Clinical applications of KaRazym®


Chronic inflammatory conditions

KaRazym® is tried and tested in numerous chronic inflammatory conditions. These include rheumatoid arthritis (RA), activated arthrosis, chronic sinusitis or Hashimoto's thyroiditis.

While rheumatoid arthritis is an autoimmune disease associated with joint-destroying inflammation, osteoarthritis is a mostly age-related wear and tear condition of the joints. Common to both is the chronic inflammation of the affected joints, which is often treated with NSAIDs.

A meta-analysis from 2016 (Ueberall et al. 2016) has compared the effect of diclofenac with enzyme therapy for arthrosis of the knee. In both treatment groups, over 75% of patients achieved a reduction in pain and mobility impairment. The study concluded that the anti-inflammatory and analgesic effects of the enzyme therapy are comparable to those of diclofenac. In the enzyme group, however, less than half as many side effects occurred (especially on the gastric mucosa). The liver values of the patients in the enzyme group were also significantly better after the end of the treatment period (3-12 weeks) than in the diclofenac group. With a similar effect on the symptoms, enzyme therapy has proven to be is superior to the therapy with NSAIDs in the treatment of osteoarthritis, mainly because of the minor side effects. The good compatibility allows the long-term use of enzyme preparations, which is a great advantage especially in chronic diseases.

Oral enzyme therapy is also recommended for the treatment of rheumatoid arthritis. The decongestant, pain-relieving and anti-inflammatory effects of the enzymes contained in KaRazym® are well-documented for the inflammatory processes of RA as well as in the case of osteoarthritis. An 11-subject follow-up study showed that the morning stiffness of the joints (a hallmark of rheumatoid arthritis) improved significantly within 3 days after taking the enzyme combination preparation KaRazym®, increasing the quality of life.

Swelling, (lymph-)edema

Traumas, edema and swelling are common and can have multiple causes. Following surgery, hematomas and edema are just as common as lymphatic edema after mastectomies. Even after sports injuries or physical contact sports, traumas can occur and cause painful swelling.

In these processes, immune cells migrate into the affected tissues and trigger an inflammatory reaction. This promotes healing, but the associated swelling and warming of the tissue is oftentimes painful. NSAIDs are a common treatment in these cases. However, several controlled studies have documented that oral enzyme preparations such as KaRazym® have a specific therapeutic effect on soft tissue injury and concomitant edema (see Berg et al., 2005).

Sports, sore muscles

Regular exercise is one of the most important measures for long-term health maintenance. However, every athlete also knows the stress that the body is exposed to during and after intensive efforts. Above all, ambitious endurance athletes know the importance of sufficient recovery, so that the body can regenerate for the next training or competition. In addition, unfamiliar or excessive efforts, e.g. long downhill runs, oftentimes cause sore muscles.

Sore muscles are the tangible effect of small tears of the muscle fibrils (not the muscle fibers!), so called microtrauma, which occur when the muscle is overstrained. These minor injuries do not immediately cause pain. Only about 24 hours later, when the broken cells are transported away by immune cells and thereby trigger the inflammatory cascade, we feel the pain called muscle soreness.

Enzyme combination preparations have been used prophylactically and therapeutically by athletes for many years. A number of publications (e.g., Buford et al., 2009) show that combined preparations of bromelain, papain, pancreatin, and rutin, as contained in KaRazym® tablets, reduce the symptoms by accelerating the healing of the inflammatory response. It is also interesting to observe that the symptoms of muscle soreness can be significantly reduced if a suitable enzyme preparation was taken before the exercise.

According to recent findings, the intake of enzyme preparations to accelerate muscle recovery also makes sense. In a study (Miller et al. 2004), it has been shown that enzyme intake accelerates the recovery of the contractile function of the muscles and reduces the pain sensation after exercise. The authors explain this effect with the reduction of the inflammatory processes by enzyme intake. Reduction of the inflammatory processes leads to less edema and thus to a faster restoration of the muscle function, as well as a reduced response of the pain receptors.

KaRazym® can also be used in competitive sports because none of the ingredients are covered by the Doping Prohibited List.

Mastopathy / Mastodynia

Mastodynia is a feeling of pain or tension in the (female) breast. The cause of the cycle-dependent, usually premenstrual mastodynia can be seen in the cyclical hormone fluctuations. The estrogen-related water retention leads to the feeling of tension and heaviness in the breasts. The anti-edematous (decongestant) effect of KaRazym® tablets can relieve the feeling of tightness in mastodynia.

Mastopathy is a fibrocystic alteration of the breast. It is characterized by an imbalance between epithelial and connective tissue growth with severe proliferative and regressive changes in breast tissue. Symptoms include hardened swelling, nodules or cysts, as well as increased premenstrual tension and chest pain (mastodynia). The causes of fibrocystic alterations in breast tissue are not fully understood, although it is known that they are hormone-dependent.

