I want to address the use of the supplement serrapeptase for treating lymphedema and lipedema. But first, let’s start with some definitions. As an Amazon Associate I earn from qualifying purchases
What is Lipedema?
Lipedema is a medical condition that causes abnormal accumulation of fat mainly in the legs, hips, and arms. It is often mistaken for cellulite or obesity, but it is a distinct medical condition that affects predominantly women.
What is Lymphedema?
Lymphedema is a chronic swelling (edema) of lymphatic fluid – which is a protein rich fluid transported through the lymphatic system. In addition to a noticeable swelling, there is also heaviness, pain, decreased range of motion and can leave a person susceptible to repeated bouts of skin infection (cellulitis).
While there is no cure for lipedema or lymphedema, there are various treatments available, including complete decongestive therapy, which includes four components; compression, skin care, manual lymphatic drainage and exercise. Read more about that in The Complete Lymphedema Management and Nutrition Guide. In this article, we will discuss what serrapeptase is and how it may be used to treat lymphedema and lipedema.
What is Serrapeptase?
Serrapeptase is also known as serratiopeptidase and serratiapeptase, it is a proteolytic enzyme, meaning that it breaks down protein into it’s smaller components. It is a natural enzyme produced by the bacterium Serratia marcescens found in the intestines of Bombyx mori silkworms. The enzyme allows the moth to digest and absorb it’s cocoon.
Serratia was identified as an opportunistic human pathogen in 1959, but production strategies were developed to create large scale safe supply of serrapeptase by creating a mutant strain of Serratia marcescens via UV radiation and chemical changes (Nair, 2022).
The enzyme’s mechanism of action is fascinating – it breaks down proteins into smaller fragments, facilitating their removal from the body. This property is thought to contribute to its therapeutic effects of reducing inflammation and pain.
What Does Serrapeptase Do?
There have been human, animal and cell studies of serrapeptase, but only a limited number. Three of the functions that appear to be outcomes of taking serrapeptase that are relevant for lymphedema and lipedema include: anti-inflammatory, anti-fibrinolytic and anti-infectious. I’ll discuss each of these roles in more detail.
Anti-Inflammatory Actions of Serrapeptase
Serrapeptase was first used as an anti-inflammatory in Japan in 1957 (Jadhav, 2020). How does it work? In the normal pathway of inflammation, cyclooxygenase (COX-I) is release after injury, which breaks down arachidonic acid, which is responsible for the production of interleukins and prostaglandins. Interleukins and prostaglandins are responsible for pain and inflammation. The serrapeptase enzyme was found to have a high affinity to bind cyclooxygenases (COX-I and COX-II), and prevent the inflammatory chain of events and prevent the pain and inflammation from developing (Nair, 2022).
I prefer to share human research in my blog, but when it’s not available I will share animal research, which I always disclose (be careful of blogs that describe research but don’t tell you it’s animal research). In this study, albino rats had a either sub-acute or acute inflammation (Swamy, 2008).
Sub-acute inflammation was brought about by using sterile cotton pellet soaked in distilled water containing penicillin and streptomycin implanted in the armpit of rats under anesthesia. After the trial period, the cotton pellet was extracted and weighed to see how many granuloma cells attached to it.
The acute inflammation was brought about by having carrageenan injected to the hind paw to induce edema (swelling).
After the sub-acute or acute inflammation procedures, the rats were then tested with one of three enzymes: serrapeptase, chymotrypsin or trypsin at three different dosages with and without aspirin to see which would be the most effective anti-inflammatory. Saline was used for the control group. The enzymes were given half an hour before injection and every day for ten days.
The best anti-inflammatory response to the acute inflammation came from serrapeptase and for the sub-acute inflammation from serrapeptase and chymotrypsin with and without aspirin. But, the dosage was important. None of them worked at the lowest dosage.
