Holistic Health Supplements The Health Benefits of Serrapeptase The silkworm enzyme believed to reduce pain and inflammation By Cathy Wong facebook twitter Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health. Learn about our editorial process Cathy Wong Medically reviewed by Medically reviewed by Emily Dashiell, ND on July 29, 2020 facebook linkedin Emily Dashiell, ND, is a licensed naturopathic doctor who has worked in group and private practice settings over the last 15 years. She is in private practice in Santa Monica, California. Learn about our Medical Review Board Emily Dashiell, ND Updated on December 11, 2020 Print Table of Contents View All Health Benefits Possible Side Effects Dosage and Preparation What to Look For Serrapeptase is an enzyme derived from Serratia E-15, an intestinal bacteria a silkworm uses to dissolve its cocoon once it transforms into a moth. Serrapeptase is believed to exert anti-inflammatory effects to reduce pain and swelling, mostly of the upper respiratory tract. It is also used to relieve pain following minor surgery. Serrapeptase was first isolated by scientists in Japan in the 1960s and soon after became a bestselling drug there (brand name Danzan), later finding its way onto drugstore shelves in Europe and North America as a dietary supplement. Doubts about the drug's efficacy led its manufacturer, Takeda, to voluntarily withdraw it ) in 2011. Despite the recall, there are plenty of manufacturers that still produce serrapeptase supplements and point to its efficacy in clinical studies. Also Known As Butterfly extractSerratiopeptidaseSilkworm enzyme Andrew Holt / Photographer's Choice / Getty Images Health Benefits Proponents of alternative medicine claim that serrapeptase can help treat a wide range of medical conditions. Chief among these are: Pain and inflammation following oral surgeryChronic upper respiratory concerns, including bronchitis, sinusitis, laryngitis, and pharyngitis (sore throat) Claims of health benefits of alternative treatments often extend beyond a substance's intended use, encompassing what seems to be an almost encyclopedic range of medical conditions. With serrapeptase, proponents claim the enzyme can dissolve blood clots, alleviate symptoms of arthritis, prevent atherosclerosis (hardening of the arteries), and treat diabetes, asthma, inflammatory bowel disease (IBD), leg ulcers, and fibrotic breast disease. To date, there is no evidence that it can treat any of these conditions. That is not to say there is no benefit to serrapeptase use. However, studies that make up the current body of research are often poorly designed or too small to be statistically relevant. Here are a few that provide some of the more compelling pieces of evidence in support of serrapeptase use. Oral Surgery A small study published in the International Journal of Oral and Maxillofacial Surgery suggests that serrapeptase may help alleviate pain and swelling resulting from dental surgery. The study involved 24 healthy people, all of whom underwent the surgical removal of impacted molars. Half were given a 1,000 milligrams (mg) of Tylenol (acetaminophen) plus 5 mg of serrapeptase, while the other group received the same amount of Tylenol with a placebo. According to the researchers, in the seven days following surgery, the serrapeptase group had less cheek swelling (as measured by calipers) and pain intensity (as measured by numeric scale) than those given the placebo. Despite the promising results, the conclusions were limited by the size of the study and the highly subjective nature of pain measurements. Natural Remedies for Tooth Pain Upper Respiratory Symptoms Serrapeptase has long been touted for its ability to alleviate throat pain, hoarseness, and sinus congestion associated with upper respiratory infections and illnesses. According to a 2017 review published in the Asian Journal of Pharmacological Science, serrapeptase exerts effects similar to cyclooxygenase-1 (COX-1) and cyclooxygenase-1 (COX-2) inhibitor drugs like Aleve (naproxen) and Celebrex (celecoxib). In addition to alleviating inflammation, serrapeptase also appears to break down exudates (fluids that seep out of tissue as a result of inflammation). By exerting anti-inflammatory, anti-exudate, and analgesic (pain-relieving) properties, serrapeptase could very well alleviate common upper respiratory tract symptoms. However, to date, there is little qualitative evidence of such benefits. Of the available research, a 2003 study in the journal Respiralogy