate it in such a way to be gentler to tender tissue.
   A. This is an interesting way to use serrapeptase. We have no idea if it works better under the tongue or how safe it is to take serrapeptase this way.

Q. I just received my order of serrapeptase and was wondering if serrapeptase is something you take every day, or for a certain amount of time and take some time off and then take again. i am just concerned about toxic effects from serrapeptase taking everyday?
   A. Since little human research with serrapeptase is available in the West, it is preferable to take breaks from use until we learn more about the full clinical effects and side effect profile of serrapeptase. At this time we don't have full knowledge of potential serrapeptase allergic reactions, side effects, cautions or dangers, and how it interacts with medicines and other supplements. We also don't have a full understanding of which medical conditions serrapeptase is most effective for. Therefore, limit your use of serrapeptase to maximum 5 tablets per week.

Q. I saw on your web site that there is at least one other person who has had a negative experience with this enzyme. I too was disappointed and shocked as it caused me extreme muscle and joint pain after two weeks. And it sounded like a product that could have really helped me. I took 2 caps serrapeptase (40,000 units each) on an empty stomach one hour before breakfast. I did this for about three weeks. After I stopped the serrapeptase I did notice some improvement, but it has been a week since then, and I'm still in a lot of pain, joints and muscles.
   A. We find this strange since this potential serrapeptase side effect has not been mentioned in the medical literature, yet you are the second person who has reported it to us in the past 3 years. We will keep monitoring this potential serrapeptase side effect. Perhaps the dosage was too high.

Q. I was reading your website in search of anyone with side effects from taking serrapeptase. I just turned 50 and was recently diagnosed with osteoarthritis in my lumbar spine. Otherwise I am perfectly healthy. After taking 60,000IU twice daily for a week, I noticed some intermittent swelling in my hands and a "fullness" in my head. I decided to get my blood pressure checked and it was about 150/90 when it has always been about 115/70. This continued for another few days when my doctor suggested stopping the serrapeptase for 2 weeks. I did this and the swelling left after a couple of days and my blood pressure returned to normal. Three days ago I resumed the serrapeptase at 1/2 the dosage (60,000IU/day) and the swelling and elevated blood pressure (146/92) have returned. Unfortunately, my back improved significantly both times I was on the serrapeptase. Is it possible that the swelling and blood pressure are a side effect of some positive effect the serrapeptase is having and would go away eventually?
   A. This is the first we have heard of serrapeptase influencing blood pressure, but it may be possible since the full side effect profile of serrapeptase is not yet known. However, it does appear that the side effects could be dosage related, so we suggest using only 20,000 units a day and taking 2 or 3 days off each week, or using the serrapeptase every other day.

Q. I thought I'd let you know my experiences with serrapeptase (Serralone 400mg per capsule). I started using it in the hope that it would help reduce the appearance of my varicose veins (I am only 32). As it is also an anti-inflammatory I thought it may also help with my adult acne as my infections are prone to being very swollen and red. Well, it seems to have certainly helped with the acne swelling, my spots are not as inflamed and angry looking but I have developed an awful lot of spider/thread veins that I never had before and I didn't notice and difference to my varicose veins. I have stopped taking it now as I am worried about the thread vein situation worsening.

Q. I have looked through the previous newsletter articles but can find nothing on serrepeptase. Are you able to advise serrapeptase dosage and length of time that you consider safe to take the supplement (I have been taking it for chronic sinus infection as well as osteoarthritis and ankylosing spondilytis) and what sort of breaks you consider best.
   A. The reason we do not have specific dosages and length of use is because there are hardly any human studies that can give us these answers. Hence, until we know more, we feel it is best to take frequent breaks and discuss with your doctor on further details. Your doctor may wish to read this page on serrapeptase.