What does this mean for lymphedema and lipedema? I will tell you that in other research I’ve read, the injection of carrageenan into the hind paw is the standard model for inducing lymphedema in rats, so I think this research is consistent in that methodology today and I think this study, serves as a good model for lymphedema.
These results are promising for the treatment of lymphedema inflammation, but, of course, we can’t say, that serrapeptase can reduce inflammation related to lymphedema or lipedema in humans, despite the positive results in the animal studies. I hope there will be some human trials.
Anti-Fibrosis Actions of Serrapeptase
Lymphedema and lipedema are both chronic and progressive conditions. What makes them progressive, is that over time, there is a build-up of fibrotic tissue and thickening of the skin. An important strategy, in dealing with lymphedema and lipedema would be to delay the progression of this fibrosis and slow the skin thickening, or in an ideal situation reverse the fibrosis. Could serrapeptase help with this? It is known as an anti-fibrotic, let’s look at some of that research together.
While I could not find any research on lymphedema or lipedema (not surprising), I did find a pilot study that looked at the use of enzymes for fibrosis of the lung (Shah, 2021). In this study, thirteen people with idiopathic pulmonary fibrosis (IPF) took oral supplements of Serracor-NK and Serra Rx260 three times a day for 12 weeks as follows:
- Days 10-4: 1 capsule, 3 times per day of Serracor-NK
- Days 5-8: 2 capsules, 3 times per day of Serracor-NK
- Days 9-92: 2 capsules 3 times per day of Serracor-NK plus 1 capsule of Serra RX260 3 times per day (the “therapeutic dose”)
Supplements were taken on an empty stomach (1 hour before or 2 hours after a meal) with a cup of water.
This was an open-label study, meaning that the participants knew what supplement they were taking and there was no placebo or blinding.
Idiopathic pulmonary fibrosis is a progressive disease with a build-up of fibrin in the lungs, causing lung tissue to thicken and become stiff, making breathing difficult.
After the 12 weeks of supplements these are the results:
Well Being (measured with the WHO-5 Well-Being Index):
- 62% reported a significant improvement in the Well-Being Index
- 15% had no change in Well-Being
- 15% had a reduction in Well-Being
Shortness of Breath:
- 38% reported a significant improvement in shortness of breath
- 46% showed a small improvement in shortness of breath
- 15% had worsening of shortness of breath
Respiratory Questionnaire (measured symptoms, activity and impacts):
- 46% very effective improvement
- 8% moderate improvement
- 15% slight improvement
- 31% decline in respiratory questionnaire scores
In describing the reason for this study, the authors state that “since the factors involved in idiopathic pulmonary fibrosis include chronic inflammation, and uncontrolled healing response, and progressive fibrosis or scarring, treatment with the systemic enzymes serrapeptase and nattokinase is a rational approach.”
I feel like, you could easily substitute lymphedema or lipedema into this statement, making systemic enzymes a potential “rational approach” for these conditions too (but of course, speak with your health care professional first…and keep reading to find out about precautions).
While not every patient improved, these authors suggested that perhaps these patients needed a longer period of supplementation than 12 weeks. They concluded that “the present study suggests that the oral enzyme supplements improve symptoms and the ability to perform activities, and well-being. Further randomized placebo-controlled trails with larger populations and for longer durations are warranted.” Under the funding disclosure in this study, it was noted that the supplements used in this study were provided by AST Enzymes, in Chino, California.
Anti-Infection Actions of Serrapeptase
If you’ve had cellulitis due to your lymphedema, you know how scary and uncomfortable that can be. Many people with lymphedema also have repeated bouts of cellulitis and they can live in fear of their next attack. Could serrapeptase help reduce infections or help your antibiotics to work more effectively?
Cellulitis is often caused from the bacteria Streptococcus pyogenes and/or less frequently Staphylococcus aureus (Burian, 2024).