reported that four weeks of serrapeptase given at a dose of 30 mg daily reduced the amount and thickness of mucus coughed up by people with chronic bronchitis. Despite flaws in the study design, the findings were significant enough to suggest that serrapeptase may play an important role in mucus clearance in people with chronic obstructive pulmonary disease (COPD) and other respiratory diseases. Can Antioxidant Foods Fight COPD? Possible Side Effects While serrapeptase has been used for up to four weeks in clinical research, little is known about its long-term safety. Common side effects tend to be mild but may include: NauseaStomachacheMuscle and joint painCoughRash Although it is said to alleviate upper respiratory symptoms, serrapeptase has been known to cause pneumonitis (lung inflammation) in some. The condition appears triggered by a sudden drop in white blood cells called eosinophils and occurs mostly in elderly adults. A 2016 report in the Journal of Clinical and Diagnostic Research also suggests that serrapeptase may increase the size of an abscess, in part by breaking down exudates in surrounding tissues. Serrapeptase should not be used if you have an abscess of any sort, including an abscessed tooth. Doing so may facilitate the further spread of infection. The safety of serrapeptase in pregnant women, nursing mothers, and children has not been established. Given the potential harms and uncertain benefits, it may be best that these groups avoid serrapeptase. Interactions Serrapeptase may interfere with blood clotting and should be avoided if you are taking blood thinners like Coumadin (warfarin) or Plavix (clopidogrel). Taking them together may cause easy bruising or bleeding. For this same reason, you should stop using serrapeptase two weeks before a scheduled surgery to avoid excessive bleeding. Dosage and Preparation There are no guidelines for the appropriate use of serrapeptase. Doses of up to 30 mg daily have been used safely in short-term studies. Serrapeptase supplements are readily sourced online and in certain health food and nutritional supplement stores. Most are sold as capsules, gelcaps, or enteric-coated tablets with doses ranging from 34 mg (20,000 international units, or IU) to 500 mg (300,000 IU). As a general rule, it is best to avoid high-dose formulations. Not only are they more costly, but there is no evidence that higher doses are any more effective than lower doses. Always use the smallest dose possible and never exceed the recommended dose on the product label. If side effects persist or worsen, stop taking serrapeptase and advise your doctor. To avoid stomach upset, take the supplement with food or choose an enteric-coated tablet, which dissolves lower down in the intestinal tract. This can also help slow the breakdown and deactivation of serrapeptase by stomach acids. What to Look For Dietary supplements are not strictly regulated in the United States. To ensure the highest quality, opt for brands that have been tested by an independent certifying body like U.S. Pharmacopeia (USP), NSF International, or ConsumerLab. If you are strictly vegetarian or vegan, double-check that gelcaps are made of a vegetable-based gelatins rather than animal-derived bovine or porcine gelatin. Serrapeptase can be stored safely at room temperature. You should discard any supplement that has expired or shows signs of spoilage or deterioration (including changes in color, texture, or smell). Natural Ways to Fight Inflammation Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Bhagat S, Agarwal M, Roy V. Serratiopeptidase: a systematic review of the existing evidence. Int J Surg. 2013;11(3):209-17. doi:10.1016/j.ijsu.2013.01.010 Health Science Authority. HSA Updates on the Phasing-Out of Serratiopeptidase-Containing Preparations as Medicinal Products.Singapore: November 29, 2011. Additional Reading Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain, and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008 Mar;37(3):264-8. doI:10.1016/j.ijom.2007.11.011 Nakamura S, Hashimoto Y, Mikami M, et al. Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease. Respirology. 2003 Sep;8(3):316-20. doi:10.1046/j.1440-1843.2003.00482.x Rajaram P, Bhattacharjee A, Ticku S. Serratiopeptidase–A Cause for Spread of Infection. J Clin Diagn Res. 2016 Aug;10(8):ZD31-ZD32. doi:10.7860/JCDR/2016/21388.8302 Tiwari, M. The role of serratiopeptidase in the resolution of inflammation. Asian J Pharma Sci. 2017 May;12(3):209-15. doi:10.1016/j.ajps.2017.01.003