Systemic enzymes refer to enzymes which have the ability for activity anywhere in the body (in contrast, digestive enzymes have specific action in the stomach and small intestines only).
Systemic enzymes may help to reduce inflammation and pain by stimulating macrophages and helping the body to break up large pro-inflammatory immune complexes that have accumulated at the site of injury or illness. These enzymes work not by stopping or blocking inflammation, but by supporting and quickening the process. Systemic enzyme supplements include pancreatin, trypsin, and chymotrypsin, which are made from animal sources, and bromelain and papain which come from plant sources.
Systemic enzyme supplements usually come in the form of enteric-coated tablets in order to protect the enzymes as they pass through the stomach and into the intestine, where the active enzymes are absorbed into the lymphatic system and dispersed throughout the body to sites of injury and inflammation. They are typically taken on an empty stomach (one hour before or two hours after eating).