Q. I refer to a category of systemic enzymes which are fibrolytic —  fibrolytic enzymes break down fibrin and reduce or prevent scarring. Examples of these are serrapeptase and nattokinase. So, more precisely, could a fibrolytic enzyme like serrapeptase possibly reduce the fibrosis in an inflammation damaged esophagus (as in eosinophilic esophagitis) or an inflammation-damaged airway, as seen in asthma? Both undergo eosinophilic inflammation and with time, remodeling which includes fibrosis.
   A. We really do not know, there is so little research done with serrapeptase, hopefully we will know more in the next few years.

Q. Are there any studies saying whether or not serrapeptase would be helpful in costochondritis? Also, why would spider veins be a symptom of serrapeptase use?
   A. I am not sure why spider veins are related to the use of serrapeptase. I have not seen research regarding serrapeptase and costochondritis.

Q. I have read a lot about serrapeptase from your website and I am wondering how it will help with scar tissues formed after myomectomy surgery of six years ago.  I read in your website that only little research has been done on serrapeptase and edema which I interpret to mean scar tissues; is this correct.
   A. Edema is fluid accumulation in tissues, it is not a scar. We don't have any research on serrapeptase and post myomectomy scar formation.

Q. Hello, and greetings from Paris. I just came across your great website and was particularly interested by the reports about serrapeptase side-effects. I am considering to start taking Neprinol or Vitalzym for my fibroid problem. While reading the ingredient list of both supplements I noticed that they don't give the exact amount of serrapeptase included in their formula. All they say is that one tablet contains 500mg or 15000 units of their mix of enzymes. How is one to know the amount of serrapeptase included in that blend? I am worried that if I adhere to their recommended dosage my intake of serrapeptase might be too high. On the other hand, I am really interested in reducing the size of my fibroid. Do you think it would be an option to take your recommended dose of 20000 units/day of serrapeptase alone without the other enzymes? I can get serrapeptase here in France without a prescription.
   A. It is best to ask the manufacturers of Neprinol or Vitalzym regarding the dosage of the serrapeptase in their products. As to serrapeptase and fibroids, we have not seen such research yet, and you may consider reading about fibroids on this website.

Q. How is serrapeptase manufactured? Do they kill silkworms to do it? I have several friends who are interested in a serrapeptase product but they are all vegetarians.
   A. Serrapeptase is made by specific bacteria found in the gut of silkworms and these bacteria "digest" their cocoons. That is the extent of our knowledge, the exact steps are not revealed to us by the manufacturer.

Q. I recently purchased a bottle of serrapeptase. I have visited a few websites, and came across your site. You seem to cast some doubt on the use of this supplement, in regards to the amount a person should take. I guess there is more then one opinion, in this regard. I guess, as a consumer, we have to make up our own mind, correct? I went to another site on serrapeptase, and found out that it has been used for at least 25 years, with NO side effects. It has been used in Europe, and Asia, doctors prescribing and using it to treat patients with major problems. I would tend to use this supplement, then use some prescription drugs, with major side effects, as we have seen in the past few years, especially with arthritis drugs.
   A. There is a lot of information published on serrapeptase and other supplements on the internet. It is up to the consumer to decide which web site they find the most reliable and honest. Serrapeptase has a lot of potential as a supplement, but we still have a lot to learn about its full benefits and risks.

Q. I'm adding to your data re joint/muscle pain side effects - I ordered the enzyme from Nutri-Health - object was relief of sciatic pain from traumatic injury of several years ago, on the theory that the nerve might be irritated by scar tissue. Total relief after 48 hours (4 doses of 20,000), but I continued it for a few more days to see if it would help with knee pain from torn meniscus. Overall achiness and finally real pain kept increasing to the point that I was finding it difficult to move when I found your site with the few references that matched my experience. I recovered from that effect after 2 days and stayed off the enzyme for a couple of weeks. Last week I tried it again to be certain and within 2 days began the pain once again. This time I have stopped the serrapeptase for good. There is probably no interaction involved as I take no prescription drugs, but do take many antioxidants and other supplements that reduce inflammation. However, I do test positive for rheumatoid arthritis although I am symptom-free through a strict diet.

Different misspellings that have been seen for serrapeptase include serapeptase and sierrapeptase

This serrapeptase page was last updated March  2008