In addition to the anamnesis and the examination, the diagnosis of mastopathy is mainly made by sonography. The clinical diagnosis of fibrotic cystic mastopathy requires further clarification in order not to overlook proliferations in the sense of precancerous disease. The differential diagnoses of mastopathy include, above all, breast cancer and benign tumors of the breast.

Although the majority of fibrocystic alterations in the female breast are benign, one should not underestimate the psychological stress that accompanies the discovery of every nodule in the breast. Because each time there is also the suspicion of breast cancer, which has to be ruled out.

The (additional) treatment with bromelain, as contained in KaRazym®, has been shown to be effective in the treatment of cycle-related symptoms of fibrocystic alterations. While enzyme therapy can not make cysts disappear, it can halt their growth and relieve tension pain in the chest. The patients thus experience mental and physical relief.


During the menopause of women there is a strong decrease of the hormones (estrogen, progesterone) that are produced in the ovaries. Typical side effects are discomfort such as hot flashes, fatigue, sleep disorders, nervousness, irritability, depressive mood, headache, dizziness, dry vagina, etc.

Some time ago, however, it was recognized that the decrease in hormone levels in women during menopause can have serious consequences, namely the development of low-grade, systemic (= whole-body) inflammation. The reason why low-grade, systemic inflammation develops especially during the menopause is probably that the anti-inflammatory estrogen is also greatly reduced. These chronic inflammations are manifested by the permanent elevation of the blood levels of inflammatory markers (such as CRP, IL-6, TNF-alpha, etc.).

As an appropriate measure against low-grade, systemic inflammatory conditions, the oral intake of enzyme preparations, such as KaRazym® tablets, has proven especially effective in the menopause.

Complementary oncology

With the enzyme combination preparation KaRazym® we address patients who are looking for complementary cancer therapies. The aim is to support the effects of classic therapies and to reduce their side effects which can be very severe.

In clinical trials, it has been demonstrated that complementary treatments can increase the quality of life and also the survival of patients. These complementary recommendations include a balanced diet, exercise, psychological support and dietary supplements such as enzymes or certain trace elements and vitamins.

Proteolytic enzymes can reduce the side effects of standard tumor therapies, inhibiting inflammatory processes and tissue swelling; the quality of life of patients is significantly improved, the incidence of erysipelas is significantly reduced. The anti-inflammatory effect also reduces gastrointestinal disorders such as diarrhea and vomiting. The fibroses which frequently occur after irradiation can also be reduced by enzymes. In lymphoedema (e.g., after breast cancer therapy), the administration of enzymes has also been proven effective.


The actual flu disease (influenza) is transmitted by the influenza virus, a virus particle measuring 80-120nm in size. The infection usually occurs via droplets (inhalative, inoculant, alimentary or mechanical).

Influenza viruses are aggressive pathogens, that is, they possess, in conjunction with suitable host cells, the property of being able to reproduce extraordinarily fast and thus to attack a whole organism within a very short time and subsequently also to infect other organisms.

After the fusion with a host cell, for which the surface antigens hemagglutinin and neuraminidase are decisive, the virus "annexes" the cell. The host cell DNA is restructured according to the scheme of the virus RNA, the cell metabolism and thus the protein synthesis run from then on, until the death of the host cell, according to the genetic information of the virus. The cell is used for virus replication.

Hemagglutinin (H) and neuraminidase (N) are two key building blocks of every influenza A virus and, in their function as docking proteins, are essential for the transmission of the virus to the host cell. The hemagglutinin ensures that the viruses bind to the host cell; the neuraminidase ensures that the viruses can detach from the host cell after propagation and infect new cells.

In science, bromelain has long been used to remove hemagglutinin from the viral surface in vitro (see Schmeisser et al., 2016, Schaap et al., 2012, Khurana et al., 2011). This plays a role e.g. in vaccine development. Without the surface protein hemagglutinin, the virus cannot infect new cells, so it has been rendered harmless by treatment with bromelain.

Due to this effect of bromelain on influenza viruses, enzymatic combination preparations with bromealin, such as KaRazym®, are also suitable for the prophylaxis and treatment of the actual flu.

Due to the mode of action of the ingredients of KaRazym®, bromelain, papain and pancreatin, the type of flu strains (A, B or C) is irrelevant, these substances are effective in all three species. Ideally, KaRazym® should be taken as a preventive measure when a flu epidemic is starting. Prophylactic intake provides the best protection. Once an infection with influenza viruses has taken place and viruses have invaded human cells, it can only tone down the disease or its symptoms.

The use of KaRazym® should not replace a flu vaccine (especially in the case of at-risk individuals). In the elderly, a weakened immune response to the vaccine is most likely due to a weak immune system, meaning the protective antibody titer is not fully achieved and thus the vaccine protection is not completely given. Flu prevention with KaRazym® is also recommended for immunocompromised patients who cannot be vaccinated and for pregnant women who are not vaccinated.