As part of the infectious process, the bacteria create biofilms to protect themselves. The biofilms can attach to biotic surfaces like your tissue or abiotic surfaces like a prosthetic devices, for example an artificial knee or hip. The biofilm bacteria are resistant to your own immune system and can even develop a tolerance against antibiotics given to treat your infection.
Just like serrapeptase helps the silkworm break out of it’s cocoon, serrapeptase breaks up the protective biofilm that bacteria form around itself. This anti-biofilm ability allows the antibiotics to penetrate into the pathogenic bacteria (Jadhav, 2020).
In a study of staphylococcus aureus, both the methicillin-susceptible staphylococcus aureus (MSSA) and methicillin-resistant staphylococcus aureus (MRSA) types, serrapeptase was effective in inhibiting the formation of biofilms (Jadhav, 2020).
Other Actions of Serrapeptase
Serrapeptase is also linked to wound healing, mucus reduction, and prevention of clotting. I won’t go into detail on those attributes in this blog, as I’m focused on usage of serrapeptase for issues related to lymphedema and lipedema, but the references below will have more information if you’re interested.
Precautions for Serrapeptase
If you are taking blood thinners, such as aspirin, plavix, brillinta etc, then you need to speak with your health care provider before taking proteolytic enzymes as the additional blood thinning effect of the serrapeptase may be too much for you (Shah, 2021). For the same reason, you would need to stop them two weeks before any surgery, to avoid excessive bleeding. They have not been testing in pregnant or breastfeeding women and only in short term studies (see Drugs.com for a full list of precautions).
In the study with lung cancer, the dosing of enzymes was gradually introduced to prevent what was euphemistically referred to as “minor symptoms of intestinal cleansing“….so don’t be too far from home if you are trying these for the first time and just like in the research, starting with a lower dose and working up, is likely prudent.
Should I Try Serrapeptase for my Lymphedema or Lipedema?
Being somewhat impatient myself, I understand that you want answers now, and don’t have the luxury to wait for more research that could take years. I would suggest you speak to your health care provider to find out if serrapeptase would be right for you to try and at what dosage. When trying anything new with your lymphedema or lipedema care, it’s important to track your observations. For this purpose, I recommend that you use lymphedema or lipedema journal.
Bottom Line of Serrapeptase for Lymphedema and Lipedema
While serrapeptase may be a promising treatment for lymphedema and lipedema, more research is needed to fully understand its efficacy and safety. If you are considering using serrapeptase, it’s recommended to speak with your healthcare provider first to determine if it is the right treatment for you.
If you enjoy this topic, then you will like these blogs:
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References for Serrapeptase for Lymphedema and Lipedema
Burian EA, Franks PJ, Borman P, Quéré I, Karlsmark T, Keeley V, Sugama J, Cestari M, Moffatt CJ. Factors associated with cellulitis in lymphoedema of the arm – an international cross-sectional study (LIMPRINT). BMC Infect Dis. 2024 Jan 18;24(1):102. doi: 10.1186/s12879-023-08839-z. PMID: 38238718; PMCID: PMC10797905.
Jadhav SB, Shah N, Rathi A, Rathi V, Rathi A. Serratiopeptidase: Insights into the therapeutic applications. Biotechnol Rep (Amst). 2020 Oct 17;28:e00544. doi: 10.1016/j.btre.2020.e00544. PMID: 33134103; PMCID: PMC7585045.
Nair SR, C SD. Serratiopeptidase: An integrated View of Multifaceted Therapeutic Enzyme. Biomolecules. 2022 Oct 13;12(10):1468. doi: 10.3390/biom12101468. PMID: 36291677; PMCID: PMC9599151.
Shah N. Effects of Systemic Enzyme Supplements on Symptoms and Quality of Life in Patients with Pulmonary Fibrosis-A Pilot Study. Medicines (Basel). 2021 Nov 5;8(11):68. doi: 10.3390/medicines8110068. PMID: 34822365; PMCID: PMC8624573.
